Minimizing Carbon Monoxide Poisoning
The Derecho storm that assaulted the Midwest on August 10, 2020, caused over $3 Billion in lost corn and soy crops. This was approximately 1/3 of the total corn and soy crops in Iowa according to the Iowa Department of Agriculture. It also left millions of dollars of damage in its wake as it crossed multiple communities and left thousands of people without power.
Many of us have come to take electricity for granted. We rely heavily on our various computer systems for the internet and electronics that provide news, entertainment, and means to work remotely. We use electricity to meet our lighting needs, power our refrigeration systems, and our air conditioners (a necessity in Iowa in August). Power is even used to heat the water we use for bathing, washing clothes, and dishes. For many, loss of power is more than an inconvenience, It can even pose a threat to health.
The electrical utility workers in the hardest affected communities worked around the clock to restore electricity. Electrical companies called in help from as far away as Canada. The teams feverishly worked to get as many of their customer’s power as quickly (and safely) as they could.
Iowans are often seen as patient and love to live “Iowa Nice”, but many citizens became impatient with what they saw as slow progress. Home standby generators and portable backup generators seemed like the optimal short-term solution to our need for backup power. Unfortunately, improper and placement of these machines can lead to a trip to the hospital or even death, as reported in Marshall County by Unity Point Health.
The Threat of Carbon Monoxide Poisoning
Carbon Monoxide (CO) is an odorless, colorless gas so detection without a proper detector can be difficult. The Centers for Disease Control and Prevention (CDC) states that early symptoms of CO poisoning from breathing CO are headache, dizziness, weakness, chest pain, and confusion.
When exposed to higher levels over long periods of time often leads to unconsciousness, occasionally causes permanent brain damage, and can be deadly. Depending on the length and amount of exposure, recovery time for survivors can be very lengthy. It is important to note that people can die from CO poisoning before they have symptoms.
Minimizing CO Exposure from Portable Generators
Experts warn that there are some very simple steps that can be taken by those operating generators to minimize exposure to Carbon Monoxide. Here are 3 tips to stay safe!
1. Physical Placement of the Generator
Only use generators in outdoor locations. Generators should have at least 20 feet of space between the generator and the doors, windows, and other openings of your home or business (including garages). Never use a generator inside your home, garage, or business- even if windows and doors are left open.
2. Use Battery-Operated or Battery back-up CO Detectors
Early detection of dangerous levels of CO is critical in keeping yourself and others safe. Use CO detectors near every sleeping area in your home and, while using a generator, near the wall that is closest to the generator. Make sure to check the CO detectors regularly to be sure they are functioning properly. Modern smoke detectors are sometimes equipped with a built-in carbon monoxide detector, so check to see if yours does, and be sure to test the batteries often.
3. Know the Signs of Poisoning and When to Seek Help
Symptoms of carbon monoxide poisoning can be confusing as they have often been described as “flu-like”. Watch for the symptoms in yourself and those around you. If you have been running a portable generator and have begun to experience any of the following symptoms, seek immediate medical assistance by calling 9-1-1 or the Iowa Poison Control Center at (800) 222-1222.
- chest pain
- upset stomach
One Last Tip- Avoid Back-Feeding
It’s important to fully read and understand your generator’s owner’s manual before operating the machine. Serious or fatal injury can occur when the power company reconnects your service if proper precautions are not followed while connecting and disconnecting your generator.
Be sure to shut down your main disconnect (turn off your main breaker) to the house so that the generator does not back-feed into the main power systems. Failure to do this can result in dangerous back-feeding of power and can severely injure technicians working on downed lines.
The safest practice is to use a manual transfer switch to power your home with a portable generator. This isolates your home’s electrical system from the utility lines before connecting power from the generator. The manual transfer switch also protects the generator from a sudden power surge when the utility company restores power.
Beyond the “New Normal”
It’s been about four months since the COVID-19 outbreak forced many professionals to work from home. Most of us have been forced to adjust to a new normal, regardless of our profession or industry. For some, this new way of life has created new risk factors and has taken a toll on their physical and mental health.
Pre-COVID-19, a large number of people suffered from many various types of anxiety disorders. Post-COVID-19, required isolation may make it worse. For example, those who suffer from Social Anxiety Disorder experience everyday social interactions differently than those without. These daily interactions can cause irrational fear, self-consciousness, embarrassment, and more.
Even with social interactions becoming virtual through Zoom and other virtual meeting software, those who struggle in social situations may find a sense of increased anxiety due to stresses that come with the use of technology.
With the spread of COVID-19 becoming worse in many parts of the US, it is important to have tools to properly survive (mentally and physically) whatever comes next. In today’s article, we hope to equip you with the tools to fight anxiety and depression, implement a bit of self-care, and find new motivation.
According to the CDC, “pandemics can be stressful”. Social distancing may be the best way to ensure you avoid contracting COVID-19, but the added isolation can lean to the feeling of loneliness, increased stress, and anxiety(1). This mental health strain can begin to cause physical health strain, increased drug and alcohol abuse, and toxic communication with friends and loved ones.
We not only stress about our jobs, financial situation, personal health, and the health of loved ones, we also stress about the unknown. As humans, we tend to become more anxious the less control we have over a situation. If there is no solution or end to the situation in sight, we may begin to lose hope and become increasingly hostile towards the situation.
With increased heart rate, chest pain, shortness of breath, panic attacks due to increased anxiety can cause serious concerns about heart problems or cardiac arrest (heart attacks). This short term affliction can affect anyone, not just affect people with anxiety disorders.
We all react differently in stressful situations, but how you prepare yourself and fight the potential threat of mental health strain can make coping much easier (and healthier).
6 Proven Tips for Decreased Stress
The following are the Centers for Disease Control and Prevention (CDC) recommended tips for ensuring you can focus a bit on self-care to stay mentally healthy in times of excessive stress.
1. Take breaks from the news
News sources that provide little more than confirmation bias can make it feel like there is no news unless it is bad news. News stories found on television, social media, newspapers, and blogs are often the source of added stress. Taking a day to unplug and decompress from the news can be a great way to reset your outlook on your own situation.
2. Mind your physical health- Take a break!
Sitting at a desk for eight hours without a break is unhealthy in any situation. It is not uncommon for people to bury themselves in their work as a form of controlling what they can. When in a state of hyper-focus, it is easy to forget to take a break.
Setting a timer to remind you to take a break is a great way to force yourself to step away from your work, take a few deep breaths, meditate, and stretch your legs. This is a great time to grab a healthy snack, take a power nap (30 minutes does wonders), or even step outside for fresh air.
Finding time to exercise is not as difficult as one might think. For example, taking a jog or walk around the block with your dog is a great mid-day exercise for you and your pet- just remember to wear a mask if you may be in contact with others! According to https://www.ncbi.nlm.nih.gov/, exercise has been proven to have great lasting positive mental effects!
"Exercise improves mental health by reducing anxiety, depression, and negative mood and by improving self-esteem and cognitive function(2). Exercise has also been found to alleviate symptoms such as low self-esteem and social withdrawal(3)."
3. Make time for “You Time”
On occasion, we need a little reminder that it’s okay to indulge in something you enjoy. Perhaps it would be a good idea to take a hot bath to unwind, read a few chapters in that book you keep meaning to get back to, or even do a bit of Yoga (if that is your thing)! Taking time when you are “off the clock” to do things you enjoy can be a great way to reset yourself, mentally.
4. Use Lists to take control of what you can and organize your thoughts
An easy way to avoid stress caused by things that are beyond your control is to utilize apps for goal setting, lists, and reminders. Setting these up forces you to think about the things you have control over and organize them in a smart, efficient (and often creative) way. Here are some of the reasons that organizing thoughts and to-dos into lists helps:
- Lists provide a little dopamine hit when you get to check something off. These small success steps can go a long way to add up to a more positive outlook.
- Lists provide a way for you to work through questions and confusions and provide a process towards a solution in a positive psychological way
- Lists help add a sense of a “lightened load” psychologically as they make tasks feel less gargantuan and more manageable
- Lists help combat procrastination and the feeling of helplessness. By creating a list of actionable items, you create steps in a plan.
- Lists help you set achievable goals
By creating a list, you create a plan. When you have a plan, you have more of a sense of what you can control. Another bonus tip is to declutter your work area. A fresh workspace can be like a breath of fresh air, psychologically.
5. Use apps to keep you moving
Fitness apps like Google Fit are a great way to track your daily activity and stay encouraged to do more. Many of us are competitive by nature. For a great challenge, ask yourself the following questions: can you get more steps in than you did yesterday? Remember how we talked about setting goals?
Setting a goal in the app for the number of steps you plan to take in the day is a great way to stay motivated to stay physically healthy. The app even has a way to track other physical activities like riding a bicycle, rowing, jogging, or hiking
Apple enthusiasts needn't worry: iOS has a recently redesigned Health app that consolidates data (including important fitness data) from all your favorite apple devices to help keep you on track.
6. Don’t be afraid to ask for help
No matter how isolated you may feel, you are not alone. The “We’re All In This Together” tagline that many companies are using offers little comfort to those who feel truly alone.
The anxiety caused by panic disorders, specific phobias, and even undiagnosed issues can intensify feelings of deep depression. You may feel like no one could possibly understand what you’re feeling and you may even consider hurting yourself. Please remember that hurting yourself is never the answer.
Reaching out to friends or family for a bit of talking therapy can really help. Even a virtual chat or (if it’s safe) a small get-together, can be a great reminder that there are people who care about you and how you’re feeling. Support and a sense of community can help you feel re-connected can help too.
Virtual support groups, counseling, or therapy sessions are available to those in need. If you are ready to reach out and would like to talk to someone, we may be able to help.
If you or someone you care about is considering suicide, please contact the National Suicide Prevention Lifeline.
Don't Ignore your Thirst
The days are becoming warmer and as a result, many people are spending more time outside in the sun. When planning to be outside in the summer for a prolonged period, we often remember sunscreen and drink plenty of water before we go outside. Unfortunately, we tend to forget to stay hydrated throughout the day. This can lead to serious physical health issues as well as mental health issues.
Anyone can become dehydrated, especially when extremely active, engaging in intense exercise, or prolonged exposure to excessive heat. Young children and older adults are at a higher risk of the dangers of becoming dehydrated. In children, dehydration is typically a result of severe diarrhea and vomiting while older adults have a naturally lower volume of water in their bodies.
The Benefits of Drinking Water
Scientists estimate that our bodies are composed of about 60% water (with muscle being composed of about 80% water). According to an article on healthline.com, monitoring your fluid intake and staying hydrated has many proven physical and mental health benefits including:
- A dramatic impact on our physical performance with noticeable effects observed with as little as 2% water loss
- Helps moderate our temperature control, motivation, and fatigue level
- Impact on energy levels and brain functionality (including memory)
- Prevention and treatment of headaches
- Helps treat Urinary (kidney) stones
- Helps with weight loss
- Electrolyte regulation and cell hydration
Symptoms of Dehydration
It is important to understand and be able to identify the symptoms of dehydration so that you may stay hydrated. The easiest and most common sign that you may be becoming dehydrated is if you start to feel thirsty.
Infants and young children both show signs of dehydration similarly. The signs of dehydration in this age group include having a dry mouth and tongue, lacking tears when crying, and the lack of a wet diaper for more than three hours.
In adults, the symptoms of dehydration include extreme thirst, dark-colored urine, fatigue, dizziness, and fatigue. Both children and adults with clear urine are typically well hydrated.
Dangers of Dehydration
Dehydration can have very serious health implications including death. The negative effects of dehydration are many. Here are 5 Dangers of Dehydration:
Many things can cause seizures. One common cause is the result of your body not getting enough of the electrolytes that it needs. Electrolytes help carry electrical signals from one cell to another and when your electrolytes are not properly balanced, your body may react with seizures.
2. Urinary and Kidney problems
Prolonged dehydration has been shown to contribute to many urinary problems. Some of these problems may include urinary tract infections, kidney stones, kidney damage, and even kidney failure, according to an article by mayoclinic.org.
Kidney stones (renal calculi) can be extremely painful and are the result of minerals and salts forming inside the kidneys then binding together to form hard crystal-like stones. There are many types of kidney stones and, because they come in various sizes, may only be detectable by a CT scan.
Kidney stones are often the result of poor diet combined with excess body weight, prolonged exposure to extreme heat, and dehydration. Patients suffering from kidney stones are often encouraged to increase their water intake as a form of treatment. Increased hydration can help the stones pass more quickly.
Those who do not drink enough water are at higher risk of kidney stones. Staying hydrated is a great way to help prevent kidney stones.
3. Heat Injuries
Any medical professional will tell you that exercise is great for your mental and physical health. An active and healthy lifestyle helps your body fight diseases, keeps your heart healthy, and keeps your mind focused. Failure to drink enough water while vigorously exercising can cause everything from heat cramps to heat exhaustion and even heatstroke, which can be fatal.
4. Low Blood Volume Shock (Hypovolemic Shock)
When your body does not get enough water, it can cause low blood volume. Low blood volume can cause a drop in blood pressure and have an adverse effect on the amount of oxygen in your body. This life-threatening condition is the result of losing more than 20% of your body's blood or fluid supply.
If your heart does not have enough fluid, it cannot pump enough sufficient blood throughout the body. Left untreated, Hypovolemic shock can lead to organ failure.
Stay Hydrated, Stay Safe
In times of excessive exposure to the sun or rigorous exercise, a good rule-of-thumb is to drink fluids every 20 minutes. This may increase your urine output but will help to keep your body hydrated and functioning at its full potential. Another important time to stay hydrated is if you're sick and experiencing vomiting or diarrhea.
June is National Men’s Health Month
With Father’s Day and the transition of Spring into Summer, men often find themselves becoming more active in June. This is great because National Men’s Health Month is a time for men and those who love them to focus on health issues that are often overlooked or altogether avoided by men.
If you’re a guy, pay attention. If you have a special guy in your life, now is the time to help him get/stay healthy.
Guys, Let’s Talk About Your Habits
Here’s some food for thought: on average, men die 5 years sooner than women, and rank higher in 9 out of 10 of the leading causes of death (including cardiovascular disease and suicide). Your health matters.
Humans are creatures of habit, both good and bad. Men, there has never been a better time to start (or reinforce) some healthy habits that will keep you at your prime for years to come. It’s time to consider the things you’ve been avoiding.
Do you eat a salad every day? Great!
Your snack of choice is a fruit? It should be!
Do you try to do a bit of cardio in the form of walking the dog, playing outside, and going on hikes or bike rides with the kids? Even better!
Those are great habits, and you should keep them up, but these are not the habits we’re talking about here. When was the last time you had a physical? Last year? A few years ago? Don’t be ashamed. You’re not alone. The unfortunate truth is that men are statistically far less likely to go to the doctor than women, especially if it is for an “embarrassing” procedure or problem.
You shouldn’t be embarrassed or ashamed, you should go get a physical. Your life could depend on it.
The Dangers of Skipping a Physical
Here’s a (not-so) fun fact for you: Heart disease is the leading cause of death in men with nearly 1 in 13 living with some form of cardiovascular disease and heart disease being the cause of 25% of all male deaths in the United States according to the CDC.
Illustration- 1 in 13 men are living with cardiovascular disease
“Half of the men who die suddenly of coronary heart disease had no previous symptoms. Even if you have no symptoms, you may still be at risk for heart disease.” – Center for Disease Control and Prevention
Why Men Need to Visit their Doctor Regularly
The CDC notes that the risk for heart disease can be greatly decreased with a healthy lifestyle, diet, and annual check-ups. You may be good at (or at least working at) your diet and getting more physically active, but the third recommendation is just as important. After a physical and maybe some blood work, a personalized plan be created between you and your physician to help you get and stay healthy.
Your medical professional is great at planning for heart health, disease prevention, and more. This kind of plan can help you to know your blood pressure, determine if testing for diabetes is needed, help you to know and understand your cholesterol and triglyceride levels, and discuss mental health and great stress-relieving tips!
Doctors can also recommend very important, and often avoided, screening for cancer. Cancer is the second leading cause of death in men and according to the American Cancer Society, starting at age 45 men should start regular prostate screening for cancer. In fact, as many as 1 in 9 men will be diagnosed with prostate cancer so screening for early detection is important. A simple 3-5 second exam could save your life!
Now it’s Really Time to Man Up…
Let’s talk about colon cancer. According to the website stopcoloncancernow.com, 1 in 20 men will develop colon cancer. The good news is that it is very detectable thanks to colonoscopies. These procedures are extremely successful at screening for, diagnosing and treating (even stopping potential) colon cancer.
What You Need to Know About a Colonoscopy
Men generally don’t like the idea of a colonoscopy. Some feel it’s invasive and unnecessary while others just don’t understand it and are too embarrassed to ask. Here are 3 facts you need to know about the benefits of a colonoscopy.
- The exam is very thorough as it examines most of the colon from the rectum to the cecum and can detect a vast number of health issues that are usually not able to be detected by other means.
- A colonoscopy can detect and remove polyps. Polyps are usually benign masses that can potentially cause cancer, so early detection and removal through colonoscopy can save you a lot of time, pain, health problems, and money!
- A colonoscopy can detect internal bleeding called Gastrointestinal bleeding.
“Colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Screening tests can find precancerous polyps, so they can be removed before they turn into cancer. Screening tests also can find colorectal cancer early, when treatment works best.”- CDC
Get Healthy, Stay Healthy!
Your mental health matters too. As we mentioned earlier, men are more likely to complete suicide than women. The CDC states that 1 in 10 men are likely to experience some form of anxiety or depression. It's okay to seek help. Realizing you are experiencing depression isn't a weakness, it's a strength, and so is knowing when and how to ask for help.
1 in 10 men experience anxiety or depression
Get outside, go for a jog. Make it apart of your morning or evening routine. Download apps like Google Fit or get a Fitbit. What better month then National Men’s Health Month to kickstart the next healthy chapter in your life?
It all starts by setting up that appointment with your doctor that you have been putting off. Set up that annual visit, make a plan, and stick with it. Your family, friends, and body will thank you!
The following is a letter to the editor of General Surgery News from our very own David Coster, MD, FACS, FASMBS. This letter has been reprinted here with the express consent of the author. The original letter can be found here.
As a surgeon and early adopter of robotic surgery some 10 years ago, I am having an increasing problem in tolerating the rhetoric of the invented controversy over “laparoscopic” versus robotic surgery. In our hospital, robotics is used around the clock and on weekends as needed. All OR staff know how to do the setup, and it is used judiciously for appropriate cases, of which we have now done thousands in general surgery.
"Robotic surgery “is” laparoscopic surgery, but with a better set of instruments. So what is the basis of any argument against using a better tool?"
The robot is a laparoscopic technology that allows the surgeon to control each instrument; there is no longer any need for a “camera operator” or an assistant to hold something. There is no reason to expect that robotic laparoscopic surgery would be any “better” than regular laparoscopic surgery in regard to the usual outcomes. It doesn’t have to be; it only has to be as good.
Where robotic surgery “is” better—and demonstrably so—is in cases that could otherwise not be done by minimally invasive techniques, that is, the most complex types of surgery that one could only hope to perform laparoscopically and those procedures that eventually are converted from regular laparoscopic to open because the laparoscopic technology does not offer the range necessary to complete the case successfully. Here there is a clear advantage to robotic surgery, but no one is bothering to talk about it.
You cannot tell me that successfully avoiding open surgery is of no benefit to the patient. In my practice, I do a lot of complex procedures in patients who have had many other operations, and it is in this patient population that the robotic approach really shines. In addition, robotics offers advantages for the surgeon in every possible way: visibility, exposure, technique, ease of use and comfort for the operator. Since when does the surgeon experience not count as a “measurable outcome” for comparison? Being better for the surgeon is no small thing, as this has never occurred in the past with any new technologies. One can see things better, and often things that would have gone unnoticed with regular laparoscopy; one can manipulate better and perform the operation with more finesse and less tissue damage; one can be more certain of the quality of their work when using robotic technology.
Robotic laparoscopic surgery is still laparoscopic surgery, but with a better tool. It’s time for surgeons to stop setting the bar at whether or not patient outcomes are better, as all they have to be is the same. Why? Because the process for the surgeon, for once, is better. No longer does one have to suffer to complete a laparoscopic operation; rather, it can be completed with ease, aplomb and a certainty of perfection that was previously not possible.
"Those who think robotic surgery is going to go away are wrong."
Many of us do nearly all of our procedures these days robotically, and we have a much nicer day as a result. The costs will go down as the approach becomes the norm, as it inevitably will. As with the controversy of laparoscopy versus open surgery in the 80s and 90s, this controversy of laparoscopy versus robotic laparoscopy is tied to the fear of being left behind. I would suggest a healthier approach to robotics is simply to add it to your skill set so you have it when you need it for difficult cases where such technology is not just a perk but a requirement.
David Coster, MD, FACS, FASMBS