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January 10, 1997     Cape Gazette
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January 10, 1997

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26 - CAPE GAZETTE, Friday, January 10 - January 16, 1997 HEALTH & FITNESS Child's meningitis poses no threat to others By Kerry Kester Meningitis, recently diagnosed in a Shields Elementary School first grader, does not pose a threat to the general popula- tion. The infection, although contagious, is not easily transmitted in typical daily envi- ronments such as a classroom or a swim- ming pool. The infected boy, who was diagnosed at Beebe Medical Center on Saturday, Jan. 4, was taken to A.I. DuPont Institute for his treatment, where he is reportedly doing well. He is expected to be released from the hospital within a week. The school's office was flooded with phone calls from concerned parents throughout Monday. Later that morning, the school's principal and Kay Jennings, R.N., school nurse, wrote a letter to be sent home to parents later that day. The letter explained that their children were not at risk of getting meningitis. "There was concern that the school should be shut down - that we should not even be there," said Jennings. "People were kind of in a panic - they were afraid for their kids." Jennings contacted the state's epidemiology branch of the Division of Public Health, and she included a menin- gitis fact sheet with the letter sent home to parents. By Tuesday, she said, there were fewer phone calls. "Basically, people needed to know what to look for," said Jennings. Once parents understood that there was no danger to their children, she said, activities in the building resumed at a normal pace. Jennings said only a couple of parents have kept their children home from school, including one child from the middle school. "If there were any questions about their child's safety, I've referred them to their family doctor," she said. According to Scott Olewiler, M.D., Beebe Medical Center's specialist in infec- tious disease, there are different forms of meningitis, which is the inflam- mation of the membranes cover- ing the brain or spinal cord. The infection may be drug in- duced, caused by a virus or fungi, or it may be the result of a bacter- ial infection, said Olewiler. The bacterial infection is perhaps the most serious form of the disease which in any of its forms can, if left untreated, can cause death. The Shields' student was diag- OLEWILER nosed with a bacterial meningitits. Those most likely to contract the illness are younger people, with the peak age being between five to 10 months, "but infection is commonly seen in patients up into their 20s," said Olewiler. Approximately 10 percent of the popula- tion harbors one of the bacterias known to cause the disease at any given time, but few will have the germs penetrate the tissue in the throat, enter the blood stream and lodge in either the membrane cov- eting the brain or the spinal cord. "You don't see a lot of meningi- tis in adults," Olewiler said. Olewiler explained that people could harbor the germs in their systems for long periods of time, but never develop the illness. "It's around us all the time," he said. "Most people nev- er get sick. It's mostly dependent on the host." Children, however, with their less fully developed immune systems, are more prone to acquiring the illness. Usually, he explained, children will contract the disease within 24 hours after being exposed to the bacteria. The symptoms include high fever, headache, a stiff neck, confusion, and se- vere vomiting, as well as purplish rash-like spots that will appear on the skin. The symptoms are clearly noticeable, explained Olewiler. "It's really not subtle. "We do look for secondary cases," he said, which generally appear within seven to 10 days following the first case. The in- fected person, however, stops being conta- gious 24 hours following the first dose of the antibiotic used to treat the disease - usu- ally penicillin. Those who have casual contact with Continued on page 28 Drug treatment for Parkinson's disease offers many patients more comfort and mobility By Kerry Kester Parkinson's disease is one of the more common diseases to afflict the elderly pop- ulation. Hundreds of people in the Cape Region are currently being treated for the disease, which generally strikes people at about age 60. Nationally, more than two and a half percent of 85-year-olds have the disease. The disease impacts a patient's physical, social and emotional life. Drug treatment, however, does provide many patients with greater control over their bodies and helps improve the quality of life. "Parkinson's disease is a degeneration in the area of the brain that produces a chemi- cal called dopamine," said Michele Mangum, M.D., a Lewes board certified neurologist. Having dopamine in the sys- tem, she said, is essential to people retain- ing fluidity of movement, and without it people cannot move quickly or smoothly. "The typical Parkinson disease patient has arresting tremor, postural instability, a slowness of movement, a shuffling gait, de- creased facial expression and rigidity or stiffness," said Mangum. Patients may have a stooped postures and have difficulty taking a first step. They may take very small steps. Sometimes, pa- tients will be moving forward and suddenly "freeze" for just a moment. Difficulty caused by the postural afflictions may cause a patient to have difficulty maintain- ing balance and fall, or it may lead to a pa- tient dropping or falling into a chair in the act of attempting to sit down. "Some patients may be prone to multiple falls," said Mangum, but with the availabil- ity of assistive devices such as motorized wheelchairs, canes and walkers, risk of seri- ous injury is minimized. The tremors may make fine motor activi- ties such as buttoning a shirt or threading a needle nearly impossible. Eventually the tremors can make it challenging, if not im- possible for a patient to get eating and drinking utensils to the mouth. Tremors al- so impact handwriting. Letters are often misshapen and are tiny, so that written doc- uments, including signatures, may be illegi- ble. In advanced stages, another manifesta- Continued on page 32 Preparing athletes for surgery reduces anxiety, promotes healing For the young athlete surgery can be a frightening and stressful experience. Very often this is their first major surgery or illness. For this strong and healthy individual, the thought of being bedridden in unfamiliar place may be difficult to accept. The athlete will proba- bly have many questions and fears concerning his injury, surgery and hospital routine. It is important for the coach, school nurse, athletic trainer or team physician to prepare the ath- lete for the surgical experience. and to provide general informa- tion concerning pre-operative care. Before the athlete enters the hospital encourage them to ask questions and express their fears and anxieties. Use terminology that the athlete will be able to un- derstand. The use of diagrams or skeletons may be helpful. The following are some guide- line that will help the athlete ad- just to his hospitalization. For pre-operative care: Emphasize the importance of complying with the hospital ad- mission time. There will probably be necessary tests and final evalu- ations. Describe the routine blood and urine required. Explain to the athlete that the anesthesiologist will be visiting and evaluating him to determine the appropriate anesthetic. Explain the legalities that re- quire a consent form to be read and signed. A full explanation of surgical procedures and possible complications must be given be- fore the individual signs the per- mit. Explain to the athlete that they are to restrict food and liquid eight to 12 hours before surgery to pre- vent vomiting and aspiration dur- ing surgery. Indicate that the area requiring surgery will be washed with an antiseptic soap such as povidone- iodine solution to reduce the pos- sibility of infection. This type of solution often leaves a brownish tint on the skin, which means it is working to protect the area from germs. Explain that an I.V. (intra- venous infusion) may be inserted into the athlete's ann. This allows a route for administration of med- ications and fluids to maintain body hydration. When the athlete HEALTH TOPICS Roger "Doc n Hunt is an ath- letic trainer, strength coach and fitness instructor at Sus- sex Technical High School. He has 21 years of sports medicine experience and has lectured throughout the Unites States, China, Finland and the Bahamas. can orally accept fluids and med- ications, the I.V. will be removed. Inform the athlete that a pre- operative medication is frequently prescribed to promote relaxation and to decrease anxiety. The med- ication may cause drowsiness, Let the athlete know that they will be taken to a "pre-op" room (waiting area) for approximately one hour before being transported to the operating room. For post-operative care: Tell the athlete they will be in the recovery room until all vital signs are stable (temperature, pulse, respiration and blood pres- sure). The athlete will then be transported to their regular room. Explain that their vital signs will be monitored every four hours. If a cast has been applied cir- culation checks will be made peri- odically by the hospital staff. Pain medication may be given every three or four hours, depend- ing on the physician's orders. The medication may reduce, but may not stop the pain completely. Following surgery, the ath- lete's diet will progress from liq- uids to regular diet usually 24 hours later. Tell the athlete they may bring small personal items such as walkmans or portable radios, but to check with hospital staff. Friends or relatives may visit but they are to adhere to visiting hours. The athlete may experience weakness and fatigue for several days after surgery so this should be explained to them. If there are any other questions which they have, the questions should be di- rected to the physician. Do not give the athlete incorrect informa- tion. Do not tell them "they won't feel a thing," or "there's nothing to it." They are false statements. The more positive the athlete's attitude toward surgery, the better they will accept their injury and operation. It is mentally beneficial to pre- pare the athlete for surgery. This will reduce the level of anxiety and provide the athlete with a more positive hospital experience.