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Blood Drive December 19

Diabetes and flu: what you need to know

There are certain groups of people who are at risk of serious flu complications each year, including those with diabetes.

Seasonal flu activity can begin as early as October and continue to occur as late as May. Flu cases were reported at the University of Alabama at Birmingham as early as September, and now is the time to prepare for the upcoming flu season, said Fernando Ovalle, M.D., professor of medicine in the UAB School of Medicine and senior scientist in the UAB Comprehensive Diabetes Center.

“Diabetes can weaken your immune system against the flu, and it also puts you at an increased risk of flu-related complications,” Ovalle says. “The weakening of the immune system makes it harder for your body to fight the flu virus. Being sick can also raise your blood glucose and prevent you from eating properly. You are also at risk of flu-related complications like pneumonia.”

There are several things Ovalle said diabetics and parents of children with diabetes can do to give some protection from the virus:

• Get a flu vaccine shot. The nasal spray vaccine is not safe for people with diabetes.
• Talk to your health care provider about the pneumococcal vaccine. It will help protect against pneumonia.
• Keep track of blood glucose. It can be affected by illness.
• Wash your hands often with soap and water or an alcohol-based hand rub.
• Try to avoid close contact with sick people.
• Practice the good-health habits like getting plenty of sleep and exercise, managing stress, drinking plenty of fluids and eating healthy food.

For people with diabetes who think they have the flu, Ovalle suggests doing the following:

• Contact a health care provider immediately. Symptoms include fever or feeling feverish or experiencing chills, cough, sore throat, runny or stuff nose, muscle or body aches, headaches and fatigue. In children, vomiting and diarrhea can be common.
• Continue taking diabetes pills or insulin.
• Test blood glucose every four hours and track results.
• Stay hydrated; drink lots of calorie-free liquids.
• Try to eat normally.
• Weigh every day. Losing weight without trying is a sign of high blood glucose.

“Experiencing the flu is no fun for anyone, and especially those with diabetes,” said Ovalle, who has an active clinical practice and serves as the director of the Multidisciplinary Comprehensive Diabetes Clinic at UAB. “Be vigilant and smart, especially when it comes to washing your hands. And if you every have any questions or concerns, contact your healthcare provider.”

Source: University of Alabama at Birmingham Press Release 

Stopping diabetes in its tracks

For many of us, it is hard to imagine the daily care required to control diabetes. For those with the disease, a normal day consists of constantly monitoring blood sugar levels, coordinating meals, exercising, medications and/or insulin injections.

“Diabetes is rapidly growing and a leading cause of death in the U.S. impacting nearly 26 million people in the U.S. alone,” says Pat Cooper, vice president for clinical operations at Quorum Health Resources (QHR). “What's more, an estimated 7 million Americans have the condition but remain undiagnosed.” High blood sugar symptoms are easy to dismiss. Excessive hunger, increased thirst, frequent urination, blurry vision, numbness in hands/feet or a waistline that exceeds 40 inches in men and 35 inches in women--are all causes for concern.

To clarify the urgency of treating diabetes, Dr. Gene Barrett, president of the American Diabetes Association (ADA) recently introduced the term "prediabetes"--describing those individuals with high blood glucose (sugar) who are at risk for developing diabetes. Once a person has full-blown diabetes (Type 2), their bodies either do not make enough insulin or the insulin that they are making does not work properly.

November is National Diabetes Awareness Month and November 14 is World Diabetes Day. The month offers numerous opportunities to get involved locally and nationally to raise diabetes awareness.

The cause of diabetes varies, but obesity, inactivity and genetics are generally responsible. The various types of the disease include: type 1, which is typically diagnosed in children under 17-years-old (but has been seen in people who are in their 30’s); type 2 (typically seen in patients over 20 years-old, but has been diagnosed in children as well) and gestational diabetes, which occurs in pregnant women. Most women with gestational diabetes do not remain diabetic after the baby is born, however they are at increased risk of developing Type 2 diabetes in the future.
Patients with diabetes can help prevent complications such as cardiovascular disease or stroke with the right medical treatment. According to the ADA, reducing diastolic blood pressure from 90 mmHg to 80 mmHg in people with diabetes reduces the risk of major cardiovascular events by 50 percent.
When diabetes is left untreated it can lead to serious complications such as:
· Kidney failure

· Heart disease
· Stroke
· Nerve damage
· Blindness
· Non-traumatic lower-limb amputations
“Diabetes and other risk factors such as high blood pressure and high cholesterol can increase the likelihood of serious complications that affect your heart, blood vessels, nerves, eyes and kidneys,” explains Sherry McCafferty, RN and diabetes educator at Penobscot Valley Hospital. “It is important to take a diabetes or prediabetes diagnosis seriously to avoid life-threatening complications. Managing your diabetes can help reduce your risk of serious complications, give you more energy and a better sense of well being.”

Researchers are hopeful that one day diabetes patients will only require insulin injections once a week or less. The Harvard Stem Cell Institute (HSCI) recently discovered a hormone that naturally regulates insulin. When tested in mice, the hormone triggered the pancreas to produce insulin up to 30 times more than the normal rate. While the hormone has not yet been approved for humans, the research is welcome news to the millions who administer insulin each day.

While there is no cure for diabetes, treatment options consist of following a meal plan that is low in sugar and solid fats, regular exercise, oral medications, and insulin injections. Consult your healthcare professional to understand your risk for diabetes or to determine the best treatment options that will help you manage the disease.
To curb symptoms, patients are encouraged to follow the suggestions below:
· Visit your local healthcare provider regularly for screenings and treatments
· Eat a diet plentiful in fruits and vegetables, moderate in lean protein and fish, whole grains, and skim milk/milk products.
· After seeking medical evaluation, engage in physical activity for 30 minutes, 5 days a week
· Do not smoke
· Limit refined sugars and grains
· Maintain a healthy body mass index (BMI)

For more information on diabetes and diabetes awareness, please visit the American Diabetes Association’s website at
This article provided courtesy of Penobscot Valley Hospital and Quorum Health Resources, LLC (“QHR”). 

Flu shot may protect against heart disease

WebMD News from HealthDay

By Serena Gordon

HealthDay Reporter

TUESDAY, Oct. 22 (HealthDay News) -- If avoiding an achy, feverish week or so laid up with the flu doesn't motivate you to get a flu shot, a new study linking flu shots to a lower incidence of heart disease might persuade you to roll up your sleeve.

People in the study who got flu shots were one-third less likely to have heart issues, such as heart failure or a heart attack, compared to those who opted against vaccination. The flu shot was associated with an even greater reduction of heart problems if someone had heart disease to start with, according to the study.

"This is one further piece of evidence to convince patients to go out and get their flu shot," said the study's lead author, Dr. Jacob Udell, a cardiology and clinician scientist, at Women's College Hospital at the University of Toronto.

Results of the study are published in the Oct. 23/30 issue of the Journal of the American Medical Association.

Past research has suggested a link between the influenza virus -- the virus that causes the flu -- and an increased risk of heart events. And, conversely, previous research done on the influenza vaccine has suggested an association between the vaccine and a reduced risk of heart issues. But, most of these studies were small and none looked specifically for a heart-protective effect from the influenza vaccine.

The flu vaccine is currently recommended for everyone over 6 months of age in the United States, according to the U.S. Centers for Disease Control and Prevention. The vaccine is highly recommended for certain groups, including people with heart disease.

To get an idea of how well the vaccine might protect against heart events, the researchers reviewed all of the clinical trials done on the influenza vaccine from 1947 through mid-2013.

The investigators included six randomized clinical trials comprising nearly 7,000 people in their analysis. The average age of the study participants was 67, and about half were women. Just over 36 percent had a history of cardiac disease.

The researchers found that those who received an influenza vaccine were 36 percent less likely to have a heart event than those who hadn't had a vaccine.

When the researchers looked at just the three trials that included people with recent heart disease, they found an even greater potential protective effect. People with recent heart problems who got the flu vaccine were 55 percent less likely to have another event compared to those who didn't get the vaccine.

The risk of dying from cardiovascular disease was nearly 20 percent lower for those who received the flu vaccine versus those who hadn't, according to the study.

Udell said this study wasn't designed to prove that influenza vaccine can lower heart disease risk, but he said that the researchers believe they've come close to proving cause and effect without conducting a clinical trial specifically designed to look for a protective effect from the flu vaccine.

Don't put off your annual mammogram

By Terri Coolong, PVH Cancer Support Group Leader


October 1, 2013 - Approximately 1 in 8 women will develop breast cancer in their lifetime and the risk increases with age. Breast cancer is second only to lung cancer in cancer deaths among women. However, 2.9 million breast cancer survivors are living in the US…the largest group of all of cancer survivors. Death rates due to breast cancer have been declining since 1989, believed to be the result of earlier detection, increased awareness, along with better treatments. October is Breast Cancer Awareness Month -- a great time to remember to schedule your annual mammogram. 


Mammography and breast self-exams remain the gold standards in early detection. Mammography can detect minute changes in the breast before women develop any symptoms. Tumors that can be felt tend to be larger and more likely to have spread beyond the breast. Smaller tumors that have not spread are more likely to be cured.

Many women feel stressed by their yearly mammogram and some women even cancel the appointment with no intentions to reschedule. I know how emotionally stressful the exam can be, but it is so much better to know than to wonder what changes might be taking place.

During a mammogram, the breast is positioned between two plates to spread the tissue for imaging. Mammograms can be a little uncomfortable because of the pressure, but should not be painful, and the discomfort is very brief. If you are feeling pain during a mammogram, let the technician know. Most clinics use cushions on their machines now, which improve comfort. Although a mammogram is an x-ray, the amount of radiation is extremely small and should not lead to an increase in cancer. It is important to remember that out of 1,000 mammograms done, only 2-4 women receive a cancer diagnosis.

As part of National Breast Cancer Awareness Month, all patients who receive a mammogram at Penobscot Valley Hospital in October will receive special “pink” gifts. Ask your healthcare provider for a referral to receive your annual mammogram, or call the Imaging Department at (207) 794-7118.

Another exam that may cause a woman stress is her monthly breast self-exam. Many women wonder if they are “doing it right,” which leads them to just stop doing these exams. Women with naturally lumpy breasts may despair in finding an actual tumor, but trust me, you are likely to know the difference. There are many different ways to do a breast exam, but there is no “right” way. Whether you go in circles or up and down across the breast, what is most important is covering the whole breast on a regular basis so you are familiar with its normal feel and can note any changes. The breast exam should also include a visual exam in the mirror for areas that are puckered or dimpled, scaly patches, or the presence of a rash. The goal is to report any changes to your healthcare provider right away.

Neither a mammogram nor a breast self-exam can diagnose cancer. In order to do make a diagnosis, a physician will order a biopsy. A biopsy is the only way to tell if cancer cells are present. Many biopsies are done by needle, where a small core of the tumor is extracted and examined for cancerous cells. Sometimes a surgical biopsy is needed. This removes more tissue which is examined in the lab for cellular changes. A surgical biopsy helps determine what stage and grade the tumor is and what type of treatment is required.

Although breast cancer is rare in men, it does occur. Any man who notices visible changes in their breast tissue or a mass should report these to his doctor.

November 15 is the date for the 7th Annual Downeast Living With Cancer Conference in Bar Harbor. The keynote speaker this year will be Dr. Thomas Openshaw, Director of Oncology Research at Eastern Maine Medical Center. This is a free daylong conference for patients, caregivers, and medical professionals. I have attended many, and always find new information. Lunch is available for just $10. To register, visit:

The PVH Cancer Support Group meets on the 2nd and 4th Tuesdays of each month at 6 pm in Conference Room B at the hospital. This October’s meetings are on the 8th and 22nd. If you aren’t ready yet to visit the support group but would like to talk to someone about cancer, please call 794-7149, leave a brief message, and we will get back to you shortly.

The Penobscot Valley Hospital Cancer Support Group will be selling hand-made jewelry at the Auxiliary craft fair which takes place on October 17-18 in the main lobby of the hospital. Please stop by between 9am and 3pm to make a purchase. Proceeds from their sales will help area cancer patients. 

Who Should Get Vaccinated Against Influenza


August 23- Everyone older than 6 months is recommended for flu vaccination with rare exception. The following lists include all people recommended to get the flu vaccine, those who are not recommended to receive either the flu shot or the nasal spray vaccine, and those who should take certain precautions before getting vaccinated. Talk to your doctor or nurse if you have any questions regarding which flu vaccine options are best for you and your family.

All persons aged 6 months and older should be vaccinated annually, with rare exceptions.

Vaccination to prevent influenza is particularly important for persons who are at increased risk for severe complications from influenza, or who are at high risk for influenza-related outpatient, emergency department, or hospital visits. When vaccine supply is limited, vaccination efforts should focus on delivering vaccination to the following persons (no hierarchy is implied by order of listing):

  • are aged 6 months through 4 years (59 months);
  • are aged 50 years and older;
  • have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus);
  • are immunosuppressed (including immunosuppression caused by medications or by human immunodeficiency virus);
  • are or will be pregnant during the influenza season;
  • are aged 6 months through 18 years and receiving long-term aspirin therapy and who therefore might be at risk for experiencing Reye syndrome after influenza virus infection;
  • are residents of nursing homes and other chronic-care facilities;
  • are American Indians/Alaska Natives;
  • are morbidly obese (body-mass index is 40 or greater);
  • are health-care personnel;
  • are household contacts and caregivers of children aged younger than 5 years and adults aged 50 years and older, with particular emphasis on vaccinating contacts of children aged younger than 6 months; and
  • are household contacts and caregivers of persons with medical conditions that put them at higher risk for severe complications from influenza.

Special Consideration:

  • People who have ever had a severe allergic reaction to eggs, or who have a severe allergy to any part of this vaccine, may be advised not to get vaccinated. People who have had a mild reaction to egg—that is, one which only involved hives—may receive the flu shot with additional precautions. Make sure your healthcare provider knows about any allergic reactions. Most, but not all, types of flu vaccine contain small amount of egg.

The following groups should not receive the flu shot (TIV):

  • People who have ever had a severe allergic reaction to influenza vaccine.
  • People with a history of Guillain-Barré Syndrome (a severe paralytic illness, also called GBS) that occurred after receiving influenza vaccine and who are not at risk for severe illness from influenza should generally not receive vaccine. Tell your doctor if you ever had Guillain-Barré Syndrome. Your doctor will help you decide whether the vaccine is recommended for you.
  • People who are moderately or severely ill with or without fever should usually wait until they recover before getting flu vaccine. If you are ill, talk to your doctor about whether to reschedule the vaccination. People with a mild illness can usually get the vaccine.

The following groups should not receive certain types of flu shots:

  • People under 65 years of age should not receive the high-dose flu shot.
  • People who are under 18 years old or over 64 years old should not receive the intradermal flu shot.

The following groups should not receive the nasal spray vaccine (LAIV):

  • Adults 50 years of age and older or children from 6 through 23 months of age. (Children younger than 6 months should not get either influenza vaccine.)
  • People who have ever had a severe allergic reaction to eggs. People who have had a mild reaction to egg—that is, one which only involved hives—may receive TIV (not LAIV) with additional precautions. Make sure your healthcare provider knows about any allergic reactions. Most, but not all, types of TIV flu vaccine contain small amount of egg.
  • People who have had a severe reaction to the vaccine in the past.
  • People with asthma and children younger than 5 years with one or more episodes of wheezing within the past year.
  • Pregnant women.
  • Anyone with certain muscle or nerve disorders (such as seizure disorders or cerebral palsy) that can lead to breathing or swallowing problems.
  • Anyone with a weakened immune system.
  • Anyone in close contact with someone whose immune system is so weak they require care in a protected environment (such as a bone marrow transplant unit). Close contacts of other people with a weakened immune system (such as those with HIV) may receive LAIV. Healthcare personnel in neonatal intensive care units or oncology clinics may receive LAIV.
  • Children or adolescents on long-term aspirin treatment.
  • People with a history of Guillain-Barré Syndrome (a severe paralytic illness, also called GBS) that occurred after receiving influenza vaccine and who are not at risk for severe illness from influenza should generally not receive vaccine. Tell your doctor if you ever had Guillain-Barré Syndrome. Your doctor will help you decide whether the vaccine is recommended for you. Tell your doctor if you have gotten any other vaccines in the past 4 weeks.
  • Anyone with a nasal condition serious enough to make breathing difficult, such as a very stuffy nose, should get the flu shot instead.
  • People who are moderately or severely ill with or without fever should usually wait until they recover before getting flu vaccine. If you are ill, talk to your doctor about whether to reschedule the vaccination. People with a mild illness can usually get the vaccine.

PVH Receives 2nd Vaccination Award from Maine CDC

(Lincoln, ME)— For the second consecutive year, Penobscot Valley Hospital has received recognition from the Maine Center for Disease Control and Prevention for their extraordinary efforts to vaccinate staff from influenza. During the 2011 - 2012 flu season, over 90% of staff working at Penobscot Valley Hospital received the influenza vaccination. A consistent and coordinated effort by PVH Staff resulted in an even greater achievement in 2012 – 2013 as 95% of PVH employees were vaccinated.

“This award reflects everyone’s commitment to protecting our patients from influenza. The award once again illustrates a total team effort on the part of PVH staff,” states PVH Infection Prevention Practitioner Sherry McCafferty, RN.

According to the Maine CDC, vaccinating healthcare workers against the flu is a proven strategy to decrease transmission of influenza to vulnerable patients. The Maine CDC is working with the Maine Hospital Association and the Maine Medical Association to increase vaccination rates of all healthcare workers in a combined focus on patient safety.

Jessica Fogg, Penquis District Public Health Liaison with the Maine CDC and DHHS, who presented the award to PVH stated: “I would like to congratulate Penobscot Valley Hospital on its achievement…Influenza vaccination is an important patient safety measure. I am pleased to give this award to PVH for two years in a row and it is the only award in Penobscot County this year.”

Influenza (the flu) is a serious disease that can lead to hospitalization and sometimes even death. Anyone can get sick from the flu, but certain people are at greater risk for serious complications from the flu, including:

older people,

young children,
people with chronic lung disease, diabetes, heart disease, neurologic conditions, and certain other long-term health conditions,
pregnant women.
As we embark upon a Maine summer, we are more concerned with black flies than the flu. Rest assured that as flu season approaches, the staff at the PVH Specialty Clinic will be once again well prepared to be your ally in fighting influenza.

Pictured, left to right are Penobscot Valley Staff, Senior Director of Human Resources, Sarah Loman; Infection Prevention Practitioner, Sherry McCafferty; Maine CDC Public Health Liaison, Jessica Fogg; Specialty Clinic Clinician, Kate Peabody; and Practice Manager, Kathy Schneider. 

Urology Services Available in Lincoln & Millinocket

(Lincoln & Millinocket, ME) Millinocket Regional Hospital, in collaboration with Penobscot Valley Hospital in Lincoln and Mayo Regional Hospital in Dover-Foxcroft, is starting a new urology clinic.
Ahmad Abed Elnoor, M.D. will begin seeing patients in June. Dr. Abed Elnoor will spend half of his time at Mayo and split the remainder of his time between Millinocket and Lincoln.
Urology is the branch of medicine concerned with the urinary tract in both sexes and the genital tract in males. Dr. Abed Elnoor is trained to manage benign and malignant medical and surgical disorders of the adrenal gland and the genitourinary system. He is able to perform a variety of clinical urological procedures in the office setting, as well as a full range of endoscopic, laparoscopic and open surgery procedures in the operating rooms at Mayo, Millinocket and Penobscot Valley. Surgical services will include penile, scrotal, kidney and ureter, and bladder and prostate procedures.
Dr. Abed Elnoor completed his medical education, general surgery residency and urology residency training at the Jordan University of Science and Technology in Irbid. At Jordan University, he was Chief Resident in the Division of Urology, Department of Surgery, and also had the highest rank on the Jordanian Urology Board examination.
Dr. Abed Elnoor moved to the United States in 2009, where he completed a pediatric urology fellowship at A.I. DuPont Hospital for Children in Delaware. He completed a second fellowship in andrology at the Department of Urology, Detroit Medical Center in Michigan. Andrology is the medical specialty dealing with male health, particularly relating to problems of the male reproductive organs, such as erectile dysfunction and male infertility.
Dr. Abed Elnoor, who is fluent in English and Arabic, lives in Dover-Foxcroft. He and his wife, Tamara, are the parents of two young sons, Zaid and Hashem.
Some referrals require prior authorization from your insurance company, so please check with your Primary Care Provider (family doctor) to schedule an appointment with Dr. Abed Elnoor. Patients with questions may reach Dr. Abed Elnoor’s local office at Millinocket call 723-3003; at Penobscot Valley Hospital, contact at 794-7215; or at Mayo Surgical Associates call 564-4466.

Dr. Abed Elnoor will begin practicing urology services in Lincoln, Millinocket and the Dover-Foxcroft region later this month. He will be seeing patients at Mayo Regional Hospital, Millinocket Regional Hospital and Penobscot Valley Hospital in both clinical and surgical settings.

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