Somewhere Between Not Hard Enough and Too Hard

During the past several weeks, we’ve been focusing on heart disease. We’ve talked about the signs of a heart attack and how they may differ between men and women. We’ve talked about knowing your numbers and getting your blood tested to learn your cholesterol and triglyceride levels.

This week, we turn our attention to your heart rate when it comes to resting and exercise. Are you making that workout count? Cardiovascular exercise has tremendous physical and mental benefits to reduce your risk factors for chronic disease and increase your overall mental and physical wellness.

Remember, you should always visit with your healthcare provider before you begin any new exercise regimen to be sure you are healthy enough for exercise.

When you have the go-ahead from your healthcare provider, it’s time to learn your numbers. The American Heart Association recommends knowing your resting heart rate and your maximum heart rate.

First, determine your resting heart rate in the morning as you wake up but before you get out of bed. Place your first and second fingertips on the inside of your wrist and feel for your heartbeat. Using a clock or watch with a second hand, count the number of beats you feel in a ten-second period. Multiply this number by six and you have your resting heart rate per minute.

The AHA says that your maximum heart rate for exercise is 220 minus your age. If you are 50 years old, your maximum rate during exercise is 170. Your range should be 50 to 85 percent of that number.

A simple way to know where your heart rate may be is that if you are working at 50 percent, say while on a stroll with a friend, you can carry on a conversation. If you are engaging in moderately intense activity, you can still talk, but probably not be able to sing. If you cannot say more than a few words at a time before needing a breath, you are working vigorously.

Another way to learn your personal target heart rate is at the Paul W. Ahrens Fitness Center. Our personal wellness coaches will conduct a fitness test on our treadmill to determine your ideal numbers.

GRMC offers wellness coaching to help you wherever you are on your wellness journey.

If you are just starting out with exercise, our coaches will work with you and your physician to help you assess your needs and create a safe and effective workout that is just right for you. Or if you have been exercising for a while and want to step up your efforts for a greater challenge, they can design a super workout.

Take this journey step by step. First step: Talk with your healthcare provider. Second step: Call GRMC Wellness Services at 641-236-2999 and ask to make an appointment with a personal coach today.  

Doctor's office? Urgent care? ER? Where do I go?

Because life’s injuries and illnesses don’t conveniently happen according to schedule, GRMC is providing another option for care. Manatt Family Urgent Care will open on Thursday, February 13 at 7 a.m. for walk-in service.

Emergency Conditions:

If you are ever in doubt, come to the GRMC emergency department or call 9-1-1 when these conditions are present:

     Bleeding that will not stop

     Breathing problems (difficulty breathing, shortness of breath)

     Change in mental status (such as unusual behavior, confusion, difficulty arousing)

     Chest pain

     Choking

     Coughing up or vomiting blood

     Deep or large wound

     Fainting or loss of consciousness

     Feeling of committing suicide or murder

     Head or spine injury

     Severe or persistent vomiting

     Sudden injury due to a motor vehicle accident, burns or smoke inhalation, near drowning

     Sudden, severe pain anywhere in the body

     Sudden dizziness, weakness, or change in vision

     Swallowing a poisonous substance

     Upper abdominal pain or pressure

           From American College of Emergency Physicians

Manatt Family Urgent Care is staffed by Wendi Beck, PA-C and Heidi Powers, ARNP. Michelle Rebelsky, MD, is the clinic’s medical director.

Urgent care does not replace your primary care provider, but can serve as a bridge for care when you can’t get in to see your regular provider.

Urgent care is for:

·       Non-chronic conditions that are urgent, but do not require emergency care.

·       Patients age two years and older.

·       Times when you need to be seen but can’t get into your regular healthcare provider because their schedule is already full or before and after primary care offices are closed.

Urgent, but not emergency health issues include:

Respiratory illnesses:

Colds, coughs

Chest or nasal congestion

Seasonal allergies

Sinus infections

Sore throats/laryngitis

Mild fevers

Head, ear and eye conditions:

Minor headaches

Pink eye/stye

Ear ache/infections

Skin conditions:

Rashes/itch

Athlete’s foot

Cold sores

Insect bites

Sunburns

Cuts that need stitches

Stomach and general urinary infections:

Diarrhea

Nausea/vomiting

Yeast or bladder infections – burning during urination

Minor Injuries – other conditions

Mild asthma

Simple burns

Cuts that need stitches

Minor sprains/strains

Minor musculoskeletal injury

For example, let’s say it is Tuesday afternoon and your child’s school calls to tell you that your child is running a fever and is complaining of an earache. You call your regular healthcare provider and they do not have any openings available for your child to be seen that day. That’s a good time to go to Manatt Family Urgent Care. No appointment needed, just come in.

Another example – Your husband twists his ankle at softball practice at 5:30 p.m. Your regular healthcare providers’ office is closed. Another good reason to drive to Manatt Family Urgent Care.

Don’t have a medical home or a regular primary care provider? Manatt Family Urgent Care staff will help you find a provider who meets your needs.

If your healthcare providers’ office is closed and Manatt Family Urgent Care is closed and your medical need – including those listed above – cannot wait until one of them is open, come to GRMC emergency department.  We’re always there when you need us.

Links:

1. Recognizing Medical Emergencies

http://www.nlm.nih.gov/medlineplus/ency/article/001927.htm

The Number One Killer of Women

Do you know the warning signs of a heart attack?

We’re pretty well acquainted with signs in men and while everyone experiences a heart attack in their own way, there are symptoms that make you pay attention. Men tend to experience symptoms in their chest – tightness, pressure, and pain.

For women, the signs are much more subtle. They look and feel differently. It may feel like the flu coming on with nausea, sweating, lightheadedness. Women may feel the tightness and pain in their jaw or in the back between the shoulder blades or radiating down the arms rather than in their chest. There may be shortness of breath even without chest pain.

Because these heart attack symptoms in women tend to look a lot like other health issues, women will often dismiss them. And that is where the danger lies. Don’t ignore these symptoms – seek help immediately. If you are wrong and it is the flu, count yourself lucky. If it is a heart attack, those minutes truly make all the difference between life and death.

Learn more. Go to www.heart.org.

February 7, 2014 is Go Red for Women Day. Show your support by wearing red.

http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Heart-Attack-Symptoms-in-Women_UCM_436448_Article.jsp

A Walk in the Shoes with One of the Nation’s Top 50 Rural Hospital CEOs

“Undercover CEO” is a popular new television reality show where the CEO of a major corporation will go undercover and work in an entry level position somewhere within the organization. They learn a great deal about their employees and how they do their job. Many learn that the processes their employees go through in their work are difficult, awkward, and sometimes, truly rewarding.

 

From time to time, GRMC President and CEO Todd Linden does this, but not undercover. He will shadow an employee to learn how they do their job to be able to have a full sense of the hospital operation at every level. Todd refers to this as “A Walk in the Shoes.”

Let’s take a quick “walk in the shoes” with Todd.

A typical day? There’s no such thing as a typical day. Every single day presents something new. There is an agenda to the day that can be cast aside at a moment’s notice if say, for example, the local high school experiences a sewer leak and more than 35 students and teachers arrive in the emergency department. If that happens, Todd jumps in and takes on the role of helping to escort students to receive medical attention.

Most of his days are back-to-back meetings with physicians, department managers, conference calls, patients and members of the community, and with other administrative team members. He makes time to join the GRMC Auxiliary Board monthly meeting to update them on what’s new at GRMC. Meetings with board members, potential donors, and teams of people working on capital improvements and renovations fill his daily agenda.

Meetings in the community. Todd currently serves as a trustee of Grinnell College and on the Grinnell Chamber of Commerce board. He has served on several community boards and committees.

Email. Todd receives hundreds of emails on a daily basis and does an amazing job of sorting and replying given the sheer number of them.

Phone calls. If communication isn’t by email, it’s by telephone – landline or cell while he’s dashing to a meeting.

Travel is a big part of the job. Sometimes, meetings have to happen face-to-face and not via telephone. Todd is a hospital administrator who is regularly called upon to present to groups around the country on topics like healthcare reform and board governance. During his tenure at GRMC, Todd has created a well-worn path between Grinnell, Iowa, and Washington, DC, where he has advocated for healthcare reform, equity in Medicare reimbursement, and for the greater Poweshiek County community.

It’s no surprise to us that Becker’s Hospital Review this week named Todd as one of the “Top 50Rural Hospital CEOs to Know.” 

In the announcement, BHR says: “These 50 presidents and CEOs have shown commitment to providing high-quality, accessible care to their patient populations and have approached the challenge of rural healthcare with great aplomb.”

For 20 years, Todd has been president and CEO of GRMC. That’s pretty impressive when the national average tenure for a hospital CEO is five years.

It’s been Todd’s vision and leadership that has led GRMC to be the organization we are today. Congratulations, Todd, on this well-earned national recognition!

*For this list, "rural" was defined as being located outside a major metropolitan area or healthcare hub. Leaders were selected based on a number of factors, including awards received; local, regional and national leadership positions held and their organization's recent performance. Nominations were also considered.

Know Your Risk

A long-time community service of GRMC has been the annual wellness blood screen.

This year’s wellness screen is scheduled for Wednesday morning, February 12. It will be held from 6:30 to 9 a.m. in the West Tomasek Conference Center, GRMC, in Grinnell. You do need an appointment and you need to come fasting for at least 12 hours. To make an appointment for the screening, call GRMC wellness department at 641-236-2999. 

It includes a comprehensive metabolic panel with the fasting lipid profile for cholesterol levels; complete blood count (CBC); glucose and other tests to measure liver and kidney function; as well as metabolic indicators of early disease status. This comprehensive screening ensures that your physician has the most complete information about your overall body system function. And, the results may give the motivation to change your lifestyle habits to enhance health and well-being. Heart disease is the number one health concern for Americans.

We often say that knowledge is half your health. Keeping an eye on these numbers is important to achieving and maintaining your health.

Can we get sick from the cold?

The past several weeks have seen some wide swings in winter temperatures. From upper 40’s one day to below zero in 36 hours, our climate goes from spring to the deep freeze in very short order.

What does this do to our bodies? Can it make us sick?

The short answer is, no. Infection – either bacterial or viral – is what causes illness, not outdoor temperatures.  If you have a chronic respiratory condition, such as asthma, the swing in temperatures, particularly cold air, can trigger attacks or mask itself as a cold if not already diagnosed.

But everyone is running around with a Kleenex at their nose! The news is filled with reports on the progression of seasonal influenza across the nation! And it is cold! We don’t hear about this in the summer!

In cold weather, we stay indoors. At school, work, and home, we are often in close quarters with other people. All it takes is one child in a classroom with an upper respiratory infection to spread the germs to other children. Those children go home and live indoors with siblings, parents, grandparents. Parents and grandparents pick up the infection and take it to work with them, and the transfer of the illness continues.

Does cold weather make us sick? Not directly, no. How we live indoors during cold weather just might.

While we might not get sick from the cold, we certainly can get sick of the cold.

Nine weeks until the first day of spring. But who’s counting?

Links:

1. Can the Cold Give You a Cold?

http://www.everydayhealth.com/cold-and-flu/colds-and-the-weather.aspx

2. Iowa Department of Public Health “The Gift That Keeps On Giving: Norovirus”

http://www.idph.state.ia.us/IdphNews/Reader.aspx?id=7D6A749D-9CCE-4842-898C-5CA370216589

America's hospitals are leading the way

This week, Rich Umbdenstock, president and CEO of the American Hospital Association wrote the following message. It's an editorial written by Umbdenstock and submitted to national newspapers as a paid advertisement, known as an "advertorial."

A Message from America's Hospitals

Rich Umbdenstock, President and CEO, American Hospital Association

Those blue and white signs with the big H have always carried the promise of help, hope and healing. The hospital of the future will continue to extend that promise, but in new ways that will improve quality while lowering costs. The word hospital will be less about a building and more about a coordinated system of care.

The Challenge

The environment the hospital of the future faces will be extraordinarily challenging. Providers will have incentives to work more closely together to coordinate care, improve quality and safety, and keep patients healthier.

That's a challenge. Ten thousand Baby Boomers celebrate their 65th birthday each day. More than half of them will have multiple chronic conditions like hypertension, diabetes and heart disease, yet they will live and require health care services far longer than previous generations. Chronic conditions are also increasing in younger people. 

Medical and information technologies hold out great potential for improved care, but they come with a huge price tag. And even after the expanded insurance coverage emerging from the Affordable Care Act, hospital emergency departments will continue to treat millions of people without health insurance. 

Hospitals are taking dramatic action now so they will be ready tomorrow to keep the promise of care to the patients and communities they serve.

That means embracing methods of improving the quality of care while at the same time reining in costs. It means becoming proactive instead of reactive - that is, working to keep people healthy instead of waiting for them to become sick. And hospitals are making tremendous progress.

Engagement

Hospitals are engaging patients and families, community leaders, physicians and their own staffs in a revolutionary effort to improve wellness, control expenses, improve efficiency and increase quality and accountability. The goal:  Keep people healthy and out of emergency departments; identify and eliminate costly treatments that don't improve patient outcomes; and provide the support patients need to stay out of the hospital once they are discharged. Hospitals will reach out, moving care into their communities in nontraditional ways. Some hospitals are merging to take advantage of economies of scale and provide the latest treatments, reconfiguring to better meet community needs and provide their patients with access to state-of-the-art equipment without breaking the bank.

Innovation

Increasingly, hospitals are being paid for the value they provide rather than the volume of the patients they treat. Hospitals are responding by using evidence-based practices to, for example, eliminate preventable infections and complications and better manage advanced illness.

These steps can result in lower costs, higher patient satisfaction and outcomes, and fewer unnecessary readmissions. They are using information technology to track the quality of the care they provide. They are also analyzing information so they can spot patterns that could lead to better treatments for certain conditions or groups of patients. All of these efforts are paying off; the growth in hospital spending is at a 15-year low.

These are not simple transitions. But hospitals are determined to do whatever it takes to continue meeting their commitment to their communities.

Just as a Model T and a brand-new hybrid are both cars, the community hospital of the future will still be your hospital. When you follow those blue and white signs, you will find people who work around the clock to provide emergency services, perform surgery and care for patients who are ill or injured. But in the coming years, the image of a hospital will be less about four walls and more about partnerships that advance the health of individuals and communities.