Ski and Snowboard Injuries

In the full throes of winter, the Adirondacks are notorious for their winter sports activities, namely skiing and snowboarding. I know that Whiteface Mountain in Lake Placid is one of my favorite places to ski and I have seen firsthand many of the injuries that result from these sports. According to the U.S. Consumer Product Safety Commission, leading causes # 1 and 2 of winter sports-related injuries are from snowboarding and skiing. I found an article from the Adirondack Sports Medicine and Physical Therapy Center on skiing and snowboarding injuries and how to best prevent them. The article mentions that beginners are most likely to get injured. Therefore, they recommend skiing with an instructor and taking lessons your first few times. They also recommend warming your muscles up before you start as cold, unstretched muscles and tendons are much more prone to injury. Other helpful hints include wearing appropriate protective gear such as a helmet. I have skied with a helmet my whole life, and while I would like to think that I am not a complete amateur, you can never be too careful. Even if you are a very good skier or boarder, you cannot control others around you and that is often where the most injuries result. It is also very easy to get dehydrated on the slopes so make sure that you are drinking enough fluids and do not ski or board when you are already tired. You are more prone to make mistakes this way and injure yourself.

Another major source of injury in this cold exposure is frost bite. I have experienced myself how easily this can happen and you need to take great care to not leave much of your body exposed to the cold. Make sure that you are skiing or boarding with someone else and have them take notice of your face (especially your nose!) because sometimes you cannot always feel frostbite coming on.

As a physician living and a practicing in a rural area I would do my best to identify those patients of mine that partake in these outdoor winter activities and make sure that they are doing their very best to prevent injury. Many of these tips are very simple to implement and are just a matter of patient education.



http://www.stemc.org/outpatient-services/adirondack-sports-medicine-and-physical-therapy-center/health-and-fitness-articles/skiing-and-snowboarding-injuries-and-prevention/

Coming Back Down to Earth

Coming Back Down to Earth 

http://www.lakeplacidnews.com/page/content.detail/id/521122/ADIRONDACK-GADABOUT--Thaws-present-economic-threat.html?nav=5059

I came across this article in local Lake Placid Newsaper the other day about how the recent January thaws present an economic threat to areas like Lake Placid that rely on outdoor recreation to attract visitors. Such activities like skiing (downhill and cross-country), ice fishing, sledding and skating make the Adirondacks a great winter vacation spot. However, the recent warmer temperatures have thrown a wrench into this. The author focuses on making the best out of this seemingly unfortunate turn of events. For example, he cited how other activities such as hiking can still be enjoyed. It used to only be the "die hard 46ers" who would brave the treacherous winters to knock another peak off of their list. There are even 46 clubs dedicated to acheiving this monumental task in winter conditions only. That may not be so difficult any more as this article mentions. Recently, the author has seen many more younger families hiking the peaks. He cites how this new initiative could incite a movement amongst younger hikers to take on the challenge. In a world where today's youth derives most of their entertainment from TV, video games, etc indoors, it is important that we don't lose site of the importance of spending time outdoors. As a soon-to-be physician and outdoor Adirondack enthusiast, I share this sentiment. To me, the Adirondacks and Outdoor Experiences are synoymous. If I were to practice in a community in an area like the Adirondacks I would encourage my patients to take advantage of the great world in their own backyards. To me, there are many health benefits that go along with living in an area like the Adirondacks. Not only is the physical health and exercise important, but the mental component of health is also nurtured by spending some time outside and enjoying the natural beauty. I would highly encourage my patients to enjoy the outdoors and would like to play an integral role in the community to foster this sentiment. The author of this article talk about organizing a climbing campain or initiative that I would love to be a part of.

Help with Healthcare

Help with Healthcare

http://www.adirondackdailyenterprise.com/page/content.detail/id/540022/Library-will-host-healthcare-workshops.html?nav=5049

This article in the the Adirondack Daily Enterprise talks about how a local library in Tupper Lake will host healthcare workshops. The whole of United States has been struggling with the changes of the  Affordable Care Act and this does not exclude the rural county of Essex, NY. These workshops are led by Jill Rock, an education and outreach specialist and by Sandy Duquette, a health insurance administrator of the North Country Chamber of Commerce. These women have cited the confusion that people have been experiencing and how many people have reached out asking for help.

I think that rural communities will struggle more with the changes in the healthcare policy given their isolation. Therefore, I think that these workshops are a great idea and should be implemented in other small communities. Because of their physical isolation, it makes it harder for people to understand the healthcare changes and how it will affect them given their lack of communication. Furthermore, because rural counties tend to be of lower socioeconomic status and generally are more blue-collar workers, people have limited access to the internet. This will make it particularly difficult for people to access the already difficult healthcare.gov website. It is nice to see this type of community outreach and I hope that other small communities implement similar programs.

Poison Ivy!

Poison Ivy!

http://www.adirondackalmanack.com/2010/07/adirondack-outdoor-hazards-poison-ivy.html

The Adirondacks are a vacation spot for many. Home to the 46 High Peaks, tons of people travel to the "Dacks" to hike the many mountains and explore the beautiful nature. One of the greatest hazards of hiking is not the precarious terrain, or even the mountain lion lurking in the boulders, it is Toxicodenron radicans. Most of us know it as Poison Ivy and nearly everyone can tell you what it looks it. The classic 3 red leaf structure can be a misleading description. Green is the color you want to look for, accompanied by jagged edges and bilateral symmetry. The article I found in the Adirondack Almanack talks about how this notorious plant is an environmental hazard of the North Country. It is important to be aware of how to avoid the plant and the precautions you need to take. The article also provides tips for how to avoid the symptoms.  For example, the oil that causes the dreadful allergic reaction is water resistant, so you must use soap and water to clean any potentially affected areas, and quickly. 

If I were a physician working in a rural area such as the Adirondacks, it would be incredibly important that I knew about the health hazards that poison ivy causes. It is necessary to inform your patients about what to watch out for and the necessary precautions to take. Prevention is the key and it is my job as a physician to educate my patients. 

Reflections on Rural Health in Essex County

It has been a very neat experience to study the health network and delivery system in a county that I have grown to love since childhood. The Adirondacks have always been very special to me and I have always seen myself living there in the future. This project has presented many aspects of rural health in Essex County that I had never considered. It has strengthened my convictions to live there and take a part in the community so that I can improve many aspects of rural health.

One of the things that I found my shocking about Essex County was the obesity rate. I naively assumed that the people who lived in the Adirondacks were the active, "outdoorsy" type. However, this isn't necessarily the case. The County Health Department Director told me that those are the kind of people who come to visit the Adirondacks. The permanent residents who live are not vacationers, they are blue-collar residents who struggle to make a living in difficult economic times. I did not realize how strong the correlation was between lower socioeconomic status and poorer health. Not only can people of lower socioeconomic status not afford healthcare as much, they also tend to be less educated. In many instances, this population lacks the education about certain preventive practices and habits to lead a health life. This all translates into poorer health that is then only compounded when access is limited in a rural community. 

I have a great passion for physical fitness, nutrition and a healthy lifestyle. I also love to teach so I can see myself playing an educational and motivational role as a physician in a rural community. This project has opened my eyes to many aspects of health that I did not know existed. It has further motivated me to pursue a career and life in a rural community like Essex where I can help to make a difference in people's lives.

Children's Mental Health in Essex County

http://www.familiesfirstessex.org/welcome.html

The program called "Families First" of Essex County is a support network for families whose children suffer from mental health issues. I could not find whether or not mental health among children was a predominant issue in this county, however, I think it is an important medical issue among any community. Specifically, I would imagine that rural communities such as Essex County would suffer disproportionately from mental health-related issues given the fact that communication and access to resources is scarce. Indeed, this program was founded in 1992 to provide services to a growing part of the community whose needs were unmet. Families First facilitates opportunities to meet other families whose children have similar emotional or behavioral challenges. They also provide a family support specialist who meets with individual families in their homes and coaches and educates parents on how to deal and manage their children's needs. In addition, they also provide a case worker to prevent residential placement of such children.

As a "local medical expert" I would love to get involved in this program that Essex County has established. I think that the support system is a great way for parents to network with other families and family support specialists. As a physician, I would do my best to screen for emotional and behavioral issues among my younger patients and would strongly advocate this program. I think it is a great preventive program that targets the issue in its infancy, instead of addressing more severe circumstances down the road. While mental health issues are not necessarily preventable, I think that they can be managed in a such a way as to prevent the issues from becoming debilitating. In addition, this program would have a great impact on the community as it would raise awareness about children's mental health and promote greater compassion and support.

EAHCN: Exemplary Patient-Centered Health Care

http://www.plattsburgh.edu/offices/centers/cisp/eahcn/index.php

I found an organization called the Eastern Adirondack Health Care Network that focuses on patient-centered initiatives. EAHCN is a coalition of health care providers that span Essex, Franklin and Clinton Counties. This network strives to achieve many unique goals that include improving the financial viability of rural health care providers and enhancing partnerships with neighboring communities to share services in rural areas. One of the projects undertaken by this network includes a healthy youth development program that works within local communities to prevent substance abuse, teen pregnancy, delinquency, violence and school dropouts. Other projects include geriatric mental health and arthritis management.

The EAHCN exemplifies many aspects of the patient-centered medical home initiative. It focuses on better communication between the patient population and health-care providers. It revolves around getting patients more involved in the healthcare process. I would love to be a part of this network as a rural healthcare practitioner. I think it is important to reach out to the community and increase patient involvement.  I could see myself getting involved in some sort of health living initiative that would include outreach programs that that teach nutrition, fitness, mental wellness and other healthy lifestyle behaviors. This is my personal passion and I would love to launch an initiative in the local community that I live and work in.