Friday, March 11, 2011

Seven Out of Ten People with Colon Cancer Have No Symptoms

By Martha Hunt, MA
Health Promotion and Wellness

Colorectal cancer is the third leading cause of cancer in males, fourth in females in the U.S. It is estimated that in 2010 there were 102,900 (colon) and 39,670 (rectal) new cases and 51,370 (colon and rectal combined deaths. Among both men and women, incidence rates have fallen steadily since 1985.

There are two reasons why you may need a colonoscopy which is a form of colon cancer screening. First of all, a colonoscopy will help test for and maybe help prevent colorectal cancer. Secondly, when you access the age or risk appropriate annual screening that you need, you bring funds into the Naval Hospital so that we can continue to offer the same high quality care we now provide. Remember, there is no free lunch in life and when you do not access the annual tests needed for your gender and age, then not only are you putting your health at risk but Navy Medicine can then cut our budget impacting the staffing and services we offer.

What is a colonoscopy? -- Colonoscopy examines the entire colon with the use of a flexible tube with a camera at one end. The test generally lasts about 30 minutes, is safe and usually painless. There may be some discomfort, but you are usually given a sedative to help you to relax.

Colonoscopy is usually needed only once every 10 years if the test results are normal.

Colonoscopy detects more than 95 percent of early colon cancer. Colonoscopy is the only test that can also prevent cancer because the doctor can remove polyps – small growths that may develop into cancer if left alone – before they turn into cancer. Other colon cancer screening tests do not examine the colon as thoroughly or remove polyps.

What are the risk factors for colon cancer? -- Being over age 50 is the leading risk factor for colon cancer as more than 90 percent of colon cancers occur after age fifty. Also, if you have ever had anyone in your family with colon cancer, your risk is very high. If you have a family member with colon cancer, your provider may even suggest a colonoscopy well before age fifty.

Other risks for colon cancer include tobacco use, obesity, being either African American or of Ashkenazi (Eastern European) Jewish ancestry. Having other colon diseases such as ulcerative colitis or Crohn’s disease may also increase your risk of developing colon cancer.

There are other tests for colon cancer screening that are less invasive but they may not be as accurate as colonoscopy or TRICARE may not pay for them. Fecal Occult Blood Test (FOBT) and Fecal Immunochemical Test (FIT) Tests are tests that check for hidden blood in the stool. This test should be done every year. Sigmoidoscopy is a test similar to colonoscopy but because it examines less than half of the colon (not the entire colon as colonoscopy does), it can miss some cancer. This test should be done every 5 years.

How can you lower your risk of developing colon cancer? -- Stop using tobacco. You can talk to your provider about medications that can help and call health promotions at 830-2814 to receive counseling that can help you change how you deal with stress. If you don’t change how you deal with stress, you may find it hard to get completely off tobacco. Maintain a healthy weight and exercise regularly with at least 30 minutes of moderate physical activity (such as a brisk walk) at least 5 days a week. Also, eating a diet high in fruits and vegetables will help prevent colon cancer.

If you have any of the risk factors for colon cancer, ask your primary care provider about colonoscopy. If you would like to meet with one of our specialists regarding colon health screening, you can call the general surgery clinic at 760-830-2070 to schedule an appointment - no referral from your primary care provider is necessary for this appointment. And remember, the more age and risk appropriate annual testing you take advantage of, the better your health and the more funds that are given to the naval hospital. This increased funding then allows us to maintain or expand the staffing and services we offer.

Wednesday, January 5, 2011

Do you know what your medical care options are?

By Dan Barber, Public Affairs Officer
Robert E. Bush Naval Hospital

Anytime you have an immediate life-threatening medical problem you should call 911.

Our medical staff here at the Robert E. Bush Naval Hospital would rather have the patients err on the side of caution with the realization that when they arrive at our Emergency Medicine Department (EMD) that our professional staff will assess the medical condition with a process called Triage.

If your condition warrants it, immediate medical attention will be given. However, if the medical staff determines that your condition is not life-threatening you may have to wait before treatment is rendered, while patients with unstable illnesses or injury are taken care of first.

On occasion you may have to wait for several hours to be taken care of. This process is necessary in every emergency room where medical care is never given on a first-come first-served basis.

The hospital’s EMD is not designed to be a walk-in clinic, in most cases, patients seeking care for an illness in the EMD, may be better cared for by their Primary Care Provider.

With this in mind and in the interest of providing the best possible care for patients presenting for care in the EMD, the Emergency Room Triage Nurse has the ability of contacting Central Appointments or the Clinic Registered Nurse (during normal business hours) so an appropriate health care provider can better assess treatment for an illness and allow the patient to avoid a potentially long wait in the EMD. “We want to make sure that all of our patients coming into the EMD for treatment are given the care they need. If they choose to wait in the EMD to see a doctor, they will be allowed that choice,” said HMC (SW/AW) William Monroe, the hospital’s Customer Relations Officer.

“It is always in the patient’s best interest to call the Appointment line at 830-2752 to obtain a same day appointment. A scheduled appointment minimizes waiting time that would typically be experienced with an emergency room visit. In addition, before you leave the clinic, it is better that you book any necessary follow up appointments with the clerk at the front desk or the clinic nurse you are visiting or by calling 830-2752,” Monroe added.

If your symptoms are not severe enough to prompt you to seek an appointment, the Naval Hospital offers an Over-the-Counter (OTC) medication dispensing program for your convenience. OTC medications may be obtained for family members between 2-18 years old and only by a parent or guardian. Patients who are not eligible to receive OTC medications are pregnant or breast-feeding mothers, children less than two years old, and those who are currently in flight status or in the Personal Reliability Program.

All patients must have a valid military identification card in their possession at the time of dispensing.

Each family member will be eligible to receive a maximum of four different items in a three-month period. These medications will be entered into each person’s computer prescription record to screen for allergies, overlapping medications and duplications.

A request form must be completed, which includes a brief question-and-answer assessment of your medical condition(s) and current medication(s) you are taking. You will receive a handout discussing the proper use, dosages, cautions and side effects associated with the medications you request and receive. If your medical condition does not improve or if it worsens within 48 hours, you should seek advice from a medical professional.

This program is designed to offer access to many common cough and cold, sore throat, fever, headache, stomach upset and minor gynecological conditions that are listed below:

* Acetaminophen (Tylenol) 325mg tablets & elixir
* Ibuprofen (Motrin) 200mg tablets & suspension
* Diphenhydramine (Benadryl) capsules & elixir
* Pseudoephedrine (Sudafed) tablets & syrup
* Triprolidine w/ pseudoephedrine (Actifed) tablets & elixir
* Guaifenesin (Robitussin) syrup
* Guaifenesin w/ dextromethorphan (Robitussin DM) syrup
* Saline nasal spray/drops
* Cepacol throat lozenges* Maalox (regular) 5 ounce bottle
* Clotrimazole (Gyne-Lotrimin) 1 percent vaginal cream (not for the patient’s first yeast infection and only one issue every 6 months)

“Have you ever considered that you, as a patient, have a major impact on the type and quality of care you receive at your Naval Hospital… we are here for you, said Monroe. “Every decision made by the leadership of Navy Medicine is made with you the patient in mind. How can the best possible care be delivered to you with assets available… facilities, money and staff,” Monroe added.

Tuesday, November 23, 2010

Holidays Got You Down? Join the Facebook Discussion, Connect With Others

By Kristin Musch
Behavioral Health Educator, TriWest Healthcare Alliance

With the holidays rapidly approaching, many of us may be hoping for a perfect Season: relaxation, connection and joy with family and friends. Often times, though, stress, anxiety, feelings of separation and sadness can creep in. That disconnect—what we hope to experience versus what we might actually face—can be called the “holiday blues.”

It doesn’t help that television and movies often show the holidays as wonderful, family events. No stress. No challenges. Everyone is happy and sitting around the table and no one ever struggles with money.

Of course, in reality, we know that’s not always true. Acknowledging those sad or stressful feelings, then finding ways to cope, might help you feel better. That’s why here at TriWest, we’ve launched a Facebook discussion board to help you connect with other military families and find ways to help each other.

How to Join the Facebook Discussion
We hope this discussion board will act as a supportive environment for service members and their families to connect and share how they get through their greatest stressors during the holidays. As a behavioral health educator for TriWest, I will monitor the forum, periodically posting general tips and offering suggestions.

So, how can you join? Just follow these four steps:
Log into your personal Facebook account.
“Like” TriWest’s Facebook page at www.facebook.com/triwest
Click the “discussions” tab toward the top of the page.
Click the “holiday blues” discussion and post your thoughts!

I hope to see you there. And remember, realism is the key to beating the holiday blues. Keep your expectations and your budget realistic—don’t be afraid to share your concerns with others— and you’ll have a fabulous holiday season!

Monday, October 18, 2010

Flu Shots Available at Naval Hospital

The flu vaccine will be provided to all TRICARE Prime eligible beneficiaries at the hospital’s Clinic Waiting Area ‘A’ (TriWest waiting area) Oct. 25 – 29 from 8 a.m. to 4 p.m.

Active duty personnel will be seen in respective Battalion Aid Stations. Marine Corps Communications and Electronics School and Headquarters Battalion staff and students will be seen in the Adult Medical Care Clinic.

This year’s vaccine, which has been formulated to also protect against the H1N1 virus, is recommended for all people over the age of 6 months; however children under 2 years old or with a medical condition, will be vaccinated in the Family Immunization Clinic.
If necessary, additional vaccine sites will be announced.

Those unable to get their flu shots during the above dates can be seen in the Family Immunization Clinic on a walk-in basis during normal clinic hours while vaccine supplies last.

Monday, September 27, 2010

Appointment 'No Shows' Continue to Challenge Hospital

Showing up late or not showing up at all for medical appointments is an ongoing challenge for Naval Hospital Twentynine Palms in trying to manage a productive clinic schedule and serve our population.

The hospital is not a walk in clinic. The clinics are run on an appointment basis, and they try to stay on schedule.

According to the hospital’s latest figures, in August there were 825 ‘no shows’ for appointments at the hospital.

These 825 appointment slots were productively used; however it could keep 825 potential beneficiaries from receiving treatment in a timely manner. Maybe more importantly, these missed appointments could mean that some Marines or Sailors may not be 100 percent ready for deployment because they may need glasses or have an undiagnosed medical issue, leading to a serious problem for the member and their command.

Occasional emergencies arise, or a procedure takes longer than anticipated which delays some appointments. However, over the years, it has been shown that when patients are kept waiting beyond their appointed time, it is usually because a previous patient showed up late. If this happens the clinics can see the late patient and keep everyone after them waiting, rush through the appointment (which we will not do), or reschedule the appointment for another time.

If late for an appointment, the hospital clinics will see you if the schedule permits and it does not inconvenience other patients. If the providers feel that seeing you late will cause an inconvenience for other patients, then you will be asked to reschedule.

If unable to keep an appointment, please give the hospital as much notice as possible. This is in consideration of the hospital staff that will attempt to fill the appointment slot with another patient.

Here are some tips that will help you become more punctual; Give yourself extra time, just in case you are delayed by weather, traffic or other circumstances. Keep only one planner; carry it between your home, workplace, or daily appointments. Use a watch, or an electronic organizer with a beeper to provide you with reminders.

Monday, September 20, 2010

Whooping Cough Outbreak in Calif. -- Vaccinate to Protect

By Shari LopatinTriWest Healthcare Alliance

An outbreak of whooping cough has swept across California, according to the Centers for Disease Control and Prevention (CDC). But, you can take action to protect yourself and your families.
Whooping cough, also known as “Pertussis,” is an upper-respiratory infection. It’s extremely contagious and can be deadly to infants, according to the CDC. It can also cause adults to become very sick.

For the first eight months of 2010, the CDC reported more than 3,000 cases of whooping cough in California, including eight infant deaths. This is a seven-fold increase from the same time period in 2009—where only 434 cases were reported across California.

Get vaccinated! TRICARE covers it . . . A vaccine does exist for whooping cough, as does a booster shot for adults who received the vaccine as children. According to the CDC, the best way to prevent whooping cough is to immunize against it.

Whooping cough is most dangerous to infants. More than half of infected babies younger than 1 year old must be hospitalized, according to the CDC. Therefore, getting vaccinated is especially important for families with infants, to prevent spreading the disease to their child. Additionally, caregivers working around babies and young children should get the immunization.
Because the immunity provided by the vaccine for whooping cough fades with time, a booster shot is available for pre-teens, teens and adults.

The whooping cough immunization is a TRICARE-covered benefit. Military families should talk to their doctors about it.

What are the symptoms? According to the CDC, whooping cough usually begins with cold-like symptoms, followed by severe coughing one to two weeks later. These coughing fits may continue for 10 weeks or more.

Early symptoms include:
* Runny nose
* Low-grade fever
* Mild, occasional cough
* In infants, “apnea”—a pause in breathing

However, as the disease progresses, the traditional symptoms of whooping cough will develop and include:
* Many fits of rapid coughs followed by a high-pitched “whoop”
* Throwing up
* Exhaustion and fatigue after coughing fits

Should you believe you or your child has become infected with whooping cough, seek treatment immediately. Early treatment is very important, according to the CDC.

Where can I get more information?The CDC has some of the most up-to-date information on the whooping cough outbreaks. Find tips on prevention, treatment, symptoms and statistics at www.cdc.gov/pertussis/about/index.html.

Additionally, follow TriWest Healthcare Alliance on Facebook and Twitter for updates on the whooping cough outbreaks.

TriWest is the regional contractor responsible for administering the TRICARE health benefit in 21 western states, including California. Follow TriWest at:
www.facebook.com/triwest AND www.twitter.com/triwest

Tuesday, July 27, 2010

Patient's Have Major Impact On Quality of Care Offered

By Dan Barber, Public Affairs Officer
Robert E. Bush Naval Hospital

Have you ever considered that you, as a patient, have a major impact on the type and quality of care you receive at your Naval Hospital?

Every decision made by the leadership of Navy Medicine is made with you the patient in mind. How can the best possible care be delivered to you with available assets … facilities, money and staff.

The Department of Defense uses a random survey of the hospital patient’s to grade how your hospital is doing compared to other Medical Treatment Facilities.

This survey is used to provide an independent, impartial evaluation of care provided to the Marine Corps Air Ground Combat Center beneficiaries. You may have received a letter in the mail following a recent visit to one of the hospital’s clinics. If you took the time to open that letter and follow the directions to participate in the survey, then you will have input into future decisions Navy leadership makes in determining the type and quality of care you will receive at your Navy Hospital here.

The purpose of this survey is to provide an evaluation of the health care you receive. This information will provide tools for leadership to make informed decisions about the type of care that will be made available to you; it will provide insight for targeting quality improvements; it will allow for external comparisons of other health care services in the region; and it will promote medical care that is consistent with clinical guidelines.

Other ways for you to participate in the care you receive at the Robert E. Bush Naval Hospital is to let one of the hospital’s customer service reps know your feelings… Did you feel that your health care was lacking in some way? Were you totally happy with the services you received? Either way, it is important for the hospital to know how they are taking care of you.

In addition, the hospital conducts the Healthcare Consumer Council meeting every Quarter… this Town Council type of meeting is designed to allow the Combat Center’s healthcare beneficiaries to express concerns, compliments or constructive criticism to the leadership of the hospital.

Just recently a comment made to the commanding officer of the hospital resulted in an effort to provide a link from the hospital’s web site to the DoD’s Parenting Education site. Also available for you to provide constructive comments to the hospital is the Robert E. Bush Naval Hospital Face Book site… look us up, tell us how we are doing… your opinion matters to us.