All posts in Doc Talk

Doc Talk: Don’t miss your shot

Ellen MacKinnon, MS, RN, AGCNS-BC, Director of nursing

Every autumn, we hear warnings from healthcare organizations and cautionary stories in the media about influenza season. It would be delightful to announce that there won’t be any flu cases this year but we all know that’s not true. In fact, Teton Valley Health has already confirmed 3 positive cases of Influenza Type A with laboratory testing. We’re off to an early start this year so let’s help protect each other by being proactive.

Teton Valley Health supports recommendations provided by the Centers for Disease Control that encourage everyone 6 months of age and older to get vaccinated. This year’s vaccine has been altered to better meet the current strains that are circulating throughout the U.S. and worldwide. Even if the virus “drifts” into different strains, vaccinations still produce antibodies that can repel flu or shorten the recovery time. 

There are two general vaccination protections available: trivalent and quadrivalent. Trivalent doses focus on three types of influenza strains. Quadrivalent vaccines are composed to repel four flu lineages. Teton Valley Health offers quadrivalent immunizations in both injectable and nasal mist applications. High dosage shots are recommended for older people and people who are more vulnerable to attacks on their immune systems. Children between 6 months and 8 years who’ve never had a flu shot or have only had one vaccination may need to be given 2 doses spaced at least 4 weeks apart.

Immunizations are proven to give the best protection against the flu. Additional common-sense habits are also very important such as frequent, thorough hand-washing, staying home if you’re sick, and avoiding crowded indoor events. It’s also important to know that flu antiviral drugs can significantly shorten the severity of the infection if taken within 48 hours of symptoms.

Remember, people with the flu are most contagious in the first 3 – 4 days after they become ill. Sometimes, the contagious stage begins one day before symptoms begin, which is really sneaky and unfair. Complications include bacterial pneumonia, ear infections, and worsening of chronic medical conditions such as diabetes and asthma. It’s estimated that in the U.S. last year, over 70,000 people died from the effects of influenza.

Most insurances cover the costs of flu shots. If you don’t have coverage, you may be eligible for assistance to get an immunization for yourself and your family. Teton Valley Health offers a Community Assistance Program to help people afford appropriate medical care, and Driggs and Victor Clinics also offer sliding fee scale pricing. Call (208) 354-6331 for more information about financial assistance.


Up in Smoke – Tips for staying healthy during wildfire season

Dr. James Pohl

James Pohl, MD, FCCP

Pacific Northwest fires have drawn attention to our fragility and susceptibility to alteration in something as basic as our air supply. Contaminants vary from event to event and our vulnerability varies from person to person. It’s safe to assume that toxicity, density, and length of exposure to the contaminant increases medical risk factors in direct relation to the health status of the person breathing the air.

Typically, a forest fire produces carbon dioxide, water vapor, carbon monoxide, particulate matter, hydrocarbons and other organic material, nitrogen oxides, trace minerals and thousands of other compounds depending on the uniqueness of the burning matter and surrounding conditions. The toxic effects of all dissipate with wind and weather but as we all witnessed lately the elements can still deliver sufficient toxic amounts to cause problems that are very real.

All of us probably experienced the obvious irritating effects of the elements in the air. External eye irritation and redness and perhaps a runny nose reflect the local inflammatory response to these agents in ambient air. As in all medical matters, if there are pre-existing conditions affecting eyes or nasal passages, the smoke will make them worse and require medical attention, but the vast majority of people simply have to put up with it.

The effects can be more serious if the exposure is more intense or prolonged or involves an individual whose health is compromised by acute or chronic unrelated conditions. The most obvious example would be individuals with heart and lung disease. The ability to breath easily and effectively is most imperative in these individuals. If their “work of breathing” is increased, or their ability to oxygenate or ventilate is compromised by irritation of upper and lower airways, things can get out of hand quickly and require timely intervention by medically trained individuals. It’s safe to say that any patient with substantial heart or lung ailment is at risk, i.e. not just asthmatics or coronary artery disease patients.

So how do we address this problem?

  • Anticipate. Check weather reports and Air Quality Indices when fires are ongoing.
  • Prepare. Make contingency plans to avoid pollutants. Stay indoors as much as possible with air filters in place. Do not plan prolonged exercise outdoors until the Air Quality Index allows.
  • Be practical. If you cannot avoid exposure, wear a mask. To be effective, the mask has to fit proper and it must be designed to filter out particulate matter and fumes and gasses. The P95 mask is appropriate.
  • Be careful. If you have chronic lung or heart disease do not forget your meds or oxygen if prescribed.
  • Be smart. If you experience increased cough, shortness of breath, chest pain or sputum production call your Healthcare Provider and avoid more serious problems that can be avoided.

Dr. James Pohl offers care in pulmonology and sleep disorder at Driggs Health Clinic. He’s now accepting new patients. Please call (208) 354-2302 to make an appointment.


Pay attention to attention deficit

Anna Giemza-Palmer, NP

I was watching a film with my husband the other day and before I knew it, I was on my phone checking out Facebook even though I really enjoyed the show. I lost track of the plot and we had to rewind so I could catch up. I thought to myself, why can’t I just concentrate on the movie?

A report from Pew Research Center shows that a third of our society believes cell phones make it more difficult to focus on a single task. Well, that sounds like me, I thought. But is it a habit or a distraction, or perhaps neither?

Although frequent cell phone use is a habit that I can control, some people struggle to maintain control over their ability to stay on task. Centers for Disease Control and Prevention reports that around 6 million children in the U.S. have been diagnosed with ADHD (attention-deficit/hyperactivity disorder), or ADD (attention deficit disorder, a subset of ADHD). Unfortunately, CDC also indicates that in Idaho, not many children receive medical management or behavioral therapies for this brain disorder.

Children, adolescents, or even adults who suffer with ADHD or ADD present with several symptoms, such as daydreaming or zoning out, forgetting appointments or assignments, making frequent mistakes, having difficulty waiting for their turn and many other symptoms. Patients may appear to be overly active or inattentive or a mixture of both. Many times, causes of such behaviors can be identified. Sometimes, we don’t really know what causes these symptoms but we can identify risk factors that may predispose people to have problems managing these types of behaviors.

Diagnosis can consist of several steps and it is very important to rule out other factors that may contribute to either a child or adolescent not paying attention in school such as bad vision, problems with hearing, or other causes. When physical problems are ruled out, the probability of ADHD is somewhat high. Then, we can use therapy and medications to help manage the symptoms. Often, we see noticeable improvement in kids, adolescents, or adults who have begun treatment and therapy for ADHD. They’re able to pay attention in class, at home, and while playing sports, and their academic performance improves.

If you or a loved one seems to have symptoms of attention deficit disorder, I encourage a visit with your medical provider. Together, you can decide what steps to take to better manage your life.

Anna is a Nurse Practitioner specializing in psychiatrics. She works closely with mental health professionals and physicians to support patients living with mental health disorders. Anna is available to meet with patients 12 and older. Call (208) 354-2302 or follow our patient portal link here to schedule a visit.