By Joanne Chaconis, R.D.
I think I am a lot like my dad…same sense of humor, just as stubborn and we both love sweets. Practically a carbon copy, with a few exceptions. One of those exceptions? I drink fully enough fluids daily to keep me well hydrated. My dad, on the other hand, is not as diligent. Every conversation that I have with him always includes reminders (some gentle, some not-so-gentle) of the importance of drinking enough fluids.
This seemed to be an important and timely topic to discuss. Timely because of the summer season we are now enjoying. There are many factors that increase our need for fluids and they include: excessive perspiration, fever, vomiting, diarrhea and hyperventilation. I should also mention here that under some medical conditions (such as certain cardiac and renal diseases) your fluid needs may actually decrease. Always check with your physician.
A general rule to follow when determining fluid needs for a healthy individual (according to the Committee on Dietary Reference Intakes) is:
Age in years ml/kg (wt)
Young, active (16-30) 40
Average activity (25-54) 35
Older (55-65) 30-35
Older (>65) 25-30
Here is an example: To convert ml to ounces, divide by 30.
To convert kg to pounds, divide by 2.2.
A 50 year-old adult weighing 150 pounds:
150 pounds divided by 2.2 kg = 68 kg
68 kg x 30-35 ml = 2040-2380 ml
2040 – 2380 ml divided by 30 ml = 68-79 ounces, which translates to between 8 ½ to 10 eight ounce servings daily.
Best beverage choices are water, sugar-free juices and sodas and decaffeinated beverages. Also fruits are a good choice because they are about 20 percent water-packed.
So…toast a loved one (here’s to you dad!) with an eight ounce glass of cool water and stay hydrated!
Monday, August 27, 2007
It Only Takes A Second
By Cynthia Leslie, M.D.
Most people would probably tell you that a second is very short, but I think time is relative and it depends on what you do. I work in Saint Francis Hospital’s very busy Trauma Center, and I am constantly reminded that seconds are very precious. The trauma team treats thousands of patients who have been harmed in different ways. Some have been injured in car crashes and some have been shot or stabbed. A number of our elderly neighbors require treatment due to falls. Whatever the injuries are, there is always a common denominator. Patients need our help and we have seconds in which to give it.
When patients arrive in the trauma room, the trauma team is ready. We first look for life-threatening injuries that require immediate treatment. If a patient has trouble breathing, her lung could be collapsed. If the patient has internal bleeding, he may present with signs of shock. When the body is oxygen deprived, the brain is extremely vulnerable and brain death can occur in as little as four to six minutes. The trauma team’s job is to immediately assess, resuscitate and treat and we do all of that very quickly because we know that seconds count.
Trauma is the number one killer of our youngest and healthiest neighbors. It is also a merciless scavenger that maims the old and frail. Heart disease and cancer are widely known public health problems, but the grisly toll that trauma takes frequently goes un-noticed. Hundreds of thousands of people have died on U.S. highways. Hundreds of people die every day as the result of senseless violence. Trauma is more than an injury. It is a national epidemic and until we acknowledge the damage it does, we won’t do much about it. People are driving way too fast and people are much too angry. If you think that rage and speed don’t kill you need to think again. Trauma is killing our youngest, our oldest, our best and our brightest. We need to address the problems and we need to do it now.
It only takes a second to crash into a tree, but that second could be avoided by driving a bit more slowly. It only takes a second to hit and kill a child, but that second could be avoided by refusing to drink and drive. It only takes a second to remember to use your seatbelt and it takes another second to tell your children to do the same. If we use our seconds wisely we will save our neighbors’ lives. What better way to use them when it takes so little time
Most people would probably tell you that a second is very short, but I think time is relative and it depends on what you do. I work in Saint Francis Hospital’s very busy Trauma Center, and I am constantly reminded that seconds are very precious. The trauma team treats thousands of patients who have been harmed in different ways. Some have been injured in car crashes and some have been shot or stabbed. A number of our elderly neighbors require treatment due to falls. Whatever the injuries are, there is always a common denominator. Patients need our help and we have seconds in which to give it.
When patients arrive in the trauma room, the trauma team is ready. We first look for life-threatening injuries that require immediate treatment. If a patient has trouble breathing, her lung could be collapsed. If the patient has internal bleeding, he may present with signs of shock. When the body is oxygen deprived, the brain is extremely vulnerable and brain death can occur in as little as four to six minutes. The trauma team’s job is to immediately assess, resuscitate and treat and we do all of that very quickly because we know that seconds count.
Trauma is the number one killer of our youngest and healthiest neighbors. It is also a merciless scavenger that maims the old and frail. Heart disease and cancer are widely known public health problems, but the grisly toll that trauma takes frequently goes un-noticed. Hundreds of thousands of people have died on U.S. highways. Hundreds of people die every day as the result of senseless violence. Trauma is more than an injury. It is a national epidemic and until we acknowledge the damage it does, we won’t do much about it. People are driving way too fast and people are much too angry. If you think that rage and speed don’t kill you need to think again. Trauma is killing our youngest, our oldest, our best and our brightest. We need to address the problems and we need to do it now.
It only takes a second to crash into a tree, but that second could be avoided by driving a bit more slowly. It only takes a second to hit and kill a child, but that second could be avoided by refusing to drink and drive. It only takes a second to remember to use your seatbelt and it takes another second to tell your children to do the same. If we use our seconds wisely we will save our neighbors’ lives. What better way to use them when it takes so little time
Honoring Home Care's Unsung Heroes
By Dana Pavelock
We often get calls and questions about Personal Care Aides and Home Health Aides. The general public has developed their own perception based on a slew of articles that may or may not really capture the essence of who these people are and how important the work is that they do. This has often led to misconceptions about the level of training or skills of these workers.
For the most part, individuals performing this level of para-professional health care service consist of a group of people who have a commitment to caring for others. They are men and women of varying ages and backgrounds who understand the vital role that they serve. They provide services and care to individuals on either a short term or long-term basis to improve quality of life, preserve dignity of self and maintain patient’s ability to remain home for as long as they choose. Services range from companionship to total care, one hour a day to live in aides, with settings ranging from plush private homes to inner city projects. Home Health Aides and Personal Care Aides experience much satisfaction providing care and develop wonderful relationships with patients and family members alike, and at the same time often are under appreciated for who they are and what they do.
PCA’s and HHA’s are required to complete training classes ranging from seven days to two weeks in length through a health training curriculum that is approved by the Department of Social Services and the NYS Department of Health. Some of the training consists specifically on working with children and disabled population, meal preparation, complex diets and nutrition, spending & budgeting, care of the home & personal belongings, infection control, personal care related to bathing, dressing, grooming, ambulating and transferring patients, use of mechanical lifts and other medical equipment, and assisting with medications.
HHA’s receive enhanced training in areas such as how to measure vital signs, prepare complex modified diets, assist with prescribed exercise programs, use other prescribed medical equipment, provide special skin care, and assist with dressing changes. The training is very detailed and students not only have to complete the training, they need to pass academic testing and demonstrate competency in each module. They are also required to participate in on-going in-service training throughout the year and demonstrate competency in the field under the direct supervision of a Registered Nurse. For more information regarding the training curriculum and to see exactly what services and activities are permissible by a Home Health Aide please visit the following site: www.nyhealth.gov/ and search Home Health Aide Training.
Like other agencies that deliver HHA & PCA services, every week we receive positive feedback from patients we serve who express high levels of satisfaction in for the services of our aides, who routinely go above and beyond the call of duty. HHA & PCA staff never cease to amaze us with their focus on providing exceptional care and customer service, doing so from the heart without seeking recognition. In many ways they are the unsung heroes in our health delivery system.
Please help the health care community recognize the valuable and important role our home care aides provide. We ask that you simply understand the work they do and whenever you have the opportunity, let them know how appreciated they are for what they do.
We often get calls and questions about Personal Care Aides and Home Health Aides. The general public has developed their own perception based on a slew of articles that may or may not really capture the essence of who these people are and how important the work is that they do. This has often led to misconceptions about the level of training or skills of these workers.
For the most part, individuals performing this level of para-professional health care service consist of a group of people who have a commitment to caring for others. They are men and women of varying ages and backgrounds who understand the vital role that they serve. They provide services and care to individuals on either a short term or long-term basis to improve quality of life, preserve dignity of self and maintain patient’s ability to remain home for as long as they choose. Services range from companionship to total care, one hour a day to live in aides, with settings ranging from plush private homes to inner city projects. Home Health Aides and Personal Care Aides experience much satisfaction providing care and develop wonderful relationships with patients and family members alike, and at the same time often are under appreciated for who they are and what they do.
PCA’s and HHA’s are required to complete training classes ranging from seven days to two weeks in length through a health training curriculum that is approved by the Department of Social Services and the NYS Department of Health. Some of the training consists specifically on working with children and disabled population, meal preparation, complex diets and nutrition, spending & budgeting, care of the home & personal belongings, infection control, personal care related to bathing, dressing, grooming, ambulating and transferring patients, use of mechanical lifts and other medical equipment, and assisting with medications.
HHA’s receive enhanced training in areas such as how to measure vital signs, prepare complex modified diets, assist with prescribed exercise programs, use other prescribed medical equipment, provide special skin care, and assist with dressing changes. The training is very detailed and students not only have to complete the training, they need to pass academic testing and demonstrate competency in each module. They are also required to participate in on-going in-service training throughout the year and demonstrate competency in the field under the direct supervision of a Registered Nurse. For more information regarding the training curriculum and to see exactly what services and activities are permissible by a Home Health Aide please visit the following site: www.nyhealth.gov/ and search Home Health Aide Training.
Like other agencies that deliver HHA & PCA services, every week we receive positive feedback from patients we serve who express high levels of satisfaction in for the services of our aides, who routinely go above and beyond the call of duty. HHA & PCA staff never cease to amaze us with their focus on providing exceptional care and customer service, doing so from the heart without seeking recognition. In many ways they are the unsung heroes in our health delivery system.
Please help the health care community recognize the valuable and important role our home care aides provide. We ask that you simply understand the work they do and whenever you have the opportunity, let them know how appreciated they are for what they do.
Thursday, August 23, 2007
A Visit With Mom And Rutabagas
By Sarah Daubman, R.D.
Not too long ago I sat with my mother at her kitchen table drinking coffee. Somehow the conversation turned to childhood memories, particularly those involving food and favorite recipes. “Do you know what I haven’t had in almost twenty years?” she asked. “Rutabagas.”
She went on to describe how much she loved the mashed rutabagas she enjoyed as a child. Being a dietitian and lover of food in all ways, my curiosity was piqued. Though I pride myself on the willingness to try just about any exotic, gourmet food, I could not recall ever having a rutabaga, a simple, humble vegetable at best. I questioned my mother: Is a rutabaga the same as a turnip? How do you cook it? What does it taste like?
Of course I had to research some of this information on my own. As it turns out, the rutabaga is not the same as a turnip, though they are closely related and rutabagas may be referred to as “yellow turnips.” Rutabagas are round root vegetables with yellow-orange flesh around the top and white/yellow skin around the bottom. If searching for them in the grocery store, which I later found myself doing, you will likely find them next to the turnips. Their color and larger size should help differentiate the two.
Upon returning home with the newly purchased vegetable, I set upon making mashed rutabagas for my mother. The rutabagas had a waxy covering that easily peeled away with the skin using a vegetable peeler. The next task was not as easy – cutting the rutabagas. I used a large chef’s knife to slice the root vegetable in half and then into smaller and smaller pieces. I added the 1-inch cubes to a pot of water, brought the water to a boil and cooked them until easily pierced with a fork.
Based on the recommendations of my mother and other researched recipes, I treated the cooked rutabagas much like potatoes. As many ways as there are to make mashed potatoes, so there are for mashed rutabagas. My mother’s preference was milk, butter, salt and pepper. Upon presenting the dish to her she was delighted to find them as a good as she remembered. I have since discovered other methods of preparation: mashed alone or with potatoes, turnips or squash, roasted with olive oil and herbs, grated into salads or cole slaw, diced into soup or caramelized with onions.
I find the rutabaga to have a distinct flavor, tastier than the mild turnip in my opinion. Of course, the nutritious side of rutabagas should also be mentioned (see link: http://www.vegparadise.com /highestperch4.html). I encourage you to experiment with your own recipes. If taken the time, I’m sure you will find the rutabaga a wonderful addition to your family’s meals and discover, as I did, it is a vegetable not only your mother will love.
Not too long ago I sat with my mother at her kitchen table drinking coffee. Somehow the conversation turned to childhood memories, particularly those involving food and favorite recipes. “Do you know what I haven’t had in almost twenty years?” she asked. “Rutabagas.”
She went on to describe how much she loved the mashed rutabagas she enjoyed as a child. Being a dietitian and lover of food in all ways, my curiosity was piqued. Though I pride myself on the willingness to try just about any exotic, gourmet food, I could not recall ever having a rutabaga, a simple, humble vegetable at best. I questioned my mother: Is a rutabaga the same as a turnip? How do you cook it? What does it taste like?
Of course I had to research some of this information on my own. As it turns out, the rutabaga is not the same as a turnip, though they are closely related and rutabagas may be referred to as “yellow turnips.” Rutabagas are round root vegetables with yellow-orange flesh around the top and white/yellow skin around the bottom. If searching for them in the grocery store, which I later found myself doing, you will likely find them next to the turnips. Their color and larger size should help differentiate the two.
Upon returning home with the newly purchased vegetable, I set upon making mashed rutabagas for my mother. The rutabagas had a waxy covering that easily peeled away with the skin using a vegetable peeler. The next task was not as easy – cutting the rutabagas. I used a large chef’s knife to slice the root vegetable in half and then into smaller and smaller pieces. I added the 1-inch cubes to a pot of water, brought the water to a boil and cooked them until easily pierced with a fork.
Based on the recommendations of my mother and other researched recipes, I treated the cooked rutabagas much like potatoes. As many ways as there are to make mashed potatoes, so there are for mashed rutabagas. My mother’s preference was milk, butter, salt and pepper. Upon presenting the dish to her she was delighted to find them as a good as she remembered. I have since discovered other methods of preparation: mashed alone or with potatoes, turnips or squash, roasted with olive oil and herbs, grated into salads or cole slaw, diced into soup or caramelized with onions.
I find the rutabaga to have a distinct flavor, tastier than the mild turnip in my opinion. Of course, the nutritious side of rutabagas should also be mentioned (see link: http://www.vegparadise.com /highestperch4.html). I encourage you to experiment with your own recipes. If taken the time, I’m sure you will find the rutabaga a wonderful addition to your family’s meals and discover, as I did, it is a vegetable not only your mother will love.
Bright Sunshine Equals Horrible Sunburn
By Susan Hecht, R.N.
I have to tell you, at times this summer it has been extremely hot. During one of those hot spells I had an experience with my friend, Ryan, and the hot weather. I work inside so I am fortunate enough to have an air conditioner to keep me cool. Anyone that works outdoors that I know I always express my concerns regarding sunburns and heat exhaustion. Those things that go with this wonderful summer-time weather.
Ryan is in the process of building a house. Well, he tells me that he is going to work on his house the following day. I watch the weather and see the forecast calls for a high temperature of 96 degrees. Keeping in mind that the work he is preparing to complete is OUTSIDE work, I explain to him about making sure he has plenty of water, sun block and to wear a shirt to prevent sunburn.
I must say that men are the worst when it comes to wearing sun block. I expressed my concerns about heat exhaustion, having plenty of water, taking breaks out of the sun – in an air conditioned area, if at all possible – and wearing light clothing. I would love to hear of any man who would listen to all these instructions before going outdoors to work!
Well, I must say that evening after spending a day with NO shirt on, very little to drink (I’m sure) and working on the outside deck of the house for about 5 straight hours - with no break from the sun – my friend began to complain about having the chills. You could feel the heat coming off his back.
So I asked – did you drink enough water? Did you wear a shirt? Did you take breaks out of the sun? His reply was that he needed to get the house done and I don’t have time for breaks. And, of course, he had taken off his shirt because it was so hot!
Needless to say, Ryan spent the next two days in pain with discomfort and NO work was done on the house during that time.
When he did get back to working on the house he was well armed with sun block, a jug of water and wore a light shirt. He took frequent breaks during which he applied more sun block.
It is summer time, let’s remember the things we don’t focus on with the nice weather. The sun burns so use sun block. To combat dehydration drink plenty of water or other non-alcoholic beverages. Take breaks out of the sun, preferably in air-conditioned areas. If you feel dizzy or faint see a doctor immediately. As for Ryan, he continues to work on the house but he hasn’t burned since that day.
I have to tell you, at times this summer it has been extremely hot. During one of those hot spells I had an experience with my friend, Ryan, and the hot weather. I work inside so I am fortunate enough to have an air conditioner to keep me cool. Anyone that works outdoors that I know I always express my concerns regarding sunburns and heat exhaustion. Those things that go with this wonderful summer-time weather.
Ryan is in the process of building a house. Well, he tells me that he is going to work on his house the following day. I watch the weather and see the forecast calls for a high temperature of 96 degrees. Keeping in mind that the work he is preparing to complete is OUTSIDE work, I explain to him about making sure he has plenty of water, sun block and to wear a shirt to prevent sunburn.
I must say that men are the worst when it comes to wearing sun block. I expressed my concerns about heat exhaustion, having plenty of water, taking breaks out of the sun – in an air conditioned area, if at all possible – and wearing light clothing. I would love to hear of any man who would listen to all these instructions before going outdoors to work!
Well, I must say that evening after spending a day with NO shirt on, very little to drink (I’m sure) and working on the outside deck of the house for about 5 straight hours - with no break from the sun – my friend began to complain about having the chills. You could feel the heat coming off his back.
So I asked – did you drink enough water? Did you wear a shirt? Did you take breaks out of the sun? His reply was that he needed to get the house done and I don’t have time for breaks. And, of course, he had taken off his shirt because it was so hot!
Needless to say, Ryan spent the next two days in pain with discomfort and NO work was done on the house during that time.
When he did get back to working on the house he was well armed with sun block, a jug of water and wore a light shirt. He took frequent breaks during which he applied more sun block.
It is summer time, let’s remember the things we don’t focus on with the nice weather. The sun burns so use sun block. To combat dehydration drink plenty of water or other non-alcoholic beverages. Take breaks out of the sun, preferably in air-conditioned areas. If you feel dizzy or faint see a doctor immediately. As for Ryan, he continues to work on the house but he hasn’t burned since that day.
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