Calming Information Chaos

It’s funny how childhood experiences play a part in who we become later in life. I grew up in a healthcare family. My mother is a nurse, and after school I can remember walking to the hospital to sit in my dad’s office and wait for him to get off work. I have probably had more holiday meals in a hospital than at home. So, it is no coincidence that hospitals generate a feeling of safety, security, and a sense of belonging to me. Another positive experience from my youth was one of my first jobs working in the public library. On days when I have spent more time in the hospital and the library than I have at home it is easy to see we are where we are because of what has gone into our minds and fed our dreams.
As a graduate student I spend a lot of time doing research. Having an invaluable resource such as a medical library is probably the biggest asset for success of any medical / nursing student. My home away from home is the Preston Medical Library located on the campus of the University of Tennessee Medical Center. With your first step into the Preston Medical Library, you are greeted by a team of friendly, competent, and eager to assist medical reference librarians.
I often have patients and families asking where they can find reliable information about their medical condition or what medical options are available to them or their family. We have been fortunate to have this great community resource serving our region for more than forty years. The librarians are eager to assist patients, families, and community members in finding current and reliable health information. The library offers a variety of resources to provide information on topics such as medications, symptoms and treatment of disease, preventive medicine, medical tests, support groups, and definitions of medical terms. This information is sent confidentially free of charge via mail or electronically.
The librarians will research questions like: “What kind of foods can I eat now that I have diabetes?” “My doctor says I have fibromyalgia. What does that mean?” “What are the latest treatments for Alzheimer’s?” “What clinical trials are being run on my disease or condition?” and many other questions – all at no cost to you!
The Preston Medical Library offers a consumer health information website (www.tennessee.edu/healthinfo ) with helpful links to resources that have been selected by the librarians for their provision of current, reliable information. Other websites that are helpful and reliable are: www.medlineplus.gov , www.healthfinder.org , and www.cancer.gov .
Healthcare providers often deliver information quickly to patients, so when they ask, “Do you have any questions” we tell them no. Chaos begins to set in as we realize we have no clue what the information we have received means to us. The librarians at the Preston Medical Library are there for you to help calm the chaos and arm you with reliable information. The library also offers outreach programs on how to locate and evaluate health information to organizations and community groups. They offer “train the trainer” classes to public librarians or other professions to help develop a consumer and patient health information service. All of these services are free of charge. So, when you feel overwhelmed in a world of chaos or just have a burning desire to learn about your health, remember one thing – the Preston Medical Library!

The Preston Medical Library is located at the University of Tennessee Graduate School of Medicine
1924 Alcoa Highway
Knoxville, Tennessee 37920
Telephone 865.305.9527

Email: library@mc.utmck.edu
http://www.tennessee.edu/healthinfo
Hours of operation: Monday – Thursday 8:30am to 9:00pm Friday 8:30am – 5:00pm Saturday 9:00am – 5:00pm and Sunday 2:00pm – 10:00pm

Howard Baker, RN BSN

For questions, comments, or suggestions on topics you want to read about please email me at: howard@howardsbaker.com





(left) Donna Doyle, CHIS (right) Martha Earl, MSLS, AHIP, CHIS
Evening Supervisor Assistant Director

Picture was taken at the reference desk of the Preston Medical Library where both are employed.

Squeeze Before You Sneeze

Nurses really do talk about anything and everything holding back very little when it comes to body functions, illness or any other topic for that matter. As I started doing research and talking to my friends and colleagues it didn’t take long to realize that bladder function, or the lack thereof, is a growing concern for individuals and families who suffer with these problems. Stress incontinence, overactive bladder and nocturia (awakening at night to pass urine more than once) are common and sometimes crippling conditions facing many people- especially the elderly. These conditions can have a significant impact on the environment, the individual, family, self esteem and social economic factors.
The spectrum of the overactive bladder usually has symptoms of urgency, frequency, nocturia, and is sometimes associated with urge urinary incontinence. Another type of urinary incontinence is stress incontinence, which is typically associated with anything causing pressure in the abdomen such as, coughing, sneezing, laughing, and straining which results in urinary leakage. Many patients will suffer with both stress and urge incontinence. However, about two thirds of patients with frequency, urgency and nocturia will not suffer from incontinence. Generally, younger populations suffer from stress incontinence; whereas, older populations suffer from urge and or mixed incontinence.
So what are the financial cost of stress and urge incontinence? According to a healthcare provider it is not uncommon for patients to spend $300 to $1,000 per year on routine care or “cover-up”, which are pads and diapers. On the high end that’s a little over $83 per month. The vast majority of money spent is on routine care with less than 1% being spent on a diagnostic work ups, and about 9% for conventional treatments including medications and surgical options. It becomes easy to see that the rest of the estimated $16.3 billion per year (1995 costs) are spent on covering up the problem rather than fixing it.
If you suffer from any of these urinary problems you are not alone. Studies show that about 16% of our population suffers from some type of urinary dysfunction. The National Overactive BLadder Evaluation (NOBLE) study stated “overactive bladder, with and without incontinence, has a clinically significant impact on quality-of-life, quality-of-sleep, and mental health, in both men and women.” There are many in our community who are unaware of treatment options or may be too embarrassed to seek treatment. Always discuss any changes in your urinary health and function with your healthcare provider.
The important message I want to stress is there are treatment options to address all of these conditions from nocturia and frequency to incontinence. There are many options ranging from behavioral modification, medications, bladder Botox, to surgery. Discuss your current medications with your pharmacist or healthcare provider to understand how medications may affect your urinary output. Reducing caffeine intake, smoking cessation, and weight loss for those overweight may also help to improve your condition.
Physical therapy for urinary and fecal incontinence is a viable option. Physical therapy for incontinence shows improvement for most people who can participate in therapy. Don’t be shy, talk openly with your healthcare provider to see what treatment options are right for you. Physical therapists that specialize in Pelvic Floor Dysfunction are sometimes difficult to locate. Discuss treatment options with your healthcare provider or call a physical therapy center in your area for a list of specialized therapists near you. Be proactive, take control you’ll be happier in the end.
Howard Baker, RN BSN
For questions, comments, or suggestions on topics you want to read about please email me at: letters@ubiquitousnurse.com

Knoxville has several physical therapy centers specializing in incontinence and pelvic floor dysfunction. These are only facilities of which I am aware and by no means a personal recommendation. Discuss referral options with your healthcare provider.
Mountain Spirit Physical Therapy, Inc.
Donna Edwards, PT, OCS
10429 Hickory Path Way
Knoxville, Tennessee 37922
865.560.2709

Parkwest Therapy Center
Joy Friley, PT
200 Fort Sanders West Blvd.
Building 1 Suite 201
Knoxville, Tennessee 37922
865.531.5710

The University of Tennessee Medical Center
Rehabilitation Services Northshore Medical Plaza
Lisa Gable, PT
9625 Kroger Park Drive, Suite 100
Knoxville, Tennessee 37922
865.539.0403

Cancel Your Trip

My mother recently took a trip right before the Thanksgiving Holiday that she now wishes she had cancelled. In preparing her preflight, she threw all caution to the wind. A step ladder was only 5 feet away but seemed too far when a chair was so handy. As she started her ascend to the top of the cabinet for just the right Thanksgiving dish; visions of a holiday turkey presented perfectly danced in her head. With stockings on her feet as they flew above her head her flight seemed in slow motion as her somersault took form. What happened next no one is quite sure, but her long trip included delays in the emergency room, a surgical suite for repair, acupuncture for pain, and detours around the traditions of the holidays.
Unfortunately, according to the Centers for Disease Control and Prevention (CDC) my mother’s trip is not abnormal. Trips and falls are becoming a growing concern as our population grows older. In 2000 the CDC reports that direct medical cost for fatal falls was $179 million and $19 billion for nonfatal falls. Is it any wonder why Medicare is having financial challenges? As fall related deaths among the older population continue to raise it becomes easy to see how the cost can significantly impact not only the country but also the individual. The CDC also reported that in 2005, “15,800 people 65 and older died from injuries related to unintentional falls; about 1.8 million people 65 and older were treated in emergency departments for nonfatal injuries from falls, and more than 433,000 of these patients were hospitalized” (CDC 2008).
The government is placing increasing pressure on hospitals and nursing homes to reduce falls in their facilities, but the CDC reports about half of all falls occur in the home. So, what can we do to protect ourselves or loved ones from falling at home? I recommend being proactive and taking steps to make your home trip and fall hazard free. Take this list and check them off as you go. Contact your church or social network for possible assistance or hire a professional in order to accomplish more complicated items on the list.
- Keep walk paths clear of clutter remove trip hazards like books, electrical cords, magazines, clothes and shoes
- Remove throw rugs or use double sided tape to keep them from slipping
- Wear shoes both inside and outside the home. Avoid going barefoot or wearing slippers
- Keep items used most often stored in cabinets within easy reach
- Use non-slip mats in bathtubs and showers
- Install grab bars next to toilet, tub and shower
- Night lights in bathrooms and bedrooms
- Lights in stairways
- Light switches at both the top and bottom of stairs
- Review Medications with your pharmacist or your healthcare provider
- Have your vision checked
- Begin or maintain a regular exercise program like Tai Chi to improve balance. Talk to your healthcare provider about an exercise program that’s right for you.

Senior Centers in the community offer Tai Chi classes, seek them out and get involved. Contact the health department for additional resources and seminars offered as they work to decrease falls in our community. Form a falls prevention outreach in your church it’s a great way to protect your family while keeping them safe. Falls can happen at any age. “Cancel your trip” and the detours of your life.
Howard Baker, RN BSN
For questions, comments, or suggestions on topics you want to read about please email me at: howard@howardsbaker.com

What The Heck Are We Eating?

Ringing in the New Year seems to fill the air with chatter of those New Year’s resolutions of losing weight and getting fit. As the Pied Piper of infomercials and fad diets hypnotize and mesmerize you with six pack abs and sex appeal with claims you will never be hungry and it tastes good too. This is a good time for straight talk to weed through the myths and pave your way to success for a healthier slimmer you in the coming year.
Walter Willett from the Harvard School of Public Health made a statement that is mind boggling and inspiring: “A healthy diet, regular exercise and not smoking has been estimated to be able to eliminate 80% of heart disease and 70% of some cancers.” It took awhile for me to wrap my head around this concept and to realize the truth in what he was saying. Once I realized there are many studies supporting this statement I came to the realization that simply changing our dietary habits can have a profound effect on our health.
A lot of the information out there is contradicting about what a “healthy diet” is or how to achieve it. So, where are we to find strong, evidence-based, reliable information to help make sense of a good diet vs. bad diet? I am not a supporter of the USDA’s food pyramid because it contradicts current research. However, I do like The Healthy Eating Pyramid developed by the Department of Nutrition at the Harvard School of Public Health. I found the Harvard website (www.hsph.harvard.edu/nutritionsource/) a great source of information which is cutting edge as well as clear and easy to understand and supported by rigorous research.
What the heck have we been eating over the last decade or so? When we look at the data we see that Americans are more obese than ever. We all are either currently on or have tried a fad diet or at least known someone who has or is. So with all this dieting why are we still grossly overweight? Do fad diets really work? Are they healthy? Which fad diet is best? The simple answers to these questions are, yes fad diets do work, and usually not based on balanced nutritional formulas. So, which fad diet is best? Studies show that no one fad diet is better over another and the most important factor to achieve success is to adhere to the diet. My suggestion if you are going to use a fad diet, use it to kick start your weight loss goal, while formulating healthy lifestyle changes for long term success.
No matter what music the Pied Piper plays, weight gain or loss is based on simple calories in verses calories burned. Look for simple ways to cut calories. For example one 20oz bottle of soft drink has 242 calories and one per day per year totals 88,330 calories divided by one pound of fat (3,500 calories) and you have either a weight gain or loss of a little over 25lbs per year. Don’t let your weight loss be a fad. Eat the right foods, get some exercise, and make a lifestyle change. You will not only feel better, but you will look better and live healthier longer.
Howard Baker, RN BSN
For questions, comments, or suggestions on topics you want to read about please email me at: howard@howardsbaker.com