Get Help ‘Creating a Healthy Lifestyle’ March 14 at Gifford

Free health fair and diabetes expo focuses on chronic illness

Gifford chefs Ed Striebe and Steve Morgan

Gifford chefs Ed Striebe, left, and Steve Morgan present at a past Diabetes Education Expo. The annual, free event is expanded this year to all with chronic illnesses and includes a health fair as well as presentations, including a cooking demonstration by Morgan.

Gifford Medical Center will hold a free Health Fair and Diabetes Education Expo on Friday, March 14 from 10 a.m. to 2 p.m. in the Randolph hospital’s Conference Center and visitors’ entrance.

The fair, redesigned from past years, is open to anyone with a chronic condition, not just those with diabetes. It does not require registration, and puts a strong emphasis on “Creating a Healthy Lifestyle” – the fair’s theme.

Gifford has held a Diabetes Education Expo for eight prior years. While the diabetes epidemic remains, organizers from Gifford’s Blueprint for Health team decided to expand the event this year to other conditions because so much of what is being discussed is applicable, explained Jennifer Stratton, Gifford certified diabetes educator.

“Most people who have chronic conditions have something in common,” Stratton said. “I also wanted to open it up to those with pre-diabetes to help prevent diabetes from actually happening.”

The day includes vendor booths and a health fair open throughout the 10 a.m. to 2 p.m. event. Vendor booths are located in the hospital’s visitors’ entrance south of the hospital near the Gift Shop. Vendors this year are local community resource agencies and organizations talking about services and help available locally.

Health fair booths are in one of the hospital’s conference rooms and include blood pressure checks, foot checks, glucose monitoring, goal-setting guidance and guidance on healthy lifestyle choices, physical therapy exercises, tobacco cessation help, diabetes education, information on support groups, and more. The booths are operated by experts from Gifford as well as local dentist Dr. John Westbook and local optometrist Dr. Dean Barelow.

Special presentations will also be offered in a second conference room, including a 10-10:45 a.m. talk by Stratton on “Advances in Diabetes Management;” an 11-11:30 a.m. talk on “Using Herbs to Complement Your Diabetes Wellness Plan” by Sylvia Gaboriault, a registered dietitian and certified diabetes educator; and a 1-1:30 p.m. cooking demonstration on “Sugar ‘Less’ Baking” with Gifford chef Steve Morgan.

Participants may drop in or stay all day. A couple of raffle drawings will be offered and the hospitals’ cafeteria will be open for those wishing to buy lunch.

Learn more by calling Gifford’s Blueprint team at (802) 728-7710. Gifford Medical Center is located at 44 S. Main St. (Route 12) in Randolph. Drive past the hospital, south on Route 12, and take the entrance just after the medical center to access the visitors’ entrance. The Conference Center is marked with a green awning. For handicapped accessibility, go in the main entrance marked “Registration” and take the elevator to the first floor.

Generator Safety

Brad Salzmann

Brad Salzmann, PA-C

By Brad Salzmann, PA-C

Portable generators can provide a temporary source of electric power when “grid” power is not available. Many of us have portable generators for back-up power when the electricity “goes out.” While these generators can be very useful, there are safety considerations of which to be aware.

Carbon Monoxide: Most portable generators run on fossil fuels (gasoline, diesel, biodiesel, kerosene, propane, natural gas) and therefore emit carbon monoxide (CO) as one of the exhaust gases. Carbon monoxide is a colorless, odorless, deadly gas that causes hundreds of accidental poisoning deaths each year. These unintentional poisonings occur most often during the colder months and after disasters. Therefore, it is important to make sure the home or business has functioning CO detectors and to test them monthly.

Placement: Portable internal combustion engine generators must be placed and run outdoors where exhaust fumes cannot enter enclosed spaces. The current recommendation is to place them on a level, well-ventilated, dry area at least 25 feet from a building and away from windows, vents and doors (including the neighbor’s). It is NOT OK to run them in an attached garage, porch, or in the basement. Because most generators are not weatherproof, they should be protected from direct exposure to rain and snow. Most generators are very noisy; try to place them in a location that minimizes disruption.

Connections: Generators must not be connected directly to a home’s electrical circuit. The electricity can back feed into the power lines connected to the home. Utility transformers then can increase the voltage to thousands of volts and kill utility workers miles away. Nor should a generator be plugged into an outlet in the home or garage, for the same reason. A common, but improper practice is to plug the generator into the dryer outlet with a 220-volt cord. The best way to connect is to have an electrician install a box with a cut-off switch that prevents back feed into the grid. These are typically wired to several pre-determined essential circuits such as the furnace, water pump, refrigerator, etc. If using an extension cord, use one that is approved for outdoor use and heavy duty enough to carry the electrical load. Check the generator’s operating manual for correct grounding instructions.

Power: Portable generators do not typically have enough power to run an entire household. The wattage of the generator should be at least 1.3 times the total wattage of the appliances used. Overloading the generator can make it run hot and catch fire, and/or damage the appliances and electronics. Try to avoid starting all appliances at once.

Fuel: This seems obvious, but make sure you know the type of fuel your generator uses, and the type of fuel you have to fill it. Keep fresh fuel on hand; gasoline and biodiesel have a shelf life of about 6 months, diesel about a year. Adding appropriate fuel stabilizers can extend the useful life of these fuels. Remember, if the power is out, gas stations may not be open. Fuel should be stored in approved containers, correctly labeled, and kept outside of living areas and away from the generator and other potential ignition sources. Turn off the generator and let it cool down before refilling; never refill a running generator. Wear gloves and safety glasses while refilling, and have a B class fire extinguisher nearby.

Generator use: Test your generator regularly; once a month is best, but at least once a season. Only a qualified service technician should perform repairs. Engine parts get very hot; serious burns may result if touched.

Having a portable generator during power outages can be very handy, and even life-saving for those dependent on electric life support systems. However, if appropriate safety measures are not adhered to, generator use can be dangerous and deadly.

Brad Salzmann is an orthopedics physician assistant at Gifford in Randolph. He also has a master’s degree in disaster medicine and management, and serves as part of the national Disaster Medical Assistance Team based in Worcester, Mass.

After 50 Years on Dry Land, Lori Sedor Tried – and Loved – Water Aerobics

water aerobicsThis story appeared in our
Fall 2013 Update Community Newsletter.

Lorraine “Lori” Sedor has a myriad of health problems and a healthy fear of the water. So when certified diabetes educator Jennifer Stratton invited Lori to attend a water aerobics class Gifford was offering at the Vermont Technical College pool, Lori thought “no way.”

A retired school driver, 67-year-old Lori of Braintree has diabetes, an enlarged heart, rheumatoid arthritis, injuries from an accident, and uses a walker to get around. She also nearly drowned at age 16 and hadn’t swum since.

But Lori told Jennifer she’d try it, if only to prove her wrong.

“She told me that I could do it and I told her I couldn’t, and she was right, as much as I hate to admit it,” says a good-natured Lori.

The class started back in January and lasted six weeks. She was slow at first, but soon she was doing jumping jacks, twisting, bending, touching her knees, “and I swam.”

“I loved it. I was able to exercise whereas on land it’s harder to exercise. My body felt better. It’s just fantastic.”

After the class, Lori’s daughter bought her a year’s pass to the pool and for a couple months, Lori and a friend went two or three times a week. Health problems have prevented Lori from swimming since, but she expects to soon be back in the pool.

“I can’t wait to go back,” Lori says. “I’d recommend it for anyone who needs to exercise.”

Another water aerobics class is taking place now. If you have a chronic condition, call Jennifer Stratton at 728-7100, ext. 4 to learn about future classes.

Get Help Signing Up for an Insurance Plan from ‘Navigators’

Vermont Health Connect

Beginning Jan. 1, federal law requires all Americans to have health insurance or face a tax penalty. Gifford has specially-trained staff called “navigators” available to help you sign-up for a health plan.

This information appeared in our
Fall 2013 Update Community Newsletter.

Beginning on Jan. 1, federal law requires all Americans to have health insurance or face a tax penalty.

In the Green Mountain State, Vermont Health Connect is the new online marketplace where individuals, families and businesses with 50 or fewer employees can shop for, compare and purchase insurance plans.

Open enrollment for these plans began this October. Vermonters can determine their eligibility and enroll online. For those without computer access or needing in-person support, Gifford has resources to help.

Across the state, “navigators” have been trained and taken rigorous exams to provide one-on-one assistance with the Vermont Health Connect marketplace.

Gifford has three navigators through its Health Connections office, a part of the Vermont Coalition of Clinics for the Uninsured, as well as the medical center’s Blueprint for Health team.

If you’re:

  • A Vermonter without health insurance,
  • A Vermonter who currently purchases insurance yourself,
  • A Vermonter with Medicaid or Dr. Dynasaur,
  • A Vermonter with Catamount or the Vermont Health Access Program,
  • A Vermonter with “unaffordable” coverage provided by your employer, or
  • A small business with 50 or fewer people

and you need help understanding the exchange, get help by calling Gifford Health Connections at 728-2323.

Individuals who are fully enrolled by Dec. 16 will have health coverage starting Jan. 1.

Under Vermont Health Connect, an employer-sponsored plan is considered “unaffordable” if your premium for yourself is more than 9.5 percent of your household income. To learn more, call (855) 899-9600 or visit www.healthconnect.vermont.gov.

Gifford Offering ‘Family and Friends CPR’ Course

Gifford Medical CenterRANDOLPH – Gifford Medical Center’s Blueprint Community Health Team is offering a non-certification CPR course, called Family and Friends CPR.

The class is Wednesday, Nov. 20 from 6-8 p.m. in the Randolph hospital’s Conference Center.

The course will cover CPR for infants, children and adults and is designed to provide anyone with the basic skills needed to keep someone alive in the event that his or her breathing or heartbeat has stopped.

All are welcome to the course. There is a $5 fee. It is for the instructional booklet, which participants take home.

Attendance is limited to 12. Register by calling the Blueprint team at the Kingwood Health Center at (802) 728-7100, ext. 3.

The Gifford Conference Center is at the main medical center on Route 12 in Randolph. Park and look for the green awning marked “Conference Center.” For handicap accessibility, take the elevator from the main lobby to the first floor and follow signs.

September is National Preparedness Month

By Brad Salzmann, PA-C

Brad Salzmann

Brad Salzmann, PA-C

This September marks the 10th annual National Preparedness Month. Sponsored by the Federal Emergency Management Agency (FEMA) and endorsed by the president of the United States, the month urges all Americans to recognize the importance of preparedness and working together to enhance national security, resilience and readiness.

All disasters are first and foremost local, and all emergency response starts locally. Individuals, families, communities, and businesses that are even somewhat prepared fare far better than those who are not prepared. While it’s impractical to prepare for all possible scenarios, every bit of preplanning and preparedness does make a difference. Outside help is not always immediately available. Think back to past emergency events you were involved in, or talk to someone who has been affected; what were some of the things you wished you had thought of and prepared for ahead of time?

The basic mantra is: Be informed, make a plan, build a kit, and get involved.

Being informed means staying updated on local situations and information and knowing what to do before, during, and after an emergency. All types of media, including social media sites, are used now for news, information, and directions. VT 211 (Get connected, Get answers) is a free, confidential, 24/7, reference to access hundreds of community resources, sponsored by the Vermont United Way (www.vermont211.org); it is not for emergencies (911), nor is it directory assistance (411). VT 511 (www.511vt.com) is free reference sponsored by the Vermont Agency of Transportation with updated road information.

Making a plan starts with where to meet; how to communicate with loved ones; evacuation and shelter-in-place options; plans for pets and livestock; plans for infants, elderly and those with special needs; obtaining important medications; and retrieval of important documents. Businesses and communities should also plan for identifying and preparing for alternate ways to continue crucial operations, and recovery. Plans really should be tested, updated, and adjusted periodically. September is a great time to do this!

Kits are generally divided into three categories: Personal “go” kits are in a backpack or duffle that can be easily grabbed and carried. They should have sufficient supplies for you to survive for 24 hours. Mobile kits are in a larger container that can be put or kept in a vehicle. Supplies should be adequate for three days of survival for you and your family. Home kits contain enough supplies and equipment needed in event of an extended shelter-in-place situation.

Getting involved means working with family, friends, community or larger organizations in planning for, preparing for, responding to, and mitigating for emergency events. There are a variety of organizations and groups that are always looking for volunteers.

You may have heard of the survival rule of threes: three minutes without oxygen, three days without water, and three weeks without food. My rule of threes has to do with redundancy. One should strive for three ways to obtain water, shelter, food, and light, as well as three methods of communication, three routes of evacuation, three alternate places to go, and methods to get there, and so on.

There is an abundance of good information available on emergency preparedness. For those of you with Internet access, there are excellent sources from FEMA (www.ready.gov), the Centers for Disease Control and Prevention (http://emergency.cdc.gov/preparedness or http://bt.cdc.gov/planning), the Red Cross (http://redcross.org/prepare/location/home-family, or http://redcross.org/prepare/nationalpreparednessmonth), the Vermont Department of Public Safety, and many others. The Vermont Department of Emergency Management has printed an excellent Family Emergency Preparedness Workbook, which is available online at http://vem.vermont.gov, as well as by calling 1-800-347-0488 or writing to 103 South Main Street, Waterbury, VT 05671-2101. There are even smart phone apps now available with vital emergency preparedness information. If this all seems overwhelming, check out Do1Thing, at http://do1thing.com. This breaks down preparedness into monthly doable and affordable projects.

Finally, watch out for scams and fraud. Unfortunately, there are a few individuals who prey on the misfortunes of others. Never give out your account numbers or Social Security number, or pay in advance for anything unless you are 100 percent sure it is safe.

Please, take this opportunity to enhance your preparedness for emergencies, even if it’s just to make a few lists and jot down a few ideas.

Brad Salzmann is an orthopedics physician assistant at Gifford in Randolph. He also has a master’s degree in disaster medicine and management, and serves as part of the national Disaster Medical Assistance Team based in Worcester, Mass.

Staying Healthy in the Heat

Brad Salzmann

Brad Salzmann, PA-C

By Brad Salzmann, PA-C

Even short periods of high temperature, humidity, or exertion can cause serious health problems. Heat-related illness and deaths are preventable, yet many people suffer serious health illness or death every year.

The Centers for Disease Control and Prevention reported an average of 618 heat-related deaths per year in the United States from 1999-2010. Extreme heat is defined as temperatures that are substantially hotter and/or more humid than are typical for that location at that time of year.

HOW MUCH HEAT IS TOO MUCH?

There is no specific temperature or humidity level that must be obtained for heat-related illness or death to occur. The National Institute for Occupational Safety and Health, for example, reported a healthy 30-year-old landscaper died of heat stroke on a day that never went higher than 81 degrees. Heat-related illness and death rather occurs when heat pushes the body beyond its ability to compensate. The human body cools itself by sweating; the sweat brings heat to the surface where it evaporates. High humidity reduces the ability of sweat to evaporate.

WHO IS AT MOST RISK?

Body heat is produced two ways: internal (metabolic) heat is generated by physical exertion, and environmental heat is from high air temperature; humidity; direct sun exposure; heavy clothing; and lack of water, rest, and cooling. Anybody can succumb to heat. However, the elderly; very young; people with handicaps who are unable to take care of themselves or communicate; those with mental illness, cardiovascular, lung or other chronic diseases are at increased risk. Outdoor workers in agriculture, construction, logging, and firefighting are at increased risk, as well as those involved in exertional exercise outdoors. Statistically, 68 percent of heat-related deaths are male. There are some studies that predict risks will increase with climate change.

HEAT-RELATED ILLNESS

Heat rash is a skin irritation caused by excessive sweating; it is most common in young children. Heat rash looks like a collection of pimples or small blisters, usually on the neck, chest, or in the groin and elbow creases. Treatment for heat rash is to provide a cooler, less humid environment; dusting powder may help.

Heat cramps are caused by excessive sweating, which depletes the body of salt and fluid. Heat cramps are muscle pains or spasms, usually in the abdomen, arms, and legs. Heat cramps can be serious for those with heart disease or who are on a low-salt diet, and medical attention should be obtained. Otherwise, stop all activity, sit quietly in a cool place, drink clear juice or a sports beverage, and rest for several hours after cramps subside. If cramps do not subside within an hour, seek medical attention.

Heat exhaustion is a body’s response to an excessive loss of fluid and salt. It can develop after several days of exposure and inadequate replacement of water and electrolytes. Symptoms of heat exhaustion include heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea/vomiting, and fainting. Signs include cool, moist skin; rapid, shallow breathing; and a fast, weak pulse. The elderly and people with high blood pressure or who work or exercise in a hot environment are at higher risk. Treat heat exhaustion with cool (non-alcoholic) fluids, rest, cool shower/bath, air conditioning, and light-weight clothing.

Heat stroke is a medical emergency; call 911 immediately. The body is unable to regulate its temperature, which can rise rapidly. The sweating mechanism fails and fatal temperatures can rise to 106 degrees or higher within minutes. Heat stroke can present with an extremely high body temperature; red, hot, dry skin (no sweating); rapid, strong pulse; throbbing headache; dizziness; nausea; confusion; unconsciousness; or seizures. Immediate cooling is necessary! Begin cool water immersion, shower, spray, sponging, wrapped in cool wet sheets, and vigorous fanning until emergency medical services are available. Do not give fluids by mouth.

Sunburn can cause first or second-degree burns. Ultraviolet radiation (sun exposure) damages the cells of the skin. Protect skin from excessive exposure by seeking shade, especially during the midday hours; wearing lightweight clothing, hats, sunglasses with UVA and UVB protection; frequent application of sunblock (SPF 15 or higher); and avoiding indoor tanning.

Skin cancer risk is increased with exposure to the sun. The three most common types are basal cell, squamous cell, and melanoma. Skin cancers can invade normal nearby tissue and sometimes spreads to other parts of the body. Prevention is the best treatment.

PREVENTION

Air conditioning is the number one protective factor for heat-related illness and death. Increase fluid levels during hot weather. Don’t wait until you are thirsty; thirst is a late indicator of dehydration. Don’t drink fluids with alcohol or large amounts of sugar. If you are not urinating every two to three hours or the urine is dark, then you need to drink more. Acclimation occurs over the course of several weeks and actually causes a body to sweat more efficiently.

Minimizing exposure, staying well hydrated, frequent rests, protective clothing, and acclimation all reduce the risks of heat-related illness.

Brad Salzmann is an orthopedics physician assistant at Gifford. He also has a master’s degree in disaster medicine and management, and serves as part of a national Disaster Medical Assistance Team based in Worcester, Mass.