PhillyHealthInfo.org
The College of Physicians of Philadelphia

Table of Contents

Home Pages

This is the Home Page Section.  Any time you post a new edition of your “Home Page”, it will get added to this section.  This way, you can keep a record of all the different home pages you’ve had.  It’s also nice for linking people to past/archived versions of the home page if that’s ever something you wish to do.

About Us

PhillyHealthInfo.org is a program of The College of Physicians of Philadelphia, a not-for-profit cultural and scholarly institution founded in 1787 with a long history of providing health information to the public.

In September 2003, the College, under the leadership of former President, Thomas W. Langfitt, M.D., converted an on-site consumer health information program online by launching PhillyHealthInfo.org.  This online resource provides direct and anonymous access to trustworthy consumer health information and local resources in the Delaware Valley (Bucks County, Chester County, Delaware County, Montgomery County, Philadelphia County).  This website is free of advertising and does not require any registration.

Because of the College’s neutrality, we are able to feature hundreds of health and medical organizations, services and events, regardless of affiliation.  For more information on our resource listing policy, please see our inclusion criteria.

Additionally, PhillyHealthInfo.org is committed to working with Greater Philadelphia educational organizations to improve health literacy and information access across all populations and bridge information, technological and cultural barriers to health information.  We do this by working with local organizations to identify and provide community needs for health information, locate non-English and easy-to-read materials, and provide free listings to Delaware Valley health organizations, resources, services and events.

Our Mission

The College of Physicians of Philadelphia is dedicated to advancing the cause of health and upholding the ideals and heritage of medicine.  PhillyHealthInfo.org helps serve that mission by promoting interest about important health issues and provide the tools and resources to allow consumers to make informed decisions about medical care.  PhillyHealthInfo.org strives to provide information to meet the needs of a diverse clientele, with special attention to race, ethnicity, literacy, and language.

PhillyHealthInfo.org is a work in progress that depends upon help from many Delaware Valley community partners – including funders – who share the goal of improving the health of the public.

We are continuously updating our database of local health resources.  We welcome suggestions, and submissions of additional Delaware Valley health resources we may be missing or information about an upcoming health-related event. We are committed to improving and expanding Philly HealthInfo.org in an effort to provide the most accurate links to health information resources in the Greater Philadelphia region.

Advisory, Editorial & Public Health Boards

PhillyHealthInfo.org’s Advisory Board:

The PhillyHealthInfo.org team relies on expertise and guidance from the following:


Honorary Member(s):
C. Everett Koop, MD, ScD
C. Everett Koop Institute

Ex Officio Member(s):
George M. Wohlreich, MD
Director and Chief Executive Officer
The College of Physicians of Philadelphia

Staff Liaison:
Andrea L. Kenyon, AMLS
Director of Public Services, The College of Physicians of Philadelphia
Philly Health Info Project Director

PhillyHealthInfo.org’s Editorial Board:

Philly Health Info.org is indebted to the following Fellows (members) of The College of Physicians of Philadelphia for their assistance in editing and vetting website content:

The College of Physicians of Philadelphia’s Section on Public Health

The Section brings together public health professionals from all across the region to study public health problems, assesses potential responses and provides information for the development of health policy. 

EXECUTIVE COMMITTEE 2005-2006

COUNTY HEALTH DEPARTMENTS

THE COLLEGE OF PHYSICIANS OF PHILADELPHIA PRESIDENTIAL APPOINTMENTS

COLLEGE OFFICERS

STAFF LIAISON

Privacy Policy

Phillyhealthinfo.org uses automatic tracking systems on our web site to collect general information about visitors without identifying specific individuals. We use this information both to compile statistics about the use Phillyhealthinfo.org and to assist in enhancements to Phillyhealthinfo.org. We also track the addresses of external web sites that have established hyperlinks to Phillyhealthinfo.org. Logged information is kept indefinitely as administrative and research material; it is not disclosed outside of Phillyhealthinfo.org personnel.

Phillyhealthinfo.org does not sell or rent visitors’ identifying or contact information. Visitor information is submitted voluntarily by the visitor and any visitor at any time can request to remove his or her identifying or contact information and it will be removed in a timely manner.  Visitors registering for Phillyhealthinfo.org’s email alert service may request to be removed at any time. Phillyhealthinfo.org makes every reasonable effort to protect the security of visitors’ personal information and honor visitors’ choices for its intended use. Please be aware there is some risk involved in transmitting identifying or contact information over the Internet regardless of our efforts.

Phillyhealthinfo.org is not responsible for the privacy practices of any external web sites to which Phillyhealthinfo.org links. Concerned visitors are encouraged to read the privacy statements on those sites.

HIPAA Compliance

Phillyhealthinfo.org and The College of Physicians of Philadelphia pledge to honor and abide by the federal privacy regulations called the Health Insurance Portability and Accountability Act of 1996 (HIPPA). Information about these regulations and the rights of individuals under this Act can be found at http://www.hhs.gov/ocr/hipaa/.

Contact

If you have any questions or concerns regarding Phillyhealthinfo.org’s privacy policy, please Contact Us.

Partnering and Sponsoring Organizations

The College of Physicians of Philadelphia is grateful for the invaluable assistance it receives from private and public organizations for the development, promotion and maintenance of PhillyHealthInfo.org, a community health information resource:

Sponsors and Funders

PhillyHealthInfo.org is currently supported in part by an unrestricted operating grant from The Pew Charitable Trusts to The College of Physicians of Philadelphia.

Organizations that have provided grants and monetary gifts to the College to support PhillyHealthInfo.org in the past:

Partners

Organizations that have provided in-kind support:

Consultants

Organizations that have provided fee-based services, including development of the Philly Health Info.org web portal and resources:

Thomas W. Langfitt, MD

In Memoriam

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April 20, 1927 – August 7, 2005

Dr. Thomas Langfitt was past-President and former Board member of The College of Physicians of Philadelphia.  He previously served in leadership roles at the Pew Charitable Trusts and the Glenmede Trust Company.  Prior to joining Pew, Dr. Langfitt was a neurosurgeon.

During his time at Pew, Dr. Langfitt became committed to removing barriers to services and information, particularly with regard to health care.  Under his leadership, The College of Physicians of Philadelphia moved its consumer health program and resources online with PhillyHealthInfo.org.  Dr. Langfitt believed the College’s mission of educating the public about health – as well as its neutrality – could foster a better relationship between patient and doctor and help to fix a broken health care system.

The PhillyHealthInfo.org team was humbled by his insatiable energy, curiosity and enthusiasm.  He was a tireless advocate for Philly Health Info.org and the mission of improving the health of the public through education and increased access to health information.  We remain deeply indebted to his stewardship and steadfastly committed to his vision.

Disclaimers

Calendar

Phillyhealthinfo.org calendar listings are provided as a public service, to create access to health information and services for Phillyhealthinfo.org visitors. Inclusion of events in the calendar does not indicate an endorsement of these services by Phillyhealthinfo.org, The College of Physicians of Philadelphia, or any partner organization.

Disclaimer of Endorsement

Reference on the Phillyhealthinfo.org web site to any specific commercial product, process or service by trade name, trade mark, manufacturer, or other reference, does not constitute or imply its endorsement, recommendation, or favor by Phillyhealthinfo.org or The College of Physicians of Philadelphia. The views and opinions expressed in documents available through Phillyhealthinfo.org do not necessarily state or reflect those of The College of Physicians of Philadelphia as an institution, and may not be used for advertising or product endorsement purposes.

Medical Advice

The information (text, graphics, tables, audio and video) provided on the pages of the Phillyhealthinfo.org web site are for informational purposes only and are not to be construed as medical care or medical advice, and are not a replacement for medical care given by physicians or trained medical personnel. Phillyhealthinfo.org does not directly or indirectly practice medicine, nor does Phillyhealthinfo.org dispense medical advice, diagnosis, treatment or any other medical service as part of this free web site. Phillyhealthinfo.org visitors should always seek the advice of their physician or other qualified healthcare provider(s) when experiencing symptoms or health problems, or before starting any new treatment.  Phillyhealthinfo.org encourages visitors to share with their healthcare provider(s) any information gathered on Phillyhealthinfo.org. Phillyhealthinfo.org encourages visitors to use this information to start a dialog with their healthcare provider(s) and to become empowered in that relationship. Neither Phillyhealthinfo.org nor The College of Physicians of Philadelphia is to be held responsible for any inaccuracies, omissions, or editorial errors, or for any consequences resulting from the information provided. By continuing to view the Phillyhealthinfo.org web pages, visitors indicate acceptance of these terms. Visitors who do not accept these terms should not access, use, interact with or view these web pages.

Ownership/Copyright

The text, graphics, design, and architecture of Phillyhealthinfo.org--except for any products that have been licensed from third parties--are the property of Phillyhealthinfo.org and The College of Physicians of Philadelphia unless the licensing agreement specifies otherwise and may not be reproduced or distributed without prior written permission from Phillyhealthinfo.org. All content created by Phillyhealthinfo.org is protected by U.S. and international copyright and trademark laws. Visitors may not copy, publish, distribute, create derivative works of, or commercially exploit the content of these web pages, or use these web pages for any other purpose.

Site Hosting

Phillyhealthinfo.org is hosted on server space provided by Rackspace Managed Hosting (http://www.rackspace.com). Phillyhealthinfo.org visitors are encouraged to read Rackspace’s terms of service and conditions, privacy policy, disclaimers etc.

Limitation of Liability

All content, material and links provided by Phillyhealthinfo.org is intended for information and guidance only. Neither Phillyhealthinfo.org nor The College of Physicians of Philadelphia accepts responsibility for any errors, omissions or inaccuracies in the content, material or links on this web site. Reference to organizations or persons included on Phillyhealthinfo.org, or any web site to which it is linked, does not indicate an endorsement. Neither Phillyhealthinfo.org nor The College of Physicians of Philadelphia takes responsibility or accepts liability for any loss or damage resulting from using this website and its content or any other site to which it is linked.

When visiting Phillyhealthinfo.org, information will be transmitted over a medium that may be beyond the control and jurisdiction of Phillyhealthinfo.org and its suppliers. Accordingly, Phillyhealthinfo.org and The College of Physicians of Philadelphia assume no liability for or relating to the delay, failure, interruption, or corruption of any data or other information transmitted in connection with the use of the Phillyhealthinfo.org.

Links

Phillyhealthinfo.org provides hyperlinks to other web sites to allow visitors ready access to additional information that may be useful to the Phillyhealthinfo.org visitor’s needs. The inclusion of any link on Phillyhealthinfo.org should not be interpreted as an endorsement. Neither Phillyhealthinfo.org nor The College of Physicians of Philadelphia will take responsibility or accept liability for the availability or function of these external sites, or the content provided on any sites to which Phillyhealthinfo.org is linked. Visitors to linked sites must judge for themselves the accuracy and the quality of the information provided at the linked site(s), and take responsibility for the appropriateness of acting on such information.

Links from Phillyhealthinfo.org to external web sites are checked regularly for functionality. Non-functioning links are corrected or removed at that time.  Phillyhealthinfo.org users may report non-functioning links by clicking on the Contact Us link located at the top of every page.

Listed physicians

Phillyhealthinfo.org, The College of Physicians of Philadelphia, its supporters, partners, and the creators of this web site assume no responsibility for the clinical diagnosis, treatment procedures or schedule fulfillment of any physician listed on this web site, or to any physician whose contact information is accessible using Phillyhealthinfo.org. Information about physicians is provided as a courtesy and does not constitute an endorsement of any physician or healthcare facility.

Contact

If you have any questions or concerns regarding Philly Health Info’s disclaimers, please Contact Us.

Home Page - July 2006

Time to Quit Smoking

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Philadelphia’s smoking ban is on the books so it’s about time you kicked the habit for good.  Need help?  Use our Smoking section to find a class or a support group near you. 

Concerned about Spinach?

Recent E. coli outbreaks got you wondering about food safety? Use our Food Safety section to find information and local organizations that can help keep you and your family safe and healthy.

Prostate Cancer Awareness Month

September is Prostate Cancer Awareness Month and there are free screenings going on all over the Delaware Valley.  If you or someone you love is over 50 it’s time to get a check up.

A Tribute to Our Founder

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A tribute to former president of the College of Physicians of Philadelphia and founder of Philly Health Info, Dr. Thomas Langfitt.

In Memoriam - Thomas W. Langfitt, MD

April 20, 1927 – August 7, 2005

Melanoma International Foundation

image In 2003, The Melanoma International Foundation or MIF, was started by Catherine Poole, a melanoma survivor and patient advocate of 19 years.  Catherine is the author of Melanoma Prevention, Detection and Treatment with DuPont Guerry, MD, who headed Penn’s Melanoma Program (New Haven: Yale University Press, 1998, Revised 2005.) Ms. Poole decided to write the book because there was no where to turn during her scary bout with melanoma during her pregnancy.

After completing the book, many patients called on Ms. Poole for advice. She started a hotline, email response system and now a new moderated forum (http://www.melanomaforum.org) where patients and families can safely ask questions and get answers they can trust. This became the backbone of the MIF’s mission:  helping patients and their families understand their diagnosis and get the best possible treatment.

MIF is also focused on early detection.  When melanoma is found early it is 90% curable with simple outpatient treatment. The Melanoma International Foundation provides free screenings at its annual awareness event, Safe From The Sun, in Seattle, and at Villanova University as well as 22 new localities from coast to coast this year.  Most people find their own melanomas, so MIF teaches how to perform a skin self examination and examine their loved ones at company lunch time programs and at civic organizations.  MIF’s website has a 2 minute video that can teach people how to examine their skin as well: http://www.melanomaintl.org/minfo_examine.asp

Melanoma kills one person each hour. It is the leading cancer killer of young women and more prevalent than breast cancer in women ages 26-29.  It is the easiest cancer to screen for, but the least physician screened for cancer. It is increasing at a faster rate than any other cancer probably due to our cultural preference that a tan looks good and the prevalence of tanning parlors.  One out of three teens go to tanning parlors in which 15 minutes provide as much dangerous exposure as a full day at the beach. Also, approximately 80% of our children are sunburned each summer. This too will keep the melanoma rates climbing.

Melanoma is not a priority by any of the major cancer organizations including the National Cancer Institute or the American Cancer Society.  MIF hopes to change that and raise the priority of melanoma prevention, early detection and treatment among the major funding agencies for research.  We also are helping to get legislation passed to ban all youth from tanning salons.

This May, Safe from the Sun is back!  Our emphasis is family fun with a serious side of melanoma screening for early detection and the support of those fighting melanoma as well as honoring those we’ve lost. Philadelphia Safe from the Sun will again take place in the pavilion at Villanova University, SATURDAY May 10th, 2008:

To register for the Philadelphia event, go to: http://www.safefromthesun.org

For more information about skin cancer, please see the PhillyHealthInfo.org Skin Cancer section.

Contact Us

Help us make PhillyHealthInfo.org the best stop on the web for Delaware Valley health events, services and programs. We value your questions, comments and suggestions.


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Inclusion Criteria

Since its founding in 1787, the College of Physicians of Philadelphia has remained relentlessly neutral in its efforts to advance the cause of health and uphold the ideals and heritage of medicine.  Philly Health Info.org was designed with this neutrality in mind.  Below are the criteria we use to determine which resources and information sources will be featured on our website.

Regional Resources and Events

Regional resources include but are not limited to hospitals, support groups, health and medical organizations & associations, and health education services and programs in the Delaware Valley (Philadelphia, Montgomery, Bucks, Delaware, and Chester counties).  Events include but are not limited to time-limited happenings such as health fairs, fundraisers, lectures, workshops, and conferences.

Content

For PHI purposes, content includes but is not limited to recommended websites, quizzes, non-English language materials, easy reading materials, and hoaxes.

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MEDLINEplus.gov

Brought to you by the National Library of Medicine, MEDLINEplus is an extensive clearinghouse of information on over 700 health topics from libraries, government agencies and health-related organizations.

Features:

MayoClinic.com

Although the website address is a .com, this site is owned by the not-for-profit Mayo Foundation for Medical Education and Research and is a joint venture between Web specialists at the foundation and medical experts from the Mayo Clinic.

Features:

Healthfinder.gov

Developed by the U.S. Department of Health and Human Services and other federal agencies, Healthfinder is a good place to start your search because it doesn’t produce overwhelming results on each topic.

Features:

MedHelp.org

Non-profit organization that provides consumers with access to online support groups and physician-monitored forums.

Features:

NORD

The National Organization for Rare Disorders (NORD) is a federation of voluntary health organizations dedicated to helping people with rare diseases find information and support.

Features:

Submit An Event

Want your event to appear on PhillyHealthInfo.org? Submit the details to us using the form below:

Website Summary

A comprehensive directory of health services, events and information for Bucks, Chester, Delaware, Montgomery and Philadelphia counties.

Send To A Friend

Tell a friend about the page you’ve found on the PhillyHealthInfo.org website.

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AIDS - Philadelphia FIGHT

Philadelphia FIGHT, http://www.fight.org, is a comprehensive AIDS service organization providing HIV specialty primary care, consumer education, one-on-one advocacy and research on potential treatments and vaccines.  FIGHT was formed as a partnership of individuals living with HIV/AIDS and clinicians, who joined together to improve the lives of people living with the disease. Our mission is to end the AIDS epidemic in the lifetimes of people living with HIV right now.

Our programs include:



Project TEACH

Project TEACH is a class for people living with HIV and AIDS. It was formed in 1996 to meet the demands of People Living With HIV/AIDS (PLWHA), who needed state-of-the-art HIV treatment information, leadership development, and self-empowerment. Our mission is to empower people living with HIV/AIDS to get educated about HIV, to use that knowledge to make the best decisions for their lives and to share that knowledge and empowerment with their communities. Since 1996, almost 2000 people have graduated from our various programs, which have included TEACH, TEACH Outside, Teen TEACH, Frontline TEACH (for friends, family members and community activists), and classes and seminars in Chester County, Montgomery County, and Baltimore.

We deeply believe that anyone can learn sophisticated HIV information if they are motivated to do so.  The HIV epidemic has taught us that it is crucial for people with HIV/AIDS to share their experiences and help other people learn what they have learned. And we know that people learn best when they are supported by peers, friends and family. We provide not just good information, but resources for finding help, reducing stress, and not just living with HIV - living WELL with HIV.

We believe that people have a right to know what’s going on in their bodies, and to understand what doctors are recommending and why. In making medical decisions, people will always serve their health priorities, beliefs and goals. We want to help people identify their priorities more clearly, and support people in making decisions that are new for them.

For example, someone who has never taken antiviral medication might get a lot of pressure from friends and family to take them, or not to take them. They might know about the benefits of medications, but be scared of the potential for side effects. Project TEACH is there to give them more information about the benefits AND risks of medications, as well as what their medical provider might be thinking, so that their decisions are made with the best possible information. We’re not here to tell people to take medication, or not to take it. We’re here to help people get the best information, so that they can make decisions that reflect their goals.

For more information on Project TEACH, Philadelphia FIGHT, or any of these programs, please call 215-985-4448, or visit our website at http://www.fight.org/

To find more HIV/AIDS resources, including Delaware Valley organizations and non-English materials, visit Philly Health Info’s AIDS page.

AIDS - Spotlight on AIDS

AIDS is a condition caused by a virus called human immunodeficiency virus or HIV.  Most people who become infected with HIV will eventually develop AIDS. AIDS stands for Acquired Immunodeficiency Syndrome. “Acquired” means that the disease is spread through contact with a virus, in this case, HIV.  “Immunodeficiency” means that the disease attacks the immune system.  The immune system is what protects the body from disease.  “Syndrome” refers to the group of symptoms that are common to the disease.

It usually takes many years for someone with HIV to develop AIDS.  When someone first becomes infected with HIV, he or she might not feel sick at all.  Over time, HIV weakens the immune system of the infected person.  Eventually, the body has trouble fighting certain infections and the person can come down with pneumonia, weight loss, and other complications known as “opportunistic infections”. Many of the illnesses that the person has with AIDS are from infections that the body fought off before but now cannot.

HIV is spread through contact with bodily fluids, such as blood or semen.  The most common way of sharing these bodily fluids is through sexual contact with someone who has HIV.

HIV can also be spread by sharing needles with someone who has HIV.  If you cannot or will not stop using drugs, you should use a new needle every time.  If new needles aren’t available, old needles should be boiled or cleaned with bleach before reuse.  In addition, you should find out about needle exchange programs in your community that make clean, reliable needles available to users.  For more information please visit, http://www.preventionpointphilly.org/services/services-syringe.html

Having another sexually transmitted disease (STD), such as syphilis, gonorrhea, Chlamydia, or herpes, can also increase someone’s chances of becoming infected with HIV.  These diseases can cause sores or skin irritations in the genital area that make transmission of HIV easier.

In addition, infected mothers can pass the virus to their children during pregnancy, childbirth itself or through breast milk.  In rare cases, infected blood given in a blood transfusion can also spread HIV.  With modern screening techniques it is almost impossible to get HIV from a blood transfusion.

Despite the rumors you might hear, you cannot be infected in any of the following ways:



Currently, forty million people are living with HIV worldwide, including over one million Americans.  Twenty five percent of these people don’t know they’re infected.  That’s frightening because there is no cure for or vaccine against HIV infection.

New medicines may allow patients with HIV to live longer, better lives, but in most cases HIV/AIDS will eventually end in the death of its victims.  The best hope for preventing infection is education.  Here’s what you can do to protect yourself:



To find more HIV/AIDS resources, including Delaware Valley organizations and non-English materials, visit Philly Health Info’s AIDS page.

Edited by Ellen M. Tedaldi, MD, Professor of Medicine, Temple University School of Medicine; Director, Temple Comprehensive HIV Program; Fellow, College of Physicians of Philadelphia

Alzheimer’s Disease - Spotlight on Alzheimer’s Disease

Alzheimer’s disease (AD) is a disorder of thinking in seniors that worsens over time. By far and away the most important risk factor for AD is age, and the frequency of AD clearly increases with age so that about 40% of individuals over 80 years of age have AD.  A specific kind of memory deficit is the earliest and most obvious problem in AD.  This is difficulty learning and remembering new information like a phone message or what was eaten for breakfast.

Patients often ask the same question throughout the day, forgetting that it’s been asked many times before, and frequently repeat themselves during a conversation.  However, memory difficulty alone is not enough to say that someone has AD.  Individuals with AD also have impaired language (poor word-finding when speaking, difficulty understanding), problems with visual perception (difficulty recognizing objects, getting lost in very familiar places), and impaired planning and organizing.  Sometimes AD is associated with hallucinations, paranoia, agitation, and depression.

AD may be inherited, but this occurs only in a very small number of people.  AD is not due to strokes, head trauma, vitamin deficiency, infection, or endocrine problems, although any of these can lead to memory difficulty.  An experienced doctor can evaluate these and other problems that can cause memory and thinking impairments. Instead, proteins accumulate abnormally in the brain of an AD patient, and these proteins interfere with the functioning of brain cells or neurons.

While there is currently no cure for AD, treatments are being developed to prevent the brain cells from being attacked. These treatments should be available in the next 5 years. Several medications are available now that can help slow the progression of AD. These medicines are directed at helping some of the chemicals that allow brain cells to communicate with each other. Other treatments help manage some of the symptoms associated with AD such as paranoia, agitation, and depression.

AD is a progressive condition, and patients can become increasingly agitated and can wander. There may be difficulty sleeping through the night, often because patients are sleeping too much during the day. As the condition gets worse, patients eventually require care 24 hours a day for seven days a week throughout the year, becoming totally dependent on their caregivers for all activities of daily living.

Even with all of the love in the world, this is overwhelming for any one caregiver to manage alone. There are many services available in the area to help in the caring process, such as Adult Activity Centers and companions. The Alzheimer’s Association can provide information about these resources. The Alzheimer’s Association also sponsors free support groups throughout the area where more can be learned about AD.

Murray Grossman, MD, EdD, is an Associate Professor in the Department of Neurology at the Penn School of Medicine and affiliated with the Clinical Practices of the University of Pennsylvania, http://www.med.upenn.edu/ins/faculty/grossman.htm

Alzheimer’s Disease - Alzheimer’s Association Delaware Valley Chapter

imageDid you know that Alzheimer’s is the 7th highest leading cause of death in the world?  Currently, there are an estimated 294,000 people in the Delaware Valley suffering from Alzheimer’s disease or a related dementia.

The Alzheimer’s Association Delaware Valley Chapter is dedicated to helping people with Alzheimer’s disease and related dementias and their families through education, advocacy, support, and funding important research to find a cure.  Our core services include:

Our goal is to provide leadership to enhance care and to support services for individuals with dementia and their families, while supporting the elimination of Alzheimer’s disease through the advancement of research.  There are more than 294,000 families in our area, and more than 5.1 million nationwide, coping with the devastating effects of Alzheimer’s disease and other progressively debilitating degenerative neurological disorders.  If you need help or information, please call our Helpline/Contact Center (800) 272-3900 or log onto http://www.alz.org/desjsepa. Together, we can make Alzheimer’s disease just a memory. 

Delaware Valley Chapter
399 Market St. Suite 102
Philadelphia, Pa 19106
24-Hour Contact Center/Helpline: (800) 272-3900
Office: (215) 561-2919
Fax: (215) 561-4663
http://www.alz.org/desjsepa

For more information about Alzheimer’s disease, please see the Phillyhealthinfo.org Alzheimer’s Disease page.

Asthma - Spotlight on Asthma

Asthma is a disease that affects the lungs.  People with asthma often have trouble breathing.  They may wheeze, cough, or feel tightness in their chest.  Asthma can even cause what is known an “attack.” An asthma attack is caused by severe swelling in the lungs and can leave someone gasping for air. 

Unfortunately, asthma is the most common long-term disease in children, affecting more than 6 million kids in the United States alone.  In fact, asthma accounted for more than 14 million missed school days in 2000. 

Overall, more than 20 million Americans have asthma, 12 million of whom experience serious asthma attacks.  These attacks lead to 2 million emergency room visits and 5,000 deaths each year in the United States.

The causes of asthma are unknown and currently there is no cure.  What’s even more frightening is that the number of asthma cases has risen during the past decade, especially among children living in the inner city.

One thing is clear:  if someone has a parent with asthma, he or she is far more likely to develop asthma than a person who has no family history.

Asthma attacks can be triggered by things in the environment.  Living in a large urban area like Philadelphia may increase exposure to these environmental triggers, which include:



Once someone knows what triggers their asthma, they can take steps to reduce the triggers in their environment.  Sometimes this is easier said than done.  Some causes like pollen, air pollution, and weather can’t be helped, but other things like cigarette smoke, mold, and cockroaches can and should be fixed. 

Because these attacks don’t happen all the time and because asthma can persist without environmental triggers, asthma can be difficult to diagnose, especially in young children. Regular doctor visits to check for allergies and to determine proper lung functioning can help.
The testing of lung function is called spirometry.  Spirometry is one way to confirm the diagnosis of asthma. A spirometer is a piece of equipment that measures the largest amount of air you can exhale after taking a very deep breath.

A doctor should also ask a patient about their family history of asthma, allergy and other breathing problems, and their home environment.  Patients should make sure to be honest about any lost school or work days and limits on daily or physical activities.

It’s important to remember that even though there isn’t a cure, asthma is treatable.  The first thing someone can do is to remove the triggers in their environment that make their asthma worse.  The other thing they can do is to make sure to take any medicine their doctor prescribes.

There are two main types of asthma medication:  quick-relief medicines and long-term control medicines.  Quick-relief medicines are often inhaled into the lungs and are taken only as needed to ease the symptoms of an attack.  They work within minutes to open the airways and help breathing.  Anyone who has asthma should always have one of these inhalers in case of an attack. 

Long-term control medicines are taken everyday to control chronic symptoms in people with persistent asthma.  Many people will need both types of medicines to effectively control their asthma. 

Remember, there are three simple things someone can do to control their asthma:

When someone controls their asthma, they will not only reduce the symptoms and the likelihood of attacks, but they’ll sleep better, miss less work or school, take part in more physical activities, and, best of all, they won’t end up in the ER with an asthma attack.

Edited by James Plumb, MD. Dr. Plumb is a Clinical Associate Professor in the Department of Family Medicine at Thomas Jefferson University and a Fellow of the College of Physicians of Philadelphia.

Asthma - Philadelphia Allies Against Asthma Coalition

The Philadelphia Allies Against Asthma Coalition (PAAA) formed in 2000 to fight the rise of asthma in children living in the city. The Coalition consists of over 90 members representing more than 40 organizations including health care systems, providers, schools, insurers, community based agencies, nursing centers, state and local heath departments and parent/caregivers. Health Promotion Council is the lead agency for the PAAA. Coalition members actively participate on various committees and volunteer for special assignments.

PAAA’s programs include services that assist families in accessing healthcare services, asthma education, home-visits for trigger remediation, and social service support. These programs include the following:

The Child Asthma Link Line
The Child Asthma Link Line (Asthma Link Line) is community-based telephone center designed to coordinate the medical appointments, asthma education, and other services for parents of children of asthma. The Asthma Link Line also helps uninsured families obtain health insurance.  The Asthma Link Line is a free program and can be accessed by calling 1-866-610-6000.

Asthma Action Plan
The Philadelphia Allies Against Asthma Coalition in collaboration with AmeriChoice, Health Partners, and Keystone Mercy Health Plan developed a standardized Asthma Action Plan (AAP). The AAP is an asthma management plan designed for children with asthma to be completed by a health care provider.  PAAA has distributed the AAP to over 600 providers in Philadelphia.

Education Services
To educate caregivers and children with asthma on ways to control this disease, PAAA offers the following asthma education programs: Asthma Classes for Adults All About Asthma, Asthma Awareness Day and Smokeless Homes.

Asthma Classes for Adults
Free classes are available for adults with asthma. These classes are held at various community locations in the City. This program is a series of 4 classes addressing topics such as medications and devices, psychosocial issues, and asthma action plans. Upon completion of the class series participants receive a certificate of completion and incentives.

All About Asthma
All About Asthma is an asthma awareness and educational presentation developed for parents, community members, daycare providers, and teachers.  It is a comprehensive user-friendly 45 minute presentation addressing the following five topics: 1) What is asthma? 2) Asthma triggers 3) Asthma medications and devices 4) Controlling asthma and 5) Asthma resources in the community. 

Asthma Awareness Day
Asthma Awareness Day is a school-based program developed by PAAA members and partners to increase awareness and educate students and their families about asthma.  Asthma Awareness Day includes hands-on learning stations that educate small groups using games and activities.  These activities explain what asthma is, its triggers, medications, devices, and control methods. In addition, students and their families are informed about various asthma programs, such as the Asthma Link Line, Asthma Camp, and other services.

Smokeless Homes
Smoke from tobacco can trigger asthma attacks. More than half of children with asthma live in homes with an adult who smokes. Our Smokeless Homes program reaches out to parents and gives them tips on how to keep tobacco smoke away from their asthmatic children.

To Learn More About PAAC, call the Philadelphia Allies Against Asthma Coalition at (215) 731-6150 or visit the website at http://www.hpcpa.org/paaa.html.  Community members are welcome to join. All services and presentations are available in English and Spanish.

PAAA is determined to find ways to help children with asthma stay healthy!

PAAA is funded by: Pennsylvania Department of Health, The Philadelphia Foundation, STEPS to a Healthier Philadelphia , AstraZeneca Pharmaceuticals, Philadelphia Health Management Corporation, The United Way, and the Aetna Foundation. 

A project of the Health Promotion Council, http://www.hpcpa.org

Blood Donation - American Red Cross Blood Services, Penn-Jersey Region

If you had an hour of free time, how would you use it?

Going grocery shopping, watching your favorite reality show, chatting online with friends, or cleaning out the refrigerator?  There are a lot of activities that can be done in 60 minutes. But there’s only one hour-long activity you can do that saves lives: donating blood.

Each and every day, blood is needed for trauma and accident victims, heart surgeries, organ transplants, and treatments for leukemia, cancer, and other diseases. Since blood cannot be manufactured or substituted, hospitals and patients rely on the generosity of blood donors to provide this lifesaving gift.

In the Philadelphia area, you can donate blood through the American Red Cross Blood Services, Penn-Jersey Region. Each week, the Penn-Jersey Region operates nine community centers and more than 200 blood drives at local businesses, organizations, and schools throughout southeastern Pennsylvania and New Jersey.? So most likely there is a location near your home or work!

Although blood donations are needed throughout the year, there are certain times when the available supply becomes dangerously low. In particular, blood is traditionally in short supply during the winter months due to holidays, travel schedules, illness, and bad weather. It is important for donors to make and keep their appointments during this critical time because it can affect patient care.

However, no matter what the time of year, the American Red Cross encourages the public to include regular blood donation in their schedule and to ask their family, friends, and co-workers to give the gift of life.

Giving blood is easy, safe, and truly makes a difference in patients’ lives. Most healthy people who are at least 17 years old and weigh 110 pounds or more are eligible to donate blood every 56 days. Donors must bring appropriate identification such as a driver’s license or an American Red Cross donor card. To make an appointment at a blood drive or donor center closest to you, please call 1-800-GIVE LIFE (1-800-448-3543) or visit http://www.pleasegiveblood.org.

One hour of your time equals three lives saved. Please, make time on your schedule this month to donate blood.  It can be the most rewarding hour you spend!

Blood Donation Facts

American Red Cross Blood Services, Penn-Jersey Region.
1-800-GIVE LIFE (1-800-448-3543)
http://www.pleasegiveblood.org

Blood Donation - Be a Life Saver: Donate Blood

Each year 4.5 million American lives are saved by blood transfusions. In fact, every three seconds someone needs a transfusion, and half of us will require a blood transfusion at some point during our lives.

A blood transfusion involves the direct injection of blood into the bloodstream using an intravenous tube (a tube inserted in a vein) with a needle, usually into the arm.

Blood is about 7 percent of our body weight (10 to12 pints). It is made up of multiple components that serve very different and specific purposes:

People may need blood transfusions for many reasons. Advances in science and technology allow blood to be broken down into its specific components and transfused to treat a variety of medical conditions.

Doctors often transfuse their patients to replace blood lost as a result of a severe injury or burn. Some victims of serious accidents or falls have no visible signs of injury or bleeding, but have had injuries that cause internal bleeding. Surgery is usually required to repair the injury and a blood transfusion is often also necessary.

Occasionally people need transfusions to replace blood lost during other, non-injury- related surgeries such as heart, transplant and joint replacement surgeries. Some heart surgeries can use up to 20 pints of red blood cells. Joint replacement surgeries can use 1 to 3 pints of red blood cells.

Some people with illnesses like anemia, sickle cell anemia, hemophilia, and leukemia and other cancers also need blood transfusions. Blood platelets are commonly used to treat leukemia patients. Plasma is used to treat hemophilia and red blood cells are used to treat anemia.

Blood cannot be manufactured and, because it has a short shelf life, it must be used quickly and then replenished. Yet maintaining an adequate and fresh supply of blood is difficult when only half of the people who can donate blood actually do donate in their lifetime. And only 5 percent of those people donate once or more in any given year.

One out of every 10 hospital patients needs a blood transfusion. One pint of blood, the amount of blood given in one donation, can save the lives of three people! A blood donation is one of the easiest and most important donations a person can make. Anyone who is at least 17 years old, in good health and weighs at least 110 pounds can donate blood every 56 days.

You don’t have to be a doctor to save a life! Donate now and commit to future donations.

Michael Greenberg, M.D., M.P.H.,
Professor of Emergency Medicine and Public Health; Director, Division of Medical Toxicology
Drexel University College of Medicine
245 N. 15th Street, Philadelphia, PA? 19102
http://www.drexel.edu/med/

Cancer - Wellness Community of Philadelphia

The Wellness Community of Philadelphia (TWCP), located at The Suzanne Morgan Center at Ridgeland, Chamounix Drive, West Fairmount Park, Philadelphia, Pennsylvania, is a non-profit organization that provides emotional support, education and hope for people affected by cancer.  Participants are welcome at any stage of their illness, from diagnosis through recovery.  Professionally lead support groups for people with cancer and their caregivers meet weekly.  Other programs and services include nutrition, yoga, T?ai Chi, aerobic exercise classes, mind-body programs, and educational forums.  All TWCP programs and services are provided at no charge to participants.

Founded by a group of dedicated volunteers in 1993 at a small office on City Avenue, The Wellness Community of Philadelphia is one of 21 Wellness Communities nationwide (there are also two international locations and more in development in the United States).  In 1997, it moved to its current location at Ridgeland in Fairmount Park, Philadelphia.  Renovated and restored through community gifts, Ridgeland is a warm, home-like setting, where people with cancer and their families feel safe to talk about the challenges of a cancer diagnosis.  Participants may also enjoy the Jean C. Holler Contemplation Garden, located just beside the Suzanne Morgan Center at Ridgeland.  The Contemplation Garden is a place of peace and comfort for participants and caregivers to take T’ai Chi, meditation and relaxation programs, and to quietly reflect and restore their spirits. Meetings and large group classes are held in the renovated barn on premises.

The programs offered at The Wellness Community of Philadelphia give people with cancer and their loved ones and caregivers information, coping skills, and a greater sense of control over their lives.  Independent research shows that those who participate in support groups experience a myriad of quality-of-life benefits, including less stress and anxiety, a more positive outlook, fewer side effects from treatment, and a quicker return to work after treatment.  TWCP programs follow the Patient Active Concept, which states, ?Patients who participate in their fight for recovery along with their health care team, rather than acting as hopeless, helpless, passive victims of the illness, will improve the quality of their lives and may enhance the possibility of recovery.

TWCP serves people with cancer and their families of all ages and ethnicities in Philadelphia and throughout the Greater Philadelphia region.  Beyond their Fairmount Park location, The Wellness Community of Philadelphia serves individuals through their Community-Based Programs in six locations throughout Philadelphia.  In addition, TWCP holds programs at Hahnemann University Hospital, in the Bux-Mont area and in Chester county.

TWCP is funded solely with the help of generous gifts from individuals, community organizations, businesses, and foundations.  TWCP welcomes gifts through all area United Ways.  The Wellness Community of Philadelphia is a registered 501(c) (3) non-profit organization.

Please call (215) 879-7733 or (888) 819-3553, or visit http://www.twcp.org for more information.

Breast Cancer - Spotlight on Breast Cancer

Breast cancer is the most common cancer in women in the United States.  Approximately 225,000 new breast cancers will be diagnosed in this country in 2005.  Almost one in every eight women will develop breast cancer during her lifetime.  The risk of getting breast cancer increases with age; therefore, the risk in an eighty-year old is greater than the risk in a sixty-year old.  About 45,000 women will die of breast cancer in 2005. Despite the increasing numbers of patients who are diagnosed with breast cancer, the risk of dying of the disease remains the same or is diminishing slightly.  Earlier diagnosis is the primary reason for these improved cure rates, although better treatments also play a role. 

Many risk factors influence the chance that any woman will develop breast cancer.  Most important is family history.  The greatest risk is in women who have a mother, daughter, or sister with the disease, especially if they developed breast cancer before menopause or if both breasts were affected.  Families with a history of male breast cancer or relatives with ovarian cancer are also at increased risk.  Breast cancer genes can be detected in about 5% of breast cancer patients.  Individuals with one of the above risk factors are more likely to have the breast cancer gene.  Patients who fit the above criteria should ask their doctor if they are candidates for a genetic risk assessment program.  Other factors which increase the risk of breast cancer include:  early onset of menstrual periods (age 10 or younger), first term pregnancy after age 30, no term pregnancies, late menopause (after age 55).

There are no proven ways to prevent breast cancer.  Diet, cigarette and alcohol use have been suggested to increase your risk for getting breast cancer, however, that has not been proven.  Early diagnosis is really the key to lowering the risk of dying from breast cancer.  Every woman should have a baseline mammogram at about age 35.  Annual mammography should begin at age 40.  Ultrasound is used to aid in further evaluation in certain mammogram findings.  MRI can also be very useful in high-risk patients or in those where mammograms are difficult to interpret.  Because mammograms still fail to identify 10-15% of all cancers, an annual physical examination should be performed by a qualified examiner.  Abnormal findings on either mammogram or physical examination must be followed by some type of biopsy to determine it there is cancer.

Surgery is still the primary treatment for breast cancer.  The tumor must be removed, but in most cases this can be done without sacrificing the breast, a “lumpectomy.” Some patients still require the removal of the entire breast, a “mastectomy.” Most patients who have mastectomy are able to have plastic surgery to reconstruct a new breast.  Most patients who have a lumpectomy require radiation treatments to reduce the risk of cancer returning in the treated breast.  At the time of surgery, many patients undergo removal of the lymph glands in the armpit to determine whether cancer cells have spread to that area.  A new procedure called a sentinel lymph node biopsy is now being used in many centers to avoid removing all lymph glands in many patients.

After recovery from surgery, chemotherapy is recommended for a large number of patients.  Need for such treatments is determined by the type and size of the tumor, presence of involved lymph nodes, the patient’s age and general health status, as well as other factors.  These treatments can lower the risk of the tumor returning, or delay its reappearance.  Side effects of chemotherapy include loss of hair, nausea and vomiting, and lowering of blood counts with increased risk or infection.  Additionally, some patients are given hormone-blocking drugs which have less significant side effects than chemotherapy but are also effective in increasing the cure rate in selected patients.

Although breast cancer still affects many women in this country, early diagnosis and treatment have had a positive effect on increasing cure rates in recent years. Ongoing research is aimed at identifying ways to prevent breast cancer, improving diagnostic methods, finding less invasive surgical treatments, and developing safer and more effective drugs to prevent tumors from returning. 

Robert D. Smink, Jr. MD is a Fellow of the College of Physicians of Philadelphia.  He is Chief of Surgery at Lankenau Hospital, http://www.mainlinehealth.org/lh/

Breast Cancer - breastcancer.org

The Mission

Our mission is to help women and their loved ones make sense of the complex medical and personal information about breast cancer 24 hours a day, 7 days a week, so they can make the best decisions for their lives.

The Need

The Reach

The Advantages

The Founder


Breast Cancer - Linda Creed Breast Cancer Foundation

The Linda Creed Breast Cancer Foundation honors the memory of songwriter Linda Creed by empowering women and their families to practice breast health, fostering the healing process and establishing a public agenda for prevention and cure.

The Foundation was the first local organization to address breast cancer as a serious and widespread disease threatening the lives of women living in the Delaware Valley. Before the Linda Creed Breast Cancer Foundation was established, local women and families had limited information and access to resources when faced with a breast cancer diagnosis. The Linda Creed Breast Cancer Foundation broke the silence surrounding breast cancer, empowered women and their families to talk about it, learn about breast health and take control of their health and their lives.

LCBCF Mission

Programs and Services:

Screening
Screenings are scheduled at twelve area hospitals.  The screenings provide the three parts to good breast health care: mammogram, clinical breast exam and instruction on breast self-examination.

Mammograms
Free mammograms are provided for women with inadequate or no health insurance. 

Diagnostic Testing Services

Safe Circle
Outreach program to African-American women providing breast health information, screenings and support services.

Rainbow Circle
Outreach program to the lesbian community providing breast health information, screening and support services.

Patient Emergency Fund
The Emergency Assistance Fund fulfills a crucial need to provide non-medical financial assistance to women facing day-to-day hardships while dealing with breast cancer treatment and its effects.

Advocacy
Statewide Alert Network advocates for increased funding for breast cancer research and necessary legislation on the state and federal levels. The Foundation is a founding member of the National Breast Cancer Coalition.

Support Services
Includes Eva’s Room, a place to find information on treatment, available resources and research through books, articles, tapes and the Internet, and the toll free information line, 1-877-99 CREED.

Screenings are held in the spring (March - June) and in the fall (September - November).  Diagnostic tests are scheduled on an as needed basis.  For more information on any of the programs and services call 215-545-0800 or visit the LCBCF website: http://www.lindacreed.org.

Colon Cancer - Spotlight on Colon Cancer

Colorectal cancer refers to any of several cancers that develop in a person’s colon or rectum. The colon and rectum are parts of the human digestive, or gastrointestinal, system.

The digestive system is responsible for removing important nutrients from the food we eat and then removing waste from the body. Swallowed food is broken down in the stomach and then moves on to the small intestine. The small intestine continues breaking down the food and absorbs most of the nutrients we ingest. The remainder passes on to the large intestine, or colon. The colon absorbs water and nutrients from the partially digested food and stores waste. This waste, known as feces or stool, then moves to the rectum, which is the last section of the digestive system, where the feces is eliminated from the body through the anus.

Both men and women can develop colorectal cancer. The American Cancer Society estimates that about 106,680 new cases of colon cancer (49,220 in men and 57,460 women) and 41,930 new cases of rectal cancer (23,580 men and 18,350 women) will be diagnosed in 2006.

The exact cause of most colorectal cancers is not yet known. However, research has shown the majority of colorectal cancers occur in people with no known risk factors. However, a person’s diet may contribute to colorectal cancer risk. People who eat foods high in fat, protein, and calories may increase their risk of developing colorectal cancer. There is also some evidence that smoking and drinking alcohol may increase the risk for developing colorectal cancer.

In most people, colorectal cancer develops slowly over a period of several years. Colorectal cancer generally develops from abnormal growths, called polyps, on the lining of the colon or rectum. Polyps and colorectal cancer do not always cause symptoms, especially at first. But sometimes there are symptoms, such as:

If you have any of these symptoms, discuss them with your doctor. Only your doctor can determine why you’re having these symptoms.

Screening

Certain medical tests can find polyps so they can be removed before they grow into cancer. Screening tests can also identify colorectal cancer early, when it is most treatable. When colorectal cancer is found early and treated, the 5-year relative survival rate is 90%. (The 5-year relative survival rate is the percentage of people alive at least five years after diagnosis of cancer.)

Several tests can be used alone or in combination to screen for colorectal cancer:

Colonoscopy is the most specific examination to diagnose polyps or cancer, but requires thorough cleansing of the colon and rectum and mild sedation during the exam. You should begin screening for colorectal cancer when you turn 50, then continue getting screened at regular periods. However, you may need to be tested earlier or more often than other people if you have:

The death rate from colorectal cancer has been dropping for the past 20 years. One reason may be because polyps are being found by screening before they can develop into cancers. Also, colorectal cancer is being found earlier when it is easier to cure, and treatments have improved. Because of this, there are around 1 million survivors of colorectal cancer in the United States.

Treatment

The choice of treatment depends on the size, location, and stage of the cancer and on the patient’s general health. The three standard treatments for colon cancer are surgery, chemotherapy, and radiation. Surgery, however, is the most common treatment for all stages of colon cancer. Surgery is an operation to remove a segment of the intestine containing the cancer. A doctor may remove the cancer using several types of surgery.

Chemotherapy is the use of anti-cancer drugs to kill cancer cells. Chemotherapy may be taken by mouth, or it may be put into the body by inserting a needle into a vein or muscle. Chemotherapy is called systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells throughout the body.

Edited by John M. Daly, MD, Fellow of The College of Physicians of Philadelphia, and Professor of Surgery and Dean, Temple University School of Medicine

Colorectal Cancer

imageColorectal cancer (commonly referred to as colon cancer) is the second leading cause of cancer death among men and women combined in the United States.  The Society estimates that this year 148,810 Americans will be diagnosed with colorectal cancer and almost 50,000 will die of the disease - a number that could be cut in half if Americans followed American Cancer Society testing recommendations for the disease.

Colon cancer develops in the lower part of the digestive system, also referred to as the gastrointestinal, or GI, system. The digestive tract processes the food you eat and rids the body of solid waste matter. This cancer usually develops from pre-cancerous changes or growths in the lining of the colon and rectum. Growths in the colon or rectum are called polyps.

Colon cancer almost always starts with a polyp.  In most cases, colon and rectum cancers develop slowly over a period of several years.  Finding and removing these polyps before they become cancerous can stop colon cancer before it even starts. 

Both men and women are at risk for colon cancer and personal risk varies.  There are several factors that are associated with increased risk.  They include:

Fortunately, the death rate from colorectal cancer has been going down for the past 15 years.  Progress is credited to colorectal cancer screening, which is recommended by the American Cancer Society beginning at age 50.  When colon cancers are detected at an early (i.e. localized) stage, the five-year survival rate is approximately 90 percent; however, because screening rates are so low, only 39 percent of colorectal cancers are detected at this stage.  By getting tested, you can prevent or cure colon cancer.

Your doctor can help you make informed decisions about the most appropriate testing method.  The American Cancer Society recommends one of these five testing options:

Help the American Cancer Society honor National Colorectal Cancer Awareness Month this March and get tested.

The American Cancer Society is dedicated to eliminating cancer as a major health problem by saving lives, diminishing suffering and preventing cancer through research, education, advocacy and service. Founded in 1913 and with national headquarters in Atlanta, the Society has 13 regional Divisions and local offices in 3,400 communities, involving millions of volunteers across the United States. For more information on the Society’s research program or about how to give, call toll free 1-800-ACS-2345 or visit the Society’s homepage: http://www.cancer.org. On the homepage, click “In My Community” to learn what programs, services and events are going in Southeastern Pennsylvania.

For information, resources and events related to colorectal cancer, see the PhillyHealthInfo.org Colon Cancer page.

Depression - Spotlight on Depression

Depression, a very common problem, is a treatable medical condition. The treatment is as successful as those found with other medical problems. According to the National Institutes of Mental Health, in a given year, 10% of the U.S. population experiences symptoms of depression. Depression is not a moral failing or a sign of psychological weakness.  It is not the same as the very common feeling of being temporarily “down in the dumps” on a rainy afternoon or feeling “blue” for a day or two. Instead, depression is a serious, potentially fatal illness that can affect all areas of a person’s life: body, mind, work, family, friendships, and hobbies.

Symptoms

The name “depression” actually refers to a family of related medical conditions, including major depression, dysthymia, and bipolar disorder (manic depressive illness).  This article is limited to a discussion of major depression.  Major depression can bring about one or more recognizable symptoms, including:

Risk Factors

In some cases, major depression can occur in several generations of the same family. However, major depression can also strike people with no family history of the disease. Other risk factors for depression include low self-esteem, a pessimistic view of the world, and difficulty coping with stress.  Certain medical conditions, including stroke, heart disease, cancer, and Parkinson’s disease can also lead to major depression. Finally, a significant event or events, including job loss, death of a loved one, the end of a relationship, or financial difficulties, can trigger an episode of major depression.  A person’s first episode of major depression often results from a combination of genetic, psychological and environmental causes. It is not uncommon for victims of an episode of major depression to experience two or more episodes throughout their life. Later episodes of major depression may be triggered by the same combination of issues that triggered the first episode, or a later episode may develop without any noticeable cause.

Twice as many women as men experience major depression. The reasons for this disparity are not completely clear. Women’s bodies experience unique hormonal changes, associated with events such as menstruation, pregnancy, new motherhood, and menopause, that help account for women’s increased rates of major depression. While men are less likely than women to suffer an episode of major depression, the National Institutes of Mental Health estimates that 3 to 4 million men in the U.S. do experience major depression at any given time. This is especially troubling because men are less likely than women to admit and report symptoms of major depression, and 4 times more likely than women to commit suicide.

Major depression also occurs in older adults, but symptoms are often mistaken for normal signs of aging. Also, some symptoms of depression in older adults can result from certain medical conditions or medications an older adult is taking to treat medical conditions.  Major depression strikes children as well as adults. Symptoms of major depression in children may be mistaken for “growing pains” which the child will “grow out of”, and so the disease may go undiagnosed and untreated.

Diagnosis

Proper diagnosis of major depression begins with a physical examination by a physician. As mentioned, certain medications and physical illnesses can lead to symptoms of depression. If a physical problem is ruled out, the patient is often referred to a mental health professional, such as a psychiatrist or psychologist, for special testing. Psychiatrists are physicians with advanced training in mental illness and brain disorders. Psychologists do not have a medical degree, and cannot prescribe medication, but they do have advanced training in counseling psychology and psychotherapy. Psychiatric social workers and Advanced Practice Nurses are other mental health practitioners who can be helpful. Once major depression is properly diagnosed, the care provider(s) decide on a course of treatment.

Treatment

Psychotherapy alone can be very helpful for persons with mild depression. A psychotherapist helps depressed patients identify and, wherever possible, change the behaviors, thoughts, and feelings that helped cause or can worsen a depressive episode. The form, type, and length of the psychotherapy should always be discussed with the practitioner. 

Antidepressant medication is generally prescribed for persons with moderate to severe depression. Patients must take the prescribed dose of antidepressant medication for at least 3 or 4 weeks, and perhaps as many as 8 weeks, before feeling the medication’s full effects. Antidepressants, like other prescription medications, may cause mild, temporary side effects in some patients. Patients should report any side effects to their physician. Physicians typically direct patients to take their antidepressants regularly for up to 9 months in order to prevent a relapse. Regardless of any side effects or an improvement in their condition, patients should never stop taking an antidepressant, or change the dosage, without first speaking to their physician.

Depressed patients typically receive a combination of psychotherapy and antidepressant medication. Electroconvulsive therapy, commonly known as electroshock therapy, may be prescribed for patients with severe depression who do not respond to or cannot tolerate medication.  Although sometimes misrepresented in the popular media, ECT has been shown to be particularly helpful and even life-saving for some individuals.

What is most important is that the disorder be diagnosed and treated. Appropriate treatment can help most persons dealing with major depression. Untreated, symptoms can last for weeks, months or even years. Moreover, untreated depression effects and is painful both to the person with it and to his/her family, friends, work associated.

Major depression itself is not a fatal disease, but severely depressed persons may feel so hopeless that they consider or even attempt suicide. Patients should discuss any suicidal thoughts, feelings or actions with their mental health care provider. If a patient poses an immediate danger to themselves or someone else, they should call 911 or go to mental health crisis center or hospital emergency room immediately.

Depression is more than just “feeling blue.” If you or someone you know shows signs of major depression, talk with your healthcare provider. Help is out there.

Edited by George M. Wohlreich, MD, Director and CEO, The College of Physicians of Philadelphia

Depression - Mental Health Association of Southeastern Pennsylvania

In recognition of Mental Health Month (May), the Mental Health Association of Southeastern Pennsylvania (MHASP) called on all Southeastern Pennsylvanians who have mental illnesses as well as family members and advocates from across the five-county Philadelphia region to gather on Thursday, May 11, 2006, from noon to 1 p.m. at Dilworth Plaza (west side of City Hall) at Broad and Market Streets in Philadelphia.

“We are sending a message that recovery is our right and we intend to stand up for that right,” said MHASP’s president and chief executive officer, Joseph A. Rogers.

Rogers is internationally recognized as a leader in the peer-support and advocacy movement of people with mental illnesses. He has earned a number of national awards, including the National Mental Health Association’s highest honor, the Clifford W. Beers Award, in 1990, and the 2005 Heinz Award for the Human Condition, presented by the Heinz Family Philanthropies, which includes a medallion and an unrestricted cash prize of $250,000.

MHASP is a non-profit citizens’ advocacy, service, and education agency, founded in 1951, that promotes the recovery of adults with mental illnesses and children and adolescents with serious emotional disorders, and works to end the discrimination and stigma associated with mental illnesses. MHASP serves Southeastern Pennsylvania as well as statewide and national constituencies.

MHASP’s mission is to develop, maintain, and promote innovative education and advocacy programs and mental health services in Bucks, Chester, Delaware, Montgomery and Philadelphia counties, and to serve as a role model and technical assistance resource for state and national organizations and constituencies. MHASP fulfills this mission by promoting mental health and by working to improve public mental health systems through advocacy, education, and community behavioral health services. These include self-help and peer-to-peer services, whose importance has been recognized by the Office of the Surgeon General and by the President’s New Freedom Commission on Mental Health.

MHASP is a leader in the movement to advance the recovery of people with mental illnesses. It promotes the concept that people with serious mental illnesses are capable of holding meaningful employment, getting married, rearing children, practicing their religion, owning their own homes, participating in community and fraternal organizations, enjoying hobbies, and pursuing a meaningful and happy life.

MHASP is proud that the majority of its approximately 350 staff members, including its president and chief executive officer, are in recovery from mental illnesses and/or substance abuse disorders and/or have overcome homelessness and other serious problems to become productive and successful members of the community. MHASP has been actively involved in providing community-based, culturally competent support programs and services for people with mental illnesses since 1984 and today operates more than four dozen such programs in Philadelphia and its surrounding counties, including programs serving statewide and national constituencies.

MHASP (http://www.mhasp.org/) is an affiliate of the National Mental Health Association and supports its activities on behalf of people with mental illnesses. MHASP is also a member agency of United Way of Southeastern Pennsylvania (Donor Choice Number: 00082).

Diabetes - Spotlight on Diabetes

Diabetes is a disease in which the level of glucose in the body is above normal. Glucose is a sugar that our bodies use for energy.  An extra amount of sugar builds up in the blood stream because people with diabetes don’t produce enough of a chemical called insulin.  Insulin is made in the pancreas (an organ near the stomach) and helps the body get energy to its cells.  Diabetes can lead to serious health concerns such as heart disease, blindness, kidney failure, and loss of limbs. In fact, diabetes is the sixth leading cause of death in the United States.

People who think they might have diabetes need to see a doctor immediately if they have the following symptoms:

There are three main types of diabetes: type 2 diabetes, type 1 diabetes, or gestational diabetes.

Type 2, previously called adult-onset diabetes (meaning you get it as an adult), is the most common form of diabetes.  In fact, people are developing type 2 diabetes at younger and younger ages.  Risk factors for type 2 diabetes include obesity, lack of exercise, family history of diabetes, old age, and race or ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at a high risk for type 2 diabetes. Healthy eating, physical activity, and keep your blood sugar under control are the best ways to treat type 2 diabetes.

Type 1, previously known as juvenile-onset diabetes (meaning you get it as a child), is much less common. Like with type 2 diabetes, a balance of healthy eating and physical activity is very important.  In addition, people with type 1 diabetes often have to take insulin medication to regulate their blood sugar levels. In fact, people with type 1 diabetes need to watch their blood sugar levels very closely through frequent testing to prevent blood sugar levels from becoming too high or too low.

The third type of diabetes is gestational diabetes which happens to pregnant women. Gestational diabetes is more common in African Americans, Hispanic/Latino Americans, American Indians, and people with a family history of diabetes than in other groups. Obesity is also a serious risk factor for getting gestational diabetes.

No matter what kind of diabetes you have people with diabetes need to take good care of themselves. They should also see a health care provider who can help them learn to manage their condition.

In addition, people with diabetes may need to see an endocrinologist, a doctor who specialize in diabetes care; an ophthalmologist for eye examinations; a podiatrist for foot care; and a dietitian or a diabetes educator who teaches the daily life skills needed (like eating the right foods) for daily diabetes management.

Currently there is no cure for diabetes. The best way to treat diabetes is to prevent it from ever happening in the first place.  There are three great ways you can do this: lose weight, exercise regularly, and eat healthy.  What are you waiting for? Start today!

Edited by Gary G. Carpenter, MD, Fellow of The College of Physicians of Philadelphia and a Pediatric Endocrinologist affiliated with Thomas Jefferson University

Diabetes - Community Health Collaborative

The Community Health Collaborative (CHC), located in the Norris Square Section of Philadelphia, was established in 2004 and has applied for non-profit status. CHC’s mission is to eliminate disparities in health care by enabling low income, underserved, minority communities to access state of the art education and services and to work with the communities to lower barriers to care. CHC’s first project involves total diabetes management.

Diabetes, a chronic disease requiring complex, often daily, management decisions, is two to four times more prevalent in the African-American and Latino communities as it is in the Caucasian community. Among Latinos, the Puerto Rican and Mexican communities have the highest rates of diabetes. Type 2 diabetes, the type seen in over 95% of people with diabetes is associated with obesity and lack of physical activity, conditions highly prevalent in the Latino community. Untreated, or poorly treated diabetes can lead to heart problems, kidney failure, blindness and amputation.

In addition to the usual barriers to care such as lack of insurance, lack of access to care, low literacy, transportation and child-care, many Latinos also must contend with language, cultural and immigration issues. Because of these problems, the Latino community has the highest rate of uninsured members and high rates of diabetes related complications.

Project Dulce, the diabetes management program being implemented by CHC was begun at the Whittier Diabetes Institute in San Diego and has served over 7,000 people with diabetes. Philadelphia and CHC were chosen as the first “franchise” site. Project Dulce addresses the barriers to care by involving community members in the program at the most basic level. The hallmark of Project Dulce is the use of highly trained community members to serve as educators and advocates (promotoras). Promotoras must come from the community served, speak the language and be aware of community expressed needs, rather than imposing an “outside” program on members.

Promotoras are supervised by a nurse led team that provides diabetes care by co-managing the members with the primary care provider. Diabetes management is based on guidelines covering best practices in diabetes care. Electronic records are being established to track all aspects of care including objectives results and subjective results such as patient and provider satisfaction.

All of these efforts are based one fact; the person with diabetes is the true primary care provider and every effort must be made to give that person the education and tools to care for him/herself.

CHC may be reached at 267-972-0534 or bfgm1 @aol.com.

Domestic Violence - Spotlight on Domestic Violence

Each year, 4 million women in the United States are victims of domestic violence. It happens to women of all ages, races, religions, ethnic groups, classes, and educational backgrounds. And although it happens to men and to same-sex partners, domestic violence usually involves men abusing their female partners.

This violence results in nearly 2 million injuries and almost 1,300 deaths each year. In addition, violence can leave behind many unseen physical and emotional scars on the abused. Victims of violence often live with lasting health problems like chronic pain, gastrointestinal disorders, and irritable bowel syndrome, which limit their ability to live productive lives.

Domestic violence can also lead to sexual health issues like unwanted pregnancy, premature labor and birth, and sexually transmitted diseases including HIV/AIDS.

In addition to diseases and physical health problems, victims of violence report increased levels of depression, substance abuse, and suicidal behavior.

And domestic violence doesn’t just affect the victim, either. Everything that happens in a family is contagious. Children who witness violence are at a greater risk of failing at school, developing mental health problems, committing violent acts against others, and having low self-esteem

For every person who is abused, there is also an abuser. Understanding domestic violence involves knowing not only who is at risk of becoming victim, but who is at risk of committing violence.

Individuals who abuse their partners often witnessed violence as children. They were often abused themselves. In many cases, they have low self-esteem or abuse alcohol or drugs as a result. Abusers often feel alone and isolated due to societal factors like low income, lack of education, or unemployment. All of these factors combine to create an overwhelming feeling of hopelessness, stress, and frustration.

Domestic violence is a cycle and unless a victim seeks help, it will repeat itself over and over. In many cases, especially at first, a victim will make excuses for their partner. Often times shame, fear, or a desire to protect their family will keep a victim from contacting the authorities. An abuser may offer forgiveness or make promises to change. But soon enough the stress and frustrations of life will return and the abuse will begin again. However, neither violence nor silence is the answer.

It’s important to recognize the signs of an abusive relationship. If these descriptions sound like you or someone you know, try asking yourself, a friend, or loved one the following questions:

There are people and places that can help. If you, or someone you love, is in immediate danger call 911. 

Edited by Perry Ottenberg, MD, Clinical Professor of Psychiatry, University of Pennsylvania School of Medicine.

Domestic Violence - Domestic Violence and Our Youth

Domestic Violence is a serious social problem throughout the United States and has become well recognized as a health issue. Defined as a pattern of behavior where one uses power and control over their partner to get what they want, it is an issue that one community has found important to address with its youth.

Two key organizations bringing this message to the community are the TriCounty Health Partnership (TCHP) and Partners for Family Peace (PFP). TCHP is a community network of agencies, organizations, schools, churches and community members of eastern Berks, northern Chester and western Montgomery Counties, that has combined expertise, resources, and commitment to achieve a community where people want to live, work, play and raise children. Their focus is to strengthen families, prevent domestic violence, mentor youth to leadership and increase self-esteem.

Partners for Peace is a not-for-profit agency whose vision is a belief that it is possible to create a community where children are cared for, dating is safe, and families are peaceful. PFP’s focus is on a local child abuse program and providing educational programs on safe dating and building healthy relationships in area schools, congregations and the community. Working in the same community, PFP supports TCHP by providing leadership to the TCHP Domestic Violence Task Force. Barbara Wilhelmy, Program Director of PFP and the chair of the task force states, “We seek to raise awareness about the issue of domestic violence and have devoted a significant effort towards reaching youth.”

National statistics indicate that youth are at significant risk to experience violence and therefore, prevention and education to this population could lead to decreased incidence of violence in later years. “Approximately one in five female high school students reports being physically and/or sexually abused by a dating partner.” [1]

The TCHP task force has used creative ways to introduce the topic of safe dating to the local schools and to the community. Through an organization based in Massachusetts called Deana’s Fund, the TCHP has offered a one-woman play which focuses on experiences in dating and how to remain safe, to local schools. The presentation is followed by small student group breakout sessions led by social service experts who provide a discussion of the presentation.

Eight percent of high school age girls said “yes” when asked “if a boyfriend or date has ever forced sex against your will.” [2] Wilhelmy says, “By partnering with the schools since 2000, the task force has had an opportunity to address this important health issue in an atmosphere that is comfortable to the youth and sends the message that this is an important issue for everyone.”

Forty percent of girls age 14 to 17 report knowing someone their age who has been hit or beaten by a boyfriend. [3] While girls (and women) are more likely to experience domestic violence, boys (and men) can be victims as well. In 2001, women accounted for 85% of the victims of intimate partner violence and men accounted for approximately 15% of the victims. [4]

The opportunity to raise awareness to this sensitive issue, through organizations committed to improving the health and well being of their community, is just one area of prevention. The task force maintains a website http://www.dvresources.org which provides relevant information about the issue of domestic violence and a list of resources, both through agencies and information, to assist potential victims of domestic violence and for others interested in learning more about the topic. For more information about TCHP, the Domestic Violence Task Force or domestic violence, please log on to http://www.dvresources.org. For more information about Partners for Family Peace, please log on to http://www.family-peace.org.

[1] Jay G. Silverman, PhD; Anita Raj, PhD; Lorelei A. Mucci, MPH; and Jeanne E. Hathaway, MD, MPH, “Dating Violence Against Adolescent Girls and Associated Substance Use, Unhealthy Weight Control, Sexual Risk Behavior, Pregnancy, and Suicidality”, Journal of the American Medical Association, Vol. 286, No. 5, 2001.

[2] The Commonwealth Survey of the Health of Adolescent Girls, November 1997.

[3] Children Now/Kaiser Permanente poll, December 1995.

[4] Bureau of Justice Statistics Crime Date Brief, Intimate Partner Violence, 1993-2001, February 2003.

End of Life Care - Spotlight on End of Life Care

Most people are uncomfortable talking about death. The thought of what will happen when they or a loved one passes away is upsetting, but not talking about death can’t stop it from happening.  For that reason, planning for the end of life is an important step in coming to terms with dying.  In fact, it can be the key to ensuring a comfortable, meaningful end to your life.

Many of us will die after a long decline or battle with a terminal illness.  Thanks to new treatments, people with conditions such as heart disease, cancer, stroke, and dementia, are living longer than ever after diagnosis.  In some cases, treatment can both extend life and maintain the quality of life.  In other cases, life goes on, but it goes on painfully.  When thinking about the prospect of death be sure to consider:



There are many questions to ask yourself when thinking about your final days.  Some of the most important decisions relate to medical care.  For instance:

For each of these questions there are a variety of answers, all of which should be discussed openly with family members, friends, and healthcare or legal professionals.

Who will take care of me?

Deciding how you want to spend your final days is only part of the battle.  You also need to think about who you want to be there with you.  This can mean talking to everyone from health professionals to friends and family members.  When talking to friends and family about caregiving it’s important to ask difficult questions, such as:



What kind of treatment do I want?

As a dying patient, you have the right to accept or refuse any and all treatments, even those that might sustain life.  Here are some examples:

Do Not Resuscitate (DNR) order - A DNR (or DNAR) order instructs medical professionals not to attempt to restart your heart using CPR after cardiac arrest.  In cases where CPR may only prolong a painful death, a DNR may be necessary or desired. This may be called a Do Not Attempt Resuscitation (DNAR) order in some hospitals

Feeding Tubes and Ventilators - In cases where someone cannot eat or breathe on their own, feeding tubes and ventilators may be used to extend life.  The use of these methods may result in a quality of life issue.  It’s up to each individual patient and their families to determine what is right for them.

Where do I want to die?

There can be several options available to people who are choosing where to spend their final days.  The most common choices are: in the home, in an assisted living facility such as a nursing home, or in a hospital. Two of the more common care options used to make life easier for the dying and their families regardless of setting are hospice and palliative care. 

Hospice care is designed especially for terminally ill patients.  Hospice does not provide medical treatment designed to cure a disease; instead it works to make life more comfortable for someone who is dying.  It often consists of both pain control and emotional support for the patient and their family members.

Palliative care focuses on the physical, psychological, social and spiritual needs of patients and their families.  It moves beyond traditional hospice to encompass special therapies and counseling including art, music, and occupational therapy.

Regardless of the options, there are organizations to advise you and your family.  Some good questions to keep in mind include:



Advance Directives

Once you’ve asked yourself these questions, it’s important to put your wishes into what is known as an advance directive.  Advance directives are written instructions that communicate your wishes should you reach a point where you cannot speak for yourself.  Examples of advance directives include durable power of attorney and a living will. 

Durable power of attorney gives someone, usually a friend or a relative, the right to make medical decisions for you when you are no longer able.  It’s important to remember that durable power of attorney gives your agent or proxy the right to make all medical decisions on your behalf (including forgoing life-support) unless you decide to limit their powers. 

A living will is a set of instructions for caring for a dying individual.  A living will does not appoint another person to make decisions for you.  Instead, it lays out your wishes based on circumstances that are likely to occur at the end of life.

Edited by Paul Lanken, MD, Associate Dean for Professionalism and Humanism,
University of Pennsylvania School of Medicine; Professor of Medicine and Medical Ethics, Pulmonary, Allergy and Critical Care Division; Fellow, The College of Physicians of Philadelphia

End of Life Care - Keystone Hospice

Nearly one in four households in the U.S. cares for a spouse, family member or friend at home. More and more, those with an acute, chronic, or terminal illness choose to receive care in the privacy and comfort of their own home rather than in a nursing home or facility. However, with so many levels and providers of care available, how do you determine which are best for you and your loved ones?

Levels of care vary depending on the type of assistance required - from private duty care to skilled nursing care to hospice care.  And now, “telecare” technologies complement all levels of care with remote monitoring of vital signs, medications, and safety.

Consumers are legally entitled to select their own provider, subject only to the guidelines of which agencies your personal insurance covers. Just like people, providers come in all shapes and sizes - from small, independent non-profit providers to hospital-based agencies to national for-profit corporations.  Choosing an agency that meets your needs at every level ensures continuity in your care. Staying with the same care team with whom you have a trusting relationship maximizes your comfort and security if your medical needs change.

Private Duty Care assists those who do not have a medical need, yet would greatly benefit from assistance with eating, dressing, bathing and other housekeeping duties. You can begin private duty care without a doctor’s referral or insurance authorization and it is available on a temporary or longer-term basis.  Most private duty care is an out-of-pocket expense, but some services may be covered by insurance, supplementary insurance or long-term care policies.

Skilled Home Care is medically referred care provided by Medicare-certified agencies and is provided upon hospital discharge for management of a chronic health condition, or for a larger spectrum of medical needs.  Care is provided by a variety of health professionals - nurses, home health aides, infusion therapists, dieticians, social workers, and physical, occupational, and speech therapists.  Home care services are paid through a variety of public and private sources - including personal insurance and managed care companies, Medicare, Medicaid, Older Americans Act, Veterans Administration, and Social Services block grant programs. Some community organizations, such as local chapters of the American Cancer Society, Alzheimer’s Association, and National Easter Seal Society, also provide home care funding.

Hospice Care is for those with any end-stage diagnosis, both cancer and non-cancer such as pulmonary disease, cardiac disease, AIDS, and neurological diseases such as Alzheimer’s. An interdisciplinary team provides comfort and care to address the physical, psychosocial, spiritual and emotional issues associated with dying.  Medicare and Medicaid, as well as most private and commercial insurances, offer hospice benefits. There is typically no charge to the patient or family and it is provided regardless of the patient’s and/or family’s ability to pay.

Keystone Home Health Services, Inc. and Keystone Hospice are certified by the Community Health Accreditation Program and are licensed Medicare and Medicaid providers and serve patients throughout Philadelphia, Montgomery, Bucks, and Delaware counties. Keystone Hospice is a certified Jewish hospice through the National Institute for Jewish Hospice.  For additional information, please call Keystone’s clinical intake office at (215) 836-2440 or visit on-line at http://www.keystonecare.com

Glaucoma - Glaucoma Service Foundation at Wills Eye Hospital

Glaucoma is the leading cause of permanent blindness in the world - an estimated 67 million cases worldwide, with over 3 million affected in the United States. Once vision is lost from glaucoma it is lost for good.

Although most severe in the elderly, glaucoma affects all ages, including the newborn. The damage to the field of vision is striking, irreversible and leads to blindness if not recognized and treated. Too often the symptoms of glaucoma don’t appear until it’s too late. As the population ages and we live longer, the incidence of glaucoma and its devastating consequences are expected to reach near-epidemic levels.

For many years, glaucoma was defined as a condition in which the pressure of the fluid in the eye, the aqueous humor, is too high (above 21 mm Hg. or millimeters of mercury). In the past the doctor simply measured the pressure and that determined whether or not glaucoma was present. But that method of defining glaucoma was seriously wrong! Ninety percent of the people who were diagnosed with glaucoma by using this method did not have eye damage related to pressure, and one-third of those who had pressure-related damage were not diagnosed because their pressure was below the magic number of 21 mm Hg.

Now it is clear that a diagnosis of glaucoma is made by detecting the presence of tissue damage in the eye, especially to the optic nerve. Although pressure is a crucial factor in glaucoma, the amount of pressure that each individual eye can tolerate without damage to the optic nerve varies greatly.

In the type of glaucoma most common among people in the United States, the optic nerve gradually becomes damaged over a period of 10 to 30 years. The loss of nerve fibers occurs so gradually that the decrease in vision is usually not noticed until over half of the nerve fibers have already died. Additionally, the area of seeing that is lost first is on the side closest to the nose and involves one eye much more than the other. It often isn’t until both eyes have lost a great deal of vision that the afflicted person recognizes the loss. Contrary to what many people believe, the peripheral vision to the side is actually the last part of the vision to be lost in a person who has glaucoma.

A thorough examination which takes into account a patient’s family background (since glaucoma seems to be hereditary), pressure in the eye, visual field, and the condition of the optic nerve will allow the eye doctor in most cases to accurately determine whether a person has glaucoma. Once this basic determination has been made, the doctor will then carefully monitor the optic nerve appearance, visual field and pressure to determine if any further damage has occurred.

Treatment usually is designed to lower pressure in the eye to a level that will no longer damage the optic nerve. Sometimes this is done with eye drops, sometimes by surgically altering certain structures in the eye.

The Glaucoma Service at Wills Eye Hospital is working to minimize the impact glaucoma by:

For further information, please go the Glaucoma Service website at: http://www.willsglaucoma.org.

Glaucoma - Spotlight on Glaucoma

Glaucoma is a leading cause of irreversible blindness in adults in the world and one of the most common causes of blindness in the USA. Approximately 3 million Americans have glaucoma, but half are unaware of it. Most loss of vision from glaucoma is preventable if the disease is diagnosed and treated early enough.

Glaucoma is a disease of the optic nerve, the part of the eye that carries images to the brain. When small amounts of damage occur to the optic nerve, a blind spot occurs. These blind spots usually go unnoticed until there is a lot of damage to the optic nerve. If the entire optic nerve gets damaged, then blindness will result.

Getting a full medical eye examination, including a glaucoma check, is recommended for anyone over the age of 40. Glaucoma may take years to show signs of visual loss. The goal in Ophthalmology, the treatment of diseases and disorders of the eye, is to detect glaucoma at the earliest stage so that appropriate therapy can be started.

Clear fluid called “aqueous” is constantly produced and circulates in the front part of the eye and then drains into tiny holes. If the drainage system for the fluid is blocked, the excess fluid cannot flow out of the eye and pressure builds up, damaging the optic nerve.

There are two main types of glaucoma: chronic open-angle glaucoma and closed-angle glaucoma.

Chronic open-angle glaucoma is the most common form in the United States and is either inherited or develops with age. The risk of developing this form of glaucoma increases with age. The drainage system of the eye becomes less efficient over time and pressure inside of the eye gradually increases. In some patients the optic nerve becomes sensitive even to normal eye pressure and is at risk for damage.

In its early stages, often there are no symptoms and vision remains normal. As damage develops on the optic nerve, blind spots develop in the vision. You may not notice these blind spots until they become large and there is already a lot of damage to the optic nerve. Unfortunately, by this point the damage is usually irreversible.. Early detection with routine eye exams can help prevent this from happening.
Closed-angle glaucoma results when the colored part of the eye, called the ?iris,? is too close to the drainage system and blocks it. There are many different reasons why this can happen. The fluid inside of the eye cannot drain and a rapid increase in pressure develops causing an acute closed-angle attack. Symptoms may include a severe headache, halos around lights, blurred vision, nausea and vomiting.

This is an eye emergency and patients with these symptoms should follow up with an ophthalmologist, a medical doctor who treats eyes, because blindness can result. Typically closed-angle glaucoma can be corrected with a laser procedure.

Risk factors for glaucoma include age, elevated eye pressure, African ancestry, a family history of glaucoma, anyone over age 60 and past eye injuries.

African-Americans are three to four times more likely to develop chronic open-angle glaucoma than Caucasians. Chronic open-angle glaucoma develops earlier in African-Americans (around the age of 40) than in Caucasians, and progresses more rapidly. By age 70, the disease has attacked one in eight African-Americans, among whom it is a leading cause of blindness. In fact, African-Americans are about six times more likely to become blind from glaucoma than Caucasians.

Routine visits to your ophthalmologist are the best way to detect glaucoma. Testing your eye pressure alone is not sufficient to determine if you have glaucoma. Your ophthalmologist will also inspect the drainage angle, evaluate for any optic nerve damage and test your peripheral vision.

Glaucoma in general cannot be reversed. Treatment is aimed at controlling the eye’s pressure as a means of slowing the disease progression. Eye drops, laser surgery and in some cases surgery are the various ways in which glaucoma is treated.

Everyone should have routine eye examinations by an ophthalmologist.  There are a variety of other eye conditions in addition to glaucoma which can be diagnosed by an ophthalmologist.

An ophthalmologist is a medical doctor specializing in eyes.? This individual has graduated from medical school, followed by a residency (study in a particular field of medicine) in ophthalmology. Some ophthalmologists complete optional further fellowship training in a subspecialty of ophthalmology. An ophthalmologist has extensive training, often totaling 15 years of education following high school.

Following his or her education, an ophthalmologist takes both written and oral examinations. When these exams are passed, the ophthalmologist is then Board Certified by the American Academy of Ophthalmology.

As ophthalmologists are medical doctors, in addition to performing complete eye examinations, they can perform surgical procedures and dispense medications. They are the most highly trained of the eye care professionals.

Only Board Certified Ophthalmologists should perform glaucoma screenings and treatment.

Stephen M. Soll, MD, FACS, is a Fellow of the College of Physicians of Philadelphia. He is also Chief of the Division of Ophthalmology for the Frankford Hospital Health Care System, Philadelphia, Pennsylvania; and Chief of the Division of Ophthalmology for Cooper Hospital/University of Medicine and Dentistry of New Jersey, Camden, New Jersey.

Heart Disease - American Heart Association

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The American Heart Association is the largest nonprofit voluntary health organization fighting cardiovascular diseases, which annually kill about 950,000 Americans. Nationwide, the Association has grown to include more than 22.5 million volunteers and supporters who carry out its mission in communities across the country.

Locally, the American Heart Association battles cardiovascular disease in Bucks, Chester, Delaware, Montgomery and Philadelphia counties through its Operation Heartbeat program, a community-based initiative that seeks to strengthen the region’s “Chain of Survival” for cardiac arrest.  While the survival rate for cardiac arrest in Philadelphia is only 5 percent, this number could improve dramatically if community members follow the four steps in the Chain, which include:

Operation Heartbeat utilizes both volunteers and AHA staff to identify gaps in a community’s Chain as well as ways to implement stronger emergency response systems to improve survival rates.  These response plans frequently include CPR and AED training in schools, workplaces, community centers and churches, as well as placing AEDs with first responders such as police and fire departments and in public places where large numbers of people gather.  Recent AED placements made by the Association include the Philadelphia Phillies ballpark, the National Constitution Center, the Franklin Institute, the Forrest Theatre, and the Mann Center for the Performing Arts.

In addition to CPR and AED training, the Association works with other area organizations at a variety of community events, including health fairs, conferences and special programs.

The American Stroke Association, a division of the American Heart Association, also works within the community to raise awareness about stroke, America’s no. 3 killer.  Through its local Stroke Alert campaign, the Association screens more than 7,000 area residents annually for stroke risk, while its Operation Stroke initiative works to educate the public on the need for stroke to be treated as a medical emergency.  Operation Stroke also works with area hospitals to implement its Acute Stroke Treatment Program (ASTP) to strengthen the practice guidelines for managing stroke patients. 

For more information on the American Heart Association, call 1-800-AHA-USA1 or visit http://www.americanheart.org.

Heart Disease - Spotlight on Heart Disease

Heart Disease is the leading cause of death and disability for males and females in the United States. The term is a very general one for diseases with many different causes and origins.

The heart is basically a muscle that pumps blood throughout the entire body. It has a right and left side. The right side of the heart receives blood from the body and pumps it to the lungs where it is supplied with oxygen. The left side takes blood from the lungs and pumps it into the body where it provides our organs with nutrients such as oxygen.

The work of the heart is done in four chambers, two on each side:  two atria (at the top of the heart) and two ventricles (at the bottom on the heart).  The atria fill with blood which is then released to the ventricles. The ventricles then pump the blood into the body (left side) or the lungs (right side).  In addition, there are four valves in the heart that regulate blood flow between the chambers and the lungs and the body.

Blood travels in blood vessels.  Vessels that carry blood away from the heart are called arteries and vessels that carry blood to the heart are called veins.

Disease can affect any of the many parts of the heart, including the blood vessels that surround it.  Some people are born with these problems; others develop them throughout the course of their lives, often due to a poor diet, smoking, or a sedentary lifestyle. 

Terms to know and understand

Here are a few terms you might hear or read about in connection with heart disease:

Prevention

Preventing heart disease has a lot to do with how you live your life. Some risk factors like age, race or family history can’t be helped or changed.  Other factors are within your power to change.  Here’s a quick list of things you can do:

Edited by Bruce Jay Gould, MD, Fellow, College of Physicians of Philadelphia

Heart Disease - Zipper Club

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The Zipper Club is a nonprofit, volunteer, peer-support network composed of cardiac patients and their families whose mission is to help others like themselves. 

Working in partnership with the Pennsylvania-Delaware Affiliate of the American Heart Association, Zipper Club volunteers serve hospitals in Southeastern Pennsylvania and Southern New Jersey.

The Zipper Club was founded in 1974 by a patient who had undergone valve and bypass surgery at Deborah Heart and Lung Center.  While he was still in the hospital, a doctor asked him to speak with another patient who was feeling frightened and anxious.  Both recognized the value of peer support and human empathy in recovering from this very technical, life-altering surgery.

In the early days, Zipper Club volunteers made home visits at all hours of day or night to patients referred by hospitals and doctors.  The emphasis was on pre-op visiting and developing “heart-buddy” relationships among patients. Meetings were held in members’ homes.

The Zipper Club was incorporated in Pennsylvania in 1981 and established a relationship with the American Heart Association that continues today.  In 1991, The Zipper Club received national recognition as the 520th Daily Point of Light in the Thousand Points of Light program.

Today, Zipper Club volunteers visit patients in area hospitals, by telephone and via the Internet. They touch the lives of thousands of heart patients and their families each year.  Many volunteers feel this is an opportunity to express gratitude for their second chance at life and speak of the enormous satisfaction of helping others. They offer emotional support based on their personal experience with a cardiac diagnosis or event.  While they do not offer medical advice, they encourage healthy lifestyle by their example.  Patients feel confidence in volunteers who have “been there” and can relate to them as peers.

Additional support and heart education is provided through meetings featuring such topics as nutrition, exercise, stress reduction, and the latest information on prevention, diagnosis and treatment of heart-related diseases.  Beginning in 2007, a monthly support meeting will be held at the Klein Branch, Jewish Community Center located at 10100 Jamison Avenue (at Red Lion Road) in Philadelphia.

Participants in the Volunteer Visitor Program receive specialized training with experienced volunteers to assure appropriate interaction with patients and family members. Confidentiality is of paramount importance.

Please contact us if you are a patient or family member seeking information, reassurance or a sympathetic and knowledgeable listener.  A Zipper Club volunteer is as close as your telephone or e-mail! The Zipper Club may also be contacted through the Social Services Department of your local hospital.

The Zipper Club
c/o American Heart Association
625 West Ridge Pike
Building A, Suite 100
Conshohocken, PA 19428-0860
610-940-9655
http://www.zipperclub.com

The Zipper Club may also be contacted through the Social Services Department of your local hospital.

The Zipper Club is currently seeking men and women who have experienced bypass and/or valve surgery to join our Volunteer Visitor programs at Hahnemann Hospital, Thomas Jefferson University Hospital, the Hospital of the University of Pennsylvania (all in Philadelphia), and Phoenixville and Chester County Hospitals.

Volunteer opportunities are also available at our administrative office at the American Heart Association in Conshohocken, PA.  Please call 610-940-9655 for more information.

Influenza - Spotlight on Influenza

Influenza is a contagious virus that can cause a range of symptoms including fever, headache, cough, sore throat, runny or stuffy nose, and body aches. Diarrhea and vomiting may also occur although these symptoms are more likely to be seen in children. Symptoms of influenza range from mild to severe with some cases resulting in complications of pneumonia and death.

Although anyone can get the flu, young children, adults 65 and older, and persons of any age with a chronic medical condition are more likely to have complications of influenza. According to the Centers for Disease Control and Prevention (CDC), an estimated 200,000 hospitalizations and 36,000 deaths are attributed to complications of influenza each year in the United States. The peak of flu season in the United States generally occurs between late December and March.

The influenza virus is usually spread from person to person through droplets generated during coughing and sneezing. The virus can also be spread if a person touches a surface contaminated with the virus.

The best way to prevent influenza is to get the flu vaccine each season. Because of a flu vaccine shortage, the CDC is recommending that only persons in certain priority groups receive the vaccine this season. Priority groups for influenza vaccine include the following:

Good hygiene is important in preventing the transmission of the influenza virus, particularly when access to vaccine is limited. Everyone should take the following steps to help prevent transmission of the influenza virus:

Influenza can be diagnosed by laboratory tests. If you have the flu or think you have the flu, you should get plenty of rest, drink lots of fluids, and avoid using alcohol or tobacco. You can also take medications to relieve the symptoms but aspirin should never be given to children or teenagers because research has demonstrated an association between the development of Reye’s syndrome, a deadly disease, and the use of aspirin for treatment of flu-like symptoms. There are several antiviral medications that are approved for the treatment of influenza. These medications, available only with a physician’s prescription, must be started within two days of the onset of symptoms and be continued for five days.

Nicole Baker, MPH
Division of Disease Control
Philadelphia Department of Public Health
http://www.phila.gov/health/

Influenza - Influenza Vaccine

Every year in the United States, influenza kills about 20,000 to 40,000 people. Last year 36,000 people died in the U.S. from influenza. Probably the best example of exactly how devastating influenza can be was the influenza pandemic in 1918 this worldwide outbreak killed 21 million people in a single influenza season. Elderly adults are the group most likely to die from influenza, but infants and young children are at risk as well. Luckily, studies show that immunization of infants and young children with influenza vaccine not only decreases their hospitalization from influenza but it also decreases the hospitalization and death from influenza in elderly adults.

How is the influenza vaccine made?

The influenza vaccine is probably the hardest vaccine to make. The vaccine is made by growing influenza virus in hen’s eggs, purifying it, and completely killing it with a chemical. The influenza vaccine is unusual in that each year a different vaccine is made. Every year in the United States, the Centers for Disease Control and Prevention (CDC) determines what types of influenza we’re at risk from and makes sure that all the influenza vaccines that are made that season will protect us.

Does the influenza vaccine have side effects?

Side effects from the influenza vaccine are extremely rare. Fever or muscle aches can occur but these symptoms do not mean that you have “the flu.” Because the vaccine virus is “killed”, it does not cause symptoms, such as congestion and cough, which are common with influenza infections. Because the vaccine is grown in eggs, those with severe egg allergies may experience an allergic reaction to the vaccine. If you have egg allergies, please contact your doctor before getting a flu shot.

Do the benefits of the influenza vaccine outweigh the risks?

The influenza vaccine can cause mild side effects. In some case severe side effects do occur, but when they do they can be treated. On the other hand, influenza is responsible for about 200,000 hospitalizations and 20,000 deaths every year. Each year about 150 children died from influenza, most were previously healthy and many were less than two years old. Therefore, the benefits of the influenza vaccine clearly outweigh the risks.

Why can’t we just make more influenza vaccine to cover a possible shortage?

To account for slight changes in the types of influenza, a new influenza vaccine is made every year. The vaccine is made over the course of an eight month period and it requires a large numbers of eggs. Unfortunately, the millions of eggs required to make this vaccine are available only during March and April.

Who should get the influenza vaccine during a shortage?

The CDC recommends that every year those at greatest risk of being hospitalized and dying from influenza get vaccinated. This includes adults older than 50 years of age, children 6 to 23 months of age, family contacts of children less than 6 months of age, healthcare workers, pregnant women, people with long-term heart, kidney, lung, or metabolic diseases, or compromised immune systems, residents of nursing homes, and those in contact with high-risk groups.

To immunize everyone who needs a flu shot, we would need 185 million doses. This year we only have 53 million doses. This means that we have to let those people who are at the greatest risk of dying from the disease stand at the front of the line. For this reason, people between 50 and 64 years of age and adults with young children should not be immunized unless there is a surplus of vaccine later in the influenza season. Sadly, many who want and need the influenza vaccine will not get it this year and may be hospitalized as a result.

Will we have influenza vaccine shortages in the future?

Shortages have been blamed on pharmaceutical companies, the Food and Drug Administration, and the CDC. But the real problem is that only a few pharmaceutical companies make influenza vaccine for the United States. And at the end of most influenza seasons, the makers of the vaccine typically destroys millions of unused doses.

More companies would make influenza vaccine - and those that made it could be counted on to make enough - if the demand for vaccine was always high. We need to be consistent in our desire to protect ourselves against influenza. Only then can we count on a having all of the vaccine that we need.

Material for this article provided by:

Paul Offit, MD, Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, http://www.vaccine.chop.edu/

Nutrition - Spotlight on Nutrition

Americans are obsessed with thinness.  52% of Americans who have dieted or are dieting do so to feel better about how they look; only 16% say they diet for good health and well being.  For most people, “dieting” means removing or reducing various foods.

We all need to eat to stay alive.  Malnutrition (either too much food or not enough) can cause abnormal body function and disease.  Sometimes, even though our eating habits are good, symptoms of diseases of malnutrition develop because we cannot digest or absorb foods properly. Such diseases may not be corrected by dietary changes alone and may need additional medical treatment.

All elements needed to sustain life come from the earth and the energy from the sun through the plants we consume.  Since animals (non-human) also consume plants, they become a nutritional source when we consume animal products.

The Recommended Dietary Allowances

No one food has all of the nutrients we need.  Recommended dietary allowances (RDAs) have been created based on what foods we need for optimal health.  The foods that satisfy the RDAs fall into four groups:  (1) dairy; (2) meat/fish/poultry; (3) grains; and (4) fruits/vegetables. 

These groups make up the food pyramid, http://www.mypyramid.gov, which shows the kinds of foods and number of servings we all need to be healthy.  The food pyramid also recommends that our daily diets should contain:  55% carbohydrate, 15% protein, and 30% fat (20% unsaturated). These essential dietary nutrients, as well as vitamins and minerals, are directly connected to good health. 

Carbohydrates provide a source of energy. One such carbohydrate, glucose, can be stored in muscle and liver and used as a quick source of energy when needed.  Carbohydrates also provide fiber (bulk) necessary to help movement of the intestines.  Carbohydrates such as whole grain breads, pasta, fruits and vegetables are also rich in vitamins, minerals, and even some protein.  Fruits and vegetables are low in calories because of their high water content (up to 90%) and are a good source of fiber, complex carbohydrates, protein, and a healthy assortment of vitamins and minerals.  Fruits and vegetables provide virtually all of the vitamin C we need. 

Proteins are important because they are needed for our body structures (hair, bone, skin, muscle), hormones (growth, insulin, pituitary), protection (antibodies, blood clotting) and make up our genes.  Eating more protein beyond the recommended 15% of total calories, however, will not increase muscle size or body strength - only exercise can do that.  Food products that are high in protein include animal and dairy products, and legumes (beans, peas, lentils, peanuts). Legumes are an incomplete protein source because they lack one or two essential amino acids but if you combine whole grains, dairy products, eggs, poultry, fish and meat, that will correct this problem. Strict vegetarian diets are limited and if not consumed in adequate varieties can lead to deficiencies in vitamins B12 and D, iron, calcium, iodide and zinc.

Fat is a storage form of energy that is used for long periods of muscle activity (work, exercise). Fat provides twice as much energy than protein or carbohydrate.  There are different kinds of fats: complex lipids, steroids, and prostaglandins.  They are grouped as saturated (solid at room temperature), or unsaturated (liquid at room temperature).  The most abundant steroid in the body is called cholesterol.  Cholesterol is carried in the blood as a high-density lipoprotein (HDL or “good cholesterol”), or a low-density lipoprotein (LDL ?not good?).  Because high blood levels of LDL cholesterol have been linked to heart disease, many people think of cholesterol as a “bad guy.”

Actually, cholesterol is so important to life that our liver synthesizes (or makes) it to ensure an adequate blood level.  Fats are needed for fat-soluble vitamins (A,D,E,K), and to make you feel full.  Saturated fats are found in meat, poultry, milk, and shellfish; polyunsaturated fats are found in vegetable oils (corn, safflower, and fish oils) and mono-unsaturated fats are found in olive and peanut oils.  When reading package food labels, be aware that “cholesterol free” and “hydrogenated” mean the fats are in the form of man-made “trans-fatty acids” which are quickly converted into “bad” cholesterol.

How much should I eat?

The energy (calories) we get from food must equal the energy we use.  This can vary according to our body size, physical activity level, and other factors such as age, sex, family history, and current health status (growth, pregnancy, illness, etc.).  To find out how many calories you need to eat each day to stay at your present weight, there are several mathematical formulas or reference tables that compare lean body mass and physical activity.  One quick method is based on the idea that 13.5 calories/per pound of body weight are used by an inactive person (15 calories/lb. if moderately active; and 16.5 cals/lb for very active).  So, a 200 lb. person who isn’t very active would need 2,700 calories per day to remain at 200 pounds.  A very active 200-lb. person (like an athlete) would need 3,300 calories per day. 

A healthy body mass and composition is a sign of a healthful diet and the amount of calories you need should be based on an ideal weight.  A simple method to estimate what your ideal weight is:

If you are not currently at your ideal weight, you can determine how many calories you need to get to your ideal weight.  Take the ideal weight calculated above and multiply by 15.  A 200 lb. person who wants to be 150 lbs., should eat 2,250 calories per day (150 x 15).  You would need to adjust your eating to no more than 2,250 calories.  Whatever the goal, keep in mind that you should not lose more than two pounds per week.

How should I eat?

Once you know how many calories to eat, make sure the calories are equally distributed in six small meals throughout the day.  The three meals per day concept is not based on health recommendations but on a working force (breakfast at home, lunch on the job, and dinner at home).  By having fewer calories at each meal, your body is able to use up calories without leaving excess in storage (fat).  For these smaller meals, try using a saucer instead of a dinner plate, only one serving of food can fit on a saucer.  Another hint:  a portion of meat (4 oz) is approximately the size of your palm.

Nutrition, exercise and weight maintenance

A healthy diet and exercise will help you control your weight and lower the risk of serious health problems.  Since good health depends on many different kinds of nutrients, the best diet must meet all the dietary requirements needed to sustain life, maintain body weight, and prevent illnesses that can be caused by poor eating habits. 

Exercise is just as important as nutrition to maintain good health.  Regular physical activity - such as a brisk walk for 30 minutes, five times per week - is inexpensive and readily available.  Exercise will increase muscle tone and mass, burn calories, boost energy, lower “bad” cholesterol, relieve stress, prevent bone loss, lower the risk of heart disease, high blood pressure, diabetes, and even some cancers.

So, eat sensibly, take a walk, and enjoy good health!

Domenic A. De Bias, PhD, (1925-2006) was a Fellow of the College of Physicians of Philadelphia; Professor Emeritus at Philadelphia College of Osteopathic Medicine and an adjunct professor in the Pennsylvania State University-Frankford Hospital School of Nursing Program

Obesity - Spotlight on Obesity

Two out of every three Americans are overweight. Of these, many are seriously overweight or obese. Being overweight puts people at risk, and being obese at even greater risk, of developing serious health conditions such as high blood pressure, diabetes, heart disease, stroke and cancer. Overweight and obesity may even be life-threatening.

Luckily, even losing a small amount of weight by eating more healthfully and exercising can improve your health. If that doesn’t work, there are prescription medications or surgical techniques that could help. Before choosing any plan to lose weight, you should talk to your doctor. Some diets and other quick fixes may be dangerous to your health.

Your weight is determined by how many calories you get from the food you eat and the amount of energy you use in your daily activities. If you consume more calories than you use, you will gain weight because your body stores unused calories as fat. Therefore, overeating and lack of physical activity are the main causes of obesity.

If you think you might be overweight, your doctor can help. A physician can check your BMI (Body-Mass Index) which gives an estimate of your body fat based on your height and weight.  He or she can also check your Waist Circumference (the distance around your midsection) which also predicts the ill effects of obesity.

Here are some important things to keep in mind when it comes to watching your waistline:

Just remember, preventing obesity is up to you. With the right knowledge, a good attitude, and a safe, healthy plan, you can lose weight.

Edited by Albert Stunkard, MD, Founder and Director Emeritus, Weight and Eating Disorders Program, Professor Emeritus of Psychiatry, University of Pennsylvania School of Medicine

Nutrition - Pennsylvania Advocates for Nutrition and Activity

Pennsylvania schools have a terrific opportunity to confront one of our nation’s biggest public health problems: childhood obesity. One in three American kids is overweight, and national health experts (such as the current and former U.S. Surgeon General) agree that the associated health problems are threatening to make this generation of children the first in our history whose lifespan will not exceed that of their parents.

So why should schools, already overburdened with government mandates and high-stakes testing, be charged with addressing the problem? And why should we, as adults, care about this issue, even if we don’t have children?

If our schools don’t join as partners in the solution, we’re doomed to failure. Our children consume and expend many of their calories in school. In addition, their attitudes, preferences and behaviors are shaped by their school experiences. Schools are where the children are, so they must be part of the solution. And since schools are the center of many of our communities, it is critical that even those of us who don’t have students in school voice their support for healthier environments. What starts in the school can spread to the rest of the community, and vice versa.

Recently, the National Academies’ Institute of Medicine reported that if the nation is to fix its obesity problem, schools, governments, communities, corporations and parents must all work together to promote healthier lifestyles. The report called for a nationwide campaign similar to the successful anti-tobacco offensive.

Pennsylvania Advocates for Nutrition and Activity (PANA) is helping schools and communities find ways to address the problem by creating healthier environments that promote better eating and more physical activity. Our Keystone Healthy Zones school campaign offers free guidance, resources, materials and funding opportunities to the state’s public and private schools. This year 1,130 schools signed on, pledging to help create and support healthier environments. That’s up from 915 schools that signed on in the program’s first year, in 2004.

Some of the schools are in the beginning stages, putting together school health councils and figuring out where first to make simple changes such as limiting the hours that vending machines are available to students. Others have made elaborate plans for change, integrating nutrition education into their curriculum, revamping their physical education programs, offering creative before- and after-school fitness programs for students and staff, and revising nutrition policies to offer healthier food - not only in the cafeteria but also in vending machines and at school activities.

Schools have a lot to gain from making changes to encourage better eating and more physical activity. Several new studies, including one from the national Action for Healthy Kids, conclude that kids who eat healthfully and get regular physical activity tend to perform better academically - in the classroom as well as on standardized tests. In addition, the report says that schools are losing millions each year in health- care costs, absenteeism and lower productivity as a direct result of the numerous students - and staff - who are overweight or obese, and the health problems that result.

It is often said that obesity is a personal issue, but when it comes to creating environments that support healthy changes, our schools have a responsibility to get on board. PANA, which was created by the Pennsylvania Department of Health and funded by the U.S. Centers for Disease Control and Prevention, is here to help and partner. Log onto http://www.panaonline.org and click on “Community Champion Center” to see how you can get involved - and help us create a healthier state - for our children and ourselves.

Skin Cancer - Spotlight on Skin Cancer

Summer is a time when people spend much of their free time outside, enjoying the fresh air and sunshine. Many people wear short pants and t-shirts to keep cool. Ocean beaches, lakes and pools are popular vacation spots, where many people choose to lie out in the sun in their bathing suits to get suntanned. You may enjoy lying in the sun, but you can get hurt if you spend too much time exposed to natural sunlight or a tanning bed. Both the sun and tanning beds produce ultraviolet (UV) rays that can permanently damage your skin over time. Skin cancer is the most serious health problem that can happen as a result of this UV damage.

Skin covers our entire bodies and protects the inside of our bodies from dangers in the outside world. Skin is made up of many layers of cells. The top layer of skin we see when we look in the mirror is called the epidermis. Skin cells in the epidermis, including basal cells, squamous cells and melanocytes, are the ones that become skin cancers. Melanocytes produce melanin, the substance which gives our skin its color. The most serious type of skin cancer comes from melanocytes and is called melanoma.

The two most common kinds of skin cancer are basal cell carcinoma and squamous cell carcinoma. According to the American Academy of Dermatology, basal cell carcinoma makes up 80% of all skin cancer cases in the United States and occurs in more than 1 million people each year. Basal cell carcinomas grow slowly and rarely metastasize, or spread, to other parts of the body, such as the organs or lymph nodes. Basal cell carcinomas usually appear on areas of the body regularly exposed to the sun. Squamous cell carcinoma makes up 16% of all skin cancer cases, about 200,000 people, each year. Squamous cell carcinoma most often appears on areas of the body exposed to the sun, but squamous cell carcinoma can show up on areas of the skin not normally exposed. Unlike basal cell carcinoma, squamous cell carcinoma can spread to other areas of the body, so it needs to be diagnosed and treated early.

Melanoma is the least common but most serious form of skin cancer. Melanomas are only 4% of the skin cancers diagnosed each year. However, because melanomas can spread to other parts of the body, about one person dies each hour in the United States due to melanoma. The good news is that with early diagnosis and proper treatment, melanomas are about 95% curable. Doctors believe the sun breaks down the skin’s defenses. Even though melanomas are related to sun exposure, melanomas can appear on areas of the skin not normally exposed to the sun, such as the bottom of the feet. Skin cancers are rare in African-Americans and other dark skinned people, but people of color can get melanoma at the base of their fingernails and toenails. This may show up as a dark streak in the in the finger or toenails. Dark streaks are common and can be seen normally, so any streaks in finger or toenails should be seen by a dermatologist. Dermatologists are medical doctors who specialize in diseases of the skin.

Most skin cancers appear in people over age 50, but they can appear in younger people, and the damage can start in childhood. In fact, children who receive serious sunburns, including blisters, are at greater risk for developing skin cancer later on. The other risk factors for skin cancers include:

Skin cancer can be prevented by practicing the following steps:

The most common warning sign of skin cancer is a new growth, such as a scaly or bleeding patch or a sore that doesn’t heal. Skin cancers don’t all look the same, and their appearance may change as they grow. Skin cancers of the lip and ear may spread more commonly. Keep an eye out for any skin spot or growth that is new or changes, and speak with a dermatologist if you notice anything unusual. Pay special attention to following features of any skin growth:

See your doctor if you answer “yes” to any of these questions. The doctor will examine you and may remove part or all of the growth for study. This is called a biopsy. Treatment for skin cancer usually involves surgery to remove the growth. Sometimes your doctor will freeze or burn off pre-cancerous growths. Certain creams can also remove these pre-cancerous growths. These are growths that, left untreated, could become cancers.

Preventing skin cancer doesn’t mean you have to stay inside all summer and stop enjoying the outdoors. It just means being careful and taking steps to keep your skin healthy.

Edited by Eric Bernstein, MD. Dr. Bernstein is a dermatologic laser surgeon in private practice and Clinical Associate Professor in the Department of Dermatology at the University of Pennsylvania

Sleep - Spotlight on Sleep Apnea

Sleep apnea is a serious medical condition that affects over 4 percent of the adult population. It is characterized by frequent pauses in breathing during sleep due to upper airway closure. Many individuals with sleep apnea have hundreds of pauses in breathing during the night. They are often completely unaware of the disorder.

Some of the symptoms of sleep apnea are: loud snoring, daytime sleepiness, fatigue, irritability, and morning headaches. Often the bed partner is the first one to report a problem.

The risk factors for sleep apnea include: male sex, obesity, large neck size, small mandible (jaw), alcohol consumption, large tonsils, crowded airway anatomy and increased age. However, many affected individuals do not have these characteristics.

There are several consequences of untreated sleep apnea. Because the individual stops breathing, the body is deprived of oxygen. In addition, individuals with sleep apnea have a higher association of having hypertension, strokes, heart problems and difficulty in managing blood sugar. Furthermore, sleep apnea causes excessive daytime sleepiness, which leads to thousands of accident-related deaths each year.

Obstructive sleep apnea is usually recognized by a primary care physician who inquires about the patient’s sleep history. Once sleep apnea is suspected, the patient is usually referred to a sleep specialist who may perform an overnight sleep study (polysomnogram).

There are several treatment options for obstructive sleep apnea. For patients with mild sleep apnea, lifestyle changes may be enough to improve sleep and resolve daytime sleepiness. These changes include weight loss, avoidance of alcohol, and the prevention of sleeping on one’s back. Often, the individual will require additional therapy. The most popular treatment for sleep apnea is Continuous Positive Airway Pressure (CPAP). CPAP utilizes an air pump that blows room-air to a mask that the patient wears over his or her nose. The air that blows through the patient’s nose prevents the airway from closing during sleep. CPAP is very safe. There are several specialized options that may accompany CPAP in order to promote comfort and compliance.

Other treatment options include using a mouthpiece (mandibular device), oral surgery (uvulo-palato-pharyngeoplasty “U.P.P.P or UP3") and other head and neck surgeries. Nasal strips, intra-nasal pressure devices and oral sprays are generally not sufficient to treat sleep apnea. Current research does not support the use of these alternatives for treating sleep apnea.

Children are also at risk for sleep apnea. They may present with similar complaints. Often it is due to enlargement of the tonsils.

Sleep apnea is a very common sleep disorder that has significant consequences. Fortunately, the inquisitive healthcare provider or suspicious patient/bed partner can recognize the symptoms of sleep apnea. With the proper evaluation, sleep apnea can be successfully diagnosed and treated.

Helpful resources:

National Sleep Foundation: http://www.sleepfoundation.org

American Sleep Apnea Association: http://www.sleepapnea.org

American Academy of Sleep Medicine: http://www.sleepeducation.com

Neil Kline, MD, is an internist and sleep medicine physician at the University of Pennsylvania, Center for Sleep and Respiratory Neurobiology

Sleep - Awake in Philly

As I prepare this column, someone made the comment: “Sleep advocacy”, that doesn’t sound too exciting. Most people, at first thought, would likely agree that “sleep advocacy” doesn’t sound exciting.

To start with the basics, it’s about helping spread the word about the importance of proper sleep hygiene—helping others realize they need a full, proper night’s rest instead of an abbreviated sleep schedule so they can fit everything possible into 24 hours.

Without adequate rest, the body begins to suffer. People who are chronically sleep deprived, whether they realize it or not, begin to suffer ailments, possible memory loss, or other problems.

One of Awake In Philly’s major focuses is on a common sleep disorder known as obstructive sleep apnea (OSA). It’s estimated that at least four percent of all men and two percent of all women suffer from it, and most of those people remain undiagnosed for a variety of reasons.

OSA is one of those problems that is unseen, and, for the most part, undetected by the individual. It’s also a sleep disorder that has historical stereotypes: middle-age, males, fat, falling asleep while standing in a door.

The truth of the matter is that there is no one-size-fits-all with apnea. Sure, many individuals who have been diagnosed so far may be overweight and men, but many people are of normal weight, and there are a fair number of women being diagnosed, as well. The thing to note is that more and more people, young and old, who are thin, some who are even athletic, who are being diagnosed with apnea.  It’s not just a male-thing.

It’s not just a weight-related issue, despite many people being told by their family doctors to lose weight and it will go away. In fact, there aren’t any conclusive studies to demonstrate that apnea will vanish by weight loss alone. Many people that Awake In Philly is involved with are at ideal body weight, some are under their ideal body weight, and others are overweight, so weight is not the chief factor that needs to be considered when evaluating someone’s potential apnea risk.

To give a firsthand account, let’s look at a real individual’s problems.

Complaints of excessive sleepiness were reported to family physicians from age 14, but other problems involving problem daytime sleepiness were documented by teachers on report cards going to back age eight. By the time the individual reached junior high, he found it necessary to rely on a pocket planner to keep track of homework assignments, work, chores, and other tasks. The memory complaints, as well as those concerning his excessive sleepiness were dismissed as being “typical teenager problems.”

While serving in the Army, he would fall asleep while standing at attention with his eyes open; doze off during classroom instruction; and actually march in his sleep, something that could be considered automatic behavior. He was often told to get more sleep, which was never a problem: he would sleep in a moving tank without problem.

After his military service, the problem sleepiness continued. By age 26, he had been fired from two jobs for sleeping in the workplace. Complaints to family physicians, again, were dismissed. At this point, his blood pressure was normal, and he had maintained his ideal body weight, just as he had throughout his life, including during his military service. The various physicians he saw over the years all said basically the same thing: You’re in better shape that I am. Your blood pressure, cholesterol, and weight are terrific. You’re muscular, fit, and look like Superman. Just get more sleep at night and things will be better.

By the time he was 33, life was spiraling out of control. He had been fired for several jobs. He left the corporate world to venture out on his own, something that allowed him to work the hours that were most convenient for him. His short-term and long-term memory had been severely impacted by this point, forcing him to constantly rely on a Franklin planner, as well as electronic personal information managers and databases for information retrieval. Remembering key points in his children’s lives was now a chore, and one that was left to the databases rather than memory.

At the age of 34, he was no longer able to make a 100-mile drive without repeated stops at highway rest areas for 20 minute naps. Those naps, over a period of months, got progressively longer, and even more frequent.

By age 35, most of his waking hours were spent in a sleep-induced stupor. No one around him knew what was going on. While out driving on work-related assignments, he would fall asleep as soon as he pulled up to a stop sign. He would wake to the sound of other drivers honking their horns. His complaints to family doctors, again, were dismissed, with the normal advice: You have a stressful life, so get more sleep.

On December 31, 1999, he went to the emergency room of a hospital in Northeast Philadelphia, complaining of severe chills, temperature, difficulty breathing, and other complaints. His blood pressure was 240/180, his respirations were 32 and shallow, lungs were filled with fluid, and he was oriented most of the time, but his level of alertness was diminished, he was often incoherent, and his blood oxygen levels were dangerously low. When a phlebotomist attempted to do an ABG draw, his blood clotted before a full sample could be taken.

The 35-year-old male was admitted to ICU with a severe bout of pneumonia, sepsis, infected post-nasal drip, and a variety of other related issues.

Not long before midnight that evening, his nurse and a respiratory therapist stood in the doorway to his room doing a deathwatch, but waiting. The patient’s monitors repeatedly set off alarms at the nursing station for the heart and respiratory monitors.

The two stood there, watching the New Years show on television, waiting on the next alarm trip. Then it happened. The respiratory therapist watched and waited. Ten seconds. Twenty seconds. Thirty seconds. The patient began gasping. He reset the monitors. Less than a minute later, the event repeated. He looked at the nurse and said, He’s going to die from apnea before he dies from pneumonia.

After calling the pulmonologist on duty that evening, the respiratory therapist had a bi-level positive airway pressure device brought to the room and he began titrating a pressure to maintain a patent airway.

Eight days later, upon discharge, the man was told he suffered a host of ailments, including obstructive sleep apnea, congestive heart failure and mitral regurgitation.

After his discharge, the man contacted his ex-wife to tell her, as well as his children, about his diagnosis with apnea. To his astonishment, his ex-wife said, “Oh, you’re finally diagnosed, huh?? I could have told you that 16 years ago!?? She said she learned of the problem while talking with a physician friend who had attended a seminar, and never told him because she didn’t want to get into an argument over the matter.

Three weeks later, during a formal polysomnogram (sleep study), he was diagnosed with having severe sleep apnea, having suffered more than 137 apneas per hour, along with cardiac arrhythmias. An apnea is defined as a cessation of breathing for a period of 10 seconds or longer.

The above story is a true illustration. In fact, it is my story, one which I am very happy to be able to share.

Life today is different. When I left the ICU, I was given two options: Use the BiPAP machine or die. I opted to use the machine, and I continue to do so, as it maintains a patent airway while I sleep, and I try to maintain a normal sleep schedule.

Sure, getting used to the machine, as well as the mask took time. In fact, for me it took about three months and nine destroyed nasal masks before I found the one I prefer. The mask is one of the two most crucial elements of xPAP therapy. The other is heated humidification.

The challenges people with sleep apnea, as well as many with a variety of sleep disorders, include memory loss, problem sleepiness, and possible snoring. As things progress, problems focusing on specific tasks, challenges staying awake or alert while driving, possibly sexual dysfunction or loss of sex drive, and moodiness/mood swings, or depression.

Years ago I was told to “just get more sleep”—but see, sleep was, in all reality, killing me.

I guess now you know the secret to my devout passion for activism in the sleep field. It’s all about helping prevent something similar from happening to others. One day I’d like to walk away from sleep activism, knowing that I don’t have to worry about others not being diagnosed, being casually dismissed because they don’t meet the stereotypes, or simply being misdiagnosed, such as being “depressed.”

About the Author

Dave Jackson is the coordinator of Awake In Philly, and spent more than 20 years as a journalist and editor, and for the past five years, has been involved in sleep activism. For more information, visit the Awake In Philly website at http://www.AwakeInPhilly.org. He may be contacted via email at , or via phone, at 215-722-2326.

Smoking - Breathe Free Philadelphia Alliance

We have known for some time that smoking causes death and disease. Now we know that secondhand smoke does, too. Secondhand smoke is a toxic substance; it contains over 4,000 chemicals, at least 69 of which are known to cause cancer. The scientific evidence on the health risks associated with exposure is clear, convincing and overwhelming. Secondhand smoke is a known cause of lung cancer, heart disease, low birth-weight births, and chronic lung ailments such as bronchitis and asthma (particularly in children), as well as other health problems.

When someone smokes in a public place, everyone else in that space smokes too. Most of the smoke generated by a cigarette is distributed into the local atmosphere, polluting the lungs of all those exposed.

Just like people in offices, workers in restaurants, bars, and other places that are not yet smoke-free have the right to breathe clean air.  No one should have to breathe toxic chemicals as a condition of employment. However, this is a real choice that far too many Philadelphians are forced to make. Those in blue-collar and service jobs are disproportionately exposed at the workplace, meaning that women and people of color carry the heaviest burden from Philly’s toxic environment.

Workplace exposure to secondhand smoke isn’t just a health issue; it’s a health justice issue. We need to protect everyone’s health, regardless of gender, race or class.

More than 75 million Americans already benefit from living in cities and states with comprehensive smoke-free laws. Los Angeles, Boston, New York, Dallas, Louisville, Austin; these are just some of the cities that have gone smoke-free, to great success. The list keeps growing, with New Jersey and Washington D.C. poised to join the fold. We know from their experiences that these policies do not hurt business. California, Boston and New York City have all seen stable or increased bar, restaurant, and hotel receipts. This is not a risky move by any means.

So what’s keeping Philly from taking this important step forward? Politics, it seems, has gotten in the way of public health. Smoke-free legislation was introduced last February and is currently stalled in City Council, lacking the nine votes needed to pass. We have more than enough information to guide a responsible decision, yet the political will and leadership is sadly lacking. We hope that Philadelphia’s elected officials will do the right thing in 2006 and steer our City in the right direction (make sure that you contact your representatives to voice your opinion on this critical issue).

Giving everyone the right to breathe clean air should not be a political battle. A comprehensive smoke-free law prohibiting smoking in the City’s workplaces would mean improved health and quality of life for tens of thousands of Philadelphians.

The Breathe Free Philadelphia Alliance is working with partners across the city to get the word out and garner support. Passing this law will be no small feat. We need your help to make change happen in City Hall! If you are interested in getting involved or have any questions please contact Katherine Gajewski, Campaign Coordinator, at 215.988.0458 or .

Sign the online petition and get more information at the Breathe Free Philadelphia website: http://www.breathefreephiladelphia.org

Smoking - Spotlight on Smoking Cessation

It’s never too late to quit smoking. This article briefly lists the health risks of smoking and then describes a number of tools and techniques that can help you quit.

When someone thinks of the risks of smoking, the first thing that comes to mind is usually cancer, especially lung cancer. According to the American Lung Association, 87% of lung cancer cases are caused by smoking. Cigarette smoke contains thousands of harmful substances, called carcinogens, which have been proven to cause cancer. In addition to cancer, smoking has been shown to cause other lung and breathing problems (such as bronchitis and emphysema), heart disease, and stroke, and smoking can worsen asthma and pneumonia. 

Smoking is not only harmful to the smoker. Secondhand, or passive smoke can cause health problems in people, including family, friends and co-workers, who come in regular contact with a smoker. Pregnant women who smoke put their babies at risk for early birth (preemies), low birth weight, and, once the baby is born, sudden infant death syndrome (SIDS).

Quitting smoking is difficult because nicotine, one of the harmful chemicals in tobacco, is addictive. Nicotine acts as a stimulant, increasing alertness and good feelings. However, once the effects of nicotine wear off, a person often feels depressed and tired, and feels a strong urge to light up a new cigarette to bring back the “high.” The Pennsylvania Department of Health reported that, in 2003, 25% of all adult Pennsylvanians identified themselves as current cigarette smokers. In addition, 25% of Pennsylvania adults in 2003 described themselves as former cigarette smokers. Hence, half of adult Pennsylvanians have never smoked cigarettes. It is also encouraging that, among those Pennsylvania adults who were currently smoking everyday in 2003, 47% had quit for at least one day in the past year.

So there is hope, and there are several ways to stop smoking, both on your own and with a doctor’s help. If you decide to try stopping on your own, consider the following steps:

You can also get professional help with quitting:

Edited by Walter Tsou, MD, MPH, President of the American Public Health Association, principal of Tsou Consulting, and a Fellow of The College of Physicians of Philadelphia.

Visual Impairment - Associated Services for the Blind and Visually Impaired

Associated Services for the Blind and Visually Impaired (ASB) provides a full spectrum of rehabilitation and life skills education for blind and visually impaired individuals. ASB also operates a 24-hour a day/7 day a week radio reading service, provides monthly recordings of over two dozen popular magazines, and produces approximately nine million pages of braille per year.  With roots dating back to 1874, ASB is the largest non-profit organization in Southeastern Pennsylvania serving people who are blind or visually impaired.

Rehabilitative and Specialized Services

ASB provides critical training and services to blind and visually impaired individuals, through our Rehabilitative and Specialized Services programs.  Students learn everything from how to safely travel in the city using tools such as a white cane or optical scope, to communicating effectively without the benefit of sight. Another important service which ASB has developed is the Latino Outreach program to accommodate the growing number of local Spanish-speaking people who have lost their vision to diabetes, glaucoma and other diseases effecting sight.

Computer Technology Center

The Computer Technology Center is on pace with the rapidly developing advances in technology geared specifically toward persons with vision loss.  Using up-to-date equipment, center staff teach how to use computers along with appropriate assistive technology such as screen readers or screen magnification software. Center courses are adapted to the needs of novices to experts. 

Braille Production

ASB’s Braille Division has been providing quality braille since 1929.  Today, ASB is one of the five largest producers of braille in the nation. With the use of modern braille presses, trained staff, and dedicated volunteers, ASB’s Braille Division brailles and proofreads over 82,000 master braille pages, and presses, collates and binds over 9,000,000 braille pages of library books, magazines, textbooks, brochures, newsletters, job-related materials, and statements for banks and utilities each year.  ASB also produces braille on a per-customer, on-demand basis for entities such as school districts so students throughout the nation can be guaranteed a high-quality education in mainstream learning settings.

Recorded Periodicals

The Recording Department produces audiotapes of books and magazines (offered by subscription) to translate printed information into a usable format for people who are blind or visually impaired.  ASB has been providing audio recordings for people who are blind or visually impaired since the 1940?s.  Today, subscribers hear such periodicals as The New Yorker, Harvard Men’s Health Watch, Popular Mechanics, Smithsonian Magazine and Forbes.

Radio Information Center for the Blind (RICB)

In ASB’s Radio Information Center (RICB), local daily and weekly newspapers are read by volunteers to thousands of people who are blind, visually impaired, or unable to read print throughout the Delaware Valley. In addition to newspapers, listeners also hear general interest programming tailored to their needs around topics as diverse as healthy living, gardening and fashion. The station airs these programs seven days a week, 24 hours each day.

For more information about ASB’s services and programs, visit our website at www.asb.org, send an E-mail to , or call 215-627-0600.

Mission Statement/ Description

Associated Services for the Blind & Visually Impaired (ASB), a private, non-profit organization, promotes self-esteem, independence, and self determination in people who are blind or visually impaired.  ASB accomplishes this by providing support through education, training and resources, as well as through community action and public education, serving as a voice and advocate for the rights of all people who are blind and visually impaired.

Visual Impairment - Spotlight on Visual Impairment

Anatomy of the Eye

Understanding visual impairment starts with understanding how our amazing visual system works.  The human eye is constructed very much like a camera.  Light waves reflected from the surface of an object enter the eye thru the cornea.  The cornea is part of the outside coat of the eye.  It allows light rays to enter the eye and partially focuses them. 

Behind the cornea is the iris.  The iris may be brown, blue or another shade of color.  It controls the size of the pupil, so that in dark areas the pupil is large and in bright areas the pupil is small. 

The lens that finally focuses the image onto the retina is located behind the iris.  The retina in the eye is like film in a camera and is located in the back part of the eye.  The image focused on the retina is actually upside down.  The nerve cells in the retina transmit the impulses to the brain via the optic nerve.  These nerve impulses eventually reach the back of the brain where they are processed and we see the images right side up.

Measuring Vision

Vision is measured in terms of central vision and side or peripheral vision.

Central vision is a measure of how well you can see straight ahead of you at a distance of 20 feet.  You’ve probably heard the term 20/20 vision.  This term is commonly used for normal sight.  It is calculated by using an eye chart.

The first number is the distance someone is standing from the eye chart, in most cases this is 20 feet. The second number is the distance from which a normal eye can clearly see a letter on the chart.  For example, someone with 20/20 vision can see and read small letters well at a distance of 20 feet.

A person with 20/60 vision would have to walk up to 20 feet to see the letters a person with 20/20 vision could see at 60 feet.  It is very important to know that a person’s uncorrected vision does not always reflect the health or disease of an eye.  Most people with poor vision that is correctable with eyeglasses or contact lenses, have healthy eyes.

Peripheral vision is measured with an instrument called a perimeter.  A perimeter measures the total area that you can see while looking straight ahead. The results are recorded in degrees. A person with normal eyes can see 180 degrees. A person with less side vision may have trouble walking, recognizing faces or driving a car - even if his or her central vision is excellent.

When your vision is 20/200 or worse without eyeglasses or contact lenses, or your side vision is 20 degrees or less, you are considered legally blind - even though you may still be able to see.  People who are legally blind may qualify for government benefits or receive assistance from public and private organizations.  As many as 1 million Americans are legally blind.

Visual Impairment

More than 3 million Americans have problems with their vision that cannot be easily improved by eyeglasses or corrective lenses. These individuals are considered visually impaired.  Visual impairment can be caused by a number of eye diseases, including:

Living with Visual Impairment

An important part of coping with visual impairment is scheduling regular eye examinations with your ophthalmologist (eye doctor).  Together you can monitor your eye health and preserve your remaining vision when possible.

In addition, there are many services and devices for people with reduced vision, including counselors, large print materials, audio publications, optical magnifiers, mobility training, and tools to improve lighting.

There are also a number of state and local agencies for the visually impaired. These agencies can help you obtain handicapped parking, low-vision services, government benefits, or information about tax exemptions for the visually impaired.  In addition, there are support group for people suffering from eye problems.

Edited by David Soll, MD, Emeritus Clinical Professor of Surgery and Head Ophthalmology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden; Fellow, College of Physicians of Philadelphia

Phillyhealthinfo.org Staff

Andrea L. Kenyon, AMLS
Project Director

Eric Darley, MS
Systems and Outreach Coordinator

Jonathan Goff, MS
Web Content Manager

2008-2009 Southeastern Pennsylvania Flu Shot Guide

image(Updated 12/8/08) Getting a flu shot can reduce your risk of becoming one of the 36,000 Americans who die from flu every year, especially if you’re at risk.  The two types of available vaccines are the flu shot and the nasal spray. Anyone who wants to reduce their chances of getting the flu can get vaccinated. However, it is recommended that certain people should get vaccinated each year:

In addition, they recommend that people who live with or care for those at high risk for complications from flu get vaccinated, including:


Worried that the flu shot is going to make you sick?  The CDC has all the answers to your questions.

PhillyHealthInfo.org is Southeastern Pennsylvania’s gateway to flu shot clinics. If you’re looking for specific information about flu clinics in your county, use one of the following links for more information:

Bucks County

The Bucks County Department of Health distributed free flu shots at locations throughout the county on Saturday, October 18th.  Check here for future clinics:

Chester County

Please call CCHD at 610-344-6252 for an appointment:

Delaware County

For information on flu shot clinics, call the Department of Intercommunity Health Coordination at (610) 891-5311 or see the link below:

Montgomery County

Click here for a complete list of locations:

Philadelphia County

Flu shots will be available to eligible Philadelphia residents at the District Health Centers beginning Monday, October 27th and at Federally Qualified Health Centers on November 5th.  Click here for times and locations.  For a list of additional community flu shot locations sponsored by the Philadelphia Department of Public Health, please see our calendar. 



Non-County Specific Flu Shots:

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Each year the Pennsylvania Public Interest Research Group visits toy stores and other retailers across our area looking for potentially dangerous toys and trends in toy safety.  The result is their annual Trouble in Toyland report.

According to the most recent data from the Consumer Product Safety Commission (CPSC), toy-related injuries sent more than 80,000 children under the age of five to emergency rooms in 2007. Eighteen children died from toy-related injuries that year.

These events provide a warning that as parents and other toygivers venture into crowded malls this holiday season, they should remain vigilant about often hidden hazards posed by toys on store shelves.

For the 2008 Toy Safety Shopping Guide, click here.

To read the Full Report, go here.

Home page - 11/24/2006

2006-2007 Delaware Valley Flu Shot Guide

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Phillyhealthinfo.org is the Delaware Valley’s gateway to flu shot clinics. If you’re looking for a flu shot in Bucks, Chester, Delaware, Montgomery or Philadelphia counties, go to our Health Events Calendar and search by day, week or month.

Trouble in Toyland?

Learn more about the hidden hazards posed by toys on store shelves. 

Hospital-acquired Infections

Find out more about a recent report listing infection rates for hospitals in the Delaware Valley. 

World AIDS Day - December 1, 2006

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There are over 39 million people living with HIV worldwide, including thousands of people right here in the Delaware Valley. Take some time this World AIDS Day to find out how you can get involved locally. 

Home page - 12/4/2006

2006-2007 Delaware Valley Flu Shot Guide

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Phillyhealthinfo.org is the Delaware Valley’s gateway to flu shot clinics. If you’re looking for a flu shot in Bucks, Chester, Delaware, Montgomery or Philadelphia counties, go to our Health Events Calendar and search by day, week or month.

Stay Warm This Winter

As another winter approaches, find out how you or a loved one can get help with heating bills in our Weather Safety section.

Trouble in Toyland?

Learn more about the hidden hazards posed by toys on store shelves. 

New Directions Support Group

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Read more about New Directions, an award-winning local support group for people with depression, bipolar disorder, and their loved ones. 

Bipolar Disorder - New Directions Support Group

New Directions Support Group, Inc. for people with depression, bipolar disorder, and their loved ones, is an award-winning support group, which attracts an average of 50 people per meeting at the Abington Presbyterian Church, 1082 Old York Road, in Abington, PA 19001, on the first and third Tuesday nights of the month from 7:30 to 10 pm. After a brief intro, we divide into small group discussions so every person has a chance to talk. Members then give on-the-spot problem-solving strategies.

Led by trained group facilitators, we encourage our participants to exchange phone numbers and call one another in good times and in bad. New Directions saves lives! All members must be diagnosed and under the care of a physician. Family members are strongly encouraged to attend. Led by a family member, they meet in a separate room.

New Directions was founded in 1986 by psychotherapist and award-winning writer, Ruth Z. Deming, who was diagnosed with bipolar disorder in 1984. She formed the group to help herself and to answer her question: Is there life after being diagnosed with bipolar disorder. Yes, indeed!

Ruth learned that by helping others, we help ourselves. She shares with the group her Keys to Recovery, which include:  Find the best possible psychiatrist and work with him or her as a partner; remain in the workforce, if possible; educate yourself about your illness and your medication; do frequent aerobic exercise, such as power-walking; get plenty of light in the wintertime; eat nutritious foods, and do things you enjoy doing. You are so much more than your illness. And, please don’t say, “I’m bipolar.” Say, “I have bipolar disorder.” This is a physical illness of the brain. Many family members do not understand this, so we urge them to attend and educate themselves.

On the third Tuesday of the month, we have a guest speaker. These include topnotch psychiatrists, employment specialists, nutritionists, cognitive therapists. We ask our members for feedback, as we are always striving to do our best. We also maintain a list of Top Doctors and Top Therapists, and have a Crisis Plan should someone be contemplating suicide.

Ruth Deming is also a therapist in private practice and enjoys doing home interventions, where she goes out to meet the family and talk to them. She loves making personal appearances to local civic organizations such as Rotary Groups, local nursing schools, and was a featured guest on a 5-minute CN8 Comcast interview.

Her message is, “For every terrible story you hear about someone with bipolar disorder or depression, there are thousands of success stories.”

She’ll be happy to speak at your organization. Email her at .

For more info, visit our website at http://www.newdirectionssupport.org or call 215-659-2366, ext. 1 to register to attend.

Don’t be a Victim of Medical Misinformation

Wondering if those internet rumors are true?  Can you really fail a drug test because of a poppy seed bagel?  Can drinking cold water give you cancer?  Or what about the miracle cures you’ve heard so much about?  Do they really work? Do some research using these helpful sites, the answers might surprise you: