Pain Care: Prevention Before Treatment

Author: Harry J. Gould, III, MD, PhD

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When a patient says, “Doctor, it hurts when I do this,” the immediate thought in response to the implied request is “Don’t do that.”  Unfortunately, in today’s society, this seems to be the best and most effective advice that a physician can provide for their patients in pain.

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The United States is in the midst of what the Centers for Disease Control describes as “The worst public health crisis in American history.”

There are reports, almost daily, to enlighten us about the fact that the over-prescribing of prescription painkillers has led to countless overdose deaths and serious consequences associated with misuse, abuse, addiction, and diversion that plague society in epidemic proportions.

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As a result, there has been a strong push by the community and regulatory agencies to limit the prescribing and dispensing of opioid analgesics across the board, while paying little attention to the underlying cause.

Pain is often under-treated or over-treated, but mostly it is poorly treated.

The system’s response has precipitated a reluctance on the part of many physicians to provide pain care for many in need, further exacerbating the primary cause of the problem.

A frequent response is to change clinical focus and redirect efforts to offer one-dimensional assessment and management that relies on interventional modalities.  Unfortunately, not all patients are identical and interventions, if ordered inappropriately or too often, can be costly and have problems of their own.

The observations and policies have mandated change and have heightened the efforts of healthcare providers to find ways to “do no harm” in their efforts to help those in need.

How then can we improve pain care and overall quality of life?  Perhaps it is time to return to basics.

As a starting point, we should consider some important truths about pain.

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The Truth About Pain

  • Pain is subjective and is different for everyone based on culture, situation, experience, genetics, age and gender.
  • Pain is a modality that is essential for survival. It warns us of present and potential tissue injury so that we can respond and minimize damage.
  • The most important reason that chronic pain is so debilitating is less the uncomfortable sensation that is experienced and more the fact that pain robs us of our ability to control of own lives. Unfortunately, many chronic pain conditions are present for a lifetime.  Thus, the realistic goal should be to minimize the effect of the underlying condition causing the pain and reclaim control of our lives rather than to eliminate pain.

Too often, patients surrender responsibility for controlling their pain to friends, physicians, physicians, drugs or procedures.

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Taking Responsibility for Your Pain

As a patient, it is essential for you to take responsibility for your pain and to participate in your own care. This process can begin by considering and implementing some obvious positive behavior changes that can maximize pain control and minimize both physical and fiscal cost.

Things You Can Do to Control Pain

  • Eat a regular healthy diet, avoiding excess, with a goal to optimize body mass index (BMI).
  • Exercise daily — regular activity from baseline to 30-60 min/day tailored to the patient’s ability to tolerate activity without a backward slide. “No pain, no gain” is not always the best approach.
  • Be sure to get enough restorative sleep.
  • Balance life experiences and schedule time for yourself that allows for participation in hobbies and enjoyable leisure activities.
  • Be aware of habitual activities and positions that add undo ergonomic stress, e.g., poor posture, wearing high heels, wearing shoes that lack adequate support, sleeping on an old or non-supportive mattress or pillow, using inadequately supportive chairs and car seats. Tailor work and living environments to minimize but not necessarily eliminate stressors and eliminate high-risk conditions.
  • Learn and take advantage of alternative forms of coping and pain control, e.g., meditation, guided imagery, self-hypnosis and relaxation.

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With proper perspective and attention to basics, one is likely to realize improved general conditioning that enhances:

  • Healing and the immune system’s ability to fight off infection and disease
  • Improved cardiovascular, pulmonary and gastrointestinal health
  • Reduced stress
  • Improved mental health
  • Increased sense of self and well-being and an overall improved quality of life
  • Reduction in pain at any level

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When setbacks occur, first consider the use of topical heat, cooling or massage and prudent physical activity to improve strength, range of motion and endurance and seek counsel for a comprehensive pain assessment early when the basics have not provided adequate results.

Suicide Prevention: Know the Signs and Where to Get Help

Author: David Fein, MD, Medical Director of  Behavioral Health Emergency Room Services

Suicide rates have been on the rise, now standing as the 10th leading cause of death in the U.S. and the 2nd leading cause of death in teens. Now more than ever, it’s critical to know the signs that might indicate a person is considering suicide, where to go for help, and how to provide appropriate support and interventions.

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Risk Factors

While there are known risk factors for suicide, such as being older, male, or single, there are additional risk factors to be mindful of as well. These include dramatic changes in behavior, such as getting one’s affairs in order, giving away possessions, increasing substance use, and expressing feelings of being trapped, a sense of hopelessness, or the belief that there is no purpose or meaning to life.

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Many suicides occur during moments of extreme anxiety and hopelessness about the future. In fact, interviews of people who attempted suicide reveal that, oftentimes, they experienced profound regret about their decision almost immediately.

We should strive to never let temporary feelings of hopelessness drive us or a loved one to a permanent act like suicide. If you feel you are trapped with no way out and think the only solution is death, know that many resources are available to help you through the crisis.

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Where to Find Help

Each parish has a community mental health center and a mobile crisis unit that are available 24/7 to provide support for people in a behavioral health crisis. Calling the crisis unit does not necessarily mean you will be brought to the E.R. They are there to provide support to you – sometimes over the phone, sometimes in person.

Metropolitan Human Services District serves Orleans, St Bernard, and Plaquemines parishes. Call (504) 568-3130 for their clinic, and (504) 826-2675 for their mobile crisis unit. Jefferson Parish Human Services Authority serves Jefferson Parish. Call (504) 838-5257 for their clinic and (504) 832-5123 for their mobile crisis unit.

If a friend or loved one is in crisis and unwilling to seek help, another option is an Order of Protective Custody, which is signed off by the parish’s coroner and gives the police legal authority to bring the person to the hospital for an evaluation. To  request for an Order of Protective Custody in Orleans Parish,  call (504) 658-9660; in Jefferson Parish, call (504) 365-9100; in St. Tammany Parish, call (985) 781-1150.  

There are also national services such as the Suicide Hotline (1-800-273-8255) and the National Alliance on Mental Illness (NAMI) (1-800-950-6264) which also has a Crisis Text Line (just text NAMI to 741-741). As always, emergency rooms and 911 are available 24/7 in case of an emergency.

Dr. Fein is an Assistant Professor of Psychiatry and Associate Director of the LSU-Ochsner Psychiatry Residency Training Program, LSU Health New Orleans School of Medicine.

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Protect your Children: Get them Vaccinated

By Gail Burke, DO, Family Medicine Physician

GettyImages-532334752.jpgWith a new school season starting, many parents are making lists to make sure their child has everything to begin the school year prepared. Protecting your child’s health should be number one on your list.

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One of the best ways to keep your children healthy is to get them vaccinated. From newborn to college age, you can protect your children from 16 serious diseases, including polio, meningitis, diphtheria, flu, rotavirus and tetanus. Vaccinations work! Some terrible diseases that ravaged human beings for centuries were eliminated with the discovery of vaccination, such as the dreaded small pox virus, which the World Health Organization declared globally eradicated in 1979.

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Vaccinations save lives

Before vaccines, many children died from diseases that vaccines now prevent, such as polio, measles and whooping cough. Those same germs exist today; because most children are vaccinated, we don’t see those diseases as often. Vaccination not only protects your child; it also protects the other children in the classroom and school, by something known as “herd immunity.” Germs can travel quickly through a community, such as your child’s classroom, and make a lot of children sick. If enough people get sick it can lead to an outbreak. But when enough children are vaccinated against a disease, the germs can’t travel as easily from person to person and the whole group is less likely to get the disease. That is “herd immunity!”

As a very busy parent, you’ve got enough to keep track of with your child’s multiple school and afterschool activities.  Keeping track of a vaccination schedule is one less thing for you to worry about, because your child’s doctor will do this job.

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Well-child visits and immunizations

Vaccinations are designed to be given automatically during well-child visits. Your family doctor or pediatrician will schedule these well-child visits and keep track of your child’s vaccinations and give you a health record with the history of your child’s vaccinations. This record is often required by your child’s school and other programs to ensure the health of all the children. And don’t worry. If your children have missed any vaccines, your doctor can use a “catch up” vaccination schedule to get them back on track.

There are free resources to help parents such as the CDC charts, “2018 Recommended Immunizations for Children from Birth through 6 Years old” and the “Recommended Immunizations for Children 6 years old through 18 years old.”

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Vaccination safety

Some parents are confused and worried about vaccinations. They’ve heard that vaccinations can cause autism or long-term neurologic problems. Moms and Dads want to do what’s in the best interest of their children. All parents, and children, deserve the best science-based information on this topic. The CDC and many scientific groups have done extensive research on vaccine safety; their studies continue to find there is no scientific basis for this claim. Based on these major research findings, the American Academy of Pediatrics and the American Academy of Family Medicine support vaccinations for all children, infancy through college age. You are encouraged to bring your questions and concerns to your family doctor.

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Additional benefits of vaccinations

There is another important benefit for parents who vaccinate their children. Their children are less likely to develop the childhood illnesses which require time off school for kids and time off work for parents. It also cuts down on need for doctor’s visits, and with very sick children, the need for hospitalization.

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Programs that can help

Vaccinations can be expensive and many families cannot afford to pay for vaccines on their own. If you are unable to afford vaccinations for your child or if the vaccinations are not covered by your health insurance, do not let this stand in the way of protecting your child. He or she may be eligible for programs such as the Vaccines for Children program, a federal program established in 1998.

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Finding your ‘Medical Home’

When you register as a patient at the UMC/LSU Family Medicine Clinic, this becomes your “Medical Home,” for you and every member of your family, no matter his or her age. One of the key beliefs of family medicine is disease prevention! We are dedicated to promoting your child’s health, through vaccinations and lifelong education on healthy lifestyle. We believe that vaccinations are one of the best lifelong strategies to prevent serious life threatening diseases and keep you and your loved ones healthy.

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Dr. Gail Burke is a board certified family physician in the UMC/LSU Family Medicine Clinic. To learn more about Family Medicine at UMC, visit http://www.umcno.org/familymedicine or call (504) 962-6363 to schedule an appointment.

Essential Immunizations for Adults

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You want to pass on certain things like family traditions, a grandmother’s quilt or dad’s love of books—but no one wants to pass on a serious illness. Take charge of your health and help protect those around you by asking about vaccines at your next doctor’s visit.

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Vaccines

Vaccinating our children is commonplace in the United States. But many adults don’t know which vaccines they need, and even fewer are fully vaccinated. Every year, thousands of adults in the U.S. become needlessly ill from infectious diseases. Many adults are hospitalized and some even die from diseases that could be prevented by vaccines.

Not only can vaccine-preventable diseases make you very sick, but if you get sick, you may risk spreading certain diseases to others. That’s a risk most of us do not want to take.

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Babies, older adults and people with weakened immune systems (like those undergoing cancer treatment) are especially vulnerable to infectious diseases. They are also more likely to have severe illness and complications if they do get sick.

You can help protect your health and the health of your loved ones by getting your recommended vaccines.

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The good news is that getting vaccinated is easier than you think. Adults can get vaccinated at their primary care doctor’s office, pharmacies, workplaces, health clinics and health departments.

Most health insurance plans cover the cost of recommended vaccines—a call to your insurance provider can give you the details.

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What vaccines do you need?

All adults should get:

  • Annual flu vaccine to protect against seasonal flu
  • Td/Tdap to protect against tetanus, diphtheria and pertussis (whooping cough)

Some additional vaccines you may need (depending on your age, health conditions and other factors) include:

  • Hepatitis A
  • Hepatitis B
  • Human Papillomavirus (HPV)
  • Meningococcal
  • Pneumococcal
  • Shingles

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Traveling overseas?

There may be additional vaccines you need depending on the location. Find out here. 

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Still not sure what vaccines you may need?

Take this short quiz.

Be a Good Sport: Tips for Preventing Youth Sports Injuries

Author: Patricia Clesi, RN, UMC Trauma Services Coordinator

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Youth participation in organized sports offers excellent benefits socially and physically, including reducing the risk of childhood obesity.

However, almost 1/3 of all injuries incurred in childhood are sports-related.

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In fact, high school athletes account for about 2 million injuries, 500,000 doctor visits and 30,000 hospitalizations each year in the United States according to the Centers for Disease Control and Prevention.

A 2016 report from the U.S. Department of Health and Human Services said knee injuries, ankle sprains and concussions are among the most common outcomes in studies identifying risk factors for sports-related injuries. One study from the National Health Interview Survey even showed that sports, on average, account for 14 percent of all emergency department visits for life-threatening injuries, the majority of which (32%) come from those 18 and younger.

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Despite the scary statistics, more and more American children are participating in youth sports in recent years.

To make sure you or your child are not part of the numbers and prevent injury, consider these 5 simple, but potentially lifesaving, tips during this National Youth Sports Week:

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1. Warm Up

Time should always be set aside for warm up and stretching before playing sports. This will help prevent injury to muscles during play.  All major muscles groups should hold the stretch for 20 to 30 seconds.

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2. Gear Up

Appropriate and properly fitted sports gear should be used always. Helmets should be well maintained, age appropriate, and worn correctly.  There are no “concussion proof” helmets, however, it will help prevent skull fractures and traumatic brain injuries.

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3. Hydrate

Hydration before, during and after practice and games are very important to prevent dehydration, especially in the summer months.

Water is the best option to hydrate athletes.

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4. Rest

Overuse injuries are common, especially in youth playing on multiple teams of the same sport at the same time. Rest will help avoid these injuries.

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5. Report

Players should be encouraged to report any pain, injury or illness to their coaches and parents.

For more child safety tips, visit http://www.umcno.org/injuryprevention.

Summertime Skincare

Author: Brian D. Lee, MD, UMC Dermatologist and Kelly R. Stewart Chairman of the LSU Health Sciences Center New Orleans Department of Dermatology

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The warmth of summer sunshine draws many people outdoors to participate in a variety of activities during these beautiful days.

It’s important to protect your skin from the damaging potential of sunlight.

This article focuses on the simple steps necessary to avoid sun damage and maximize your fun in the sun.

The Truth about Tanning

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First thing’s first: There is no such thing as a healthy tan. Tanned skin is simply an indication of damaged skin. People who tan dramatically increase their risk of developing skin cancer and destroying the elasticity of the skin, causing sagging, leather-like skin that will make them look much older than their actual age.

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Artificial sun tanners afford no protection against the harmful rays of the sun and may give one a false sense of protection. People with dark skin need to wear sunblocks because their darker natural skin color does not afford them enough protection.

The Damaging Effects of the Sun

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The damaging effects of the sun includes the induction of:

  • Skin cancers
  • Premature aged appearance
  • Sun induced eye diseases including eye cancers, and increased risk of cataracts and glaucoma.

Protecting Yourself and Your Children

To protect oneself from the sun, sunblocks, sunglasses, and sun protective clothing must be used.

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Children less than 6 months of age should not use sun blocks because of concerns regarding their absorption of the sunblock ingredients. They should wear loose fitting, long sleeve shirts and pants, wear a hat of tightly knit material (when held up to light there should be darkness inside cap) and sunglasses where are labelled to protect against the two types of sun rays: UVA and UVB.

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Everyone should limit their outdoor exposure between 10:00 a.m. and 2:00 p.m. Shade areas may contain 80% of non-shaded areas. It is best to be inside at the peak sunlight intensity hours.

Sunscreen

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Sunblock should be of a SPF of 30 or greater and the container should also indicate 100% blockage of UVA sunlight.

One ounce of sunblock (a small jigger) is necessary to rub into the skin 20 to 30 minutes prior to sun exposure to allow sunblock absorption. Spray sunblocks should be sprayed onto the hands and rubbed into the skin to avoid eye exposure.

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There are two types of sun blocks: physical and chemical. Physical sun blocks contain zinc oxide and titanium dioxide and protect by causing reflection the harmful rays. These are excellent products which eliminate the risk of allergic reactions to ingredients in chemical sun blocks. They are available in lotions, gels and sprays.  Most sun blocks sold are chemical sun blocks.

While the potential for allergic reaction (rashes/itching) is very rare, the possibility exists. When shopping for chemical sunblocks read the ingredient label and look for a product that contains avobenzone and does not contain oxybenzone. Oxybenzone may have a possible link to the production of hormone imbalances (low testosterone). Clear spray sunblocks are favorites of men for applying to their skin. Perspiration, degradation and swimming eliminate the sunblocks, so application every 2 hours is recommended.

Grab your sunblock, sun glasses and a hat and have a wonderful day at the beach!

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Top Items to Keep in Your Hurricane “Go-Bag”

Author: Melissa Mitchell, UMC Emergency Management Coordinator

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Hurricane season begins June 1 and ends November 30. People living around the Atlantic coastline and the Gulf of Mexico should take note of the proper precautions for this hurricane season. Listed below are the top items every household should have ready to go in the event of a hurricane.

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1. Personal Identification

Consider including copies of the following items for each family member:

  • a driver’s license
  • social security card
  • birth/marriage certificates
  • vehicle registration
  • proof of insurance
  • will and insurance documents
  • property deeds

The best way to keep track of all information is to have it in a waterproof container or a binder, labeled, with a protective sleeve on it. During hurricane season there is always the potential threat of flooding and damaging important papers. The best solution for this problem would be to have all of it packaged and ready to go. And don’t forget to bring cash! ATM’s may not be operating.

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2. First Aid-Kit

To be prepared, a first aid kit is a must.  It would contain all health-related items and medicines a family may need, especially prescription medications. Each family member should have a list of medications that are prescribed to them and other important health concerns in this kit.   Include things like waterless hand cleaners, antibacterial soap, and sunblock.

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3. Toiletries

An emergency pack should always hold any toiletries a person would use daily. It is best to change out these items every hurricane season due to expiration dates. Items like deodorant, toothpaste, toothbrush, soap, and personal should be included.

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4. Bottled Water

Water is a necessity and having it ready and bottled to go is essential. Each person should have one gallon of water per day.

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5. Food

At least 4 days’ worth for each person. It is best to pack the following types of food:

  • High Energy Foods: Along with water, high energy foods should be considered as well. High energy foods are foods that do not contain a high amount of water and would fill a person’s stomach up more. The best option to stack up on would be peanut butter, crackers, and protein or energy bars.
  • Pre-Packaged, Non-Perishable Food Items: Food items like oatmeal, mac and cheese, fruit snacks, and chips/pretzels are pre-packaged food that last a long time. A family should pack enough to accommodate family size and the pack should be updated and checked every hurricane season.

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6. Electronics

  • Flashlight: Each family member should have their own flashlight. Wind-up flashlights work very well and don’t require batteries.
  • Lantern: Even though flashlights are on the list, a lantern would be a good thing to have as well. The lantern would help in larger rooms and are easier to use if a person needs two hands to do a job.
  • Radio: The radio should be battery operated and the frequency for the weather channel can be taped to the radio itself.
  • Batteries: Batteries are a must have for being prepared for any inclement weather season.
  • Cell phone charger, computer cords, and a wind-up or solar powered cell phone charger.

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7. Clothes and Shoes

Enough for 4 days per person. Be sure you have:

  • Rain jacket
  • Protective shoes
  • Hat for shade

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8. Pets

  • Pet food
  • Veterinarian info & medications
  • Bottle water and bowls
  • Carrier or crate
  • Bedding
  • Tags, collar, and leash
  • Plastic refuse bags or litter

With the top items listed above, every family should print and review the Louisiana Emergency Preparedness Guide.  This guide will have everything a Louisiana resident should have on hand to be prepared this hurricane season.

For more information on Emergency Preparedness or helpful tips, visit: 

 

For up-to-date emergency alerts, follow your local news and weather channels.

Click here to watch how to pack a basic storm survival kit.

Is HIV How you ID?

Author: Lauren Richey, MD, MPH, FIDSA, UMC Internal Medicine and Infectious Disease Specialist and LSU Health Sciences Center Associate Professor of Medicine

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Human Immunodeficiency Virus (HIV) is an infection that can cause serious damage to your body and immune system if not treated; however you can be without symptoms for many years. The lack of symptoms makes people think they are healthy, and, as a result, they often do not seek out or request testing.

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It is important to find out about the infection early because there are simple, effective treatments which can keep you healthy and prevent any damage to your immune system.

The only way to know if you have HIV is to get tested.

How Do I Get HIV?

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HIV can be transmitted through:

  • sexual fluids during sexual activity,
  • mother to child during birth,
  • breast feeding, and
  • blood.

Blood transmission can occur through blood transfusions and the use of intravenous (IV) drugs.

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How is HIV/AIDS Diagnosed?

As mentioned before, early HIV infection often causes no symptoms, and must be detected by testing a person’s blood for the presence of antibodies — disease-fighting proteins — against HIV. These HIV antibodies generally do not reach levels high enough to detect by standard blood tests until 1 to 3 months following infection, and may take as long as 6 months to do so.

People exposed to HIV should be tested for HIV infection as soon as they think they may have been exposed to HIV.

When a person is highly likely to be infected with HIV and, yet, antibody tests are negative, a test for the presence of HIV itself in the blood is used. Repeated antibody testing at a later date, when antibodies to HIV are more likely to have developed, is often recommended.

Who Should Get Tested?  Everyone! 

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There are a lot of misconceptions about HIV and how it is transmitted but anyone, regardless of race, sex, gender, sexual orientation, or educational level, who has had sex should be tested.

The Centers for Disease Control and Prevention (CDC) recommend that everyone between the ages of 13 and 64 gets tested for HIV at least once as part of routine health care. About 1 in 7 people in the United States who have HIV don’t know they have it.

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People at higher risk should get tested more often. Sexually active gay and bisexual men may benefit from more frequent testing (for example, every 3 to 6 months).

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If you’re pregnant, talk to your healthcare provider about getting tested for HIV and other ways to protect you and your child from getting HIV.

What are My Options for HIV/AIDS Treatment?

As with many other conditions, early detection offers more choices for treatment. Today, there are medical treatments that not only can slow down the rate at which HIV weakens the immune system, but  may keep HIV in check so that the individual has a chance to live a normal life span.

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Unfortunately, there is no cure for an HIV infection.

Talk with your healthcare provider for more information regarding various drug therapies for the treatment of HIV/AIDS.

Where Can I Get Tested?

We offer testing at University Medical Center New Orleans in the Infectious Disease Center (ACB building, Clinic 4C). There is also routine HIV testing in our Emergency Department. So if a medical condition or any risk of exposure to HIV brings you to the ED, you can get tested!

To find other testing centers near you, you can enter your zip code into: gettested.cdc.gov.  Other places include your primary medical doctor, OB/GYN doctor, or at a community testing event.

How Can I Protect Myself Against Acquiring HIV?

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  1. Use Condoms: Using condoms during sexual encounters is one of the simplest ways to prevent HIV transmission.
  2. Take PreP (pre-exposure prophylaxis): PreP involves taking a daily medicine to prevent HIV acquisition and is very effective.
  3. Use Clean Needles: If you inject drugs, using clean needles, and never sharing needles, is another way to prevent HIV transmission.
  4. Talk to Your Partner: Before having sex for the first time with a new partner, you and your partner should talk about your sexual and drug-use history, disclose your HIV status, and consider getting tested for HIV and learning the results.

Where Can I get PreP? Where Can I Receive Treatment for HIV?

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The HOP (HIV Outpatient Program) clinic nested in the Infectious Disease Center of the ACB building Clinic 4C provides both comprehensive HIV care and PreP.

Call (504) 702-4344 to make an appointment or to refer a patient. 

Click here for more HIV Resources.

About the Author

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Dr. Lauren Richey, MD,MPH, FIDSA is an Internal Medicine and Infectious Disease specialist in New Orleans, Louisiana. She has more than 11 years of diverse experience with HIV and other infectious diseases.

 

 

The Lasting Impact of Sudden Impact

Author: Natalie Moll, Student and Sudden Impact Graduate

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Driving is the first freedom teenagers often experience.

Unfortunately, motor vehicle crashes are the number one killer of teens.

When I was 16 years-old I had my first Sudden Impact experience, and since then, I have never viewed driving the same.

What is Sudden Impact?

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Sudden Impact is an interactive program that educates high school sophomores about the dangers of driving impaired, driving without a seat belt, and distracted driving. It is facilitated by the Injury Prevention Program for UMC’s Level 1 Trauma Center and by the Louisiana State Police.

The program also offers mock crashes and mock trials to further educate teenagers on the consequences of reckless driving. It has a big reach. Since the program’s inception 20 years ago, it has been expanded to 16 additional hospital host sites in 9 regions of Louisiana. It is in more than 120 schools.

The Presentation

On day one of Sudden Impact, we were presented a slide show filled with information on the risks of driving without seat belts and driving impaired (at the time, distracted driving wasn’t a large part of the program).

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I remember we took an anonymous test before the start of the presentation that asked questions such as:

  • How often do you wear your seat belt?
  • Would you or have you gotten behind the wheel after having a drink?

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Then, we heard from three speakers — a woman from the Trauma Prevention Team, a state trooper, and a woman who had been injured because of a drunk driver — that really ingrained three lessons I still think of when I get behind the wheel:

  1. Sometimes bad things happen to good people.
  2. 100 percent of crashes are preventable.
  3. Seat belts save lives.

Following our three speakers, we took an anonymous post-test that asked the same questions as the previous one. However, when compared to the pre-test, we noticed a 22% increase in responses that aligned with safer driving habits.

For example, one of the questions asked: How often will you wear a seat belt while in a car? During the pre-test, only 64% of students answered “always,” but for the post-test, 97% of students answered “always.”

The Mock Crash

About a year later, I had my second Sudden Impact experience. It was the mock car crash, which stressed the consequences of motor vehicle crashes as a result of impaired driving, distracted driving, and not using seat belts…along with everything that happens next — EMS arrival, the trip to the hospital, the family being notified…the list goes on. While the presentation I went through the year before was eye-opening, the only way to describe the mock crash is INTENSE.

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Sudden Impact set up a crash in our faculty parking lot in the morning, and while I knew there was going to be an assembly, I never thought I would have to witness girls I knew hanging out of cars screaming in agony. Although it’s all fake, it’s chilling how real it feels. Watching a classmate being loaded into a coroner’s van while her mother is crying is an image that will forever with me. It reminded me that I have to make the conscious decision to think about the consequences of my actions, especially when driving.

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The Injury Prevention Team also returns to some schools three years after the first presentation for an anonymous survey for high school seniors that asks about the effectiveness of the overall program.

97% of the seniors said they felt that Sudden Impact kept them from driving impaired, driving distracted and not using their seat belts as well as practicing safer driving habits.

The Impact

I’m a college junior now, and I practice safer habits when I’m driving or riding in a car because of the Sudden Impact program. It gave me a true perspective of the dangers that come with driving. I think it was important that I learned the risks of reckless driving the same time I was learning the rules of the road, and it was important for me to hear it from those three speakers. I paid more attention to the things they were saying because they were the ones saying it.

Now, I never get in a car without using the seat belt or while impaired, and I never have to remind my friends who went through the program with me to do the same. It’s because we all understand the consequences of our potential actions…and that may not be the case had we not experienced Sudden Impact.

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Remember: 100% of all motor vehicle crashes are preventable. Drive safely, and remember the impact you have while on the road.

 

About the Author: Natalie Moll

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Natalie Moll is a junior at Louisiana State University in Baton Rouge. She is majoring in mass communication with a concentration in public relations and a minor in sociology. Natalie is also a founding member of the Omega chapter of Alpha Delta Pi, where she serves as Sisterhood Chair.

Am I Experiencing Vicarious Trauma?

Authors: Jennifer Hughes, PhD, and Alisha Bowker, LCSW, UMC Trauma Recovery Clinic Team

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At times it can feel nearly impossible to find the motivation to keep showing up to work, week after week, especially after working long hours or dealing with crises and looming deadlines. Working in the medical and helping fields, especially, we are often overwhelmed with horrific stories of violence, pain and trauma, which can dramatically alter the way in which we understand the world, ourselves and others.

The clinical term for this phenomena is Vicarious Trauma (VT).

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What is Vicarious Trauma (VT)?

Vicarious Trauma can be defined as a change in a helper’s inner experiences after working with people who have experienced traumatic events. Trauma can be defined as a deeply or distressing event that one directly witnesses or hears about. This can include natural disasters, interpersonal violence, war, divorce, childhood abuse and so on.

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Does Everyone Experience VT?

VT is a natural consequence of being an empathetic human, and being exposed to a population who has experienced trauma. Those often impacted by VT are social workers, case managers, doctors, nurses, first responders, etc. It is an inevitable hazard in these lines of work and, unfortunately, cannot be avoided, but definitely can be addressed and managed.

VT can also extend not only to helping professionals who work with this population, but also to the caregivers or loved ones of a survivor.

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How Does VT Impact My Life?

Vicarious Trauma is an ongoing process that slowly builds over time the longer we are exposed to the stories of trauma survivors. It generally begins to impact us in three different realms:

  1. Identity: It begins to impact our identity, which changes the way we see and define ourselves.
  2. Worldview: It impacts our worldview by skewing the ways in which we understand others or understand how to interact with those around us.
  3. Spirituality: It can impact our spirituality, and replace feelings of hope with feelings of cynicism and despair.

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VT Versus Burnout

Vicarious Trauma is different than burnout, as it truly only develops after being exposed to traumatic stories. Burnout is a state of chronic stress, particularly in a work environment, that leads to physical and emotional exhaustion, cynicism, detachment and feelings of worthlessness.

While the symptoms are similar, burnout is generally not rooted in trauma exposure.

Signs and Symptoms of VT

Some of the most common signs and symptoms of VT fall under these 5 areas:

  1. Cognitive: Intrusive thoughts, sounds or images about the traumas an individual has been exposed to, difficulty concentrating, constantly thinking about survivors outside of work, becoming more cynical or negative in one’s thinking patterns.
  2. Physiological: Ulcers, headaches, chronic pain, stomach aches, sweating or heart racing when reminded of a trauma
  3. Spiritual: Lose hope, see others as bad or evil and lose sight of the good in humanity, difficulty trusting our own beliefs
  4. Behavioral: Hair trigger temper, isolating, using unhelpful coping to manage big feelings (drinking, drugging, gambling), need to control everything and everyone
  5. Emotional: Lose touch with one’s own self-worth, isolate from loved ones, feeling overwhelmed or emotionally restricted

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So now that we have the language to define the symptoms we are experiencing, what can we do about it?

Thankfully there is an answer for this and it can be broken down into three phases:

Anticipate and Protect, Address and Transform

  1. Anticipate and Protect: Arrange things ahead of time to anticipate the stress of your work and its impact on you.
    • Become aware of VT and start to look out for signs and symptoms. Intentionally plan for a healthy balance between your work life and personal life.
    • Find a support system, particularly amongst colleagues who share this language and can support you as needed.
  2. Address: How you take care of yourself in and out of work
    • Engage in Self-care: Attending to yourself physically, spiritually, emotionally and psychologically
    • Self-nurture: Engaging in activities or things that provide comfort, relaxation and play
    • Escape: Getting away (whether literally or mentally)
  3. Transform: Transform the negative aspects of this work into positive connection and meaning
    • Create Meaning: Find ways to hold onto your values and identify even in the face of trauma
    • Infuse current activities with new meaning: Mindfulness, Connection to others
    • Challenge negative beliefs: Actively challenge negative thoughts or cynicism/ Re-frame your thinking

While vicarious trauma is a very common and inevitable consequence to the work that we do, the exciting news is that we have the tools to fight back. This is an ongoing process that will continue to look different at different stages of our careers, so it is a process we must continuously be engaging with.

Both individually and collaboratively, begin to identify the signs of VT in your own life and use the template above to make a plan for how to begin addressing and counteracting these symptoms.

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Remember, you are not alone with your vicarious trauma, and do not have to manage it alone either.