Your Medications: Keeping Yourself Safe - A Blogathon 2013 Guest Post

A guest post by Jane Neff Rollins, MSPH

As I head off to my college reunion tomorrow, I am packing what I need for a five-day trip, including my medications. I take only one prescription drug, for an underactive thyroid gland. But I also take two nutritional supplements – Vitamin D (because my last blood test showed that my level was too low) and Calcium (which is recommended for all women my age – 61). Because I sometimes have trouble remembering whether I’ve taken a given pill by the time mid-afternoon rolls around, I transfer my gel caps and tablets to a calendar box, a plastic box that has smaller boxes with hinged lids labeled M, T, W, Th, F, Sa, and Su for the days of the week. If the Tuesday box is empty, and it’s Tuesday, I know I’ve taken my allotment for the day.

According to the Partnership for Health Care Excellence, a Massachusetts not-for-profit organization dedicated to helping patients be more actively engaged with the health care system, we should all keep our tablets and capsules in the original pill bottle or package.

So I’m a bit of a scofflaw when it comes to that bullet point, but I do follow all their other recommendations for medication safety. To learn what they are, download the PHE fact sheet: "What you can do to take your medications safely."

If you take lots of meds, it’s a good idea to schedule a “brown-bag checkup,” either from your primary care doc or your local pharmacist. You put all of your prescription and over-the-counter meds, and any nutritional supplements or herbs you may take, into a brown paper bag and bring it with you.

Your doctor or pharmacist will double check to see:

• If you are taking the correct dosage at the right intervals
• If you are using pills that are expired, or have been discontinued or recalled
• If you are taking pills prescribed by two different doctors that do the same thing
• If anything you take (Rx, OTC or “natural”) might interact poorly and cause side effects

Taking charge of your health care by knowing what medications you take, and working with your doctor or pharmacist, will help ensure that you are taking medications safely.


Jane Neff Rollins, MSPH, is the author of the upcoming book “Health Care Navigation 101: Get the Health Care You Deserve.” She also trains working adults to navigate the health care system effectively and blogs at www.getthehealthcareyoudeserve.com. Jane takes complex ideas and makes them easy to understand for consumers and health professionals. Her medical writing has appeared in the Los Angeles Times, Reed magazine, www.drdrew.com, medical journals, and trade magazines.

4 Questions to Ask if Your Child's Doctor Recommends a CT Scan

You may have seen on the news that a new study was just published in the journal JAMA Pediatrics, reviewing how radiation doses from CT scans need to be adjusted even more and done even less frequently on children in order to lower their risk of developing radiation-related cancer later on in life. The researchers  discussed how children are smaller than adults and don't need as much radiation for their CT images as do adults, among other issues. This finding, of course, makes sense.

The study goes on to say that by reducing radiation doses and reducing unnecessary exams, the long-term cancer risk for children who have these tests could drop as much as 62 percent. We do know that exposure to radiation, even from medical exams like CT scans (also called CAT scans) can increase a person's later-in-life risk of developing some sort of cancer. Fortunately, as technology is adapted and more is learned, newer guidelines and modern scanners are providing for less radiation exposure than ever before, particularly among children.

Of course, we want to do everything we can to reduce any risk of our children of causing cancer, but it is important to understand that as impressive (and important) that 62 percent reduction in risk is, the chances of developing radiation-caused cancer are low to begin with. That's not to say it doesn't happen, it does. But it isn't common, so this needs to be kept in mind when looking at the numbers.

So, why is this study important? It's a reminder that not all CT scans that are ordered may be necessary. It's a reminder that not all facilities that do these scans on children are using calculations that are appropriate for their pediatric patients' size. And it's a reminder that we need to ask questions and understand why tests are being done on our children.

The American College of Radiology released a statement yesterday, in response to the study, in which it said: "Diagnostic scans reduce the number of invasive surgeries, unnecessary hospital admissions, and the length of hospital stays. However, they must be used judiciously, when indicated, and when the needed information cannot be obtained in other ways, in order to minimize radiation exposure to all Americans - particularly children.

Keeing this all in mind, what is a parent to do? There are four questions that parents should ask when a doctor recommends that their child undergo a CT scan:

1- What benefit will there be from having this scan performed? (Why do it?)

You want to know what the doctor is looking for and why the CT scan is the right test for this.

2- Is there any other exam that would be equal to or better than a CT scan?

You want to learn if a regular x-ray or an MRI, which doesn't use radiation, could be be performed instead of the CT scan with equal or better results.

3- Will the radiation dose be adjusted to account for my child's size?

One issue that affects radiation exposure is that not all tests are properly calibrated for children, particularly if the facility does not see many pediatric patients and are not experienced in dealing with children of various ages and sizes.

4- Is the facility ACR accredited?

The ACR accreditation involves surveying of medical imaging equipment to assess that it meets industry standards and that the radiologists who are interpreting the findings are qualified to do so, reducing the chances of more exams being ordered on the same patients.

There is no doubt about it. Exams such as CT scans do save lives. But we need to be sure that the people doing these tests are doing them properly, that the equipment is maintained properly at at the most recent standards, and that the proper exams are being ordered for the right reasons.

11 tips to Keep Outdoor Spaces Safer for Seniors

It’s summer time! And if you live in a colder part of the country, summer often means it’s outdoor time for both family and friends. This added living space may mean you may entertain more or you just might move your usual activities, like eating dinner, outside for a few months.

If you have an older parent or friend with limited mobility who will be joining you in your outdoor space, be it a patio, a deck, or a balcony, there are a few safety issues you might want to take into consideration to reduce the risk of injuries.

Here are some tips to help you keep the fun in summer time:

Lighting

1- Good lighting helps keep people safe inside and outside. For outdoor lighting, be sure the lights are secured and highlight any possible obstacles, such as stairs, ramps, or furniture. If there are shadows that can make the obstacles hard to see, you may want to add some lighting to those areas.

2- If you don’t like the idea of having bright lights on all over, consider using motion-sensing devices to trigger your lights. This way, when someone approaches the area, the lights go on as needed. An added bonus is that you don’t have to worry about turning off lights after everyone has gone inside.

3- You may have seen small lights on steps. These can be very useful, especially in places where you might not want full bright lights. Small lights can be placed on the stair risers themselves, or along the step sides.

Remove obstacles

The smallest things can be a tripping hazard for anyone, not just someone with limited mobility. Here are some of the more common ones:

Extension cords
Furniture
Outdoor carpeting
Uneven patio blocks


4- Extension cords for lights, sound systems, or other electronics can pose a tripping hazard. If you need to use lengthy cords, it’s best to fasten them along a wall or railing, out of foot reach.

5- Outdoor furniture is often not as stable or heavy as indoor furniture. Many have wheels on them to make them more portable, easier to move around. This has a drawback: if a guest loses his balance, he may reach for one of these pieces of furniture for support. If there are wheels or the furniture is light, it may push out from underneath, causing a fall. If your furniture has wheels, see if they can be locked, to prevent this type of accident. If the furniture is very easily moved, it’s best to keep it along the walls or railings.

6- Keeping the furniture clustered in one area also reduces the risk of people bumping into the pieces or tripping on a table or chair leg.

7- If you have outdoor carpeting, check it regularly to be sure it’s not lifting along the edges or bubbling near the center. If there are signs of wear, watch that area to make sure it doesn’t split and cause a tripping hazard. Some people place mats at the front of the door so people can wipe their feet. Ensure that the edges or corner of the mat don't curl up.

8- If your patio is made of stones, these should be inspected for shifting. All the stones should be as flush with the ground as possible, to reduce the risk of tripping.


Stairs or steps

9- Patios and decks that have stairs or just go up a step can pose a risk for falls for anyone. You can reduce the risk by installing solid hand bars to both sides of the steps.

10- If stairs are a barrier, you may need a ramp for better accessibility to your patio or deck. If a permanent ramp is not an option, there are different styles of portable ramps available. Don’t forget that backdoors often have a step over them to get outside. This may need a ramp too.

11- Gates are also a good safety feature if you have stairs – they’re not just for young kids. If you have people on your deck, particularly if they use a wheelchair or walker, it could be easier for them to get too close to the edge of the stairs and fall. A gate would decrease this risk.


It’s fun to do things outside, particularly if you can’t do so all year round. But don’t forget the safety issues, because the last thing you want is for your outdoor fun to turn into tragedy.
Do you have any safety ideas to add?

Fireworks Beautiful but Handle With Care

Few things make huge crowds gaze admiringly at the sky like fireworks. A well orchestrated fireworks show is a beauty to behold. I live in Montreal, where the Montreal International Fireworks Competition is a perfect example of how the beauty of explosives can be mixed with the beauty of music to create a magical evening. But not all fireworks displays are so well coordinated or safe. Most, I dare say, are homemade, neighborhood endeavors, which can be dangerous.

June 1 to July 4 is Fireworks Safety Month in the United States. Every year, an estimated 9,000 fireworks-related injuries, mostly burns and eye injuries, are reported. According to the American Association of Ophthalmology, one-quarter of those eye injuries result in permanent loss of vision or blindness. And children are at the highest risk:

Children are the most common victims of firework accidents, with those fifteen years old or younger accounting for half of all fireworks eye injuries in the United States. For children under the age of five, seemingly innocent sparklers account for one-third of all fireworks injuries. Sparklers can burn at nearly 2,000 degrees Fahrenheit, which is hot enough to cause a third-degree burn.

In 2006, a study published in the journal Pediatrics, reported that over a period of 14 years, 85,000 children had been injured by fireworks. Their average age was almost 11 years old and 78 percent of those injured were boys. Not all who were injured were doing setting off the fireworks: at least 22 percent were bystanders.

The most common devices that caused injuries were firecrackers, causing 30 percent of the injuries, followed by sparklers or novelty devices (20.5 percent of injuries) and then aerial devices.

The eyeball was the most commonly injured body part (21 percent), followed by the face (20 percent), and the hands (20 percent). The most common injuries were burns.

Emergency action:

So what do you do if someone is injured by fireworks?

Eyes:

- If a chemical has splashed into the eye, flush it with clean water as soon as possible.
- If an object is in the eye or punctured the eye, do not try to remove it. If you can put a small paper cup or something similar over the eye, this could provide protection until you get to the emergency department.
- Do not rub the eye.
- Even if the injury affects one eye only, cover both eyes. This helps reduce the eye movement (as the uninjured eye moves, the injured one will too, perhaps increasing the severity of injury).

Burns:

- If the burn is first or second degree (red, blistering, but not black or charred), the usual course of action is to stop the burning process as quickly as possible with cold water - not ice water. If running water isn't possible, you can use a clean cloth for a cold compress, gently over the area. Do not press down on the skin.
- If blisters form, do NOT break them. This could introduce infection into the area.
- If you are going to cover or wrap the burn, be sure you do not use something that has lint or bits of cotton that can come off and stick to the skin. The best bandage is a sterile gauze.
- Watch closely for signs of infection (increased pain, fever, oozing from the burn). If you have any concerns, seek medical advice.
- Third degree burns must be treated as a medical emergency. Call 9-1-1 for emergency help.

Fireworks can be a wonderful way to finish off a fun day, a way of celebrating what has passed and what will be. They are beautiful to behold. But they are also dangerous and must be treated with caution and respect.