The Medical Center was there for us

The Daily News, originally published on 6/21/2011

On Jan. 13, my wife, Pam, was admitted to The Medical Center to receive fluids due to having the flu.

That afternoon, she was rushed to the ICU and soon placed on a ventilator as her organs were failing due to sepsis. Our family was placed in a dire situation, and many people advised us to get her to Nashville or Louisville. We chose to remain at The Medical Center.

Surely there is not a better hospital in the world. Throughout 104 days, Pam was cared for in a loving way, first from the nurses in ICU, then in 3A Step-Down. As she got better, we were moved to 4B, and from there we went to 4D for open heart surgery. We were treated with only the best of care.

The whole hospital became our friends, from the receptionist at the door, to the staff in the cafeteria. Kind words of encouragement came from all. The people in occupational, speech and physical therapies were wonderful. They were Pam’s encouragers and cheerleaders, bringing her back to us so that we could take her home.

The co-workers of our daughter, who is a nurse in the NICU, went the extra mile to see that she could be with her mother during those long, dark days and nights. We had the greatest team of doctors in the world, all who became our friends and confidants: Drs. Urigoda, Kaul, Collins, Shadowen, Issacs, Simms, Roteller, Thompson, Zhu, Casmadine, Moore and Carter and Lisa Burton. Bro. Joe and Bro. Britt were a constant light with their prayers and love.

To all at The Medical Center and all who prayed for Pam, we say, “Thank you, from the bottom of our hearts.”

Anthony, Pam, Trevor, Autumn, Jessie, Lexi, Haley and Tyler Madison

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Rx drug abuse on rise: Five in BG died from apparent overdoses last week

by Deborah Highland, The Daily News, originally published on 6/12/2011

Five Bowling Green residents died last week in apparent prescription drug overdoses.

“We have seen a dramatic increase in that over the last several years,” Warren County Coroner Kevin Kirby said.

Pending toxicology reports on the five will give Kirby an absolute answer to the cause of death. However, evidence at each scene points to accidental prescription drug overdose as the killer.

Last week’s victims are part of a growing prescription drug abuse trend in Kentucky, making its way west from the eastern part of the state. Some 82 people die every month in Kentucky from prescription drug overdoses.

“It’s staggering, the destruction we’re seeing from prescription drug abuse,” Warren County Commonwealth’s Attorney Chris Cohron said. “I would say 90 to 95 percent of the cases we see in circuit court have a drug component to them.”

Dr. Bart Spurlin, the emergency room medical director at The Medical Center, is not surprised by the number of drug overdose deaths here last week.

Spurlin estimates that 10 to 20 percent of the people seeking emergency room treatment are actually trying to get their hands on prescription meds. He estimates that a higher percentage of emergency room patients are seeking treatment for something that has been caused by drug abuse, such as falls, car wrecks, burns and infections caused by dirty needles.

“We know for a fact that one in five Kentuckians are addicted to some sort of prescription drugs,” Spurlin said.

“It is truly an epidemic,” he said. “The flu outbreaks always make the news, but this sort of thing is the ongoing epidemic.

“I think almost every family has a family member or distant relative who has this problem with drug abuse, but they don’t necessarily want to talk about it.”

Law enforcement officials specializing in drug investigations have seen a dramatic jump in the number of prescription pills seized and drug diversion. Drug diversion is what occurs when one person obtains prescription medicine legally and then sells it to someone else.

Typically drug abusers are looking for narcotic pain medicines such as hydrocodone, oxycodone, OxyContin, Dilaudid, methadone and benzodiazepine drugs such as Klonopin and Valium.

“I think we’re seeing prescription diversion picking up here in the west,” said Kentucky State Police Capt. Bill Payton, who oversees the Drug Enforcement Special Investigations West division in Bowling Green. DESI detectives investigate drug cases in Warren and 62 other counties in the western part of the state.

In 2005, DESI West investigators seized 28 hydrocodone pills compared with 2,339 in 2009 and 30,609 in 2010; 58 Xanax pills compared with 283 in 2009 and 3,385 in 2010; and 90 OxyContin pills compared with 728 in 2009 and 4,534 in 2010.

The 2010 numbers are higher than a normal investigative year because of a large-scale drug seizure that took place in 2010, Payton said. However, the numbers are still climbing at an alarming rate when comparing 2005 against 2009.

The Bowling Green-Warren County Drug Task Force has shown substantial year-over-year gains in some categories as well, Director Tommy Loving said. In 2008, task force investigators seized one hydrocodone pill. In 2009, that number climbed to 201, and last year investigators more than doubled the number when they seized 424 hydrocodone pills. In 2009, the task force didn’t seize any oxycodone. Last year investigators seized 152 pills.

Opana, a relatively new name to law enforcement officials, is a painkiller that is also starting to gain popularity among drug abusers in the western part of the state, Payton said. Last year DESI investigators seized 291 Opana pills. So far this year, they have seized 928.

“That’s pretty substantial growth there,” Payton said.

While many abusers get their hands on pills by going from one doctor to the next in search of prescriptions, the vast majority of pills are coming from out of state.

Many out-of-state clinics that bill themselves as pain clinics are really what investigators call “pill mills.” In a pill mill, a patient can walk in, pay a fee, see a doctor briefly and walk out with 100 or more pain pills. Florida pill mills have plagued Kentucky law enforcement officials for several years. Prescription pills are also making their way into the commonwealth from Michigan and Mexico.

Yet Florida remains “the number one source state” for diverted prescription drugs here, said Kentucky State Police Lt. Vic Brown, who is the KSP liaison to the Appalachian High Intensity Drug Trafficking Area.

“We’re trying to go after some of the rogue doctors,” Brown said about the Florida drug pipeline. “We’ve closed down three clinics already.”

But just like any other government agency, manpower and dollars are stretched thin for law enforcement officials, who often have to divert their attention to Kentucky’s other problem drug, methamphetamine. When law enforcement officials are notified about a meth lab, they have to suit up and respond to remove the lab because the chemicals are volatile. One-bottle meth labs can become fireballs in an instant. That means taking attention away from pill cases.

“This is a problem we can’t arrest our way out of,” Brown said. “It’s going to take legislation to stop the (out of state) doctors,” Brown said. He would like to see a nationwide prescription drug monitoring program.

“We don’t really have that big of a problem in Kentucky,” Brown said about doctors over-prescribing. He attributes that to the electronic prescription drug monitoring system known as the Kentucky All Schedule Prescription Electronic Reporting, or KASPER, system. Any doctor or pharmacist can sign up to use the system, which allows them to see if their patient has already obtained a prescription for the same or similar drug from another doctor. When used, it prevents doctor shopping, Loving said.

Spurlin is among the minority of Kentucky doctors signed up to use the KASPER system. Only 30 percent of Kentucky doctors use it, and 23 percent of pharmacists use it.

“Overall we have an excellent medical community here and get excellent cooperation from physicians,” Loving said. “The majority of physicians don’t want to deal with doctor shopping to begin with. We just wish more of them would use KASPER.”

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Visual simplicity: Department of Agriculture releases new food guide that’s easier to understand

by Alyssa Harvey, The Daily News, originally published on 6/11/2011

When it comes to learning about healthy eating, Americans now need only to look at a plate.

The U.S. Department of Agriculture released a new dinner plate-based guide to replace the Food Guide Pyramid last week. The symbol encourages people to make half the plate fruits and vegetables and the other half grains and protein. There is also a component for dairy products.

The change is a positive one, local registered dietitians said.

“The biggest thing about (the MyPlate symbol) is that it is much more simplified. Sometimes if you have too much information people just turn it off,” said Sue Gulley, a registered dietitian at Greenview Regional Hospital. “At a glance, you can look at it and see what you should have for each meal.”

Andrea Norris, a registered dietitian and community wellness manager at The Medical Center Health and Wellness Center at Greenwood Mall, agreed.

“It’s an easy to understand visual cue to tell what they need nutritionally on their plate,” she said. “It’s a really good uncomplicated symbol of what our food choices are supposed to look like to live a healthier life.”

The USDA’s Food Pyramid was complicated for some people, said Amy Meador, a registered dietitian with the Barren River District Health Department.

“When it was on food packaging, just to look at it it didn’t mean anything,” she said. “We can all relate to a place setting. People can look at the (MyPlate symbol) and compare it to what their plate looks like in a meal.”

There are also tools on the MyPlate website, choosemyplate

.gov, that will be helpful to people, Meador added.

“We get asked a lot about recipes. There is a link you can go to that has recipes for each food group that I think will be really useful,” she said. “There are menus for a 2,000-calorie diet.”

The concept of using the plate isn’t new.

“We have used this in the past for educating a lot of our diabetics and patients who can’t read or who don’t want a lot of information to start with,” Gulley said. “When we do education, half your plate should be fruits and vegetables. This tells people you should have this for every meal.”

Meador said she has also used it with diabetics and with people who want to lose weight.

“It just hasn’t been put into a graphic like this until now,” she said. “I think it’s going to be something that’s a lot easier for people to understand.”

The symbol can be tailored for anyone, even those with specific dietary restrictions, Meador said.

“Milk doesn’t work for a lot of people, but they can eat yogurt or use lactose-free milk for a substitute,” she said. “Food allergies tend to be a specific food, such as peanuts. That’s a protein food, but they can eat certain meats so there are still foods that they can eat.”

Norris said she plans to use the new symbol at upcoming programs to teach children about healthy eating. The free classes will be from 10 a.m. to noon July 7 and July 12 at the Health and Wellness Center. Preregistration is required by calling 745-0942.

“We’ll talk about eating out healthy, serving sizes, physical activity and food labels,” she said. “If you’re grocery shopping with mom or dad, you can see what are the healthier choices at the grocery store.”

The guide also gives dietitians an opportunity to discuss what types of foods make up the different components.

“A lot of people don’t know what a protein is. That’s your eggs, meat and dairy products,” Gulley said. “We just don’t eat enough dairy.”

Gulley said she has even struggled with getting enough dairy.

“I’ve made myself start having skim milk at lunch, and I eat yogurt,” she said. “Kids tend to like yogurt. If you have those things and keep it on hand, they tend to eat more dairy.”

People may worry about the cost of some of the food – particularly fruits and vegetables – but they don’t have to be expensive, Gulley said.

“It can be the ones on sale this week or a combination of vegetables and fruits,” she said. “This is something you should have every single meal.”

While the guide doesn’t have specific servings, that doesn’t give anyone an excuse to pile the plate.

“Portion control is definitely important,” Meador said. “It takes being mindful of how much you’re putting on the plate.”

— For more information about the new food guide, visit www.choosemyplate.gov.

Tips from www.choosemyplate.gov:

Balancing calories

• Enjoy your food, but eat less.
  
• Avoid oversized portions.
  

Foods to increase

• Make half your plate fruits and vegetables.
  
• Make at least half your grains whole grains.
  
• Switch to fat-free or low-fat (1 percent) milk.
  

Foods to reduce

• Compare sodium in foods like soup, bread and frozen meals, and choose the foods with lower numbers.
  
• Drink water instead of sugary drinks.
  

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Hospital holding tune-up for men: Preregistration required for event next weekend at the Corvette museum

by Alyssa Harvey, The Daily News, originally published on 5/28/2011

The Medical Center is working to get men as excited about their health as they are about their cars with the Men’s Health Tune-Up.

“They give a lot of thought to taking care of their cars, but not so much of their health,” said Community Wellness Director Linda Rush. “If you don’t take care of your car, you’ll have problems. It’s the same with your health.”

The tune-up will be from 7:30 a.m. to 11:30 a.m. June 4 at the National Corvette Museum. The event is free and open to men of all ages, but preregistration is required.

“We’re asking that the men call to register to get an idea of how many we’ll have,” Rush said.

The day will begin with a light breakfast and free screenings from 7:30 a.m. to 9:30 a.m. The presentations “Tune Up to Better Health” by Dr. Brian K. Macy, a family medicine and sports medicine doctor at Graves-Gilbert Clinic, and “Prostate Cancer: What All Men Need to Know” by Matthew Rutter, a urologist at Graves-Gilbert Clinic, will begin at 9:45 a.m.

“I’m going to talk about the general health screenings that are recommended by most of the national organizations that are out there, mainly for primary prevention of prostate cancer, colon cancer, blood pressure and vision,” Macy said. “I’ll also talk about how exercise is used as a primary preventive tool.”

Men are typically less likely to see a doctor unless it’s absolutely necessary, Macy said.

“I see them come when they’re urged on by a spouse or with their spouse,” he said. “It usually means that there’s something wrong, something a little more serious.”

Macy said the screenings are important.

“If we can prevent those serious things from happening, I think we will be a healthier community, a healthier society,” he said. “When we don’t get these screening mechanisms in place, we lose out on that ability to find these diseases early.”

The screenings will include blood pressure, body fat analysis, vision, skin cancer, back and neck, balance and colon cancer screening kits. Prostate cancer screening will be free to members of the Men’s Health Alliance and Senior Health Network, but those who are not members can join either program during the tune-up for $10 and receive the free PSA screening. Participants will also receive discounted tickets to the National Corvette Museum and passes for a Bowling Green Hot Rods game.

“We want to get men out into an atmosphere that will be comfortable and informal to get information on their health,” Rush said. “Sometimes men are a little more reluctant to set up physician appointments. This is an opportunity to not only get the screenings done, but to talk to professionals.”

— For more information or to preregister, call 745-0942 or toll free at 877-800-3824.

Copyright 2011 News Publishing LLC (Bowling Green, KY)

March of Dimes walk raises over $50K: About 500 come out for March for Babies event

by Deborah Highland, The Daily News, originally published on 4/16/2011

Mary Mihok had four tiny reasons for walking in the March of Dimes March for Babies on Saturday morning.

Kinley, 2 pounds, 4 ounces; Kale, 2 pounds, 2 ounces; Aiden, 2 pounds, 8 ounces; and Eli, 1 pound, 15 ounces. The quadruplets were born July 20 at 28 weeks of gestation at Centennial Hospital in Nashville. That’s 12 weeks premature.

“I believe that the research they’ve done has gotten my babies healthy,” Mihok said just before beginning the walk at Phil Moore Park, pushing the babies as she walked. “Twenty years ago a baby born at 28 weeks would have serious health problems.”

About 500 walkers here helped raise more than $50,000 for the organization, said Melissa Martin, spokeswoman for the Barren River division of the March of Dimes. The Bowling Green walk was one of seven over the weekend, with others in Elizabethtown, Ashland, Somerset, Frankfort, Owensboro and Middlesboro.

Andreas Carothers and Tamieka Seton found out about the walk from hospital personnel at The Medical Center, where their daughter Dreniaha Carothers is still being cared for after being born nine weeks early.

Their older daughter, 1-year-old Adrean Carothers, smiled, stuck out her tongue and guzzled water in her stroller while her parents walked. She was also born early at 30 weeks. But to look at her now, she’s a happy baby proud to show off her front teeth.

“I came out to show support because I have two preemies,” Carothers said. “I myself was a preemie.

“I believe every child deserves a fighting chance,” he said.

Liz Wooldridge, a respiratory therapist in The Medical Center’s neonatal intensive care unit, organized the hospital’s walking team, which raised more than $8,400 for the cause.

“It’s important for us to be here because we’re trying to fund the research to be able to care for our babies better and to help in supporting the March of Dimes,” Wooldridge said. “Their research is vital to what we do.”

Stephanie Richards of Bowling Green walked in honor of her preemie, Kayleigh Ann Richards, who was born at 32 weeks.

Richards started to go into labor at 29 weeks, and doctors were able to prevent Kayleigh’s birth for four weeks to give her additional time to develop.

“They (March of Dimes) help families like us that have to be in NICU,” Richards said.

“It is amazing,” she said of the organization’s research. “We are very thankful.”

Richards’ team raised more than $2,000 for the walk.

Mandy Kucela has lost two babies: Brenner, whose heartbeat stopped three minutes prior to delivery that came three months too early, and Baby Bunny, lost to a miscarriage at eight weeks. Kucela is now 20 weeks pregnant with Brooke.

“The March of Dimes is my entire life,” Kucela said. “It’s my past, present and future. There is no way I could be a mother without the organization.”

She credits March of Dimes research for helping medical staff determine why she couldn’t carry a baby full term. She had a surgical procedure to correct the problem and gives herself daily injections of a medicine to prevent pre-term labor.

Kucela went to work for the Barren River division as the director late last year.

“Now I go to work every day to save babies,” Kucela said.

Copyright 2011 News Publishing LLC (Bowling Green, KY)

March for Babies Saturday: Family shares story of how their child beneftted from March of Dimes

by Alyssa Harvey, The Daily News, originally published on 4/29/2011

Marissa Butler smiled as she watched her 7-month-old son, Ramsey, kick and coo while listening to music coming from his play mat Tuesday at their home in Alvaton.

“You’re so silly,” she told the baby as his face lit up with a big grin. “I see you.”

Butler picked up Ramsey, placed him on her lap and watched as he looked wide-eyed at everything in front of him.

“I love the wonder in their eyes,” she said.

It was a moment that Butler wasn’t always sure she would see. Ramsey was born at almost 26 weeks gestation at Vanderbilt University Medical Center in Nashville. That’s 14 weeks earlier than a full-term pregnancy, which lasts 40 weeks.

“He’s our first child. We didn’t know what to compare it to,” she said. “We got a crash course on how to take care of him. It’s kind of good we didn’t know all the risks, but at the same time to be able to share a positive story.”

The Butlers are sharing their story as the Bowling Green ambassador family for the March of Dimes, and the family will participate in the organization’s March for Babies. The walk, which helps raise money for research and programs for the March of Dimes, will begin with registration at 9 a.m. Saturday at Phil Moore Park followed by the walk at 10 a.m. The event will be held rain or shine.

“We want to do anything we can to spread awareness,” Butler said. “We want to give families a ray of hope.”

The family’s team, called Team Ramsey, has raised more than $3,000 so far, Butler said.

“We have family from here and Nashville coming,” she said. “He’ll be in his stroller.”

There are currently 300 people preregistered for this weekend’s March for Babies, but organizers are anticipating between 500 and 800 people, said Mandy Kucela, March of Dimes Barren River Division director.

“It’s our largest fundraising event. We’re looking at $60,000 brought in from the walk,” she said. “Company and family teams get together and raise money for the cause. We ask that walkers make a donation to support the cause. It all goes to the March of Dimes.”

The organization’s mission is to prevent premature birth, infant mortality and birth defects, Kucela said.

“In Kentucky, we have more premature births than the number of freshmen enrolled at (the University of Louisville) and (the University of Kentucky) combined,” she said.

The mission isn’t just about helping babies born too early, Kucela said.

“It’s about all babies,” she said. “We want to help all babies have a healthy chance at life.”

Butler had no indication that Ramsey would be born early.

“I was having a completely normal pregnancy,” she said. “I had no complications. He had strong heartbeat.”

One evening in September, Butler was preparing dinner when she felt that her water might have broken.

“By the time I got to The Medical Center to wait on my husband, Shane, to park the car, my water had definitely broken,” she said. “I didn’t lose all my fluid. I wanted to get to 34 weeks.”

Butler was sent to Vanderbilt, which would be better equipped to care for a micro-preemie. Butler’s labor was held off for a few more days, but on Sept. 20 she woke up with a fever and other flu-like symptoms.

“They hooked me up to a monitor,” she said. “By the middle of the morning, they could tell he was being affected by my illness.”

Ramsey was born by cesarean section and weighed in at 2 pounds, 2 ounces.

“It was the scariest but happiest moment of my life at the same time,” Butler said. “It was fear completely balanced by faith.”

When Butler marveled at how tiny her son was, the staff told her that they had seen smaller babies.

“The (neonatal intensive care unit) was constantly reassuring us. We could tell they were very experienced with this,” she said. “They didn’t sugarcoat anything. Yes, he had a struggle, but there were many others who struggled harder.”

Ramsey stayed at Vanderbilt’s NICU for nearly seven weeks before being transported back to The Medical Center, where he stayed for seven weeks. He was able to go home four days before Christmas – five days before his original due date. He is doing well, Butler said.

“I just got to meet him a little earlier,” she said. “I got to look into his eyes a little earlier.”

Some of the knowledge, technology and skill used in the NICU are results of March of Dimes research, Butler said.

“The more donations the March of Dimes gets now, they more they can help NICUs across the country,” she said.

— For more information about March for Babies, call 746-5111 or visit www.marchforbabies.org.

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Changing diet often helps those with celiac disease

by Alyssa Harvey, The Daily News, originally published on 4/16/2011

Lynn Denton sometimes misses eating biscuits.

“That gets to be the hardest thing,” the Scottsville woman said.

Denton knows that taking a nibble on a piece of bread could make her very sick. She suffers from celiac disease, an autoimmune disorder in which the body reacts to the protein gluten, which can be found in wheat, bran, rye and some oats.

“Gluten is in pretty much everything,” said Dr. James Curtiss, a gastroenterologist at Physicians Specialty Center at Greenview Regional Hospital. “One in 200 people are susceptible to it.”

It used to be that celiac disease would be diagnosed in pediatric situations in which an infant or child would have diarrhea, failure to thrive or dehydration, Curtiss said. Now more and more adults are being diagnosed with it.

“It’s mostly because people are aware of it, and there is better testing,” he said.

Celiac disease – which happens more often in people of northern European ancestry or who have a genetic predisposition for it – is more than just diarrhea, constipation and abdominal cramping, Curtiss said. Some other symptoms are joint pain, fatigue, certain rashes, low iron or anemia, low vitamin D, low calcium and mood irritability. Celiac disease can be associated with other autoimmune illnesses such as Type 1 diabetes and thyroid disease as well as Down syndrome and fertility issues.

“There are a number of things that you look at,” he said. “Not everybody has symptoms.”

Patients also have a small risk of intestinal malignancy, Curtiss said.

“Celiac can be fatal, but thankfully it’s not very often,” he said.

Denton said she had several symptoms when she was diagnosed about five years ago.

“I was having trouble with my stomach. I had chronic diarrhea and breaking out on my arms, knees and around my waist,” she said. “I went to other doctors about that, and they didn’t know what it was.”

The disease may be genetic in Denton’s case, she said.

“My mother died of colon cancer when I was 4 years old,” she said. “It could’ve been because of celiac disease. They didn’t test for stuff like this back then.”

There are some blood tests that can detect celiac disease. Curtiss also does a biopsy of the small intestine, a 10-minute procedure in which the patient is sedated. Once celiac disease is diagnosed, Curtiss talks to the patient about treatment, which can include a gluten-free diet or, for those whose disease doesn’t respond to dietary changes, steroids.

“Treatment is kind of tough. Ninety percent of people respond to dietary changes,” he said. “Some can make minor changes and receive benefit.”

Patients with celiac disease often need a dietitian to help them adjust to a new way of eating and get the nutrients that the small intestine cannot absorb as well. Linda Howsen, community dietitian at The Medical Center, said patients should read food and beverage labels as well as things that may come in contact with the mouth such as lipstick, medicine and toothpaste. They also should be careful about sharing utensils, such as a bread knife, that may have come in contact with a gluten product.

“It’s a cross contamination issue,” she said.

Because more stores carry gluten-free products, patients with celiac disease can have a lot more freedom than they used to, Howsen said.

“The big concern in some of the gluten-free products is the low level of nutrients, but some gluten-free products are fortified,” she said. “If they are not, you can take a multivitamin or buy enriched gluten-free products.”

Gluten-free products aren’t necessarily like those with gluten, though, Howsen said.

“They may have a different taste and texture,” she said. “You may have to do some manipulation to make it taste and have the texture the way you want it.”

Denton said she has changed her way of eating and takes extra vitamins, including calcium, vitamin D and vitamin B12 shots. She has increased her intake of fruits and vegetables.

“I try to eat foods that are gluten free,” she said. “I can tell when I eat something I’m not supposed to.”

She encourages others who have celiac disease to do research so they know what they’re facing.

“I purchased books,” Denton said. “You really need to watch what you eat. It could lead to more serious complications.”

The following websites have information about celiac disease:

The National Center for Biotechnology Information

www.ncbi.nlm.nih.gov

Celiac Disease Foundation

www.celiac.org

Celiac.com

www.celiac.com

The Gluten Intolerance Group of North America

www.gluten.net

Celiac Sprue Association

www.csaceliacs.org

American Dietetic Association

www.eatright.org

Copyright 2011 News Publishing LLC (Bowling Green, KY)