By Nola Goodrich-Kresse, Public Health Educator for the Orleans County Health Department

Memorial Day is also the unofficial start of summer with many swimming pools opening for the season. Although swimming is a physical activity that offers many health benefits, pools and other recreational water venues are also a place where germs can be spread and injuries can happen.

Recreational Water Illnesses, also known as RWIs, are caused by germs spreading by swallowing, breathing in, or having contact with contaminated water in swimming pools, hot tubs/spas, lakes, rivers, or oceans.

Contrary to popular belief, chlorine and other disinfectants do not kill germs instantly. While most germs are killed within minutes, Cryptosporidium (also known as Crypto) can live for days. Before they are killed, these germs can cause RWIs, such as gastrointestinal, skin, ear, respiratory, eye, neurologic and wound infections. The most commonly reported RWI is diarrhea caused by germs such as Crypto, Giardia, Shigella, norovirus and E. coli. Swallowing just a mouthful of water that contains these germs can make you sick.

Ways to prevent RWIs include not swallowing the water you swim in, keeping poop (feces), pee (urine) and germs out of the water, checking (or knowing) the free chlorine level (1 -3 mg/L or parts per million) and pH (7.2 – 7.8) before getting into the water, and taking children on bathroom breaks or checking swim diapers every 30 – 60 minutes. Make sure you change your children’s diapers in the bathrooms or away from the water.

As it is important to take precautionary measures to protect yourself against RWIs, also taking the same measures to prevent other injuries while swimming, such as those chemically related, drowning and sunburn are important too!

Chemicals are needed in order to maintain good water quality in a pool but are also responsible for thousands of emergency room visits each year.

ALWAYS:

Secure pool chemicals away from children and animals.

Keep all pool chemicals in original containers.

Read product label and manufacturer’s directions for each use.

Use appropriate protective gear, such as safety glasses and gloves, when handling pool chemicals.

NEVER:

Mix chlorine products with each other, with acid, or with any other substance.

It is a sad reality that every day 10 people die from drowning, and that 2 out of those 10 are children under 15 years old.  Following these steps can help save lives

Staying close, being alert and watching children in and around the pool:

Never leave a child unattended in a pool or spa and always watch your child when he or she is in or near water, it only takes a second to slip under the water.

When using a public pool, always keep alert for your children, do not depend on the lifeguards as they have a lot of people to look after.

Teach children basic water safety tips.

Keep children away from pool drains, pipes and other openings to avoid entrapments.

Have a telephone close by when you or your family are using a pool or hot tub/spa.

If a child is missing, look for him or her in the water first.

Share safety instructions with family, friends and neighbors.

Learning and practicing water safety skills:

Learn how to swim and teach your child how to swim.

Learn to perform CPR on children and adults, and update those skills regularly.

Understand the basics of life-saving so that you can assist in a pool emergency.

Having appropriate equipment for your pool or spa:

Install a four-foot or taller fence around the pool and spa and use self-closing and self-latching gates.

Install and use a lockable safety cover on your hot tub/spa.

If your house serves as a fourth side of a fence around a pool, install door alarms and always use them. For additional protection, install window guards on windows facing pools or spas.

Install pool and gate alarms to alert you when children go near the water.

Make sure any pool and spa you use has compliant drain covers, ask your pool service provider if you do not know.

Maintain pool and hot tub/spa covers in good working order.  Never walk on pool or spa covers.

Consider using a surface wave or underwater alarm.

While enjoying the water, don’t forget to protect your skin too!  There is no such thing as a “healthy” tan.

Stay in the shade, especially during midday hours:

Wear clothing that covers your arms and legs.

Wear a hat with a wide brim to shade your face, head, ears, and neck.

Wear sunglasses that wrap around and block both UVA and UVB rays.

Use sunscreen with sun protective factor (SPF) 15 or higher, and both UVA and UVB protection.  Slather it on and refresh it after a couple of hours, after swimming or sweating.

One activity urges public to take precautions against rabies

By Nola Goodrich-Kresse, Public Health Educator for the Orleans County Health Department

This is a big week for Orleans County 6^th graders. Today and Wednesday all 6^th graders will have the opportunity to participate in the Annual Orleans County Conservation Field Days at the 4-H Fairgrounds. The event is organized by the 4-H Youth Development Program of Orleans County Cornell Cooperative Extension.

This year the Orleans County Health Department will be playing an interactive game called Rabies Alert. Rabies Alert gives the students an opportunity to take on different “identities” such as wild and stray animals, domesticated (pets) animals and people who are possible pet owners.  After a brief discussion about what rabies is, the students shake hands with each other for a minute and then the fun begins.

Once the students have had contact with each other they are then broken into 4 separate categories – wild animals, stray animals, domesticated animals and people.  Health Department educator then walks the students through a mock investigation of a potential rabies exposure.

Each step of the “investigation” is explained and the end result encourages students to make sure their pets are safe and vaccinated against rabies regularly and to stay away from all wildlife as we can never be sure if animals have rabies.

So what is rabies and how do you protect yourself, family and pets?  Rabies is a deadly virus that attacks the nervous system and all mammals, including humans, can get it.  Rabies may or may not show clear symptoms such as staggering, dragging of hind legs, excessive drooling of saliva as the animal or person cannot swallow, fear of water, nocturnal (night active) animals out in the daylight, no fear, the animal may appear tame or have excessive rage and will attack anything including known predators.

Rabies is spread through saliva and nerve tissue of infected animals and is most often seen in skunks, bats, raccoons and foxes. Because bats have very small, sharp teeth, teeth marks may not be noticed or felt, especially if someone was sleeping, is an unattended child or is disabled. Therefore it is important NOT to release bats found in homes that may have had contact with a human or pet. Contact the health department for instructions on how to safely contain a bat.

If there is a possible exposure to rabies, the animal must be tested. The brain tissue of the animal must not be damaged.

If the animal cannot be tested and a potential exposure has occurred, the individuals and domesticated animals are evaluated to determine the risk of infection. Exposed individuals may have to receive a series of shots and the animals will either receive a booster (if vaccinations are current) and period of confinement or, if the animal doesn’t have current vaccinations, it may have to be euthanized (put down).

It is important to report a possible exposure as soon as possible to your doctor and your local County Health Department to determine what steps to take. Immediately wash bites and scratches with soap and water to prevent the virus from spreading to the nervous system and call your doctor. To report bites or scratches from potentially infected animals, call your local County Health Department or after hours, your non-emergency Sheriff’s Department number.

The majority of exposures received at the Health Department are due to carelessness. To protect yourself and family members avoid touching ALL wildlife and stray animals, including baby animals, and assume they could be infected with rabies.

If your pet has had contact with a wild or stray animal do not touch your pet as it may have saliva on its fur. Use rubber gloves and confine your animal to avoid contact with its fur.

Protect your animals and home by not leaving food and water where wild animals and strays can have a free lunch.  Fix all openings in your home and outbuildings and tightly cover garbage cans so animals can’t get access. Make sure your animals have current rabies vaccine. Do not allow your animals to roam, as they are at increased risk of exposure.

ALBION Five years ago Orleans County officials welcomed ProAct Inc. to the community so residents without health insurance or limited insurance could get a discount on prescriptions.

The program is free to residents and the county government. ProAct has saved county residents $645,000 in the five years on 21,000 prescriptions, company officials reported to the Legislature.

“That’s money going directly back into residents’ pockets which they can spend on other essentials,” Kayse Diamond, communications coordinator for ProAct, told county legislators on Wednesday.

The program saves residents an average of 36 percent on prescription drugs, and residents can even catch a break on medicine for their pets. The discounts tend to range from 10 percent to 20 percent off of brand drugs and 20 percent to 50 percent discounts on generic prescriptions.

“The program has been a godsend for us,” said Legislature Chairman David Callard.

ProAct is a subsidiary of Kinney Drugs. ProAct runs the program for free, with the hope it will boost foot traffic to its stores.

The company is seeing about a 20 percent drop in utilization of the prescription cards due to lower unemployment, Diamond said.

“More people are getting jobs with benefits,” she said.

The company signs up participating pharmacies that agree to offer the discounts. The company also runs a discount program for dental and eye care coverage.

For more information or to sign up for a card, click here.

Photos by Tom Rivers – Bill Gajewski, administrator for Orleans Community Health in Albion, said the site at the corner of Route 31 and Butts Road is serving community needs and will provide more services as an urgent care site. Beginning the week of June 2, it will be open seven days a week.

ALBION – A healthcare center that opened in November 2012 in Albion will become an urgent care center on June 2 with expanded hours and services.

The Orleans Community Health location will be open seven days a week with later weekday hours. The site at the corner of Butts Road and Route 31 will do non life-threatening care such as X-rays, stitches, lab services for blood and urine, bandages and some other treatments, including care for strep throat and lacerations.

“People will be able to take care of their bee stings and if their kid falls off his skateboard,” said Bill Gajewski, administrator for the Orleans Community Health’s center in Albion.

The urgent care services will ease the demands at hospital emergency departments and provide quicker care for the Albion and eastern Orleans community, Gajewski said.

The center currently has 14 full-time equivalents. It is adding two or three more staff with the shift to urgent care. The urgent care model follows a push from President Obama and the Affordable Care Act to make health care more accessible and less costly, Gajewski said.

“Part of Obamacare is transitioning costs from the emergency departments, which are very expensive,” he said.

Bill Gajewski is pictured in the physical therapy room at the Orleans Community Health in Albion.

He and Orleans Community Health are working on other initiatives to make the Albion center stronger. He would like to see inmates at the Orleans and Albion correctional facilities receive X-rays, physicals and other care from OCH. That would provide a steady source of revenue for the center, and also assist the state Department of Correctional Services by shortening drives for inmate care.

Gajewski also wants to connect with schools and local businesses to have the Albion site be used for employee physicals and drug screenings.

The Albion site could also be federally designated as a rural health clinic, which would boost the Medicaid reimbursement rate by $75 from the current $11 per patient, he said.

Gajewski joined OCH in February. He previously worked as executive director/CEO of St Vincent Medical Group in Erie, Pa., vice president of The Grider Initiative at Erie County Medical Center, and president of WNY Breast Health in Amherst.

“I am very pleased to be part of this dynamic and growing health center,” Gajewski said about leading the Albion site. “We will soon be a designated Urgent Care Center, which will expand the health services available to our community. We will also be expanding Occupational Health Services to provide pre-employment physicals and drug testing for local employers. Discussions are also underway to explore the possibility of adding to our Nurse Practioner staff. I’m looking forward to being a part of this exciting expansion.”

By Nola Goodrich-Kresse, Public Health Educator for the Orleans County Health Department

You may have been hearing and seeing a lot about electronic cigarettes (e-cigarettes) or ‘vaping’ lately. There are so many mixed messages both in print, on television and through social media.

The manufacturers of e-cigarettes are marketing e-cigarettes as a “healthier” way to get nicotine. Unfortunately, they neglect to note that nicotine in any form is a poison.

E-cigarettes are a battery-powered nicotine delivery system using flavored vapor. They are designed to allow users to mimic the ritual of smoking a cigarette while inhaling nicotine.

Some may think e-cigarettes are safer than smoking a cigarette, however there are no clear studies to show this. The U.S. Food and Drug Administration (FDA) has not currently approved e-cigarettes as an effective method to help smokers quit. Initial studies have shown that the actual amounts of nicotine and other additives do not always match the labeling.

The long-term health effects of using electronic cigarettes are unknown.  Detailed laboratory tests do suggest these products contain carcinogens and toxic chemicals to which users could be exposed.  E-cigarettes also release secondhand vapor (not smoke) that can be seen and smelled.

Producers of e-cigarettes add various additives including flavors that include candy or fruit flavors which may be enticing to children. The potential for this becoming a gateway for youth to become addicted to nicotine is great.

Because of the marketing the manufacturers are using many think this is a harmless alternative to regular cigarettes. This is not true. Any products designed to deliver more than a trace amounts of nicotine can lead to addiction.

According to the Centers for Disease Control and Prevention (CDC) there is a rapid rise in the increase of e-cigarette-related calls to poison centers. In September of 2010 there was generally one call per month about poisoning from e-cigarettes. In February 2014 the average is 215 calls per month to poison centers across the nation. The number of calls involving regular cigarettes did not show a similar increase during the same time period.

More than half of the calls to poison centers due to e-cigarettes involved young children under age 5 and about 42 percent of the poison calls involved people age 20 and older.

Liquid nicotine is a poison and can be very hazardous when swallowed (ingestion), inhalation or absorption through the skin or eyes.

New York State law prohibits the sale of e-cigarettes to youth less than 18 years of age.  It is important to remember nicotine is a poison and to e-cigarettes and the cartridges with the nicotine liquid out of reach of children and handle them carefully.

If you think someone may have been poisoned by liquid nicotine, call the Poison Control Center at 1-800-222-1222, your health care provider or if the person is unconscious, 9-1-1 for medical assistance.

Photo by Sue Cook – Heather Kuepper was only 23 years old in 2011 when she was diagnosed with a brain tumor. The photo on the left was taken just hours after her surgery. On the right is her discharge from the hospital nine days later.

By Sue Cook, staff reporter

MEDINA – Three years have passed since Heather Kuepper was diagnosed with a Grade III malignant brain tumor (grade IV is the most severe). Doctors said her tumor was so big it was nearly blocking off the flow of cerebral spinal fluid and without an operation, it would continue to grow and would eventually kill her.

Before her diagnosis, Kuepper had experienced headaches, dizziness and numbness. She made an appointment with her primary-care doctor who then referred her to a neurologist in Rochester. The neurologist noticed that the movement of her left eye was jittery, while her right eye moved smoothly.

On June 17, 2011, Kuepper was scheduled for an MRI to rule out the possibility of multiple sclerosis.

“I never expected it to be anything more than that,” said Kuepper.

She was asked to have a seat while waiting for her results. She noticed many people who were also having MRIs were leaving faster than her. She assumed that perhaps other people were just there for quick follow-ups.

“They called me up and told me they were trying to get a hold of my primary-care doctor. I was waiting there for probably three or four hours. They finally got a hold of him and he pulled me into a private room. He told me, ‘I’m sorry. You have a brain tumor.’ At that point, I tuned out everything he was saying. I heard noise, but I couldn’t even focus on anything.”

Provided photo – Kuepper’s tumor, circled in red, was located in the posterior fossa. It was starting to grow on her brain stem.

Because of the size and location of the tumor, Kuepper’s first neurosurgeon referred her to Dr. Silberstein, a pediatric nuerosurgeon who had more expertise. Kuepper’s tumor was an ependymoma, which is a type of brain tumor rarely found in adults.

On July 6, Silberstein began the scheduled six-hour operation at Strong Hospital. The surgery would take 13 hours.

Kuepper woke up to find herself intubated with a breathing tube down her throat because she would be unable to breathe on her own without it during recovery. She was in a room where four nurses provided 24-hour surveillance on her.

During her hospital stay, she also had to learn to eat, talk and walk again. She was put through physical, occupational and speech therapy. She was eventually moved to a regular hospital room with less intensive care.

Nine days after admission, Kuepper was released from the hospital. She had to take 30 pills a day. Kuepper also needed 33 radiation sessions over six and a half weeks. She continued another two to three weeks of other therapy sessions to increase her functionality.

‘I’d rather look silly and stupid, than be dead.’ – Heather Kuepper

Kuepper does have some after-effects from her experience. She has anxiety problems that her doctor said can be post-traumatic stress, which is common in people who have a similar situation, because of how intense and terrifying her experience was. She also has felt survivor’s guilt, but tries to focus on how lucky and blessed she is.

“I do have issues with memory. I had just enrolled in college within weeks of finding out that I had a tumor, so I had to pause while I had the surgery and was trying to recover,” she said. “Everything I learned in that time, I don’t remember and that has caused a lot of depression issues for me, but I’m getting a lot better from that now.”

Today, Kuepper works for CRFS in Albion. She sometimes struggles with retaining new information.

“At work, I have to carry a packet of information with me for about two months before I can do it on my own,” she said.

Provided photo – Kuepper had 13 stitches to seal the nearly 5-inch incision running up the back of her neck. This photo was taken after she had begun to heal.

Kuepper explained that there are 120 different kinds of brain tumors. It is the most common form of solid tumor for children under age 15. Brain tumors are the second-leading cause of cancer-related deaths in children under age 20 (behind leukemia). They are the second-leading cause of cancer-related death in males and the fifth-leading for females between the ages of 20-39.

She advises that people should take their symptoms seriously for any illness or health problem.

“I would definitely say if you think you’re being silly getting worried about symptoms, don’t,” she said. “Go to the doctor. I had put off symptoms for a couple weeks, but when they kept happening, something in me just kind of told me to go to the doctor and see what it was. I never in a million years would have thought that I’d have brain surgery and me going through radiation. My motto now: I’d rather look silly and stupid, than be dead.”

She is also going to run a half marathon on May 25 in Buffalo. She is using the run to raise money for brain-cancer research through Race Toward a Cure during May, which is Brain Tumor Awareness Month.

For those who would like to donate to her efforts, you can see her fundraising page by clicking here.