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.
