Would an Advance Directive have helped Marlise Munoz?

Erick & Marlise Munoz

The sad story of Erick and Marlise Munoz has been in the news quite a bit lately.  Marlise lapsed into a brain-dead state in late November.  Marlise and her husband had had conversations regarding such a situation and she had told him that she did not want to be kept alive by machines. 

Such a decision, when put in writing, is called an Advance Directive.  This tells your doctors and other health care workers what type of care you would like should you be unable to make medical decisions.  It can include such things as:

  • If you are brain dead, do you want to be kept alive by machines?
  • If your heart stops, do you want to be resuscitated?
  • If you stop breathing, do you want to be resuscitated?
  • If you are unable to make health care decisions, who is to have durable power of attorney to do so for you?

These are things to be considered when you are healthy and calm.

Marlise had only her husband to communicate her wishes as she had not formally indicated them in an Advance Directive.  Her situation was further complicated due to her 14 week pregnancy and the interpretation of Texas law.  Had Marlise had an Advance Directive, the document could have communicated for her instead of relying on her husband as he was dealing with all of the emotions of such a situation.

The Caring Connections web site (http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3289) provides free Advance Directives and instructions for each state.

If you have an Advance Directive, a copy of it can be brought to the Student Health Services Health Information Services department to have it included in your medical record.  Student Health, however, is an out-patient facility and may not have access to your medical records in an emergency situation.  If your heart stops or you stop breathing within our building we will provide basic life support and first aid.  We will request emergency transport (911) and a copy of your Advance Directive will be given to the Emergency Squad to take to the hospital or it will be forwarded as soon as possible. 

Submitted by Tina Comston, M.Ed.

Reviewed by Mary Lynn Kiacz, M.D.

Looking to quit smoking? There’s an app for that!

Actually there are many apps out there to assist with those who want to quit smoking many of which are free.  Leah Kaiser of the Ohio State Health Plan reviewed a few of these apps at a recent demonstration at the Ohio State Digital Union.  Here is what she found:

LIVESTRONG MyQuit Coach(IPhone):  This app will allow you to evaluate your current status, set attainable goals and adjust preferences according to your needs.   One great feature is that it will allow you to track your cravings.    By knowing when your cravings hit, you can plan for them and develop strategies to overcome them.

Quit It Lite(IPhone): The focus of this app is to allow you to see benefits you have realized since you quit, both financially and health-wise.  It also provides a counter to show how long it has been since you quit – just in case you need such a reminder.  It can also be integrated with your social media accounts to provide additional support.

Cessation Nation (Android):  This app is very similar to Quit It Lite – but for the android.  One added bonus is that it provides a distracting game to play when those cravings hit.

My Quit Buddy (IPhone & Android): Set goals, get science facts, see the financial and health benefits you have achieved since quitting, get quitting tips.

Mindfulness Medication(IPhone & Android):  This app focuses on medication to set you in the correct mindset to quit the habit.  You can meditate while listening to a narration or you can use the timer feature to meditate without the narration.

Submitted by Tina Comston, M.Ed.

Get a Jump on Exercise

Are you looking for a cheap, portable workout?  Try jumping rope.  A good jump rope typically sells for under $20, will fit in your backpack, and one size fits all.  Extra bonus, jumping rope is a great calorie-burner.  A 15-20 minute workout will burn off the calories from a candy bar.  To see how many calories you would burn, check out the calorie counter at WebMD.  Select sports for the activity and rope jumping for the exercise.

“It’s certainly good for the heart,” says Peter Schulman, MD, associate professor, Cardiology/Pulmonary Medicine, University of Connecticut Health Center in Farmington. “It strengthens the upper and lower body and burns a lot of calories in a short time.”

If you’re looking to get started, WebMD gives the following as the basic requirements:

For novices, a beaded rope is recommended because it holds its shape and is easier to control than a lightweight cloth or vinyl rope.

  • Adjust the rope by holding the handles and stepping on the rope.
  • Shorten the rope so the handles reach your armpits.
  • Wear properly fitted athletic shoes, preferably cross-training shoes.

You’ll need a four-by-six-foot area, and about 10 inches of space above your head. The exercise surface is very important. Do not attempt to jump on carpet, grass, concrete, or asphalt. While carpet reduces impact, the downside is it grabs your shoes and can twist your ankle or knee. Use a wood floor, piece of plywood, or an impact mat made for exercise.

Give it a try.  Who knows, perhaps you’ll find yourself following in the footsteps of Tori Boggs, a second-year industrial design student at Ohio State.

 

Read more at WebMD….

Submitted by Tina Comston, M.Ed.

A Spot is not always just a Spot

Actinic Keratosis

Squamous Cell Carcinoma

About three months ago, when I was drying off after taking a shower, I noticed that there was an area on my face that felt tender.  Not sore, just that when I moved the towel across it I noticed.  I checked it out in the mirror and saw that I had a slight pink spot on my face.  I really didn’t give it too much thought and went about my day.  I would totally forget about the spot until the next day, in the shower, it would again feel tender. 

As time went on the spot became more noticeable, changing from a slight pink to more of a red and it appeared to have a scale or dry skin over it.  I thought that perhaps there was something in there that just wasn’t healing so I put some peroxide on it in the morning after getting out the shower – bad idea!  This just made it even redder and the spot became bigger.  I stopped the peroxide. 

I switched from peroxide to lotion and that did seem to help.  The spot shifted back from red to more of a pinkish hue and decreased a bit in size, but three months later and I still had the spot.  My mom has horrendous psoriasis and so I was concerned that I too may be heading that direction and I scheduled an appointment with a dermatologist. 

Five minutes into my appointment I had the diagnosis – Actinic Keratosis.  This is a small, scaly patch caused by too much sun and it can be an early warning sign of skin cancer, specifically Squamous Cell Carcinoma.  The treatment was easy enough.  The dermatologist brought out a can of liquid nitrogen and froze the area on my face.  The process was quick, taking just a minute or so, relatively painless, and I was told that it should be healed in 8-10 days.  No more Actinic Keratosis and no more risk of skin cancer.

These types of patches typically occur on the head, neck, or hands, but can be found elsewhere.  Fair-skinned, blond, or red-haired people with blue or green eyes are most at risk.  If you discover an area on your body that just doesn’t seem to heal, don’t wait three months like I did.  Schedule an appointment with a dermatologist and have it checked out.  It may be nothing, but then again, it may not.  Better to be cautious than cancerous.

Submitted by Tina Comston, M.Ed.