In Case of Emergency

ER Care vs. Urgent Care

Your 2-year-old has an earache. You slip and sprain your ankle. You’re feeling chest pain. Do you know where you should be getting care in each of these cases?

It can be hard to know, but it’s important because if you go to the emergency room when it’s not actually an emergency, your insurance may not pay for your care.

A trip to the ER is usually the most expensive kind of care. The average ER visit costs more than the average American’s monthly rent.

If you don’t need help right away, you can save time and money by setting up a same-day appointment with your doctor or going to an urgent care or convenient care clinic. These usually have extended hours, you don’t need an appointment, and many clinics have them.

But when something happens and you need care right away, you should know which things you should go to an urgent care location for, and when you should go to the ER.

Emergency Room or Convenient Care?

Earache

Visit convenient care. This needs care to keep it from getting worse, but it won’t pose a serious health risk if not treated immediately.

Sprained Ankle

Visit convenient care. This injury isn’t life threatening, but you may need medical attention to treat it.

Chest Pain

Go to the ER. This could because of a serious problem and is normally considered a medical emergency.

A trip to the ER is usually the most expensive kind of care. If you don’t need help right away, you can save time and money by setting up a same-day appointment with your doctor or going to an urgent care or convenient care clinic. These usually have extended hours, you don’t need an appointment, and many clinics have them. Carle, for example, has a few convenient care options.

Let these examples be your guide to where you should go:

Emergencies

Urgent Care Situations

  • Shortness of breath
  • Chest pain
  • Poisoning
  • Broken bones
  • Fainting, seizures, or unconsciousness
  • Sharp wounds
  • Serious bleeding
  • Constant high or rising fever
  • Migraine headaches that don’t improve
  • Uncontrolled vomiting or diarrhea
  • Bronchitis
  • Severe allergic reactions
  • Cuts, even minor ones, that need closed
  • Constant high or rising fever
  • Migraine headaches that don’t improve
  • Uncontrolled vomiting or diarrhea
  • Bronchitis
  • Allergies and asthma
  • Cold and flu
  • Minor infections, like bladder, sinus, or pink eye
  • Rash or sunburns
  • Sprains and strains
  • Back and neck pain
  • Muscle or body aches
  • Earache
  • Strep throat
  • Minor cuts
  • Minor work illness or injuries

 

It’s not always easy to know if you should go to the emergency room, especially when you need to act fast. The key is to trust your judgment. If you believe your health is in serious danger, it’s an emergency.

Understand Blood Pressure

Understanding Blood Pressure

Getting your blood pressure checked is nothing new. But do you understand it all?

What Exactly Is Blood Pressure?

Blood pressure’s the force of your blood pushing against the walls of your arteries. High blood pressure, or hypertension, is a common disease when that pressure of the blood flowing through the blood vessels is too high.

If your blood pressure gets too high, it can cause serious damage which can lead to blockage which can cause heart attacks, strokes, and heart failure.

There are 2 main types of high blood pressure:

  • Primary high blood pressure is the most common type and it tends to develop as you age.
  • Secondary high blood pressure is caused by another medical condition or use of certain medicines and it usually goes away when this issue is treated.

Risk Factors for High Blood Pressure

  • Age – Men usually develop it around age 45 and women after age 65.
  • Race – High blood pressure and serious complications are more common for African Americans.
  • Family history – It tends to run in families.
  • Certain chronic conditions – Kidney disease, diabetes, and sleep apnea can raise your blood pressure.
  • Stress
  • Pregnancy
  • Being overweight
  • Not being physically active
  • Tobacco use
  • Too much salt
  • Too much alcohol
  • Too little potassium
  • Too little vitamin D

If you have some of these other risk factors, your doctor may set your blood pressure target lower.

What Are the Numbers?

  • Systolic is the pressure in your arteries when your heart contracts, the top number.
  • Diastolic is when your heart rests, the bottom number.

 What Are They Doing?

When a nurse takes your blood pressure, you might wonder what they’re doing. These are the steps they’re following:

  • They wrap the blood pressure cuff around your arm.
  • They place a stethoscope under the cuff at the crease of your elbow (where the major blood vessel of the upper arm is.)
  • They inflate the cuff until it stops the flow of blood.
  • They slowly loosens the cuff’s valve to let the blood start to flow again and listen for sounds in the blood vessel.
  • Then, the first tapping noise they hear, they’ll note as the systolic number, the maximum pressure when the heart contracts.
  • The taps fade, and they note the pressure at the last tap as your diastolic number, the minimum pressure while your heart’s at rest.
  • Along with your numbers, they note which arm they took your blood pressure on and how you were positioned, like sitting with your feet flat.

 Where Should My Numbers Be?

Systolic Measure

Diastolic Measure

What to Do

Normal

Below 120

Below 80

Maintain a healthy lifestyle to avoid raising your levels.

High-normal

120 to 139

80 to 89

Make lifestyle changes.

High

140 to 159

90 to 99

Make lifestyle changes. Possibly start a low-level diuretic.

Extremely High

160 or higher

100 or
higher

Often 1 or 2 meds are required right away, plus lifestyle changes.

Source: Consumer Reports, “onHealth”, Volume 23 Number 2

It’s also normal for your blood pressure to change when you sleep, wake up, are active, and are excited or nervous.

If you’re worried about your blood pressure, keep an eye on your levels and take them with you to your next appointment. A broad look at your numbers can help your doctor put you on the right track for heart health.

The Right Kind of Falling in the Winter

Long View: Don’t Let Falling Lead You Down a Slippery Slope

Our central Illinois weather definitely challenged us this winter. Slippery conditions are my least favorite. I took a tumble in a local grocery store parking lot and “fortunately” there were plenty of spectators to help me up. I am guessing it was on camera, too.

For some of our older friends and family members, the potential for falling is not based on the weather, but a year-round concern. According to the U.S. Centers for Disease Control and Prevention, “Every 15 seconds, an older adult is treated in the emergency room for a fall; every 29 minutes, an older adult dies following a fall.”

Sobering statistics, to say the least.

This year, Health Alliance Medicare, with Catholic Charities of Decatur, St. Mary’s Hospital, and the East Central Illinois Area Agency on Aging (ECIAAA), is supporting a program called A Matter of Balance. This evidence-based program helps people learn to avoid falls and teaches them how to increase strength and enhance balance.

Mike O’Donnell, ECIAAA executive director, reviewed the training materials and told me, “Older adults at risk of falling often fear injury, a broken hip and having to be in a nursing home. This program encourages us to reduce the risk of falling by using sensible safeguards. We can all choose not to allow fear of falling to take over our lives by using good judgment and common sense. The fear of falling can often lead to isolation and feeling out of touch.”

Specially trained volunteer coaches lead the eight, 2-hour classes that make up the program. The classes involve group discussion, problem solving, skill building, video tapes, and exercise training. A physical therapist attends one of the classes to answer questions and discuss safety issues.

Now that I think about it, this kind of training wouldn’t hurt any of us. As usual, prevention is the best course.

The program is open to anyone, whether you’d like to learn for yourself or to better help others.

If this seems like a good idea, please contact Nicole Kirlin at Catholic Charities of Decatur at 217-428-0013, or by email at Kirlin_dec@cc.dio.org. She would be happy to talk with you and let you know if A Matter of Balance is available in your area.

I had every intention of signing up myself. I guess it must have slipped my mind. I won’t make that mistake again!

Helping Heart Disease

Vantage Point: Walk to Mend Hearts

As a child, I folded and cut red, heart-shaped Valentine’s Day cards. As a teenager, I experienced my first broken heart. And as adults, we learn the importance of taking care of our hearts by eating right, exercising, and avoiding damaging habits, like smoking, to avoid heart disease.

Heart disease, a disorder of the heart and blood vessels, affects people of all ages and is the number one killer of women. You should also know about atrial fibrillation (AFib) and stroke. AFib is where upper chambers of the heart beat irregularly, causing dizziness, fainting and a racing, pounding sensation. Stroke is a brain attack that occurs when blood clots block an artery or blood vessel, interrupting blood flow to the brain. People with AFib are five times more likely to have a stroke.

People diagnosed with heart problems may feel overwhelmed, anxious, and afraid, opening the door for depression. That’s where Greater Wenatchee Mended Hearts, a volunteer peer-to-peer support organization, comes in to inspire hope through people who are heart patients themselves. I recently had the privilege to attend one of Mended Hearts’ monthly meetings. The room was buzzing with encouragement. Mended Hearts also hosts educational speakers and sends monthly newsletters full of valuable information about heart disease.

One of the most valuable aspects of Mended Hearts is its Heart Patient Visiting Room program that lets heart patients meet other people who have gone through or are going through the same thing. Natalie Noyd, director of the cardiovascular service line at Confluence Health, says peer support coming from someone who has walked the walk helps heart disease patients feel they can get through the experience and aids the overall recovery process. Confluence Health and Mended Hearts work together, mutually spreading heart disease awareness and education, and helping patients, throughout North Central Washington.

Health Alliance provides therapy to help reduce the risk of cardiovascular disease and also offers rehab and testing. Sometimes heart disease runs in the family, so creating habits to help prevent the disease becomes extra important for people with a family history of heart problems. Health Alliance encourages you to learn more by joining the Go Red for Women Heart & Sole Walk on February 6 in various locations throughout Wenatchee.

Walks will also take place at Confluence Health Clinics in Omak and Moses Lake. To learn more about Mended Hearts, call Ann at 509-679-8181 or email mendedhearts91@frontier.com.

Wintertime Worries and Falling

Falling and SAD in the Winter

The air is getting crisper and unfortunately, the sun shines less and less. Before we know it, snowflakes and ice will begin to fall. These wintery mixes can compromise both our balance and mental health. Both falling and SAD (Seasonal Affective Disorder) can come with the winter weather.

Falling

Each year, more than 300,000 injuries result from falls. Give yourself plenty of time and don’t rush around. Be especially careful getting into and out of your car by holding onto the door or framework for support.

If you must carry things, try to distribute the weight evenly and carry them below waist level, to help keep your center of gravity low. Go down icy stairs sideways.

Take short, flat-footed steps with your feet slightly farther apart than normal with your hands out of your pockets. Keep your eyes on the ground in front of you.

Wear boots or shoes with good traction. Rubber soles are better than plastic or leather. If you wear heels, wear wedges of no more than 2 inches. Once you’re inside, wipe and dry your shoes off to prevent creating slippery conditions inside too.

If you do lose your footing, try to fall so your thighs, hips, then shoulders hit the ground in that order, to keep your arms from taking all your body weight and possibly breaking. Tuck and bend your back and head toward your chest to keep from smacking your head.

SAD

A person suffering from SAD usually experiences depression and unexplained fatigue throughout the winter, while his or her symptoms disappear with the return of spring.

The reasons for developing SAD are still largely unknown, although experts believe it’s somehow triggered by decreased exposure to sunlight.

The symptoms are very similar to depression, but someone with SAD will experience these changes in mood and behavior in a regular, seasonal pattern.

A person with SAD or depression may have a few or all of the symptoms, like loss of energy, changes in mood, trouble concentrating, appetite changes, and weight gain.

Once you’re diagnosed, your doctor may prescribe antidepressants for just the months you need them. Another option is light therapy. Light therapy uses a special light panel or box that mimics the light from the sun.

Your Home's Thermostat

Long View: No One Wins in Thermostat Wars

When I was little, I loved visiting my grandparents in the winter. There was always lots of snow, and my siblings, cousins and I would play outside for hours. Our folks would slap a stocking cap on our heads with a pair of woolen mittens and any available coat. Then off we would go. The cold didn’t even bother me then. We usually came in when our cheeks and fingers were numb, but not before.

Things have changed, to say the least. I now own every thermal article of clothing known to mankind. If it’s cold enough, I have been known to wear gloves to get the mail, and the letter box is on my front porch. Winter weather is no longer the joyful playground of my youth.

My grandmother lived with my aunt and cousin until she was in her 90s. I remember the “thermostat wars” every winter. Grandma was never warm enough and would flip the thermostat up to 85. My aunt would be “roasting to death,” as she would say, and turn the thermostat down to 65 degrees. They went back and forth until spring.

So what happens to transform cold-tolerant kids into shivering adults? Dr. Stephen Belgrave is a medical director at Health Alliance Medicare and a family practice physician. He puts it this way.

“Peripheral vascular disease affects many of our older patients,” he said. “This can slow circulation, and this often affects temperature sensations. It’s important to protect older people from extremes in temperature because of these types of sensory deficits.”

Ah, there you have it. It seems I now qualify as an “older patient.” But the question is how can caregivers help their mature friends and family members?

Here are a few suggestions:

• Be more tolerant when someone complains about being uncomfortable. Even if you think the temperature is cozy, that may not be true for older people.

• Make sure your loved ones have protection from the cold when they go outside. Check and see if they have a cold weather emergency kit in their car. If they don’t have one, it makes a great gift.

• Offer rides (in your preheated car) to the store, appointments and errands during colder months. Removing snow and warming up a car can be a serious hurdle to older adults and people with peripheral vascular disease.

• Finally, find a comfortable, temperate middle ground. Do not engage in “thermostat” wars. I can say from personal experience no one ever wins.

*This piece first ran in 2009.

Remembering with Alzheimer’s

Vantage Point: Sometimes Behavior is not a Problem, it is a Message

My grandmother died of Alzheimer’s over 15 years ago. I still remember my family’s denial. We couldn’t agree on her course of care, and it cut like a knife when she no longer recognized us.

Alzheimer’s is the third-leading cause of death in Washington. Yet current resources are treating less than five percent of those suffering. Recently, I attended an excellent presentation by Bob LeRoy of the Inland Northwest Chapter of the Alzheimer’s Association. Bob provided some staggering data which showed in comparison to diseases like diabetes, cancer, and HIV, Alzheimer’s receives the least funding for research. Yet it has grown the most drastically.

Nationally, more than five million people live with Alzheimer’s. With 10,000 people turning 65 every day, that number will grow quickly. Alzheimer’s has become the most expensive disease to treat in America and yet still lacks resources for support. Most caregivers of those diagnosed are unpaid family members.

Sadly, since my grandma’s time there have not been major strides in awareness, education or advocacy. But there are those trailblazing a path of hope. The Inland Northwest Alzheimer’s Association has a vision of a world without Alzheimer’s, where through research they can provide and enhance care to support all affected and reduce the risk of dementia through promoting brain health. Current resources include:

• Online workshops – Know the Ten Warning Signs
• Alzheimer’s Navigator – Help creating custom plans
• Community Resource Finder
• ALZ Connect – Networking with others who care for people with dementia
• Care Team Calendar – For coordination of responsibilities among family and friends
• Safety Center – Information and resources for safety in and out of the home

Find these resources at ALZ.org, or you may call 800-272-3900 for a 24/7 helpline.

Want to get involved? ALZ.org can help you find information on a 2014 Walk to End Alzheimer’s event in your area. In Douglas County, it’s a good idea to register your loved one on the Vulnerable Persons Register to help emergency responders assist and better meet their special needs. Find more.

Health Alliance Medicare encourages its members to take advantage of their comprehensive wellness benefits and in doing so hopes any signs of dementia can be identified early.  Until there is a cure taking action can help ease the pain of Alzheimer’s, both those for those who cope with the disease and those who care for them.

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