M.O.M.S. Preventative Health Program for Pregnant Women Helps Mothers Start off on the Right Foot

MOMS stands for Medicaid Obstetrical Maternal Service and its goal is to help medicaid-eligible pregnant women have a healthy pregnancy.  They provide pre- and postpartum nursing and education on various preventative subjects like nutrition, infant growth and development, exercise etc.  This is a great service offered to women who may be in difficult situations with no supportive family or means to gain knowledge and be educated on their pregnancy and how to care for a child otherwise.  MOMS works with its members to find "the right doctor for you and your baby" and maintain relationships with local doctors in order to help mothers in need find a good fit.  The great thing that MOMS offers in addition to all of its educational program is support.  It teaches women how to register for WIC (Women, Infants, and Children) a federal program that provides nutrition and health care supplements to women and children up to five years who are nutritionally deficient.  Each pregnant woman who comes to MOMS is assigned a MOMS nurse who personally follows through with that woman throughout her pregnancy.

The great thing about MOMS is it gives women information that they can use for years to come.  The Cayuga County Department of Health, which is located right in the town of Auburn also offers additional services such as flu shot clinics and other community health services.

As a future doctor, programs like this are great, but only can be optimally effective when recommended to the right patients at the right time.  Prenatal care makes a huge difference in a baby's life as well as the mother's, and as a doctor I may have patients who are going through difficult times, and having the support of a group like MOMS will help give them personal attention and education that I may not be able to offer as fully as a program like this will be able to.  Being aware of programs that are offered locally like this is crucial for their success and also to make the most out of preventative resources available and optimize the chances of producing healthy mothers and children in my community.

References

http://co.cayuga.ny.us/hhs/doh/communityhealth/moms.htm

http://web.cayugacounty.us/web/Departments/HealthDepartment/CommunityHealthServices.aspx

http://www.fns.usda.gov/wic/

Cayuga County Public Nursing Home Struggles

While searching for an appropriate article, I came across various private healthcare programs and offices that offered house visits.  While it is wonderful that these types of services are offered to the residents of Cayuga County, particularly elderly and bedridden folk, it doesn't seem like these services are available to everyone.  Cayuga County does also have a publicly-run nursing home, that provides services and living quarters for 80 members of Cayuga County, over 75% of which pay with Medicaid or have difficulty paying.  The problem is, that this facility does not perform as well as private nursing homes according to statistics, and it has recently been under review because its increasing costs of running are outweighing the profit this nursing home brings in.  Luckily, the citizens of Cayuga County seem to realize how important it is to keep such a facility up and running, especially when it seems though the amount of senior citizens in Cayuga County will continue to rise for the foreseeable future.  It is really unfortunate that the CCNH (Cayuga County Nursing Home) has higher rates of complaints, patients with anxiety, loss of bladder control, and depression.  The average pay of nurses at CCNH is lower than other private facilities in the area, and they have had difficulty finding staffing for certain positions like the director position.  The costs of the nursing home have begun to exceed revenue, particularly because of the recent cuts in Medicaid.

It is truly important that such a facility stay in Cayuga County and continue to serve locals in need.  Such a facility has been noted for accepting patients even if they are unable to pay, and providing basic care and assistance where the patients might otherwise not receive such personal or medical attention.  If the CCNH gained support by local physician's offices, perhaps they could better educate their staff and improve their statistics.  Supporting such a facility is vital to the persistence and well being of a community such as Cayuga county.

Sources

http://auburnpub.com/news/local/county-getting-out-of-nursing-home-business/article_767c5324-d1eb-11e0-9734-001cc4c002e0.html

http://nursinghomes.nyhealth.gov

http://co.cayuga.ny.us/nursinghome/aboutus.htm

http://www.auburnpub.com/app/pdf/LivingInCayCounty2011_12.pdf

Safe Doses Act

Senator Charles Schumer sponsored a bill back in March of 2012 with the intent to crack down on prescription drug theft.  Cayuga County, under the umbrella of the city of Auburn, has seen increasing drug abuse within recent years.  "Tranformations," a drug and alcohol abuse treatment center argues that the central New York state location and growing urbanization around the city of Auburn foster a "safe haven" for drug traffickers.  Drugs such as marijuana and cocaine are widely seen, but heroin, khat, MDMA, and methamphetamine are also circulated.  Correlating with the rise in drug abuse, drug-related crime has also risen.  Efforts have been made by administration, particularly to combat synthetic dugs, including a local law originally proposed by District Attorney Jon Budelmann passed September 25th making it illegal to sell or possess synthetic drugs (automatic year in jail and hefty fine).  

Support behind Schumer's bill which would essentially increase penalties and "give law enforcement agents the ability to use wiretaps and other tools to combat prescription drug rings."  After reading this article and browsing the commentary (presumably made by people who live in central New York), this law may help slightly, but doesn't seem to be a cure-all solution for the prescription drug problem that continues to steadily increase, keeping ED busier and busier.  In a rural area such as Cayuga County, the surrounding urban areas do provide easy access to illicit drugs which can be spread throughout the streets and college campuses.  I think that as a doctor practicing in a rural area with this type of demographic, its important to keep your patients educated about the harmful effects of drugs and the unknown consequences of purchasing drugs.  Many drugs, particularly synthetic drugs can be laced with components even more detrimental than the drugs themselves.  I think that although this law does not seem to be largely supported by those who live in the area, it is clear that something needs to be done about the steadily increasing drug problem, and that at least bringing it to the attention of those who live in Cayuga County is helpful.  The local synthetic drug law that was recently passed may prove to make a difference in synthetic drug use in Cayuga County, and I'll be interested to see if the statistics improve.  Its also important as a doctor to warn and educate patients about the prescriptions that you give them.  Taking the time to tell patients how the drugs are important for THEIR and only their health, and how correct dosages and usage is vital to the drugs working correctly.  Additionally, making sure that prescriptions are clear and cannot be tampered with, and perhaps having a system where pharmacies and doctor's offices can communicate about the writing of prescriptions and actual pickup will help eliminate that in between step where prescription drug theft may manifest.

Although the rates are currently rising, I think that education and awareness of the drug problem that is taking over Cayuga County can make a big impact.

References

"Auburn Substance Addiction Statistics."  http://transformationstreatment.com/new-york-drug-abuse-treatment/auburn-ny-drug-abuse-treatment/

"Cayuga County bans the sale, possession of synthetic drugs."  http://www.9wsyr.com/news/local/story/Cayuga-County-bans-the-sale-possession-of/Z5rnTfEcG0uBKhbg70faTw.cspx

"Cayuga County closer to new synthetic drug law."  http://auburnpub.com/news/local/cayuga-county-closer-to-new-synthetic-drug-law/article_a0fc786e-e22c-58e6-a814-59f05e9f6aed.html

"Schumer bill addressing upstate's growing prescription drug abuse problem clears hurdle." http://www.syracuse.com/news/index.ssf/2012/03/schumer_bill_addressing_upstat.html

"Schumer Pushes for SAFE DOSES Act to Combat Drug Thefts." http://abcnewsradioonline.com/new-york/schumer-pushes-for-safe-doses-act-to-combat-drug-thefts.html

Underlying Risks of Barn Fires

A recent barn fire in Aurelius (August 30th, 2012) posed an unexpected risk for firefighters involved once it was realized that hazardous materials were stored in the hay barn in addition to large amounts of hay and sawdust.  Union Springs Fire Department originally dispatched several firefighters early Thursday night to stop the fire, which involved no farm animals.  However, once it was gathered that chloric acid was stored within the barn, a dozen other local fire department companies dispatched volunteer firefighters to help including those from Aurora, Fleming, Skaneateles, Owasco, and Port Byron.  The chloric acid is believed to have been mostly within containing ponds, but all firefighters who walked through such ponds were treated medically for decontamination.  In addition, four firefighters were treated in the hospital for heat-related injuries, presumably due to the amount of time they spent in the barn due to the farm chemical complications.

While it appears that there are no serious injuries due to exposure from chloric acid, this chemical and other farm chemicals can pose serious risks to firefighters.  Chloric acid is a powerful acid that can cause organics and other flammables to rapidly burn upon contact.  It not only is a nasty corrosive oxidant at room temperature, but upon warming chloric acid breaks down into an unstable slew of chemicals including extremely poisonous chlorine (Cl2) and the strongly acidic and explosive perchloric acid (HClO4).  Health risks of exposure to chloric acid components include respiratory problems in lung functioning.  Air exposure can cause irritated eyes, nose, and throat.  Touching the warmed chloric acid can cause skin irritation.  If exposed to large amounts of chlorine (30ppm), one could experience vomiting, chest pain, difficulty breathing, and transient pulmonary edema.  Those with pre-existing lung and heart conditions may be particularly susceptible to exposure to such chemicals.  In addition, the "containing pond" may have stopped chloric acid breakdown from reaching air the firefighters were breathing, but when chlorine comes into contact with lake water, it can form chloroform, a chemical suspected to cause cancer.

Burning hay and sawdust also pose a risk that rural firefighters are exposed to frequently.  Long term exposure to burning straw has been found to cause chronic lung conditions and non-stop symptoms such as asthma.  Sawdust and other pressure-treated woods were treated with a form of arsenic (carcinogen, causes arrhythmia, decreases in amount of blood cells produced) before 2003, so burning of old sawdust can pose health risks for the entire community.  Arsenic remains in ashes after a fire, and can contaminate water sources and even crops.

The best solution to fires like this that frequently happen in rural communities is to educate farmers about proper storage of hazardous chemicals as to reduce accidental exposure and contamination of resources due to farm toxins.  Firefighters should take protective measures by wearing masks and protective equipment.  It is essential that communities provide funds for fire departments to provide such technological equipment.  Firefighters risk their lives to save people and their belongings, and should not have to suffer longterm health consequences for their heroism.  In addition, protective equipment would allow firefighters to fight fires more efficiently and fewer concerns of what chemicals and toxins they may become exposed to--this would allow fires to be put out more quickly and be beneficial to the community as a whole.  Firefighters who do come to community hospitals after exposure to a barn fire that may involve toxins should be given adequate tests (of liver, lung, heart function, etc.) to assure that they will be treated sufficiently to prevent longterm problems.

References:

"Four firefighters treated while fighting barn fire in Aurelius" http://www.syracuse.com/news/index.ssf/2012/08/four_firefighters_treated_whil.html
"No injuries reported in Aurelius barn fire" http://www.syracuse.com/news/index.ssf/2012/08/no_injuries_reported_in_aureli.html
"Aurelius barn fire involves hazardous material, dispatchers say" http://www.syracuse.com/news/index.ssf/2012/08/aurelius_barn_fire_involves_ha.html
Wisconsin Department of Health Services: "Chlorine" http://www.dhs.wisconsin.gov/eh/chemfs/fs/chlorine.htm
Wisconsin Department of Health Services: "Chloroform" http://www.dhs.wisconsin.gov/eh/chemfs/fs/chloroform.htm
"Straw burning a health hazard" http://www.gov.sk.ca/news?newsId=1e4bbe5c-bd55-4928-ba80-cba87d37f07f
"Possible Health Hazards Associated with Pressure-Treated Lumber" http://voices.yahoo.com/possible-health-hazards-associated-pressure-treated-5169363.html