health

This week's question: What’s the difference between Type 1 and Type 2 diabetes and is either one reversible / curable?

In Diabetes Type 1, the body does not produce insulin. This occurs when a person's own body has destroyed the insulin-producing beta cells in the pancreas. This is where a person does not produce insulin which takes glucose into cells for growth and energy. In Type 1 diabetes, your own immune system destroys cells in your pancreas, so little if any insulin is made. This type of diabetes is also known as juvenile diabetes or childhood diabetes. This type of diabetes is not preventable and not related to lifestyle. It makes no difference whether a person is fat, thin, fit or unfit in regards to a person developing Type 1 diabetes. People with Type 1 diabetes need to take insulin daily, either injected or through an insulin pump. However, research is currently being undertaken to find a way to reverse Type 1 diabetes, and a vaccine is currently being developed which may help to reverse this disease. There is no way to reverse Type 1 diabetes at this time.

In Diabetes Type 2, the cells do not respond correctly to the insulin. People with Diabetes Type 2 have one of two problems, and sometimes both. Either not enough insulin is being produced, or the insulin is not working properly, which is known as insulin resistance. The vast majority of patients who develop Type 2, did so because they were overweight and unfit for some time. This type of diabetes tends to appear later on in life and often called adult onset diabetes. However, there have been more and more cases of people in their 20s developing Type 2, but it is still relatively uncommon. Approximately 85 percent of people who have diabetes have this type of diabetes. Lack of physical activity, being overweight, and some genetic factors make it much more likely that the cells build up insulin resistance more quickly. It is important to remember that insulin resistance is not the insulin responding properly, but the cells not responding properly to the insulin. With time and dedication, Type 2 diabetes can be reversed and the results can be very rewarding with less tiredness and better all-round health. Loss of body weight and exercise can be particularly beneficial in helping to reverse the progression of diabetes. In some cases, people may find they are able to come off medication, although blood sugar levels should be checked regularly as reversing progression of diabetes is not a cure.

If you have further concerns you should contact your doctor for more information regarding your condition.

Dr. Magdi Credi

Ask the Local Doctor is sponsored by Insource Urgent Care, 35 Batavia City Centre, Batavia, (585) 250-4201. To submit a question to Ask the Local Doctor, e-mail askthedoc@thebatavian.com. To submit your question anonymously, if you wish, you can use our online form.

NOTE: This is The Batavian's first "Ask the Local Doctor" column sponsored by Insource Urgent Care. We announced the column and then no questions came in, or so we thought. Their e-mail forwarding wasn't set up right so we didn't see the questions. We actually received about a dozen questions. Those questions have been forwarded to the professional staff of Insource Urgent Care and will be considered for next week's column and subsequent columns.

This column is by Dr. Magdi Credi and it answers the question, should I get a flu shot?

The influenza season is upon us.

Here at Insource Urgent Care the vaccine is being offered for those who are 4 years and older. Unbeknownst to many, influenza is still the most prevalent disease in the United States of all the vaccinated diseases.

About 200,000 persons in the United States will be hospitalized yearly due to influenza. Up to 49,000 deaths occur yearly on American soil due to the flu. Because of this, we here at Insource are doing our best to protect you.

The Center for Disease Control currently recommends all persons older than 6 months be vaccinated. The more persons vaccinated the less chance of the flu.

In particular, two groups are strongly encouraged to obtain the flu shot: those who are at high risk of complications (i.e. pneumonia) and those who care for others at high risk. This would include the following: Parents and caretakers of children less than 6 months of age, pregnant women, persons less than 5 years old or older than 65 years old, and persons with chronic illnesses such as diabetes, asthma, and COPD to name a few. This list is not all inclusive and can be checked out on the CDC’s Web site www.cdc.gov for more information.

If still unsure of your risk or need, please stop by our medical office for clarification. We are here to provide top medical care for you and to protect both you and your family.

This post is sponsored by Insource Urgent Care, 35 Batavia City Centre, Batavia, (585) 250-4201. To submit a question to Ask the Local Doctor, e-mail askthedoc@thebatavian.com.

Flu viruses are hitting most of the nation pretty hard and Genesee County is no exception.

There have been 107 verified cases locally, according to Public Health Director Paul Pettit.

The number of verified cases is already higher than the average of an entire flu season in Genesee County.

"We're still pretty early in the primary flu season," Pettit said. "With what we've seen already, it's clear we have quite a ways to go with seasonal activity."

The flu season is typically January and into April, with the highest activity usually reported in January and February.

A verified flu case is one where there has been a lab test on a patient. Pettit noted that many flu cases never get reported or tested so there have certainly been more than 107 flu cases in Genesee County.

Pettit said anybody with flu symptoms should contact their physician; however, people should only go to the emergency room if displaying higher risk flu symptoms.

"A lot of emergency rooms are getting filled with people who don't really need to be there," Pettit said.

While there have been some reports of vaccine shortages in other parts of the country, Pettit said health department staff has checked with local pharmacies and found that for people 18 and older there is still a supply available.

"It's not to late to get a shot," Pettit said.

For children, supplies of vaccine is running low. The health department has a limited supply, but Pettit said parents should check first with their primary care physicians on availability. The health department's supply is available when other avenues to vaccinate chlldren have already been tried.

We tend to think of playgrounds as just places for children, right?

Well, there's something starting in New York City and Buffalo to change that -- the cities are building playgrounds designed to attract adults in a social environment focused on physical fitness.

As a writer for Buffalo Rising put it, "The concept is so simple that I can't believe that it hasn't surfaced all across America."

There are no known plans to build an adult playground in Batavia, but one local woman has discovered an existing playground that goes a long way in filling the void, and she thinks other adults should join her in putting it to good use.

Batavia resident Nancy Gilmartin-Marchitte said she's been using the playground at the former Robert Morris School for several months for her own exercise routine and having a blast.

She and her husband like to run on the track at Woodward Field, and one day she spotted the rings at the playground and, with her love of gymnastics, she thought it would be fun to try them out.

From that initial experiment, she discovered the playground offered her several different fun and useful exercises.

"After coming here and doing my routines, I came to realize there are adult playgrounds all over now," said the 36-year-old Gilmartin-Marchitte.

In June 2011, Robert Morris opened the new playground paid for by a grant won from Pepsi.

Now, Robert Morris is no longer a school, and though the playground is still owned by the school district, it is open to the community, Business Administrator Scott Rozanski confirmed today.

"We made the decision to leave the playground for community use," Rozanski said.

While adult use hasn't yet been contemplated by district officials, he sees no reason adults couldn't exercise there so long as they didn't prevent children from playing and helped keep the equipment in good working order.

"I would expect an adult to use wisdom and not do anything that would damage the equipment," Rozanski said.

Gilmartin-Marchitte said she's worked up a whole routine for herself that, by making it a rigorous workout, not only exercises her arms, legs and torso, it also provides cardiovascular benefits.

Her routine includes, among other things, chin-ups, exercises on the rings (her favorite), balance walks, using the swing for her abs and the parallel bars.

"Going to the playground a few times a week and exercising on the rings and chin-up bar is not only a good exercise, but brings out the little girl in me," Gilmartin-Marchitte said.

UMMC invited the public into the ICU unit today to see a new patient simulator that will be used to help train hospital staff.

The $60,000 machine is a gift from CHART, the hospital’s insurance carrier. It provides a realistic representation of various medical conditions so medical personnel can practice everything from inserting an IV to performing defibrillation.

For more info, click here.

Above, Dan Grower learns about the simulator from Pamela Lynch.

Every year in Genesee County, 350 people are diagnosed with cancer and 100 people die from cancer, which is why, according to a group of the American Cancer Society who were in Batavia today, cancer should be an important election issue.

Americans need research and treatment for the disease and the assurance of funding for both, according to Hillary Clarke, director of federal government relations, so this is an issue voters should take up with candidates for office.

At www.cancervotes.org is a voter's guide for the presidential election with responses from the two major party candidates, but Clarke said neither of the candidates for the NY-27 Congressional District responded to the Cancer Action Network's survey.

Contacted today, a spokesman for Kathy Hochul's campaign said Hochul did respond and her answers are posted on the Web site. We've not been able to find those answers and requested a direct link to the appropriate page.

The spokesman for Chris Collins, Micheal Kracker, sent the following statement in response to a simple question of what would Collins do to support the fight against cancer.

"As the brother of a cancer survivor, Chris Collins knows how important it is to support cancer research. Chris also recognizes how important it is to make sure no government bureaucracy stops doctors from giving patients like Chris' sister the treatment they need to stay healthy. We need to be sure that doctors, not government bureaucrats determine how best to care for patients. We must also promise to protect Medicare for our seniors so they continue to receive the access to affordable care they paid for their entire lives."

We'll update this post if any additional information comes in.

UPDATE: Statement from Angela Pause-Smith, communications director, American Cancer Society Cancer Action Network, Inc.: "Neither candidate responded to our questionnaire so there actually isn't a Voter Guide for this race. I'm sorry if someone told you that there was one."

UPDATE II: As soon as I posted the update above, Pause-Smith emailed the following: "So I learned literally a moment ago that late this afternoon Hochul returned our questionnaire. There is a process we need to follow to post it on our Web site and we've asked for that process to be expedited so you can see the responses, but I can't provide a time that they will be available."

UPDATE III: Pause-Smith clarifies: "It may not have been late this afternoon that she returned it, I just learned of it late this afternoon. We received it sometime today."

UPDATE IV: Hochul's answers are now available, click here.

Photo: Julie Kumiega, Hillary Clarke and Karen Hall.

Press release:

United Memorial Medical Center is pleased to announce that Urgent Care Services will open at the Jerome Center located at 16 Bank St., Batavia on July 2. Urgent Care will be co-located with Laboratory and Medical Imaging Services.

Urgent Care services are a cost effective and convenient way for patients to receive quality medical care when their primary care physician is unavailable and they do not want to spend time waiting in an emergency room to be treated for a non-life-threatening injury or illness. Co-payments for urgent care are typically less than emergency room co-pays.

UMMC’s Urgent Care Center in Batavia will be well equipped to treat a variety of ailments, including sprains and fractures; cuts and lacerations, animal and insect bites and stings, cold and influenza symptoms; ear infections, pneumonia, bronchitis, urinary tract infections, asthma, sore throats/strep and mono and influenza vaccines.

Urgent Care at the Jerome Center will be supported by United Memorial’s state-of-the-art medical imaging services, the most advanced in Genesee County. The Jerome Center is conveniently located in the heart of Downtown Batavia. It offers handicap accessibility, convenient parking, a gift shop and refreshment kiosk.

In July 2010, United Memorial opened Genesee County’s first Urgent Care Center at 3 Tountas Ave., Le Roy. There were more than 5,000 patient visits to the Urgent Care Center in Le Roy during 2011. This volume had no noticeable impact on the number of emergency room patients treated at United Memorial during the same time period.

Both Urgent Care centers will operate from 11 a.m. to 9 p.m. Monday through Friday and from 9 a.m. to 9 p.m. on weekends.

The auditorium at UMMC's Cary Hall (next to the YMCA) is all set up for important patient care -- with all of the care stations, instruments and devices of good medical care ready to help heal any teddy bears or dolls that are brought in today.

The event is UMMC's annual Teddy Bear and Doll Clinic, designed to give pre-schoolers, kindergarteners and first-graders an understanding of what is involved in medical care in case they or anybody else they know needs significant medical care.

The clinic is sponsored by Healthy Living Department and is open until 5 p.m.

Press release:

United Memorial Medical Center is pleased to announce that it will continue to provide a Phase II Cardiac Rehabilitation Program and will eventually add the service to its newest physician practice, United Memorial Cardiology and Internal Medicine, located at 229 Summit St., Batavia. Planned renovations to the practice will be altered to accommodate Phase II cardiac rehab.

Acquiring the cardiology and internal medicine practice of Dr. Keun Oh and Dr. Mohammad Rathor following Dr. Oh’s retirement in December, allows the hospital to continue to provide the medically monitored Phase II program on a smaller, flexible scale than what was previously available.

In November, United Memorial announced that it would close its Cardiac Rehabilitation Department effective March 1 due to declining patient volumes in the Phase II program and high expenses that were not offset by the self-pay, cardiac maintenance program. The 90-day time frame allowed the current eight participants in Phase II to complete the medically monitored portion of their program. For the 70 individuals enrolled in Cardiac Maintenance, the hospital has worked closely with the GLOW YMCA, Genesee County Branch, to develop a cardiac maintenance program to meet their specific needs in a community setting.

“By working with our community partners and thinking creatively, we have found a way to provide locally delivered cardiac rehabilitation services for our residents in a manner that maintains the quality and availability of care and is economically feasible,” stated Mark C. Schoell, president and CEO of United Memorial.

Phase I cardiac rehabilitation occurs while the individual is still in the hospital following a cardiac issue such as a heart attack. Phase II is an outpatient rehabilitation program that begins following discharge from the hospital, usually within a few days.

Participants in Phase II exercise regularly in a closely supervised setting. They learn stretching and cooling techniques, how to monitor their heart rate and activity levels, increase their aerobic capacity and become stronger. While exercising, a health professional assesses their heart rate and rhythm, blood pressure and symptoms of distress. Patients receive extensive education that includes risk factor modification, stress management, and nutrition counseling. Phase II is a medically monitored program and requires a physician in close proximity.

Phase III cardiac rehab is often referred to as cardiac maintenance. It focuses on long-term lifestyle changes to prevent future cardiac issues and patients continue to exercise to regain physical function. They learn to monitor their pulse and weight and watch for symptoms of coronary artery disease. Patients track their progress in written logs and share the information with their physician. Cardiac maintenance usually has a group format where participants offer support and encouragement to each other. Many cardiac rehab maintenance programs are typically held in community facilities.

When the department closure was announced, cardiac maintenance patients expressed concern about having a program to go to where they could continue with their groups. Many patients have exercised together, following the same routine for a number of years and formed deep bonds and friendships.

“The mission of the YMCA to build the spiritual, mental and physical wellness of all people aligns itself perfectly with the needs of the Cardiac Maintenance participants. We want to focus on healthy living by helping people achieve lifestyle goals through wellness, education and social interaction,” said Scott Taylor, CEO of the GLOW YMCA.  

The Genesee County YMCA is currently developing the cardiac maintenance area for all those in the program. They will waive joiner fees for current cardiac rehab participants and offer the program at the same, if not slightly reduced, monthly fee level. United Memorial will donate much of the exercise equipment currently used in the program to the YMCA for their program, easing the transition of the clients and provide education regarding nutrition and wellness through the Healthy Living Department, UMMC’s community outreach program.

The YMCA will begin offering ardiac maintenance services on March 5 and provide a smooth transition to current participants.

In a community meeting Wednesday night to discuss an unusual outbreak of tics among female students at Le Roy High School, a state health official steadfastly refused to reveal the cause of the outbreak.

Citing not just HIPPA as a reason for keeping the diagnosis of 11 girls private, Dr. Gregory Young said that as a matter of principle he didn't want to see the girls "labeled" by what their doctor has found.

Young, from the NYS Department of Health, said the cause (or causes) isn't related to the environment; it isn't anything a person "catches"; it doesn't come from exposure to something, or from anything ingested. Nor does the cause stem from prescribed drugs or illicit drugs.

State health officials know what is behind the outbreak, but Young would not disclose it. Yet he tried to reassure parents that it's safe to send their children to school.

In all, according to Young -- though some in the audience disputed the number -- at least 11 girls have come down with the "tic manifestations" (Young cautioned against calling it a syndrome). 

The doctor's explanation, and a stone barrier he put up regarding the cause, didn't go over well with parents or students.

James Dupont Jr. spoke passionately about the need for officials to be more forthcoming about what physicians have found. Dupont complained that although Young said the cause has been diagnosed, nobody's told him what caused his daughter to develop tics.

After he spoke, he went into hallway and was mobbed by reporters.

"We all have to respect that (keeping medical information private), but I tell you what, if my daughter had a diagnosis and I knew that, as a parent, I would tell you -- because I’m not a doctor and I don’t care about HIPPA," Dupont said. "I care about getting these kids better or finding what’s causing it so it doesn’t get any worse."

Later, from the back of the auditorium, Dupont called out Young on his repeated insistance that a diagnosis has been completed for the 11 students. 

Dupont asked parents in attendance whose daughters had developed tics to raise their hands. More than a half dozen adults raised their hands. Then Dupont asked how many had been told by their daughters' doctors what caused the tics. Several said they had not been given a diagnosis.

One parent spoke up and said he was told the cause was "conversion disorder."

Young said he couldn't respond to that comment.

Conversion disorder is a neurosis usually brought on difficulties in a person's life, according to Wikipedia. It is marked by numbness, blindness, paralysis or fits. Britannica.com lists tics as a manifestation of conversion disorder.

After more questioning about conversion disorder, Thomas Wallace, from the state's mental health office, said it isn't really a diagnosis. He said it can be a symptom of other issues and that it can be found in clusters of patients.

The number of patients is not out of line with national statistics for tic manifestations among a group of 500 youngsters (in fact, in a group of 500, there should be at least 20 children with tics, based on national statistics).

What is unusual, he said, is that all of the patients are girls (boys develop tics at a 4-1 ratio over girls, according to national statics, Young said) and that they all developed the manifestations at about the same time.

Several students got up to ask questions or speak out, including a girl who said her name was Jessica.

"You think it's unethical for you not to give us the cause," Jessica said. "I think it's wrong for you not to tell us."

"If you were one of the individuals involved, you might feel differently," Young shot back.

"We're friends with these people," Jessica said. "Half of them haven't even been diagnosed yet. You're not telling us the truth because you don't really know what's going on."

Young repeated that he feels uncomfortable sharing private medical information. Later, he spoke about how he's always hated bureaucrats and he realized he was being one, but he said he simply couldn't share private medical information.

The one commonality Young said he could share was that all of the girls showed a greater manifestation during times of stress.

It's not unusual, he said, for people to manifest tics in time of stress, and there are a lot of stress factors in a young person's life. All people deal with stress differently, but it's well documented that stress can cause a number of physical reactions.

One big stresser for kids today is social media.

"There's a lot that goes on in social media today that parents don't know about, that schools don't know about," said Young, noting that the community meeting coincides with the start of the school session, and the students susceptible to tics will be under a new round of stress.

Just announcing the meeting created stress for the students involved, he said, and parents should be prepared for an increase of tic activity as reports about the meeting hit the media.

Dupont and other parents afterward said they don't believe it all boils down to stress especially since, for some of the students, the tics don't seem to become less frequent when school is out (though one mother who spoke said her daughter didn't have tics over Christmas vacation).

Among Dupont's suggestions is that a parent support group be formed. Then, perhaps, parents could share more information and find commonalities among their daughters (not all of the girls know each other or necessarily had contact with each other prior to the tic manifestations arising).

Young agreed this would be a good idea and also said that in a closed group of just the parents involved, he could speak more freely about what physicians have found.

UPDATE AND CLARIFICATION: The mention of types of drugs above wasn't meant to exclude from the meaning, as it does, that designer drugs weren't investigated as a cause. They were and subsequently ruled out as a cause. PANDAS has been ruled out as a cause. HPV vaccine has also been ruled out as a cause, according to Dr. Young. ODD or ADHD can make a child more susceptible to tics, but that isn't a cause. One thing Young intimated is that there is no one cause for all the girls.

Richard Wallace has been in a motorcycle accident that led to a near-death experience, had more than 40 bones in his body broken and has been struck by lightning.

But he never takes pain medication.

“I function just fine every day," he said. "That started me to think that if I can do this, other people would benefit, too."

Those experiences led him toward natural healing practices and training in shamanism. After 10 years of training with Native American masters, Wallace said he's been a practicing shaman for 20 years.

This week, Wallace and his partner Antoinette Sidari opened Awakenings Holistic Center at 2995 W. Main St. Road, Batavia.

"We feel people need some options," Wallace said. "We have a holistic cancer program because a lot of people don’t really have other options. They go to a doctor and a doctor tells them this is what we’ve got to do and we’ve got to do it quick, and a lot of people aren’t comfortable with that being the only option.  People often research buying an automobile more than they do their own health care."

Wallace and Sidari met in 2008 and found they had traveled a similar spiritual path. More than a year ago, they began planning a business around holistic healing. After looking at several locations in Western New York, Wallace decided to convert the workshop building behind his house into the center.

"There was just nothing else around," Wallace said, explaining why the couple decided to open the center. He said even similar businesses in Buffalo and Rochester are more limited in what they offer.

Among the services offered by Awakenings are amethyst bio-mat treatment, integrated energy services, holistic cancer treatment, shaman services, meditation and soul coaching.

The store offers a variety of books on holistic healing, crystals and aromatherapy supplies.

"We approach the issues that people have not just as a medical approach, where usually you get five minutes with a doctor and he writes you a prescription," Wallace said. "We approach it with mind body spirit, because it could be an emotional issue, it could be a physical issue, so we take the time with people to see what the problem is."

After Wallace's motorcycle accident in 1985, he said he was sent home from the hospital with an undiagnosed broken neck. That led to a near-death experience, which changed his life. He said at that point, spiritual teachers began to enter his life and he "followed the call of my Native American roots"  into shamanism. He studied with the White Brotherhood for 10 years. He became an ordained minister in 2005, and was ordained again in 2009 as a priest in the Order of Melchizedek.

Sidari's printed bio says she began her spiritual journey a decade ago that "turned ionto a miraculous journey of transformation back to her true self." She's studied healing arts.

She is a certified hypnotherapist.

During her spiritual journey, she has studied the teachings of Buddhist, Hindu, Vedic, Peruvian and Mayan traditions.

Wallace said there is no licensing for what he and Sidari practice.

"A lot of what we do, like what I do, as a practicing shaman, there is no piece of paper that goes with it," Wallace said. "There’s years and years of training and lots of experiences, and practice. I would rather have that than a piece of paper."

Press release from the Genesee County Health Department:

Batavia, N.Y. (Oct. 14, 2011) -- A Genesee County death from listeria is connected with a nationwide listeria outbreak. Genesee County health officials said the death of an elderly person with underlying health conditions is linked to the outbreak tied to Colorado cantaloupes. This is the second confirmed case in New York State; the first confirmed case involved an elderly individual from Ontario County.  

More than 120 people, in 25 other states, have become infected with the listeria bacterial strain linked to the Rocky Ford cantaloupes from Jensen Farms in Colorado. Including both the Genesee and Ontario county cases, 25 people have died nationwide.

Listeriosis is caused by the bacteria, Listeria monocytogenes. This organism has been found in a variety of raw foods, such as uncooked meats and vegetables, as well as in foods that become contaminated after cooking or processing.

Listeria can cause serious illness and sometimes be fatal in older adults, pregnant women, newborns, and those individuals with weakened immune systems.

Symptoms include fever, intense headache, nausea, vomiting and signs of meningeal irritation. In most cases, listeria infection causes fever and influenza-like symptoms resembling many other illnesses. Individuals who have experienced any symptoms of listeria should contact a doctor or other health care provider. 

Listeria has a variable incubation period. It can range from three to 70 days, but symptoms usually appear within a month.

Additional information:
• On September 14, 2011 Jensen Farms in Colorado voluntarily recalled Rocky Ford Cantaloupe.
• Cantaloupes not from Jensen Farms are safe to eat.
• If consumers are uncertain about the source of a cantaloupe for purchase, they should ask the grocery store. When it doubt – throw it out. 
• More information can be found at the CDC Multistate Outbreak of Listeriosis of Website.

UMMC is making progress in dealing with a recent outbreak of Clostridium difficile, according to spokeswoman Colleen Flynn.

The number of patients being screened for potentially having C. diff has dropped from six last weekend to three.

And staff, using a sterilization machine designed to clean potentially contaminated surfaces, has learned how to use the equipment to exceed the manufacturer's standards for cleaning surfaces.

"We would really like the current cases to be the last cases," Flynn said. "We don't want any more hospital-acquired cases. We want to eradicate it all together."

Dealing with C. diff and other infectious bacteria is a concern for all hospitals, but the recent outbreak at UMMC brought the local hospital into the spotlight.

Flynn said staff noticed an uptick in C. diff cases before the news hit local media and began new procedures -- in consultation with the State Health Department -- to deal with the spike.

"We immediately took steps to see what else we could do," Flynn said.

When the weekend rolled around and the number of patients at the hospital (called the "census") dropped, staff was able to move patients out of some rooms and group patients together based on their treatment. The hospital also began extra sterilization procedures where necessary and increased staffing to stop the spread of the bacteria.

"We told the Department of Health what we would like to do and the Department of Health concurred that these were great steps," Flynn said.

From Feb. 28 to April 15, UMMC has reported 11 hospital-acquired cases of C. diff and six community-acquired cases (meaning the patients had C. diff before arriving at UMMC), according to Department of Health officials.

One patient who contracted C. diff died in March, but the cause of death has not been determined. The patient had other serious health issues and the cause of death may not have been due to C. diff.

Currently, there are five patients with C diff at UMMC. Four are being treated and one is in comfort care.

Every patient that displays C. diff symptoms -- particularly, diarrhea -- is tested for the bacteria.

Currently, only three patients are being screened, which Flynn said is a good sign the hospital's procedures are working.

"For what we usually see, this is a positive trend for where we want to be," Flynn said.

Tom Allocco, a spokesman for the Department of Health, said the spike in UMMC's numbers is not so great that it should cause public concern. When the department used the term "outbreak" in a previous statement, it merely signified an increase over previous reports of C. diff.

Flynn said UMMC went six straight months earlier in 2010 without a single case of C. diff and finished off 2010 with five straight months of no C. diff patients.

Flynn said the hospital recently purchased a machine designed to eliminate most C. diff bacteria on hard surfaces.

Staff followed the manufacturer's recommended cleaning solutions and procedures for sterilizing surfaces. Then, when scanned for the presence of live matter on the surfaces, the count came within the expected range.

However, that wasn't good enough for UMMC, Flynn said.

They tried again using extra friction and when they scanned again, there was no live matter at all on the surfaces.

"We learned something," Flynn said. "We learned, OK, use the solution mixture recommended by the manufacturer, but (by applying) more friction, we could bring the count down to zero."

In a follow up e-mail, Flynn provided this statement on UMMC's C. diff procedures.

Clostridium difficile precautions at UMMC:
If a patient is admitted with diarrhea, or develops it, while hospitalized and is being tested for C. diff, the patient is immediately placed on Contact Plus Precautions. This means that the STOP sign is placed under the room number so it can be seen before someone enters, and a Contact Plus Precautions sign is posted on the PPE caddy. It specifies that hands are to be washed with soap and water, to wash any spores that may have gotten on the hands of the person down the drain.

The recent outbreak of the potentially fatal bacteria commonly called C. diff at United Memorial Medical Center is having a ripple effect on the Genesee County Nursing Home.

Nursing Home Administrator Charles Rice told the legislature's Ways and Means Committee on Wednesday afternoon that "a lot of people are coming out of the hospital now" with C. diff.

After the meeting, Rice and the Nursing Home's Nursing Director Dawn Canale backed down from that statement. Rice and Canale said the Nursing Home has always been on alert for C. diff, but recent media reports about the C. diff outbreak at UMMC has the Nursing Home stepping up its infection control measures.

No Nursing Home residents have C. diff, Rice said, and Canale explained that any potential transfer patient from UMMC who tests positive for C. diff is not accepted as a resident at the Nursing Home.

Asked if there has been a spike recently in the number of potential transfers who test positive for C. diff, Canale said, "I don't want to say that," adding, "because two or three to me is a lot, but to you guys ..."  Canale's statement trailed off.

Canale said that every transfer from the hospital is screened and must have two negative tests for C. diff before becoming a resident at the Nursing Home.

"They always tell us (if a patient had C. diff) and we always make sure they’ve been treated and they're not contagious," Canale said.

If a person had C. diff but has recovered, the patient can be transferred, but the resident is either given a room with an other former C. diff patient or given a private room.

"We don't unnecessarily expose our fragile residents," Rice said. "Most of the time they've been treated, but we still keep a good eye on them."

Dealing with the outbreak of C. diff has been difficult, Rice said, because there is limited bed space in the Nursing Home and special precautions must be taken to separate potential C. diff carriers from other residents.

Rice also said that employees are given extra instructions on infection control and extra attention is given to disinfecting the facility.

Statement from Tom Allocco, New York Department of Health:

United Memorial Medical Center has properly reported its cases of Clostridium difficile (C. diff) to the State Health Department. The department has been working with United Memorial on the implementation of proper infection-control measures to help reduce the spread of illness. These include proper hand hygiene (simple, but probably the most important control measure), cleaning and disinfecting portions of the facility, and the separation of those who are infected from other patients. The department’s investigation of the outbreak continues. Once the investigation is finalized, the findings will be available. 

Additionally, the state health department has a public report on "Hospital Acquired Infections" that was released in late 2010 and covers data through 2009.

According to the report, in 2009, UMMC performed 28 colon procedures and of those, two patients contracted infections. That puts UMMC's infection rate at 7.1 (a number adjusted to calculate infections per 100 procedures to enable statewide comparisons). New York's infection rate for colon procedures in 2009 was 4.8.  

UMMC's rate of 7.1 is considered within the range of state average.

Strong Memorial's rate for 2009 was 5.5, also within the state average.

In 2008, UMMC's rate was 6.4, the state average was 4.4 and Strong was 4.8

In 2008, Strong performed 327 procedures and there were 16 infections. The following year, Strong performed 317 procedures and there were 17 infections.

Erie County Medical Center performed 86 colon procedures in 2008 and 98 in 2009 with three reported infections in each year. Numbers also fell within the statistical average at Highland Hospital in Rochester, while Women & Children's Hospital of Buffalo reported no infections, with about 50 procedures for each year. (For some reason, the report called W&C's zero-infection rate "statistically insignificant" and didn't give it a "blue star" on its report card).

For hip replacement surgery, UMMC's infection rate in 2008 was 3.1, and 2.5 in 2009. Both numbers fall within the range of the state average of 1.1. In 2008, UMMC performed 81 procedures with three infections and in 2009, 84 procedures with two infections. For the same procedure, Strong performed 50 operations in 2008 and 60 in 2009 with no infections.

A reporter from Rochester forwarded me this press release put out by Betsy McCaughey a couple of days ago. The message from the former Lt. Governor of New York and founder of the Committee to Reduce Infection Deaths seems particularly relevant and the information worth reading.

Hospital infections kill more Americans each year than AIDS, car accidents and breast cancer combined -- and researchers are searching for solutions. This week, a study of 153 Veterans Affairs hospitals shows that doing a simple swab test to identify and isolate the few patients carrying infection-causing bacteria can save lives. It's called screening, but even more important is cleaning. Studies are rolling in that hospitals need to be cleaner.

In fact, if you're visiting a friend or relative in the hospital, don't bring flowers or candy -- take gloves and a canister of bleach wipes.

Hospitals do an inadequate job of cleaning rooms -- so germs left behind by past patients are lying in wait. Patients are at far greater danger of infection when placed in a hospital room where a previous patient had an infection. Hospitals won't tell you who occupied the room before you.

Alarming research published in the Archives of Internal Medicine (March 28) demonstrates that a patient's risk of picking up the drug-resistant bug MRSA (methicillin-resistant Staphylococcus aureus) is much higher if the previous occupant of the hospital room had it.

Being placed in a room where the last patient had Clostridium difficile, or C. diff for short, more than doubles the risk of getting that dreaded infection, according to a new study in Infection Control and Hospital Epidemiology (March 2011). C. diff is the most common hospital infection in some parts of America.

Patients pick up invisible C. diff bacteria when they touch surfaces in their room, then eat a roll or cookie with their contaminated hands and swallow the bacteria along with the food.

C. diff causes life-threatening diarrhea -- wreaking havoc in your gastrointestinal system unless you have enough powerful "good" bacteria in your system to keep the C. diff under control. But patients on antibiotics often lack good bacteria. Some hospitals are treating desperately ill patients by giving them fecal enemas.

Pretty awful. Especially when it could be avoided by keeping the patient's room clean.

Dr. Robert Orenstein launched a cleanup campaign at the Mayo Clinic in Rochester, Minn. -- wiping the frequently touched surfaces around each patient's bed once a day with bleach-soaked wipes. The results: a 75- percent drop in C. diff infections.

Lax room-cleaning raises the risk of contracting other kinds of hospital infections, too. The No. 1 predictor of which patient picks up a drug-resistant bug called VRE (vancomycin-resistant Enterococcus) is who occupied the patient's room in the prior two weeks, according to Tufts University investigators. That two-week span could mean three or four patients ago.

A study of 36 hospitals from Boston to Washington, D.C., found that cleaners routinely overlook half the surfaces in patients' rooms. Toilet seats are cleaner than telephones and call buttons.

Doctors and nurses may clean their hands coming into the room -- but recontaminate them when they open the privacy curtain or rest their hands on the bedrail. Then they touch their patient, and germs enter the patient's body via an IV, urinary-tract catheter, wound or surgical incision.

For decades, hospital administrators and government agencies have shrugged off the notion that hospitals are dirty, saying, "germs are everywhere." They emphasize getting doctors and nurses to clean their hands -- which isn't enough.

The Joint Commission, which is responsible for accrediting most hospitals, just considers whether a hospital looks clean -- when infection-causing germs are invisible.

Food-processing plants routinely test surfaces for bacteria. Hospitals ought to meet at least the same standard.

www.HospitalInfection.org