Saturday, October 31, 2009

Finding Answers to Questions about the H1N1 Flu and the H1N1 Vaccine

Here are a couple of resources to use in your quest for the very latest information on the H1N1 flu and the vaccine.

• 1.877.ASK.VDH3 (1.877.275.8343)-- This is the statewide VDH hotline that has been set up to manage questions and inquires on H1N1 influenza. The number is staffed by physicians and nurses and are able to field questions from the general public and from healthcare professionals.

Those answering the phones are especially qualified to talk about vaccine availability, delivery, registration, etc.

They will not be providing medical advise over the phone but they will be able to provide information on where individuals can be vaccinated and other information.

They will have access to translation services so they will be able to field calls from non-English speakers. The hotline is staffed during normal business hours but they have the capability to expand their hours of operations as needed. -- The three health departments of Virginia, Maryland and DC have launched this new website to provide information to the residents of the NCR on where they can get H1N1 vaccination.

The Virginia section of the website includes specific locations in the region where H1N1 vaccine will be available to the public -- including pharmacies, big box stores and community clinics. The website also includes information to answer the question: "What to do if you get the flu?"

NY Times: H1N1 Vaccine Safe as Any Other Flu Vaccine

Warrenton pediatrician Dr. Joshua Jakum of Piedmont Pediatrics sent me this link about the safety of the H1N1 vaccine. The link takes you to an editorial in the New York Times.

Thursday, October 22, 2009

H1N1 Triggers Visitation Restrictions at Fauquier Hospital

In response to the rapid and pervasive spread of the H1N1 virus this flu season, Fauquier Hospital is temporarily restricting visitors.

Rodger Baker, CEO and president of Fauquier Health, said, “The spread of seasonal and H1N1 influenza in our community requires that we take special measures to protect our patients and staff, including limiting their exposure to visitors who may have influenza. It is difficult to determine who may be infected with an influenza virus because people can be contagious before they start showing symptoms of flu, including fever and coughing.”

“We hope these precautions will help to slow the spread of H1N1 in Fauquier County.”

Temporary Visitor Restrictions
• Instead of unrestricted, open visiting hours, there will be two blocks of visiting times: from 11 a.m. to 1 p.m. and 6 p.m. to 8 p.m.
• No visitors under the age of 18 will be permitted.
• Visitors will be limited to two per patient room.
• Visitors must enter through the front doors of the hospital or (when the front doors are locked, at night) through the Emergency Room.
• Those who exhibit influenza-like symptoms will not be able to visit patient rooms.
• Special restrictions are in place for visitors to the Family Birthing Center. Only spouses and significant others of the mothers and grandparents of the babies will be permitted. Visitors who come to the Family Birthing Center will be asked to call into the unit from an in-house phone before being admitted.
• In the adult critical care and oncology units, visitors will be limited to spouses, significant others, parents or those directly responsible for a patient’s care.
• In the pediatric units, parents will be exempt from visiting hour restrictions.
• Some visitors may be asked to wear masks and/or other protective clothing while visiting.

Changes in the Emergency Department
Fauquier Hospital’s Emergency Department, like others throughout the region, has seen a marked increase in activity in the last week because of the H1N1 flu.

On a typical weekday, Emergency Department staff can expect to see anywhere from 70 to 90 patients. On Tuesday, October 20, more than 120 patients came through the doors, 46 of them with influenza-like symptoms. Weekends tend to be even busier.

Beginning Friday, October 23, in order to speed the flow of patients through the Emergency Department and facilitate evaluation and treatment, those with flu-like symptoms will enter the Emergency Department through a separate door near the main ED entrance. The initiative will serve to isolate potential H1N1 sufferers and protect other patients from infection. The separate ED entrances will be in use between the hours of 11 a.m. and 11 p.m.

Once in the Emergency Department, those who have influenza-like symptoms will be hosted in an isolated unit, apart from the rest of the ED and the rest of the hospital.

The unit is equipped with special “air scrubbers” that sanitize the air.

Dr. Joseph Servideo, chairman of the Emergency Department, emphasized that if residents experience mild to moderate influenza-like symptoms – a fever higher than 100 degrees, coughing, sore throat, congestion, vomiting or diarrhea – it will not be helpful to come to the Emergency Department. “Stay home, take pain and fever reducers and drink plenty of fluids. In a week to ten days, you should be feeling better,” he advised. “Those with severe symptoms -- shortness of breath, repeated vomiting, dehydration or a fever above 103 -- or those with serious underlying conditions should seek medical attention from their doctors or at the ED.”

Local Pediatricians Talk about Kids and H1N1

Last Friday was a very hectic day at Piedmont Pediatrics. Dr. Dennis Rustom blamed the H1N1 flu. “We are seeing some cases here, but mostly I have been spending my days talking about it, reassuring parents and discussing what to do if they see symptoms in their children.

“More people are getting the message now: If your child has a fever, even a low-grade one, have them stay home from school – and keep them home until they are symptom-free for at least 24 hours. Manage the coughing and aches and pains with Tylenol and Motrin, and keep them hydrated.”

Dr. Joshua Jakum, also of Piedmont Pediatrics, said that most children with flu will get better in a week or so, and don’t need to see the doctor unless there is labored breathing, a danger of dehydration because of severe vomiting or diarrhea, or if the child’s skin is very pale or blue-looking.

The teenage population is being hit hard, according to Dr. Rustom. “Teenagers tend to let things go. Parents don’t know they are sick at first. By the time we see them, they feel like they’ve been hit by a truck. With kids, just like adults, sometimes it’s ‘the bigger they are, the harder they fall.’ They can feel pretty bad, but they are coming out of it just fine.”

Both pediatricians strongly recommend that children get vaccinated when the vaccine becomes available in the next couple of weeks. (See for details on flu availability.)

Dr. Jakum acknowledges that there is a fear of developing Guillain-BarrĂ© Syndrome (a severe neurological disorder) or other side effects from the flu vaccine. He responded, “You are more likely to experience Guillain-BarrĂ© Syndrome as a result of getting the flu than from getting the vaccine. We’ve been making safe vaccines for many years and have a lot of data, a lot of experience with it. The H1N1 vaccine appears to be as safe and effective as any seasonal flu shot.”

Dr. Rustom added, “Some people are afraid that they rushed the vaccine out too quickly, without enough testing, but thousands of people have taken the vaccine with very good results. If parents are comfortable with the regular seasonal flu vaccine, they should not have reservations about the H1N1 flu vaccine. Get your kids vaccinated. The benefits far outweigh any possible negatives. I’m going to get it; my kids are going to get it.”

Other questions Dr. Rustom is answering in his office are about testing and about Tamiflu (an anti-viral medication that can shorten the duration of the H1N1 flu). “We have to be very, very careful about using Tamiflu. We are concerned that if it is used too much, the flu strain may become resistant to it and we won’t have it as a tool to use in the most severe cases. Some practices are giving it out like candy, but we are administering it only when there are underlying conditions, like neurological disorders, diabetes, cystic fibrosis or very severe asthma.”

Dr. Jakum agreed, “The danger is in using Tamiflu so much that we end up having a drug-resistant super bug on our hands. We need to reserve it for the highest-risk patients. Not all pediatric patients will get Tamiflu.”

The age of the child is also a factor in how the flu needs to be treated. Very young infants are in the high-risk category. Dr. Rustom said, “We had a 4-month-old baby we hospitalized and put on Tamiflu. The baby was completely fine within 24 hours and was sent home.”

Dr. Jakum confirmed that, “We are especially cautious with the little ones, up to 24 months old.”
As for testing, Dr. Jakum explained that the tests for H1N1 "can be inaccurate and we don't always test. Instead we rely on our clinical judgement."

Dr. Rustom said, “If you or your kids have the flu, assume it’s the H1N1 flu. Ninety-nine percent of the flu out there is H1N1.”

Drs. Rustom and Jakum agree that it’s hard for parents to see their children sick, and that worrying is natural. Dr. Jakum said, “A lot of parents want treatment for their children, but the best opportunity we have is prevention: Hand-washing, coughing and sneezing into a tissue or into the fold of your elbow, and getting vaccinated.”

Dr. Rustom concluded, “The healthier you are, the easier time you are going to have if you get the flu. As I tell my parents every day, “make sure your kids get enough rest, healthy food and exercise. A healthy immune system can fight this off in four or five days.”

Wednesday, October 21, 2009

Societal Changes Necessary to Battle Obesity

In light of Dr. David Katz's speech at the recent Planetree Conference and his views that consumers need better tools to be able to determine whether or not a product is "healthy," an article on the Yahoo news site this morning seems particularly timely. It's a story about how the FDA is looking at food labels and cracking down on those that are deliberately misleading about nutritional content.

The article even suggests that products be marked with a single symbol so consumers can tell at a glance how nutritional a product is ... sounds like Dr. Katz's NuVal system.

Click on the link to read the whole article.

Dr. Katz's message is that we need societal changes to battle worldwide obesity. Although a proponent of personal responsibility, he claims that the food industry needs to make it easier for consumers to make good choices, instead of hiding behind colorful packaging and catch phrases.

As a health care system, Fauquier Health is a strong proponent of wellness. Our LIFE fitness center offers nutritional sessions with certified dietician Aren Dodge, as well as fitness memberships. Call 540-316-2640 for more information.

Tuesday, October 13, 2009

Fauquier Hospital Restricts Visitors to Family Birthing Center

In response to the rapid and pervasive spread of the H1N1 virus this flu season, Fauquier Hospital will temporarily restrict visitors to its Family Birthing Center as of October 14. No visitors under 18 years old, except siblings, will be permitted in the fourth-floor birthing unit.

Research has shown that expectant mothers, women who have recently given birth, and infants are particularly at risk for serious illness from flu. The
Centers for Disease Control has reported that 76 children have died of flu-related illnesses in the U.S. since April. Twenty-nine of these have been reported since August 30. The CDC also reports, that “19 flu-related pediatric deaths were reported this week; 16 of these deaths were confirmed 2009 H1N1 and 3 were … likely to be 2009 H1N1.”

Addressing risks to pregnant women, the CDC reports: “Severe illnesses among pregnant woman and infants have been reported in this outbreak.”

Bethann Thomas, director of the Family Birthing Center, said, “Fauquier Hospital is dedicated to keeping all of its patients safe and healthy, and is placing restrictions on visitors to protect its most vulnerable populations. Those who come to the hospital to visit new moms will be asked to call into the unit from an in-house phone before being admitted.”

Thomas, who is expecting a baby in the next couple of weeks, added, “Right now, my baby’s father is sick with the flu, so if I go into labor while he is still ill, he won’t be with me in the hospital. We’ll find a way to use Skype or some other technology for him to be a part of the delivery, but we want to make sure the baby and I are safe from the flu.”

Rodger Baker, CEO and president of Fauquier Health, emphasized, “We encourage all visitors to be aware of the health risks to our new mothers and infants. Anyone – child or adult – who is not feeling well should refrain from visiting the hospital, particularly the Family Birthing Center. We thank residents for their understanding during this pandemic.”

Monday, October 12, 2009

Find Reliable Information on H1N1 Vaccine Safety

There have been a number of headlines recently about fear over the H1N1 vaccine. The doctor who went on television to say he wouldn't give his kids the vaccine got a lot of attention. The large numbers of medical experts who are urging folks to get the vaccine ... not so much.

I would encourage residents -- parents in particular -- who are concerned about the vaccine's safety to turn off the sound bites and do some real research into the safety trials of this particular vaccine. Make up your own mind, but go to the medical information instead of relying on what your neighbor heard from a friend about the flu vaccine given in the 1970s.

This link is a good one for reliable information about vaccine safety. It's from the Centers for Disease Control:

And here is a great article that makes good common sense, stating the case for getting an H1N1 vaccine:

Thursday, October 8, 2009

Heading Home

I woke up this morning, my last in Baltimore, feeling refreshed and energetic. I had been thinking a lot about Dr. David Katz's keynote speech at the Planetree conference the day before and his simple advice: Eat. Not too much. Mostly plants. And his entreaty to move more. It's a very Planetree idea: Prevent disease before it starts with exercise and healthy eating.

I set out to enjoy a brisk walk around Baltimore's inner harbor and a healthy breakfast. One of these was easier to manage than the other.

It was a beautiful, breezy day at the harbor. The sun was warm and the clouds few. It felt good to walk after several days of sitting in meetings.

I opted for Panera Bread for breakfast -- a strawberry smoothie and a yogurt parfait. Sounds healthy, right? Wrong.

One of Dr. Katz's points was that just because a product looks healthy, and the label claims it's healthy, doesn't necessarily mean it is healthy. The Yogurt parfait sign claimed whole grain oats and 4 grams of fiber, but left out the 12 grams of fat and 29 grams of sugar. A close look at the nutritional information for a grilled breakfast sandwich of egg and cheese revealed that the two items were not that different nutritionally. The sandwich offered a few more calories and a lot more sodium, but only one gram of sugar and 18 grams of protein.

The smoothie numbers were even more surprising, with almost 300 calories and a whopping 48 grams of sugar.

Dr. Katz recognizes that our society makes it very difficult to make nutritious choices. He advocates that everyone become a "food detective" and look beyond the front of the box to the small print on the nutrition label.

As a step toward addressing this societal deficiency, he and other nutrition scientists have created a system called NuVal. The Boston Globe reported last month, "Using an algorithm, NuVal takes the 'good’' nutrients, such as fiber, folate, and vitamins, and divides them by the 'not-so-good’ ingredients, including sugar, sodium, and trans fats to determine the score. Items are not weighed equally, as it depends on their effect on health outcomes. For example, trans fats can lower a NuVal score significantly...

"The NuVal system is available at more than 500 supermarkets across the country. The company expects to more than double that over the next year and expand into chains beyond Price Chopper in Massachusetts. So far, NuVal has rated over 30,000 products across the supermarket, including beverages, dairy, produce, meats and more. NuVal scores are on the shelf tags, next to the price of items, so consumers can calculate immediately how much nutrition they are getting for the price."

It's a pretty interesting idea and if it catches on, might go a long way toward demystifying food labels and making it easier to choose healthy foods.

Until the NuVal system makes it to the rest of the country, Dr. Katz says that it's best to choose foods with the fewest ingredients on their labels -- broccoli, for instance has only one, while some breakfast cereals have dozens. And watch out for partially hydrogenated oil and high fructose corn syrup.

Please understand, I'm not picking on Panera Bread. They use organic non-fat yogurt in their smoothies and offer other good choices. And Panera provides their nutrition information online and in the store for anyone who asks for it. Not all restaurants do.

It really just means we all have to be aware and look beyond advertisements to find the best choices for ourselves and our families.

I saw a sign on my loop back to the hotel that made me smile. It was a sign for the Baltimore Public Works Museum. Over the sign, it read in smaller letters, "The Surprisingly Interesting..."

It pays to read the fine print.

Wednesday, October 7, 2009

Spirit of Planetree Winners Celebrate

It was a good time today for Fauquier Health staffers at the Planetree conference. There were several highlights.

Dr. David L. Katz, who was recently in the running for surgeon general, gave a keynote speech on obesity and its disastrous effects on our health -- our family's, our country's and our world's.
Dr. Katz is a renowned scientist, a prolific author and a dynamic speaker.

He made a convincing case for eating less and moving more. His website is and it's a must for anyone who is concerned about the health-destroying effects of obesity.

The final keynote speakers of the conference were billed as "The Three Doctors." An internist (Dr. Rameck Hunt), an emergency room doctor (Dr. Sampson Davis), and a dentist (Dr. George Jenkins), grew up together on the dangerous streets of Newark, New Jersey, poor but lucky to have one another. With a few breaks, some kind help along the way and their mutual bond, the three all reached their dreams.

In addition to their medical practices, they spend their time giving back to the community by inspiring other young people to reach beyond what they see in front of them to find something better. They are proponents of patient-centered care and try to live by those principles every day.

The presentation was sincere and endearing and was a favorite of those attending. Their website is

The finale of the day was the presentation of the Spirit of Planetree awards.

Winners from Fauquier Hospital were:
Dr. Alireza Tajick, Physician Champion award
Wendy Greenwood, Caregiver award

Winners from the Fauquier Health Rehabilitation & Nursing Center were:
Dr. Donna Vannata, Physician Champion award
Melanie Phillips, Caregiver award

Lisa Spitzer, Fauquier Health Concierge, was given a special Family, Friends and Social Support award for her outstanding concierge program.

Lots of cheering and smiles ensued during the award ceremony. It's several hours after the banquet now, but I think Lisa is still teary-eyed over the honor.

For more photos of the banquet, see the Fauquier Health Facebook page. Go to and search for Fauquier Health. (While you're there, become a fan.)

Techology and Patient Care

I attended three different Planetree seminars yesterday about technology and patient care, all from different perspectives. The last was on the best sites to find accurate and up-to-date medical information.

There is lots of information out there, but which sites have science-backed, confirmable articles?

I will start sharing these through this blog once I get back on my home turf at Fauquier Health.

(By the way, the food got "bigger" yesterday, so I'm a happy camper. Still healthy stuff, just a little more of it.)

Tuesday, October 6, 2009

Planetree Members Visit Fauquier Health

At the Planetree conference, I spoke to some folks from other healthcare faclities who went on a tour of Fauquier Hospital, the LIFE Center and the Fauquier Health Rehabilitation and Nursing Center.

Those of us who work for Fauquier Health sometimes forget how special our facilities are. It's nice to be reminded.

Folks from San Diego and Cleveland were among those who visited, as well as a group from Japan. Those I spoke to were very impressed by our beautiful, soothing environment for healing.
They loved the Bistro on the Hill and even took a turn at a Zumba class at the LIFE Center.

Day 1 at the Planetree Conference

The Planetree Model

Since its founding as a nonprofit organization, Planetree has pioneered methods for personalizing, humanizing and demystifying the healthcare experience for patients and their families.

The Planetree model of care is a patient-centered, holistic approach to healthcare, promoting mental, emotional, spiritual, social, and physical healing. It empowers patients and families through the exchange of information and encourages healing partnerships with caregivers. It seeks to maximize positive healthcare outcomes by integrating optimal medical therapies and incorporating art and nature into the healing environment.

Planetree continues to innovate, broadening our collective understanding of the concept of healing, and continuing our network’s expansion so that a growing number of patients and caregivers can experience the dignity, compassion, and humanity that are hallmarks of the Planetree philosophy.

I am in Baltimore, attending 2009 Planetree Conference on behalf of Fauquier Health. It's three days of smiles, sincerity and good feelings. So many great folks here, striving to improve their health facilities under the patient-centered care banner.

But the food is small. Tiny bran muffins for breakfast, tiny Portobello sandwiches and really tiny crab cakes for the dinner buffet. Tasty but miniature. And no dessert!

Planetree folks want everyone to be healthy and happy, so I guess they are watching out for our waistlines.

Sigh… What happened to the good old days, when a business conference meant gravy with everything and chocolate mousse for dessert?

I’ve never been to a Planetree conference before and it feels different than every other conference I’ve ever been to. As a former journalist, I’ve attended many newspaper conferences, where the competition between people was palpable. Attendees guarded their best ideas and talked a lot about their accomplishments. The jargon they used was straight out of journalism textbooks, and I always felt like a little fish in a big pool -- of piranahs.

The Planetree conference is more about sharing good ideas than about hoarding them, more about cooperation than competition. The attendees are really smart and accomplished, but they treat you like you are smart and accomplished, too. It’s a “we’re all in this together” mentality.

The “let’s make the world a better place” emphasis is very liberating. No one is here to prove they are better or more important than anyone else, so it frees me up to just soak in all the good information and enjoy the seminars.

It hasn’t all been smiles, of course. I attended a great talk on emergency preparedness, with an emphasis on the H1N1 crisis. We’re all hoping the pandemic won’t reach its potential, but we all need to be vigilant in preparing for that potential.

A little scary.

I could have used some chocolate mousse to take the edge off, but had to settle for a keynote speech from Naomi Judd, who talked in her self-deprecating hillbilly way about her recovery from hepatitis C. Did you know she used to work as a nurse?

Her talk was uplifting, but not very filling.

Good thing I have cookies in my hotel room. Planetree is also about comfort, right? And for me, cookies are comfortable.