Infection is the leading cause of death in trauma patients, so sharing ideas about how to successfully treat wounds while in the field can dramatically improve mortality rates. "A significant amount of the heavy lifting for a trauma patient is done by first responders," Anthony Sorkin, MD, an orthopedic trauma surgeon at Indiana University Health Methodist Hospital Level I Trauma Center. First responders not only manage initial treatment of wounds; they also determine the total number and severity of injuries, extricate, move and resuscitate patients at the scene of an accident.

In this week’s seminar, doctors will teach first responders to recognize conditions like high-energy pelvis fractures. “In those cases, patients can get very sick, very quickly,” Sorkin says. “We can help first responders learn some emergent steps they can take in the field to deal with such conditions and minimize damage for patients.”

Along with the educational aspects of regular seminars, Sorkin says first responders benefit personally from seeing positive outcomes. “When they pick up my wife or your brother from an accident scene and drop them off in an emergency room, they seldom get any feedback on what happens to the patient after that,” he says.

That’s why Indiana University Health Methodist Hospital will soon begin hosting presentations that let first responders meet patients who have recovered. “There’s a certain amount of trauma that comes from dealing with tragic events on a daily basis,” he says. “I think one of the treatments for that is to review happy outcomes.”

Although health care workers have resources to help them cope with anxiety, Sorkin says hearing patients express thanks for responding to their worst day is part of a loop that helps health care providers stay well. “Meetings like this are important because they help with that,” he says.
 

“The need for some sort of domestic violence program actually came up in a meeting the same day that Beth came into the emergency department,” says Lisa Heiden Peters, Registered Nurse at IU Health Ball Memorial Hospital. After Beth’s death, Lisa spearheaded Beth's Legacy of Hope, a program that trains nurses and social workers to be more aware of potential signs of abusive relationships among patients and peers. Lisa and other IU Health team members tried every avenue to get the program off the ground, but with help from  Methodist Health Foundation (and IU Health Learning Solutions, IUH Methodist Trauma Services and Emergency Medicine department) the project finally came to fruition.

“The foundation allowed us the means to do this project and see it through,” says Katy Howe, Registered Nurse at IU Health Methodist Hospital. IU Health Learning Solutions, with the input of the team members of Beth’s Legacy of Hope, created a video to educate IU Health team members on Beth’s story and how to recognize the warning signs of domestic violence, both in their patients and in their peers. “When we showed the video to our staff, the response was incredible,” says Lisa. “Everyone was very touched and it was extremely well received.”

The goal in 2013 is to roll out the video to all Emergency Room departments and Labor and Delivery units within the IU Health system. In addition, the program aims to provide wrap-around services for patients, including immediate shelter, food, clothing and help with transportation for patients in immediate danger.  Further training on domestic violence is also being provided to forensic nurse examiners and specialized crisis interventionists.
“We’ve taught all of our staff how to ask the proper questions, how to identify victims of domestic violence and what to look for,” explains Katy. In the future, once a domestic violence patient is identified, they will assigned an acuity level between one and five, with five representing a history of domestic violence, all the way up to 1, which indicates a patient is in immediate danger. “Already in 2013 forensic nurses have consulted with over 40 domestic violence patients, and we expect that number to go up as we incorporate numbers from our social workers.

To learn more about Beth’s Legacy of Hope, or if you are interested in viewing or sharing the educational video, contact Katy KHowe@iuhealth.org.

To Learn more about the work supported by our foundations, please visit iuhealth.org/giving.

Britney’s Ideal Memorial Day Menu

Beverages

• Fruit flavored water (soak fruit in water for healthy, delicious flavored water)
• Light alcoholic beverages made with recommended portions from above and low in calories. Recommended alcoholic beverage serving size is 1 serving or 1.5oz liquor, 12oz beer, or 5oz wine for women and 2 servings for men.

Appetizers

• Watermelon/cantaloupe balls
• Variety of cheese slices with whole grain crackers
• Lots of fruits and vegetables available for snacking--the more color the better

Entrée

• Turkey burgers or lean red meat (90/10 or 93/7) with avocado sauce (Avocado + skinny cow cheese) & light whole grain bun
• Grilled salmon or other fish

Sides

• Whole grain pasta salad made with diced veggies, whole grain pasta, & vinegar/oil/garlic based dressing
• Quinoa with diced bell peppers
• Mixed dark green leafy salad
• Grilled veggie kabobs (squash, tomato, potato, onion, bell peppers)

Desserts

• Fruit Kabobs (Strawberries, Blueberries, Pineapple)
• Fruit Pizza (use light sugar cookie base made with Splenda® topped with light cream cheese sauce and blueberries/raspberries or strawberries to make a flag for memorial day)
• Chocolate, chocolate chip muffins made with devil’s food cake mix + 1 can pumpkin & bake as directed on the box

Beyond food choices, safe handling of food is necessary to ensure everyone has a good time and avoids injury or sickness. The USDA offers a fact sheet that includes helpful tips on food preparation, handling and cooking, such as:

• Get Grill Ready: Always clean the grill before & after each use, as well as when you use if for the first time this season. You can do this by turning the grill temperature up, leaving the lid down allowing the grill to get up to around 500˚F to burn off any food residues. Then scrub with wire brush. Also, most gas grills have a grease trap on the back side to clean.  It can also be helpful to make sure the propane tank and gas line has no leaks. Of course, make sure the grill is not next to the house or any other flammable items.
• Careful Food Handling: Wash hands before and after preparing foods. Keep hot foods hot and cold foods cold to avoid bacterial growth and food related illness.  Ideal temps = less than 40˚F and more than 140˚F.  Do not place cooked food on plates that were used to prepare/carry raw meats and marinate meat in fridge, NOT at room temperature.
• Grilling Basics: Avoid charring of foods, which releases carcinogens. Cook at a lower temperature for longer time, rather than turning the heat up high. Make sure the grill is clean prior to use. Use a thermometer to be sure your food has reached optimal temperature internally. Safe minimum internal temps
  • Poultry 165˚F
  • Ground meats 160˚F
  • Beef, pork, lamb, & veal 145˚F
• Safe Eating Habits: Perishable foods (dairy, meat/poultry/fish, dressings, etc) should never sit out longer than 2 hours, and when the outdoor temperature is more than 90˚F, no longer than 1 hour. Keep dishes covered to avoid contact with insects (flies, ants, etc).

• Small first aid kit – Include bandages and gauze, antiseptic and antibiotic ointments, anti-itch cream, antihistamines, upset-stomach remedies, anti-diarrhea medicine, tweezers, and pain/fever relievers. Be aware that heat and humidity can affect some medicines, so avoid keeping your first aid supplies in a hot car or at the pool or beach for extended periods.
   
• Refillable water bottles – Children and adults need to stay hydrated during warm weather. Drinking at least 12 ounces of water is recommended before heading outside to exercise or play. If children participate on a sports team or attend camp, remind them to drink water and refill their bottles several times a day.
   
• Sunscreen – Use sunscreen with at least 15 SPF on cloudy and sunny days. Higher SPF is needed if family members are in the sun for long periods of time. Apply sunscreen at least 30 minutes before sun exposure, and reapply after swimming, sweating or after more than two hours in the sun.
   
• Protective clothing – Pack your bag with baseball caps, wide-brimmed hats, sunglasses and cotton clothes with long sleeves to protect your family from the sun.
   
• Bug spray – Have insect repellent on hand to protect family members from mosquitoes and ticks. Repellent with DEET is effective; however, choose one with the lowest concentration necessary for the circumstance. Formulas with 10 percent DEET are effective for about two hours, while those with 30 percent will provide protection for five hours.
   
• Health insurance card and doctors’ office phone numbers – When traveling on vacation, be sure to take your health insurance card with you, as well as the phone numbers of your family doctors.

GI motility disorders

GI (gastrointestinal) motility disorders is a broad term that describes dysfunction at any point in the digestive system — from swallowing food to expelling waste. Properly functioning motility allows you to eat, digest, and expel food thoroughly and efficiently. When motility isn’t functioning at its peak, problems arise; some may cause minor discomfort, while others could indicate a serious condition.

Mild symptoms

Easily treatable symptoms of GI motility disorders include nausea, heartburn, constipation, and diarrhea. The two things to pay close attention to, however, are frequency and severity. If symptoms only occur every once in a while, are intermittent, or are situation-specific (you knew you shouldn’t have eaten that chili-cheese dog last night), chances are that an over-the-counter remedy such as an antacid, laxative, or anti-diarrheal will bring relief. And, it may sound old-fashioned, but sometimes the simplest way to calm a queasy stomach is to take ginger ale and a couple of soda crackers.

Signs you shouldn’t ignore

There are “alarm” symptoms for which you should seek medical help right away: difficulty swallowing, food stuck in your throat or esophagus, blood in vomit or stool, or unintentional weight loss. Any one of these could indicate a serious problem. However, even mild symptoms require a doctor’s care if you experience them frequently or for an extended period of time. Vomiting for three days in a row is not normal. Being afraid to leave your house because of an inability to control your bowel is not normal.

There have been significant advancements in the treatment of GI motility disorders, some of which are only available right here at IU Health. We offer the only full-service motility lab, as well as the only temporary gastric electrical stimulation procedure, in Indiana. We have also expanded our treatments of disorders that predominantly affect women, including irritable bowel syndrome and pelvic floor dysfunction.

With the options and treatments available, there is certainly no need to suffer. So listen to your gut, and seek your doctor’s advice. The solution could lead to a better, healthier “new normal.”

Whether you’re venturing outside for that first springtime run/walk or getting the yard in shape, it’s important to take care of your body and avoid overdoing it. Taking the proper precautions will help prevent unnecessary aches, pains and other health issues so you can enjoy the summer. Here are some tips:

• Warm up and stretch before engaging in exercise or any physical activity (including yard work). As we age, our bodies become stiff, so this is especially important for adults.
• Build endurance gradually; resist “jumping in” to any activity or overexerting yourself. A good rule to remember: don’t increase your usual activity by more than 10 percent at a time.
• To keep your body fit, don’t limit exercise and physical activity to just the weekends. Be sure to exercise at least 30 minutes each day for maximum health benefit.
• When doing yard work or other outdoor chores, be kind to your back by bending forward carefully and at the knees.
• Use your leg and stomach muscles when lifting.
• Take frequent breaks, especially if you haven’t engaged in physical activity for a period of time.
• Be sure to stay well hydrated; drink water regularly while working outside.
• Protect your skin from sun damage by applying sun block of SPF 30 or higher at least 30 minutes prior to outside activity. Reapply every few hours. Wearing a hat with a wide brim that covers the neck, ears and forehead is also a good idea.
• Pay attention to your body. If you feel uncomfortable or experience a sharp pain or ache, stop what you’re doing and rest. If the pain or feeling persists, consult your doctor.

Having watched her mother suffer for a decade and then finally losing her to cancer at the age of 56, Jolie discovered her “faulty” breast cancer gene, BRCA1, through genetic testing. While only 5-10 percent of the women diagnosed with breast cancer actually carry this gene, it is a hereditary marker with a 50 percent likelihood of being passed on to the carrier’s children. The average woman has a 12 percent risk of developing breast cancer. Carriers of these BRCA genes are at five times the risk, or roughly 60 percent.

Many times, children of these known carriers opt for genetic testing, which is available through IU Health Simon Cancer Center’s  Catherine Peachey Breast Cancer Prevention Program. IU Health physicians say testing among women in their 30s and 40s, with two first degree relatives who’ve developed breast cancer, is a very common—and even daily—occurrence. The simple blood test may be covered by insurance for those determined to be high risk. Though women can then opt for observation or tumor prevention drugs after discovering these genes, many choose double mastectomies and oophorectomies (ovary removal) to boost prevention rates to 90-100 percent. One physician says he has yet to see a patient regret the decision to follow up genetic testing with the prophylactic double mastectomy.

Jolie has been dubbed a “previvor,” or someone who is predisposed to cancer but hasn’t been diagnosed. And her fight isn’t over. Following her breast reconstructive surgery with implants, Jolie suggested she may still remove her ovaries, a common choice for high-risk women once they’re done having children. Jolie is just one of many women facing these very difficult choices, but through her, others may find support in their choice.

For more information or to request an appointment, call the IU Health Simon Cancer Center at 317.944.0920.

Increased intensity in childhood sports and the number of hours kids are exposed to risky movement patterns are considered key factors in this trend. The problem is especially serious for women and girls, who may be five to six times more likely to have an ACL injury than men or boys.

Many of those injuries could be prevented by teaching kids good body mechanics and alignment, according to Tavio Henson, a strength and conditioning specialist with IU Health Sports Performance. “Coaches know it’s important, but unfortunately, injury prevention may drop to the bottom of the priority list because of time restrictions,” he says.

What’s a concerned parent or coach to do? Step up your child’s training routine to include 15 to 20 minutes of drills, three times a week with a qualified strength and conditioning coach. Look for an injury prevention program that emphasizes techniques for landing, stopping and running, plus work that improves strength, body control, coordination and balance.

Here are three tips for preventing ACL injuries:

• Landing: Land light as a feather with the chest held high and knees slightly bent –– in line with the toes, but not beyond them. The knees should not be collapsed in or bowed out. Most of the stress should be absorbed through a chain that begins as the feet and is transmitted up the legs to the hips. Practice bending from the hips — not at the waist.

• Stopping:  Decelerate rather than coming to a complete stop from full running speed. Drop the hips low and keep the chest held high over the knees and hips. Use three or four small steps before you come to a final stop.

• Switching directions: As you decelerate, lower the hips, plant the outside foot and make the turn.

To augment your child’s injury prevention program, contact IU Health Sports Performance at (317) 848-5867 for a customized, sports-specific training program.
 

Why is it so important to bring awareness to cancer?
More people than ever before are surviving a cancer diagnosis as a result of advances in prevention, early detection, treatment and follow-up care.  With a growing numbers of cancer survivors, we want to show the world that life after a cancer diagnosis can be meaningful, productive and even inspiring.

How are we honoring cancer survivors this year? 
Historically, our community celebrated National Cancer Survivors Day on the first Sunday in June.  This year Community Partners; Cancer Services of East Central Indiana-Little Red Door; American Cancer Society; Indiana University Health Ball Memorial Cancer Center; Delaware County Health Department and local businesses, Concannon’s Bakery and Wasson’s Nursery are teaming up to honor cancer survivors throughout the week of May 28 – June 2.  

How can cancer survivors participate? 
Beginning Tuesday, May 28 through Friday, May 31, cancer survivors can pick up a “survivor certificate” at Cancer Services of East Central Indiana/Little Red Door located at 2311 W. Jackson St., or IU Health Ball Memorial Cancer Center located at 2401 W. University Ave.  On Friday, May 31 from 8 am – 4 pm, cancer survivors can visit IU Health Ball Memorial Cancer Center to enjoy refreshments, pick up a “survivor certificate,” register for Relay for Life survivor activities and receive a free survivor t-shirt.  On National Cancer Survivors Day, Sunday, June 2 cancer survivors can take their “survivor certificate” to Wasson’s Nursery and Concannon’s Bakery (at either location) from 10 am – 5 pm and receive a free gift.  

On Sunday, June 2, thousands of people around the world will gather to celebrate life after cancer. National Cancer Survivors Day® is the day each year that we pause to honor those who are living with a history of cancer for their strength and courage. It is also a day to acknowledge the contributions of their families, friends and healthcare providers, as well as those engaged in cancer research.  Please take a moment to celebrate, recognize and honor the cancer survivors in your life!

For more information about National Cancer Survivors Day activities taking place in our community, please contact Cancer Services of East Central Indiana/Little Red Door at 765. 284.9063.

Melody Stanley is the coordinator of patient education and supportive services at IU Health Ball Memorial Cancer Center.  To learn more about the IU Health Ball Memorial Cancer Center, please call Melody Stanley at 765.751.1400 or visit iuhealth.org/ball-memorial/cancer.

“The primary thing we must consider when we talk about treating children with ACL injuries is that children are not small adults,” Gantsoudes says. In adults, most options for reconstructing the ACL involve drilling through the tibia and femur bones.

Surgeons can’t use these techniques on children because they could injure growth plates, resulting in abnormal growth. Reconstructing a child’s torn ACL involves different techniques and is more labor intensive. “We have to be much more careful about where the footprint of the ACL goes and where our tunnels exit the bone,” he says. Growth plates are protected during surgery using a combination of arthroscopy and live fluoroscopy to observe the work in progress.

Ignoring the injury has equally undesirable long-term consequences for children. “We have enough historical data now to show that there is permanent damage to the cartilage and premature arthritis in patients who returned to athletics without treatment for ACL injuries,” he says. “In a child of 10 or 11, that’s catastrophic.”

Gantsoudes says torn ACLs are becoming more common at earlier ages. That’s partially due to year-round involvement in multiple sports that push young athletes harder than ever. These factors increase their exposure and risk for having a tear. “There’s a safe way to do just about everything,” he says. Rather than discouraging athletic involvement, Gantsoudes says the risk for ACL tears can be reduced through preparation and awareness.

Here are some fast facts about who’s at risk and how parents can protect their athletic children against a torn ACL.

• Children should stay in shape year-round. “They shouldn’t just get up off the couch and start playing after a period of inactivity,” Gantsoudes says.

• Girls have a higher risk than boys of tearing their ACLs. Researchers think differences in anatomy, hormonal makeup, muscular balance and development patterns may play a role in the increased risk for girls.

• Parents should ask coaches and trainers how to prevent ACL injuries. There is growing evidence that a well-rounded calisthenics program during pre-season training can help reduce ACL injuries. Teaching athletes how to land appropriately, how to come to sudden stops safely and other muscle education for the lower extremities can significantly reduce the risk of ACL injuries.

• Some sports are riskier than others. Among the highest risk: girl soccer players. Before involving your child in a sport, know the risk and be prepared to mitigate them through education and training.

George Gantsoudes, MD, is part of a team of orthopedic surgeons and primary care sports medicine physicians at IU Health Physicians and Riley Hospital for Children, working together to treat orthopedic conditions and athletic injuries. For easy access to our specialty providers, we have multiple locations in the greater Indianapolis area. To schedule an appointment with one of our pediatric providers, call 317-274-2500.