Pain Care: Prevention Before Treatment

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

GettyImages-857090084.jpg

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.

GettyImages-896469402.jpg

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.

GettyImages-998493028.jpg

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.

GettyImages-175917145.jpg

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.

GettyImages-901669282.jpg

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.

GettyImages-901219888.jpg

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

GettyImages-478807474.jpg

 

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.

Worried man.jpg

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.

Lonely woman.jpg

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.

Call center.jpg

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.

Continue reading

The Unprocessed School Lunch

Author: Rosetta Danigole, Lead Dietitian at UMC

GettyImages-904531518.jpg

Planning School Lunches

The school year is upon us.  Now is the one of the busiest times for both parents and kids as they settle into new schedules and routines. For many, a big part of that experience is thinking about and planning school lunches.

GettyImages-182879786.jpg

In today’s society more children suffer from obesity, autoimmune disorders, Autism spectrum, ADHD and gut sensitivities and allergies.  Parents have to consider these concerns as well as how to pack not only a healthy school lunch but also an economical one as well.

Processed Foods

The processed food craze has certainly contributed to these disorders with the addition of the preservatives, other chemicals and gluten that some children may be sensitive to.

The summer is the time when parents may be more lenient about food choices but hope to get their kids back on track with the school year.

GettyImages-501227330.jpg

Some Recommendations

Remember to always keep the school lunches balanced with lean protein such as poultry, fish, lean beef, eggs, nuts or other meat alternatives.

Make lunches fun by making sure you use some of your kids’ favorite foods and be imaginative by including fun shaped sandwiches, a nice note from you, and maybe some stickers.

GettyImages-625811578.jpg

Here are some ideas for the Unprocessed School Lunch with special consideration for gluten free if needed for those kids with digestive complaints.

  • Fresh Raw produce such as apples, berries, cherries, bell peppers, and carrots.  Cut them up in bite sized pieces and add a fun dip such as hummus or a nut butter (check school policy regarding nuts in school lunch boxes)
  • Dried fruit such as raisins, craisins, and apple chips are also great options.
  • Hummus or Avocado dips- You may be surprised the number of kids like these “dips”.  Try adding carrots for a crispy treat.
  • Gluten free Granola Bars or protein bars- This makes a great snack for your kids.  You can find those made with dried fruits, coconut, and flax held together by honey.
  • Popcorn- This is always a healthy snack and treat and makes a tasty crunchy treat instead of potato chips.
  • Protein options- Try boiled eggs, fresh sliced turkey, or homemade chicken strips for the protein items.  Kids may also eat grass fed turkey or beef jerky for a change. If you make a sandwich you can try pita bread, bagels or gluten free bread if preferred and needed.
  • Homemade soup in a thermos- This is an old-fashioned wonderful option for your kids.  Nothing like mom’s homemade soup when it comes for lunch.  If gluten sensitive you can always use rice noodles and add nut floured crackers on the side.
  • Yogurt- Try adding a low sugar yogurt or a piece of string cheese for a calcium boost.

Most important when you have the chance introduce kids to new foods and make sure the dinner meal is full of healthy vegetables, complex carbohydrates and lean protein.

GettyImages-519332246.jpg

About the Author

r.jpg

As the lead dietitian at University Medical Center New Orleans, Rosetta Danigole manages clinical dietetic operations. She is a member of the Academy of Dietetics and Nutrition and belongs to the clinical dietitian practice group. She has been a dietitian for 35 years.

 

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.

GettyImages-477562584.jpg

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.

GettyImages-954825292.jpg

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.

GettyImages-1016398476.jpg

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.”

GettyImages-905633274.jpg

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.

GettyImages-909942050.jpg

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.

GettyImages-665515600.jpg

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.

GettyImages-902827440.jpg

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.

Gail Burke DO.jpg

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

GettyImages-669938250.jpg

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.

GettyImages-863504394.jpg

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.

GettyImages-951541842.jpg

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.

GettyImages-693058384.jpg

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.

GettyImages-650006104.jpg

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

GettyImages-846489690.jpg

Traveling overseas?

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

GettyImages-519833420.jpg

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

GettyImages-856713564.jpg

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.

GettyImages-695655958.jpg

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.

GettyImages-155017569.jpg

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:

GettyImages-969360182.jpg

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.

GettyImages-916167590.jpg

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.

GettyImages-603276388.jpg

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.

GettyImages-912588394.jpg

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.

GettyImages-695655944.jpg

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.

3 Summer Treats Perfect in this Heat

While not all may side with iHob’s decision to enter the burger industry, we can agree on this:

This summer is HOT!

GettyImages-496875851.jpg

With temperatures approaching triple digits, you may be reaching for popsicles, ice cream sandwiches and snoballs to cool you down. After all, you know what they say: “if you can’t take the heat, get out of the kitchen!” But before you overload on sugar and throw in the towel, consider a set of treats that are cool, healthy, and perfect for beating the heat.

Here are three healthy, dessert-style recipes you need to try this summer:

Stacked Fruit Salad

ce893a1c5801b8a6e1406456054801de--fruit-trifle-fruit-parfait.jpg

Ingredients

  • 2 tablespoons fat-free vanilla yogurt
  • 2 tablespoons fat-free ricotta cheese
  • 1/4 cup crushed pineapple, drained
  • 1/4 cup blueberries
  • 1/4 cup mandarin oranges
  • 1/2 small kiwi, peeled and sliced
  • 1 ring spiced apple

Directions

Mix the yogurt and ricotta cheese in a small bowl. Use a small spatula to smooth each layer as you add it to a parfait glass or a ring mold (place the mold on a plate). Spread 1/4 cup drained pineapple in the bottom. Spread half the yogurt-ricotta mixture over the pineapple. Top with a layer of blueberries. Mandarin orange segments come next, then another yogurt-ricotta layer. Arrange slices of peeled kiwi. Top with the spiced apple ring. Cover loosely and refrigerate, unless you’re ready to eat it at once. If you use the ring mold, some juice may leak out during refrigeration. Use a paper towel to dry the plate just before serving.

Serves: 1

The serving contains about 175 calories, 7 g protein, 0 g fat, 0 mg cholesterol, 38 g carbohydrates, 3 g fiber, and 56 mg sodium.

This dish is gluten-free.

Cherry Swirl Pudding

Cherry-Coconut-Yogurt-Bites-2.jpg

Ingredients

  • 2 cups fat-free plain yogurt
  • 2 cups sweet black cherries, pitted
  • 1 teaspoon pure vanilla extract
  • 1/4 cup dried, unsweetened coconut

Directions

Increase the yogurt’s density by putting it in a strainer lined with cheesecloth or a coffee filter over a bowl. Refrigerate. After 2 hours, you’ll see about 1/2 cup liquid to discard. Halve the cherries. Mix the cherries, vanilla extract, and coconut into the yogurt. Refrigerate until ready to serve in stemmed cocktail glasses (just spoon it in).

Serves: 4

Each serving contains about 145 calories, 8 g protein, 9 g fat, 0 mg cholesterol, 24 g carbohydrates, 4 g fiber, and 100 mg sodium.

This dish is gluten-free.

Pineapple Smoothies

pineapple-smoothie-recipe-2-740x925.jpg

Ingredients

  • 1 cup fresh pineapple chunks
  • 1 cup light vanilla yogurt
  • 1 cup crushed ice

Directions

Put ingredients in a blender. Puree and pour.

Serves: 2

Each serving contains about 110 calories, 5 g protein, 1 g fat, 23 g carbohydrates, 1 g fiber, and 66 mg sodium.

This dish is gluten-free and gout friendly.

Click here for more healthy recipes!

 

The Lasting Impact of Sudden Impact

Author: Natalie Moll, Student and Sudden Impact Graduate

GettyImages-481633290.jpg

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?

Sudden Impact Logo.png

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).

Distracted Driving Stats.jpg

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?

GettyImages-664449652.jpg

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.

Mock Crash.jpg

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.

GettyImages-865339342.jpg

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.

Don't Drink and Drive.jpg

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

DSC_7917.jpg

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

GettyImages-660768852.jpg

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).

GettyImages-860618272.jpg

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.

GettyImages-661611342.jpg

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.

GettyImages-831590732.jpg

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.

GettyImages-672012338.jpg

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

GettyImages-687663122 (2).jpg

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.

GettyImages-838169512.jpg

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

Tobacco and Heart Disease

Author: Johnny d’Aquin MS, RRT, RPFT, UMC Pulmonary Services Director 

GettyImages-641539530.jpg

May 31, 2018 is World No Tobacco Day, an annual program of the World Health Organization, and I can’t think of a better day than that one to quit smoking.

The focus of World No Tobacco Day 2018 is “Tobacco and heart disease.” The goal is to raise awareness on the link between tobacco, and heart and other cardiovascular diseases (CVD), including stroke, which combined are the world’s leading causes of death.

GettyImages-669940372.jpg

The Truth About Tobacco and Heart/Cardiovascular Disease

The American Heart Association (AHA) says diseases caused by smoking kill more than 440,000 people in the U.S. each year.  Smoking puts people at high risk of lung disease, including lung cancer and emphysema. Smokers also have increased risk for heart disease and stroke.

GettyImages-866260302.jpg

Cardiovascular diseases (CVD) kill more people than any other cause of death worldwide, and tobacco use and second-hand smoke exposure contribute to approximately 12% of all heart disease deaths.

  • One out of every 5 smoking-related deaths is caused by heart disease.
  • Women older than 35 who smoke and take birth control pills are at much greater risk for heart disease or stroke.
  • Cigarette smokers are 2 to 4 times more likely to get heart disease than nonsmokers.
  • Cigarette smoking doubles a person’s risk for stroke.

GettyImages-954160098.jpg

How Does Smoking Change the Heart and Blood Vessels?

Smoking:

  • Causes an instant and long-term rise in blood pressure.
  • Causes an instant and long-term increase in heart rate.
  • Reduces blood flow from the heart.
  • Reduces the amount of oxygen that reaches the body’s tissues.
  • Increases risk for blood clots.
  • Damages blood vessels.
  • Doubles the risk of stroke (reduced blood flow to the brain).

Smoking has also been linked with depression and stress.

The good news is that quitting smoking can reduce the risk of heart disease.

GettyImages-810433964.jpg

According to the AHA, stopping smoking reduces the risk for heart disease, the risk for repeat heart attacks, and death by heart disease by half.

GettyImages-672597012.jpgGet Help/Quit Smoking

UMC is partnering with the Smoking Cessation Trust to help people quit smoking.

If you smoked just one cigarette before September 1, 1988 and are a current Louisiana resident, you are eligible to register with the smoking cessation trust and get free help.

You can get free smoking cessation medications, doctor visits, quit-line coaching and counseling. Call our office at (504) 702-4636 or enroll online.

Why Wait Another Day?

GettyImages-657659924.jpg