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Home together for another Christmas

[DEC. 23, 2002]  Though they're both in wheelchairs, Ted and Mary Smith will be at home for Christmas.

Together they get their own breakfast. Mary usually makes the coffee, sometimes getting it ready the night before. Ted, who still likes to putter in his garage workshop, has just put up a new electric can opener at a height that makes it easier for Mary to open coffee cans. Mary usually does the dishes.

After breakfast, Mary helps Ted dress and get ready for the day, which can sometimes be a challenge. But Mary is an experienced caregiver; besides raising her two daughters, she took care of her mother, who died of cancer when Mary was 18, and helped raise a younger brother.

[Photos by Joan Crabb]
[Home Health Service nurse Leslie Brummett talks with Mary Smith about ways she can help her husband, Ted, remain in his Mayfair home.]

At noon on weekdays Ted gets Meals on Wheels, but Mary, who says she doesn't have much appetite, prefers to fix her own lunch. For supper there may be leftovers or something one of their two daughters brings in. The daughters, Lana Goldhammer and Linda Klockenga, both work full time but always bring food on weekends. Son-in-law Ron Goldhammer, now retired, takes care of the lawn and does the grocery shopping.

Even though he's wheelchair-bound, Ted hasn't given up all his former hobbies. He raises African violets, using special watering pots, and has just started half a dozen new plants. He hasn't done any oil paintings lately because the oils are "too messy, and can stain things," but he had been making cardinal feeders, balanced so only the weight of that particular bird will open the port and allow the bird to feed. Two of the feeders hang outside the kitchen window.

Mary says her hobby is taking care of Ted. Ted says another of her hobbies is talking on the phone, and she smiles and acknowledges that. Her daughters call every day to check on their parents.

Both love sports and watch many games on television. They especially like to watch Illini basketball games to keep track of former Lincoln Railer Brian Cook.

"That's why we have cable," Mary says.

Living at home makes it much easier for the Smiths to remain active in family affairs. Ted boasts that this year they had two Thanksgivings, one on the designated day and the other on Saturday, because the grandchildren couldn't all make it on the same day.

They will see members of both daughters' families at Christmas, Linda's on Christmas Eve and Lana's on Christmas Day. Ted says he's already finished his "Christmas shopping," writing checks for his family of five grandchildren and seven great-grandchildren.

What makes it possible for this senior couple, one already 90, the other approaching that birthday, to remain in the Mayfair home where they have lived for the last 33 years?

The answer is a lot of resourcefulness, a positive attitude, a supportive family and the help they get from the Logan County Health Department.

"I couldn't be here in my own home if it wasn't for Leslie and Teresa, the girl that comes to bathe me," Ted says.

Leslie Brummett, their case manager, sees that Ted gets the skilled nursing care he needs. Teresa Newlun, their home health aide, comes three times a week to help Ted with personal care.

"Without them, we would be in a nursing home," says Mary.

Leslie started working with Ted 3½ years ago, when he could still walk a little. Now he is completely paralyzed from the waist down, for reasons his doctors do not fully understand. However, Ted has kept his upper-body strength so he can easily propel himself around the house in a regular wheelchair, and he still does some handyman chores.

Mary has severe arthritis and has lost some of the strength and flexibility in her hands, so she uses a motorized wheelchair to get around their comfortable home. She doesn't do as much cooking as she used to because she's afraid of dropping heavy pans and dishes. She can stand when necessary, as long as she has some support.

Because Ted must be able to move from his wheelchair to his bed or his recliner, where he often sleeps, and because Mary no longer has the strength to help lift him, he's devised a custom "slide board" so he can move himself. It's made of polished maple, with a handhold cut in one end. Ted can wheel himself up to his bed or recliner and, using his board, move himself from one place to another.

[Ted demonstrates the “slide board” he made to help him get from his wheelchair to his recliner or his bed.]

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In spite of their resourcefulness, however, the Smiths couldn't stay in their home if Ted didn't have skilled nursing care. Through the Home Health Care Services offered by the Logan County Health Department, Ted gets that care from Leslie, a registered nurse who also has a bachelor's degree in nursing. Ordinarily Leslie visits Ted every 14 days, but when medically necessary she can see him oftener. Right now she's coming to his home three days a week to keep him from developing pressure ulcers. Pressure sores from skin breakdown is a common problem for immobile patients.

Home Health Services, a Medicare-funded program, allows Leslie to care for Ted at home and also funds his personal care from Teresa, a certified nurse's aide. Through another program, Caregiver Education, Leslie works with Mary to teach her how to care for Ted's medical needs, in particular, just now, his skin care. The education program is funded by Project LIFE (Local Involvement for the Elderly), through the regional Area Agency on Aging, part of the Illinois Department on Aging.

Project LIFE also funds In-Home Respite, a new program Mary can use if she decides she needs it. It provides a home health aide to come in and relieve the caregiver, who can then leave to do necessary errands or simply have some free time to care for his or her own needs.

The Caregiver Education program and the In-Home Respite program were added to the Health Department's services this spring. In spite of the funding cuts in health programs in recent years, the Health Department still has room for more clients in all of these programs, according to finance director Karen Booher.

The Smiths regard Leslie as "one of the family." She, in turn, describes them as "an amazing couple," especially because they do so much to help each other.

Being able to stay at home is often best for the patient, and it saves money for everyone: the state and federal governments and the patients and their families. Leslie and Betty Larson, the Health Department's nursing supervisor, want people to know there are programs available through the Logan County Health Department to help both the patient and the caregiver. If the Health Department can't help with a particular problem, they can often refer a family to another agency that can.

[Brummett and Larson talk over a Home Health case.]

Both the Smiths like to talk about the 40-plus years they've spent in Lincoln. Ted, whose real name is Louis, came to Lincoln Developmental Center in 1960 to be the chief engineer. He retired in 1980. Mary worked for Myers Brothers Department Store, then Witzigs. At Myers, she managed the Carriage Shop for teenagers; at Witzigs she worked in sportswear

After they retired they did a lot of traveling. "We've been in every state but three. We haven't been in Alaska, Connecticut or Maine. We even went to Hawaii," Ted says. Many of his oil paintings depict scenes from their travels, like the Colorado mountain scene above the sofa.

Their last trip was to Eastern Illinois at Charleston to see granddaughter Lindsay Klockenga play softball. One big regret is that they can't go to Florida to see the softball and volleyball teams Lindsay is coaching at a Deltona high school.

Ted's advice to younger people is to take time to smell the roses. "Do what you want to do. Go where you want to go when you can," he says.

He's glad he and Mary did, because now they can enjoy looking back at the places they've been and the things they've done.

"If it wasn't for that, we wouldn't have much to talk about," Mary jokes.

They love to visit, but they don't have as much company as they would like. Many of their old friends are gone, and many of the neighbors they once enjoyed visiting with have moved.

The Health Department staff members have become their friends, and the Smiths look forward to their visits. Leslie looks forward to them, too, and is proud that she can help this couple live where they are happiest.

The Smiths have never lost their zest for life or their sense of humor. As her visitors leave, Mary says, "Come on over anytime. We're always here."

They are hoping -- and planning -- to be at home next October to celebrate their 65th wedding anniversary. "It won't be our fault if we're not," Ted says. Both will tell you that they wouldn't still be there without the help they get from the Logan County Health Department.

[Joan Crabb]

Watching for diabetes

[DEC. 12, 2002]  About 16 million people in the United States have diabetes mellitus, a serious, lifelong disorder that is, as yet, incurable. About one-third of these people do not know they have diabetes and are not under medical care. Each year, approximately 600,000 people are diagnosed with diabetes. In Illinois, approximately 500,000 people 18 years of age and older have diagnosed diabetes.

Individuals with diabetes are at increased risk for heart disease, blindness, kidney failure and lower extremity amputations not related to injuries.

Diabetes and its complications occur among Americans of all ages and racial and ethnic groups. The burden of the disease, however, is heavier among the elderly and certain racial and ethnic populations, including African-Americans, Hispanics/Latinos, American Indians, Asian Americans and Pacific Islanders.

The term diabetes refers either to a deficiency of insulin or to the body's decreased ability to use insulin. Insulin, a hormone secreted by the pancreas, allows glucose (sugar) to enter body cells and be converted to energy. It also is needed to synthesize protein and to store fats. In uncontrolled diabetes, glucose and lipids (fats) remain in the bloodstream and, in time, damage the body's vital organs and contribute to heart disease.

There are two main types of diabetes: non-insulin dependent (type-2) and insulin dependent (type-1). Non-insulin dependent diabetes, which usually appears after the age of 40, is the most common type, affecting 90 percent to 95 percent of those who have the disease. Insulin-dependent diabetes affects the remaining proportion of those with the disease. Although this type of diabetes can occur at any age, it most often appears in childhood or during the teen years.

The signs of diabetes are frequent thirst, constant urination, unusual hunger, rapid loss of weight, and obvious weakness and fatigue.

The following have a greater risk of developing non-insulin dependent diabetes:

--Those with a family history of diabetes (parents or siblings with diabetes).

--Individuals who are obese (20 percent or more over ideal body weight).

--Members of certain racial or ethnic groups. Those who are more likely to develop diabetes are Mexican and Puerto Rican Americans (twice as likely), African-Americans (1.6 times) and Cuban Americans (1.5 times).

--Those who are 45 years of age and older.

--Individuals previously identified as having impaired glucose tolerance.

--Individuals with hypertension or who have excessive levels of fat in their blood (hyperlipidemia).

--Women who have a history of gestational diabetes during pregnancy or who have delivered babies weighing more than 9 pounds.

Non-insulin dependent diabetes often can be prevented through a healthy diet and physical activity. A number of studies have confirmed that regular exercise, especially for those who are at high risk, can prevent this type of diabetes.

Can the complications of diabetes be prevented?

A clinical study conducted by the National Institute of Diabetes and Digestive and Kidney Disease showed that keeping blood sugar levels as close to normal as possible slows the onset and progression of eye, kidney and nerve diseases caused by diabetes. The study concluded that lowering blood sugar levels reduces the risk of eye disease by 76 percent, of kidney disease by 50 percent, of nerve disease by 60 percent and of cardiovascular disease by 35 percent.

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Everyone has some sugar in his or her blood. A good blood sugar range for most people with diabetes is from about 70 to 150. This is before a meal, such as breakfast, or four to five hours after a meal. Blood sugar should be less than 200 about two hours after your last meal. Remember, everyone is different. A good blood sugar range for one person may not be the best for someone else. Ask your physician what the best blood sugar range is for you.

There are some things you can do every day to maintain a good blood sugar level and to stay healthy:

--Eat healthy food. People with diabetes do not need special foods. Foods on your diabetes meal plan are good for everyone in the family. Try to eat foods that are low in fat, salt and sugar and high in fiber, such as beans, fruits and vegetables, and grains. If you use insulin, be sure to take it before you eat, eat at about the same time, and do not skip meals.

--Exercise regularly. Exercise is good for your diabetes. Walking, swimming, dancing, riding a bicycle, playing baseball and bowling are all examples of good ways to exercise. Try to exercise regularly, at least three times a week for about 30 to 40 minutes each time. If you have not exercised in a while, begin slowly and gradually increase intensity and duration. Before beginning any exercise program, be sure to check with your physician.

--Take your diabetes medicine. Insulin and diabetes pills are the two kinds of medicines used to lower blood sugar. If you take insulin, your physician will tell you what kind of insulin to use, how much and when to give yourself a shot. Your physician or diabetes educator will show you how and where to give yourself a shot. Always use your own needles and never share them with anyone else. If you take diabetes pills, ask your physician when to take the pills. Remember, these pills do not lower blood sugar all by themselves. You will still have to follow your diet and exercise to lower your blood sugar. If you do not use insulin or take diabetes pills, follow your physician's advice about eating and getting enough exercise.

--Test your blood sugar. Ask your physician how often and when you should test your blood sugar. To test your blood, you need a small needle called a lancet, special blood testing strips and a glucose monitor (a special electronic device used to test for blood sugar). Your physician or a nurse can show you how to test your blood and give you information on glucose monitors.

--Two other tests can help you keep track of your blood sugar. You may need a urine test when you are ill or if your blood sugar is above 240 before eating. This test will tell you if you have ketones in your urine. Ketones are present when there is not enough insulin in your blood; they can make you very sick. Call your physician immediately if you find ketones in your urine. The hemoglobin A1c test shows what your average blood sugar was for the past three months. Ask your physician for this test every six months.

[Illinois Department of Public Health]

Smallpox vaccination to begin

[DEC. 10, 2002]  SPRINGFIELD -- The Illinois Department of Public Health has developed a strategy to offer smallpox vaccinations to as many as 16,000 Illinois public health and hospital personnel to prepare for the possibility of a terrorist attack, Dr. John R. Lumpkin, state public health director, announced Monday.

The U.S. Centers for Disease Control and Prevention asked each state and some cities, including Chicago, to submit plans by Dec. 9 as part of an initial phase in an effort to strengthen the nation's smallpox preparedness.  Click here for Logan County's plan.

"The probability of an intentional release of the smallpox virus remains low, but since the consequences of such an attack would be so great, we must be prepared," Dr. Lumpkin said. "This effort will focus on offering personal protection from smallpox disease to those who would be called upon to investigate and to provide treatment in the event of a smallpox release or outbreak.

"By protecting these individuals, we improve our ability to safeguard the public, and we increase the capacity and capabilities of the public health system and hospitals to respond to and control a smallpox outbreak."

Dr. Lumpkin said the Illinois plan was developed with guidance from the CDC and relies on the state's 93 local health departments (excluding Chicago) to offer vaccine to an estimated 8,000 to 16,000 public health smallpox response teams and hospital staff who would be involved in treating possible smallpox cases. The vaccination effort could begin as early as January and will require 30 days to complete. Individual and hospital participation will be voluntary.

The Illinois plan outlines the overall smallpox vaccination effort. However, local health departments will have until Friday (Dec. 13) to provide the department with details on where the smallpox vaccine will be administered and how those receiving the shot will be evaluated for the week it takes to determine if the vaccine is effective. Between 20 and 30 clinics are expected to be organized throughout the state outside of Chicago.

It is estimated that as many as five to 10 staff at each local health department, about 20 state public health department staff and 50 to 100 workers at 152 licensed Illinois hospitals that provide emergency care will be offered the vaccine. Due to a number of medical and family considerations, about 40 percent are expected to take advantage of the voluntary vaccination.

The vaccination, which was discontinued in 1972 in the United States, can cause serious, potentially fatal side effects, and individuals with certain medical conditions or family considerations should not have the shot.

Those who have a higher-than-normal risk of a bad reaction include people with weakened immune systems (cancer patients, organ transplant patients, people infected with HIV, people taking steroids), women who are pregnant or plan to become pregnant, nursing mothers, and people with eczema or certain other skin conditions.

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In addition, individuals who share living quarters with people in the higher-than-normal risk categories should not be vaccinated. For a week, people who have been vaccinated may expose others to the vaccinia virus that is used to make the vaccine. Proper covering of the vaccination site should allow people to continue working, but home exposure is thought to pose greater risk.

Plans for a second phase of the vaccination effort are not yet finalized, but information from the federal government indicates it will include all hospital workers and first responders (police, fire and paramedics). It has been suggested that the third phase would most likely include offering the vaccine to the general public. The department has previously prepared a separate plan for the CDC that describes how Illinois would provide mass vaccinations in the event of a smallpox attack.

"Unless there is an actual smallpox attack or outbreak, the risk of become ill or dying from smallpox is zero," Dr. Lumpkin said. "If an attack did occur, the vaccine can still protect people after exposure if they are vaccinated within three to four days. Vaccination within seven days will lessen the severity of illness."

The primary reason for this initial phase, Dr. Lumpkin explained, is to ensure that people in critical positions are vaccinated so they can immediately respond to the needs of the public and not have to wait to be vaccinated.

"This pre-event vaccination plan will enable public health and hospital workers to rapidly take the steps necessary to protect the public, including identifying people who need to be vaccinated to control an outbreak, establishing vaccination clinics and providing care to those who may be ill," he said.

Smallpox is a disease caused by a virus (variola) and characteristically includes skin lesions that eventually scab over; at times it has been confused with chickenpox. In most cases, smallpox is spread by an ill person to others through infectious saliva droplets but also could be spread by contaminated clothing or bed linen.

If used in biowarfare, smallpox virus could be dispersed in the air, and potential victims in the area of the release would breathe in the virus; or infected people could be sent into crowded areas to attempt to spread the disease to others.

The last cases of smallpox in Illinois were recorded in 1947. The last naturally acquired case of smallpox in the world occurred in 1977 in Somalia.

[Illinois Department of Public Health news release]

What is Logan County doing?

How are we following the vaccination plan?

[DEC. 10, 2002]  LDN spoke with Lloyd Evans of the Logan County Heath Department. He informed us that Logan County is putting the smallpox vaccination plan into effect in the two phases outlined by the Illinois Department of Public Health.

In January, a small team from Abraham Lincoln Memorial Hospital, along with teams from all hospitals in our IDPH region, will be sent to Champaign for a clinic. The members of the team will be voluntarily vaccinated against smallpox.

The date for the second phase is not yet set, but it will involve the vaccination of all health care personnel, emergency care personnel and first responders (including fire and police). This will provide Logan County with a large enough group of vaccinated individuals to deal with an outbreak were one to occur. These personnel would be able to perform a mass vaccination if necessary.

According to the CDC website, "In people exposed to smallpox, the vaccine can lessen the severity of or even prevent illness if given within four days after exposure. Vaccine against smallpox contains another live virus called vaccinia. The vaccine does not contain smallpox virus.”

At this point there have not been any threats given to either local or state officials concerning a smallpox terrorist attack. Officials have determined that the chance of an attack is slim but extremely dangerous if it were to happen.

"Smallpox is a serious disease," warned Evans. "It is highly contagious and it can spread quickly in today's mobile society." He and other health officials hold to the creed, "The only thing harder than preparing for a disaster is explaining why you didn't."

[Gina Sennett]

Health Matters

A monthly feature from  Logan County Health Department

How to quit smoking

[DEC. 2, 2002]  As the New Year approaches, we all begin to make resolutions for a healthy and happy New Year. If you smoke, you may be contemplating giving up cigarettes as your New Year's resolution. There is nothing easy about giving up cigarettes. But as hard as quitting may be, the results are well worth it. In the first year after stopping smoking, the risk of heart disease and lung disease drops sharply. Quitting will also save you money. With the average cost of a pack of cigarettes reaching $4.25, a pack-a-day smoker can save $1,400 a year by not smoking cigarettes.

Take time to think about other benefits of being an ex-smoker. This is an important first step in kicking the smoking habit — figuring out for yourself what you have to gain. And don't just switch to smokeless tobacco — the dangers and the addiction are just as damaging as with cigarettes.

Once you decide to stop smoking, a few preparations are in order. Set a target date for quitting. Don't choose a time when you know you will be under a lot of stress. To help you stick to your quit date, write the date on your calendar, find another friend or family member to give you special support in your efforts to quit or another smoker to quit with you, and make a list of how you'll reward yourself for becoming an ex-smoker.

On the evening before your quit day, throw away all cigarettes, matches and lighters and give away your ashtrays. Plan some special activities for the next day to keep you busy. Ask family members and friends not to smoke in front of you. Your goal is to get through that first important day smoke-free.

To quit successfully, you need to know your personal smoking "triggers." These are the situations and feelings that typically bring on the urge to light up. Especially during the first weeks after quitting, try to avoid as many triggers as you can.

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Replace "triggers" with new activities that you don't associate with smoking. For example, if you always had a cigarette with a cup of coffee, switch to tea for awhile.

Keep busy. Get involved in projects that require you to use your hands. When you feel the need to put something in your mouth, have low-calorie snacks on hand.

Know what to expect. You may experience some temporary withdrawal symptoms. It is important to know that these are signs that your body is recovering from smoking and symptoms will end.

Call the Illinois Tobacco Quitline 1 (866) QUIT-YES — 1 (866) 784-8937 — for help.

If you "slip," don't worry. It doesn't mean that you've become a smoker again. Most smokers "slip" three to five times before they quit for good. Get back on the nonsmoker track: (1) Don't get discouraged. Keep thinking of yourself as a nonsmoker because you are one. (2) Learn from experience. What was the trigger that made you light up? (3) Take charge. Make a list of things you will do the next time you are in that particular situation. Reread your list of all the reasons you want to quit.

You're on your way!

[Logan County Health Department]

Red Cross

West Nile Virus

West Nile virus links

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• State WNV website

• Protect your home against mosquitoes
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Honors & Awards

Announcements

The Rural Health Partnership has announced the schedule for its mobile health unit for 2002.

For more information on the mobile health unit schedule and services, contact Dayle Eldredge at (217) 732-2161, Ext. 409.

Community resource list

This family resource list to save and use is provided by the Healthy Communities Partnership and the Healthy Families Task Force, 732-2161, Ext. 409.         

(updated 2-15-02)

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