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A Clinic Triage Nurse

By tjohnson | Published August 2, 2018

Do you ever have a question about your health that you are not sure what to do about? Or are you feeling ill and not sure when to see your provider? These are great times to talk to your clinic triage nurse.

The clinic triage nurse will help you with general questions about your health and help determine the type of care you may need. Whether you are in the clinic or call in, the triage nurse can help you decide what needs to be done and provide another line of communication between you and your health care provider. The nurse will gather the needed information by listening and discussing your symptoms. This helps determine the best course of action whether it be to come to the clinic and see your provider, monitor your symptoms, or be seen in the emergency room. Providing enough information to the triage nurse gives your provider the opportunity to make the best decision with you for your healthcare needs.

If you have another question after an appointment that you forgot to ask, need to clarify instructions, or miss a call from your provider or their nurse/medical assistant and don’t want to “play phone tag” to get the information? No problem! Call the clinic triage nurse. Your provider and their nurse/medical assistant work hard to be available for their patients, but we know the clinic can be a busy place. It can be hard to reach them by phone at times. When you call to the clinic, you can talk with the triage nurse and they may be able to give you the information at that time. If the triage nurse is unable to answer a question, they can relay the question to your provider and sometimes reduce the wait time on responses back to you.

Overall the triage nurse is there to assess a situation, give advice as appropriate, and assist your provider in making sure that as a patient you are getting the best care option available.

Written by:

Paige Clayton, RN

Adair County Medical Clinic – Triage Nurse

Any references to products, services, or health care providers on this web site are not a recommendation or endorsement of products, services or providers. Links to other Web sites from this site are provided for convenience and do not constitute or imply endorsement. Effort is taken to insure accurate information, however we cannot guarantee completeness or timeliness.

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Safe Summer Fun

By tjohnson | Published July 24, 2018

Summer fun is in full swing!

With county fairs going on and the state fair going on most people will likely be spending more time with friends and family outside. Following are some tips to be mindful of for heat/sun related illnesses.
Here are a few prevention tips:
Stay Cool: avoid direct sunlight, find shady or air conditioned shelters, wear lightweight light colored clothing
Stay Hydrated: drink more water than usual, avoid alcohol or drinks containing large amounts of sugar
Wear Sunscreen: use SPF 30 or higher broad spectrum sunscreen with water resistance, apply and reapply according to the directions on the bottle

Here is a good example from the Center of Disease (CDC) on how to spot signs/symptoms of heat/sun related illnesses and what to for them:

Make sure not to forget your furry four legged friend too!

Wendy Seddon, CNA

Adair County Health System

The information provided on the Adair County Health System’s Blog is not a substitute for professional medical advice and care. If you have specific needs, please see a professional health care provider. Any references to products, services, or health care providers on this web site are not a recommendation or endorsement of products, services or providers. Links to other Web sites from this site are provided for convenience and do not constitute or imply endorsement. Effort is taken to insure accurate information, however we cannot guarantee completeness or timeliness.

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Steps to Healthy Swimming: Protection against Recreational Water Illnesses (RWIs)

By tjohnson | Published July 6, 2018

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You can choose to swim healthy! You have the power to help keep germs out the water in places we swim in the first place. Remember, chlorine and other disinfectants don’t kill germs instantly. Additionally, the mixing of chlorine with pee and sweat uses up the chlorine in the pool, which would otherwise kill germs.

We all share the water we swim in, and each of us needs to do our part to help keep ourselves, our families and our friends healthy. To help protect yourself and other swimmers from germs, here are a few easy and effective steps all swimmers can take each time we swim:

Keep the pee, poop, sweat, and dirt out of the water!

· Stay out of the water if you have diarrhea.

· Shower before you get in the water.

· Don’t pee or poop in the water.

· Don’t swallow the water.

Every hour—everyone out!

· Take kids on bathroom breaks.

· Check diapers and change them in a bathroom or diaper-changing area–not poolside–to keep germs away from the pool.

· Reapply sunscreen.

· Drink plenty of fluids.

Check the free chlorine level and pH before getting into the water.

· Pools: Proper free chlorine level (1–3 mg/L or parts per million [ppm]) and pH (7.2–7.8) maximize germ-killing power.

· Hot tubs/spas: Proper disinfectant level (chlorine [2–4 parts per million or ppm] or bromine [4–6 ppm] and pH [7.2–7.8]) maximize germ-killing power.

· Most superstores, hardware stores, and pool-supply stores sell pool test strips.

Think Healthy. Swim Healthy. Be Healthy!

By Jane Ernst, RN

Adair County Public Health Director

Effort is taken to insure accurate information, however we cannot guarantee completeness or timeliness.

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Mental Health in Rural Iowa

By tjohnson | Published June 18, 2018

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Mental Health in Rural Iowa

Mental disorders/health concerns have been recognized as a major rural health priority.

At the least, 50% of the world’s population will be impacted by a mental disorder.

Mental Health…

involves effective functioning in daily activities resulting in

Productive activities (work, school, caregiving)
Healthy relationships
Ability to adapt to change and cope with adversity

Mental Illness…

refers collectively to all diagnosable mental disorders – health conditions involving:

Significant changes in thinking, emotion and/or behavior
Distress and/or problems functioning in social, work or family activities

Mental health is the foundation for thinking, communication, learning, resilience and self-esteem. Mental health is also key to relationships, personal and emotional well-being and contributing to community or society.

Mental disorders include three major categories of mental illness:

1. Schizophrenia

2. Affective disorders (Example: major depression and manic-depressive illness)

3. Anxiety disorders (panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and phobia)

Anxiety disorders (panic disorder, obsessive-

When compared to other chronic medical conditions/disease, individuals in their teens and mid-twenties see an earlier onset of mental disorders.

When comparing rural and urban use of outpatient mental health services, rural usage is considerably lower.

Rural areas are most lacking in meeting the needs of children afflicted with serious mental health problems because of the relative scarcity of child psychiatrists/specialists.

Having more than one mental disorder is a major risk factor for suicide. A Pertinent example is having major depression combined with alcohol abuse.

Having depression, anxiety, and many other psychosocial factors are contributing to the advancement and outcomes associated with chronic illnesses, like cancer and heart disease.

Physicians who practice in rural areas are playing a larger role in mental health care than their urban colleagues. This is likely attributed to the shortage of mental health specialists and the stigma-associated reluctance of seeing a mental health professional.

ACHS is making your mental health a priority. Contact a provider for assistance.

~ David Black, PA-C – Adair County Health System

Effort is taken to insure accurate information, however we cannot guarantee completeness or timeliness.

References:

1. Robins, L.N., and Regier, D.A. Psychiatric disorders in America: The epidemiologic catchment area study. New York, NY: Free Press, 1991

2. https://www.psychiatry.org/copyright

3. Mental health and mental disorders—a… (PDF Download Available). Available from: https://www.researchgate.net/publication/255683562_Mental_health_and_mental_disorders-a_rural_challenge_A_literature_review.

4. Kessler, R.C.; Costello, E.J.; Merikangas, K.R.; et al. Section 2: Chapter 5: Psychiatric epidemiology: Recent advances and future directions. Mental Health, United States, 2000. Washington DC: Superintendent of Documents, U.S. Government

Printing Office, 2001, 29-42.

5. Rost, K.; Owen, R.R.; Smith, J.; et al. Rural-urban differences in service use and course of illness in bipolar disorder. Journal of Rural Health 14(1):36-43, 1998.

6. Lambert, D.; Agger, M.S.; and Hartley, D. Service use of rural and urban Medicaid

beneficiaries suffering from depression: The role of supply. Journal of Rural Health15(3):344-355, 1999.

7. Lambert, D., and Agger, M.S. Access of rural AFDC Medicaid beneficiaries to mental health services. Health Care Finance Review 17(1):133-145, 1995.

8. Sullivan, G.; Jackson, C.A.; and Spritzer, K. Characteristics and service use of seriously mentally ill persons living in rural areas. Psychiatric Services 47(1):57-61, 1996.

9. Holzer, C.E.; Goldsmith, H.F. and Ciarlo, J.A.Chapter 16: Effects of rural-urban county type on the availability of health and mental health care providers. Mental Health, United States.DHHS Pub. No. (SMA)99-3285. Washington, DC: Superintendent of Documents, U.S. Government Printing Office, 1998, 204-213.

10. Henriksson, M.M.; Aro, H.M.; Marttunen, M.J.; et al. Mental disorders and comorbidity in suicide. American Journal of Psychiatry 150(6):935-940, 1993.

11. Cornelius, J.R.; Salloum, I.M.; Mezzich, J.; et al. Disproportionate suicidality in patients with comorbid major depression and alcoholism. American Journal of Psychiatry152(3):358-364, 1995.

12. Schneiderman, N.; Antoni, M.H.; Saab, P.G.; et al. Health psychology: Psychosocial and biobehavioral aspects of chronic disease management. Annual Review of Psychology 52: 555-580, 2001

13. Geller, J.M. Rural primary care providers’ perceptions of their roles in the provision of mental 110Rural Healthy People 2010 health services: Voices from the plains. Journal of Rural Health15(3):326-334, 1999.

14. Wagenfeld, M.O.; Murray, J.D.; Mohatt, D.F.; et al. Mental health and rural America: 1980-1993. An overview and annotated bibliography. Washington, DC: Health and Human Services Administration, Office of Rural Health Policy, 1994, 1-116

15. Haley, W.E.; McDaniel, S.H.; Bray, J.H.; et al. Psychological practice in primary care settings: Practical tips for clinicians. Professional Psychology: Research and Practice29(3):237-244, 1998.

16. Rost, K.; Smith, G.R.; and Taylor, J.L. Rural-urban differences in stigma and the use of care for depressive disorders. Journal of Rural Health

9(1):57-62, 1993.

Posted in Clinics, Hospital, Public Health and Safety | Tagged Mental disorders, Mental Health, Mental Health Help, mental illness, referrals for mental health, Rural Iowa Mental Health | Leave a comment

Getting Care During and After Allergic Reaction

By tjohnson | Published June 18, 2018

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What was that? Was that a bee? It just bit me!! I’m allergic. What do I do?

What would you do? Well, if you know you have an allergy to bees, then you have been bit before! The symptoms of an allergic reaction can be mild to severe. Starting with the most severe:

“ANAPHYLACTIC” reaction. This is a biggie! The most common causes of anaphylaxis are food, medications, chemicals, insects, or latex. There are more, but these are the most common. Symptoms of anaphylaxis are: shortness of breath, voice changing, making a “wheezing” sound from the lungs or throat, tongue swelling, itchy throat, vomiting, a feeling of losing consciousness, or swelling of the hands and/or face.

Remedies: If you see someone or you are experiencing these symptoms, please dial 911. You will be taken to an emergency room for emergency care, which would include reversing the symptoms with medications administered through a nebulizer, a shot, or an IV). If you have had these symptoms before, you usually will carry an EpiPen with you. This is a lifesaving medication! An EpiPen is a pen that carries the medication Epinephrine in it. This is for people who have had an anaphylactic reaction before. I am sure you know someone who has one or carries an EpiPen.

Moderate cases

This form of allergic reaction would include developing hives which are red, raised, itchy patches throughout the skin that spread rapidly. Other possible symptoms include itching on the body, watery eyes, or runny nose.

Remedies: Wash the area with cool water. In addition, if available, take an oral antihistamine (such as Benadryl, Claritin, Zyrtec or Allegra). Depending on how you are feeling, you could be seen at Adair County Clinic or Urgent Care if you begin to worry about these symptoms.

Mild reaction

This form of allergic reaction is usually localized to a specific area, which can cause redness and itching to that area.

Remedies: Immediately wash the area with soap and cool water. You can apply a cool wash cloth to the area. You could also apply some Benadryl cream or anti itch cream to the area. Instead of using Benadryl cream, you could take an oral antihistamine such as Benadryl, Claritin, Zyrtec or Allegra. Try to avoid scratching the affected area.

This can usually be taken care of at home or if you feel you need to be seen by a Medical Professional, you could be seen at Adair County Clinic or Urgent Care.

It is important to note, that sometimes a reaction can occur even after an initial contact with the allergen. If you have had an anaphylactic reaction in the past, your chances of having another one is increased.

– Mikal Rasmussen ARNP, Adair County Health System

Effort is taken to insure accurate information, however we cannot guarantee completeness or timeliness.

Posted in Clinics, Hospital, Public Health and Safety | Tagged Allergic Reaction, Allergies, Allergy, Anaphylactic Reaction, EpiPen, Symptoms of Allergies | Leave a comment

Outdoor Exercise – Starting Slow and Getting Ready

By tjohnson | Published May 30, 2018

If you are like most of us in the Midwest, you are ready for spring to arrive! Spring is the season where we end our months-long hibernation, see our neighbors again, and finally start the exercise program we have been thinking about all winter long. We know the numerous physical and mental benefits of regular exercise, and even simple activities like walking for 20 to 30 minutes most days of the week can make a big difference. But what about those aches and pains after the first week? How much is too much?

Here are three tips for getting back in shape this spring and avoiding injuries:

Start slow and increase in moderation

Most experts recommend allowing a full day of rest between exercise sessions meaning Monday, Wednesday, and Friday would be a good place to start. Each week your overall activity should only increase by 10-20%. For example, if you start walking 20 minutes three days per week your total exercise for the week is 60 minutes. You’ll want to increase that by no more than 20% meaning you should aim for about 24 minute walks next week.

Check out those shoes

If you’re hitting the road for running or walking in the same shoes you’ve been wearing since Obama was president, you might want to think twice about your plan. Most running shoes begin to break down around 300 to 500 miles of wear. Many people think running 3 miles a few times per week doesn’t make them a serious runner. But that’s about 10 miles a week meaning they should plan on new shoes about every 12 months. Old shoes can lead to stress fractures, increase wear and tear on joints.

Pay attention to the small muscles

Most of us are guilty of thinking we can pick up and do what we did ten years ago. Well, if we do, we might pay the price. What used to be an easy walk or jog, now taxes muscles that adjusted to the comfy couch this winter and got another year older. Smaller muscles, such as the gluteus medius, play a key role in absorbing shock and projecting your knees. These are smaller muscles where it is more important to complete a higher number of repetitions rather than see how much weight we can lift. Make sure you work the smaller muscle groups as frequently as you work the larger muscle groups.

By: Nicholas Grimoskas, DPT

Rock Valley Therapy at Adair County Health System

Effort is taken to insure accurate information, however we cannot guarantee completeness or timeliness.

Posted in Clinics, Hospital, Public Health and Safety, Uncategorized | Tagged Exercise, getting ready to run, getting ready to walk, Outdoor Walking, Running, Shoes for Exercise | Leave a comment

Opioid Crisis in Iowa

By tjohnson | Published May 23, 2018

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Thought to be an issue only in major U.S. cities or more populated states, use of opioids (which includes heroin and prescription pain relievers) is becoming a problem of epidemic proportions in more rural areas of the country. While alcohol, marijuana and methamphetamines remain the primary substances misused in Iowa, in the last decade significant increases have been observed in the number of Iowans identifying opioids as their drug of choice at the time of admission to treatment – and in the number of overdose deaths.

Data collected by the Bureau of Substance Abuse show that treatment admissions related to opioid use have more than tripled since 2005. In addition, data from the Bureau of Health Statistics show that opioid overdose and related deaths have also tripled during the same time period (overdose meaning an opioid was identified as the primary cause of death in the medical examiner’s report; related meaning an opioid was referenced in the medical examiner’s report and could have contributed to the cause of death).

According to the Centers for Disease Control and Prevention (CDC), in 2012, health care providers wrote 259 million prescriptions for opioid pain relievers – enough for every American adult to have a bottle of pills. Prescription opioid sales in the United States have increased by 300% since 1999, even though there has not been an overall change in the amount of pain Americans report. In a study by the International Narcotics Control Board, the United States accounts for nearly 100% of the Hydrocodone used globally and 81% of Oxycodone used.

As people use opioids continuously their tolerance increases, but they may be unable to maintain their original source for the medication. This can lead them to turn to other sources and even switch from prescription drugs to cheaper and riskier substitutes like heroin. While no cause and effect relationship has been proven, prescription use and its possible connection in developing a substance use disorder and overdose warrants continued monitoring.

Several options are available for effectively treating prescription and other opioid dependence. These options include a combination of counseling approaches and medications like Naltrexone, Methadone, and Buprenorphine. See YourLifeIowa.Org for more information and resources on opioid abuse and other addictions.

Source: Iowa Department of Public Health

By Jane Ernst, RN

Director of Adair County Public Health

Effort is taken to insure accurate information, however we cannot guarantee completeness or timeliness.

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Small Changes Can Make Large Impacts – Healthy Cooking

By tjohnson | Published May 11, 2018

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By changing a few simple things in your diet, you can see big rewards. Here are a few hints:

· Use oil to replace fat in cooking and baking.

· Use applesauce to replace equal amounts of oil in recipes for quick breads and brownies.

· Substitute fat free milk for whole milk in cooking and baking.

· Trim all visible fat from meat. Bake, broil, roast or stew meat. Drain and discard the fat.

· Use spray oil (Pam) for frying.

· Use coated skillets which require less fat.

· Substitute fat free milk cheese for regular cheese.

· Baking cocoa can replace baking chocolate.

· Substitute plain low-fat yogurt for sour cream.

· Use salt substitutes such as Mrs. Dash, Tones, etc.

Fats and sweets should be used sparingly in your diet. These foods include salad dressings, cream, butter, margarine, sugars, soft drinks, candies and sweet desserts. Alcoholic beverages provide only calories and few vitamins and minerals. So, go easy on these, as well.

Remember, diets may be thought of as only for weight loss, but many people can decrease their risk of future health problems by changing to healthier eating habits.

Linda Kerns, L.P.N. ACHS Wellness Coordinator/ Assistant Health Coach

Effort is taken to insure accurate information, however we cannot guarantee completeness or timeliness.

Posted in Public Health and Safety | Tagged Baking Cocoa, Baking Healthy, Cooking Oil, Healthy Cooking, Low Fat, Small Changes in Cooking, Substitutes for Flabor | Leave a comment

Gluten Free Recipe – Chicken with Creamy Parmesan and Spaghetti Squash

By tjohnson | Published May 3, 2018

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Since becoming gluten free 7 years ago, the meal I long for is fettucine alfredo. Of course, I have tried many kinds of the gluten free pasta (Barilla is my favorite) – but I have recently discovered that I prefer spaghetti squash as a substitute for pasta. Not only is better for you – it tastes great too!

Below is one of my favorite NEW recipes.

Chicken with Creamy Parmesan and Spaghetti Squash – Serves 4

*Ingredients*	*What you will need:*
· 3/12 pounds spaghetti squash · Olive Oil · 6 chicken thighs · Salt · ¼ teaspoon dried basil · Black Pepper · ¼ teaspoon dried oregano · Aluminum Foil · ⅛ teaspoon dried rosemary · 2 baking sheets · ¼ teaspoon dried thyme · 12” large high-side pan · 8 ounces spinach






· 1 tablespoon minced garlic
· 3 packets unsalted butter
· ¼ teaspoon crushed red pepper
· 3 tablespoons white wine
· ⅓ cup heavy cream
· 2 ounces grated Parmesan cheese

1. Roast spaghetti squash

Preheat oven to 450°F. Line 2 baking sheets with foil. Halve squash lengthwise (it helps to puncture all over the squash and microwave at 30 second intervals to soften a bit), then scoop out and discard seeds.

Drizzle 1 tablespoon olive oil each side and season with ¼ teaspoon salt and black pepper. Place cut-side down on 1 prepared sheet and roast until flesh is tender and easily pierced with a fork, 25–45 minutes (spaghetti squash can vary in size, hence the wider time range). Set aside.

2. Mix spices – in a small bowl combine

· ¼ teaspoon dried basil
· ¼ teaspoon dried oregano
· ⅛ teaspoon dried rosemary
· ¼ teaspoon dried thyme

3. Roast chicken

While squash roasts, pat chicken dry with paper towel and place on remaining prepared baking sheet. Rub all over with spice mix, 1½ tablespoons olive oil, ¾ teaspoon salt, and black pepper as desired, then arrange skin-side down. Roast (with squash) until chicken is cooked through and no longer pink, 25– 30 minutes.

4. Prepare ingredients

While squash and chicken roast, rinse spinach trim and discard stems, and roughly chop.

5. Sauté spinach

Heat 1 tablespoon of olive oil. When oil is shimmering, ½ tablespoon of minced garlic and sauté, and spinach and sauté until tender, 2–3 minutes. Season with ¼ teaspoon salt and black pepper. Transfer spinach to a plate and set aside. Wipe pan clean and place over medium heat with butter. When butter is foamy, add crushed red pepper (skip or use half for less heat) and the remaining minced garlic and cook until fragrant, about 30 seconds.

6. Make sauce and pull squash

Add wine to pan with garlic and cook until slightly reduced, 30 seconds – Longer if you want less wine flavor. Add heavy cream and cook until thickened, about 30 seconds more. Remove pan from heat. Stir in Parmesan, ¼ teaspoon salt, and black pepper, then stir in sautéed spinach. Using a large fork or tongs, pull roasted squash flesh, raking back and forth to create spaghetti-like strands, and transfer to pan with spinach. Discard skins.

7. Shred or roughly chop the chicken -discarding bones and skin. Then add to pan with squash and spinach. Stir to combine. Taste and season with salt and pepper as desired.

8. Divide, Serve and ENJOY!

By Jill Rogers, Adair County Health System

Posted in Clinics, Hospital, Public Health and Safety | Tagged Chicken Parmesan Recipe, Gluten Free, Heathly Recipe, Spaghetti Squash | Leave a comment

Why Use a Pain Clinic?

By tjohnson | Published April 19, 2018

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Chronic pain is, unfortunately, part of many people’s everyday lives and how best to treat it can be challenging. Pain clinics have become more common and have been getting a lot of press but with this comes questions: What exactly is a pain clinic and what do they do there? What types of providers do they have? What can I expect if I go there? How can I be referred to one? We’ll look at these questions as we explore the benefits of using a pain clinic.

What exactly is a Pain Clinic and what do they do there?
Typically pain management clinics are clinics where pain management specialists offer evaluation, diagnosis, and treatment of diverse types of pain. Pain encompasses a wide spectrum of disorders, both acute and chronic. Arthritis, back pain, and cancer related pain are common diseases that are treated. Pain can also occur due to a reason like surgery, injury, damage to a nerve, or other medical problems like a migraine and diabetic neuropathy (nerve pain most commonly affecting the feet). At times, pain can arise and no source can be found, which can be frustrating for patients. Pain clinics offer a variety of ways to help treat pain. Oral medications, nerve blocks, spinal injections, and other interventional techniques may be used. The treatment of pain is complex, and the modalities available are rapidly changing; however, pain management providers are trained to use these to effectively help patients.

What types of providers do they have?
Pain management clinics have a physician that has been specially trained in the evaluation, diagnosis, and treatment of all types of pain. Most clinics also have mid-level providers (nurse practitioners and physician assistants) who have also been trained to help manage pain. Some clinics also include physical therapists, massage therapists, and psychologists too.

What can I expect if I go there?
On your first visit, the pain specialist will get to know you and your pain problem. He or she will perform a history and physical exam and review any previous testing. It is important to make sure you either bring or have your previous records sent to the clinic so they can be reviewed. Based on this, an individual plan will be developed to help treat your pain and more testing may be needed too.

How can I be referred to a pain clinic?
The best way to be referred to a pain management specialist is through your primary care provider (PCP). This will ensure effective communication between your PCP and the pain management providers. Patients are also referred by other providers too—back surgeons, neurologists, and cancer doctors when the need arises.

Healthcare is becoming a team effort to ensure patients can live and function well. Pain management clinics are an effective and integral part of the healthcare team to help those who are dealing with pain. If you or a loved one think you may benefit from being seen in a pain management clinic, please speak with your provider about getting referred for an appointment.

Adair County Health System’s Specialty Clinic currently has Central States Pain Clinic visiting monthly. You don’t need to travel to see them, they come to us right here in Adair County.

Written by:

Tim Piearson, DO

Family Practice Provider

Adair County Health System

Effort is taken to insure accurate information, however we cannot guarantee completeness or timeliness.

Posted in Clinics, Hospital, Public Health and Safety | Tagged Chronic Pain, Living with Pain, Pain Clinic, Pain Team, Whole Person Care | 1 Comment

Blog

A Clinic Triage Nurse

Safe Summer Fun

Steps to Healthy Swimming: Protection against Recreational Water Illnesses (RWIs)

Mental Health in Rural Iowa

Getting Care During and After Allergic Reaction

Outdoor Exercise – Starting Slow and Getting Ready

Opioid Crisis in Iowa

Small Changes Can Make Large Impacts – Healthy Cooking

Gluten Free Recipe – Chicken with Creamy Parmesan and Spaghetti Squash

Why Use a Pain Clinic?

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