Features,  Health Matters,  Red Cross,  Calendar,

West Nile Virus,  Honors & Awards,  Announcements

Health & Fitness News Elsewhere  (fresh daily from the Web)

Features

Research uncovers nutritional
boost for patients on IVs

[DEC. 26, 2002]  It's been more than eight years since Helen (not her real name) underwent two life-altering traumas in the brief span of two weeks. First, the vessels to her small intestine became blocked, much the way that vessels become obstructed in a heart attack. In Helen's case, she experienced what amounted to a "small intestine attack."

As a result, doctors had to remove her small intestine, forcing her to receive all of her nutrition for the rest of her life through intravenous feeding. What's worse, two weeks after Helen lost her small intestine, the vessels to one of her arms became blocked, and doctors had to remove her arm at the shoulder.

Kelly Tappenden, U of I assistant professor of nutrition, is doing work that might have a significant impact on people such as Helen -- or anyone who must receive IV feeding, either for short periods or throughout life. In hospital stays, the average length of time that patients receive intravenous feeding is seven days. But after three to five days, the small intestine begins to atrophy because of lack of use.

What Tappenden and other researchers have discovered is that short-chain fatty acids from dietary fiber can revive an atrophying gut. In fact, the short-chain fatty acids can actually cause the small intestine to grow in size, she said.

More people than you might expect find themselves in situations similar to Helen's, Tappenden said. For whatever reason, they have lost more than 50 percent of their small intestine, as a result experiencing "short bowel syndrome." Like Helen, they receive all of their nutrition, seven days a week, through a scientifically assembled mixture delivered intravenously. The technical name: total parenteral nutrition, or TPN.

In addition to adults who suffer severe trauma to the intestine, a key population of those with short bowel syndrome is premature infants. One of the most common surgeries performed on premature babies is the removal of a portion of the small intestine because of "necrotizing enterocolitis."

According to Tappenden, the slang for this disease is "dead gut," because the premature infant's small intestine is indeed dying. To save the child's life, much of the intestine is removed, and the child ends up receiving TPN for life.

[to top of second column in this article]

Prior to the late 1960s, when TPN was first developed, these patients would have starved to death.

In research on piglets with short bowel syndrome, Tappenden found that if a TPN mixture includes short-chain fatty acids, it can begin to increase the size of the small intestine within 24 hours. In laboratory models, she has found that the gut can increase in size by 30 to 50 percent -- although the increase wouldn't be quite as dramatic in human patients.

In addition to boosting the small intestine's size, short-chain fatty acids can increase its function -- the ability to transport nutrients through the lining and to the rest of the body.

Tappenden's research has documented this increase in nutrient transport, specifically with glucose and glutamine. She says the dramatic improvement in nutrient transport, thanks to fiber, may offer help to the elderly. Of people over age 65, roughly 50 percent suffer from inadequate absorption of nutrients.

At one time, common knowledge said that fiber did little more than provide bulk to the diet, creating the sensation of being full after a meal. But this and other research shows that fiber can do so much more.

As for Helen, Tappenden met this remarkable Copenhagen woman during a visit to Denmark in 2000, and she found that Helen was coping with courage, grace and her sense of humor intact.

"She had gone through horrendous trauma, but I was impressed with her wonderful outlook," Tappenden noted. "She said the loss of her small intestine and arm certainly changed her life, but she was still able to do everything she wants. She said the biggest problem is that she likes to swim, but with one arm she just keeps swimming in circles."

Asked Tappenden: "How many people could cope with everything she has gone through?"

[U of I press release]

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.]

[to top of second column in this article]

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]

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.

[to top of second column in this article]

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

January health and safety classes offered
through American Red Cross in Lincoln

[DEC. 24, 2002]  SPRINGFIELD --- The Illinois Capital Area Chapter of the American Red Cross is announcing their lifesaving health and safety classes being offered in January. All classes listed below will be conducted at the Logan County office, 125 S. Kickapoo in Lincoln.

Infant and child CPR -- Learn the skills necessary to perform CPR on an infant and child. This is an excellent class for new or expectant parents. Certification is good for one year. The class is $25 and will be offered Jan. 15 from 5:30 to 9:30 p.m.

Adult CPR/AED -- Learn the skills necessary to perform CPR on an adult, and learn how to use an automated external defibrillator. Certification is good for one year. The cost is $25, and the class meets Jan. 13 from 5:30 to 9:30 p.m.

First aid -- Learn basic first aid skills for controlling bleeding, immobilizing and treating sudden illness, and dealing with emergencies related to hot and cold. Certification is good for three years. The cost is $20, and the class meets Jan. 14 from 5:30 to 9:30 p.m.

 “Our health and safety classes are about helping families stay safe,” says Mary Ogle, chief executive officer of the American Red Cross Illinois Capital Area Chapter. “We have a long-term goal of making sure that at least one member of every household in central Illinois is trained in how to save a life.”

To register or for more information call (217) 732-2134 or register online at www.il-redcross.org.  

[to top of second column in this article]

All American Red Cross disaster assistance is provided at no cost, made possible by voluntary donations of time and money from the American people. The Red Cross also supplies nearly half of the nation's lifesaving blood. This, too, is made possible by generous voluntary donations.

To help the victims of disaster, you may make a secure online credit card donation at www.il-redcross.org or call 1 (800) HELP NOW -- 1 (800) 435-7669 -- or, for Spanish, 1 (800) 257-7575. Or you may send your donation to your local Red Cross or to the American Red Cross, P.O. Box 37243, Washington, D.C. 20013.

To donate blood, please call 1 (800) GIVE-LIFE -- 1 (800) 448-3543).

[Provided by Heather Adams, coordinator of emergency services and education, Illinois Capital Area Chapter, American Red Cross]

West Nile Virus

West Nile virus links

LDN articles

• Local authorities watching WNV

Federal websites

• CDC WNV home page

State websites

• State WNV website

• Protect your home against mosquitoes
• State surveillance site
• Logan County surveillance site

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)

Back to top