Saturday, May 11, 2013

National Orange Popsicle Week Comes to Knoxville to Raise Stroke Awareness


Learn more about stroke from staff at University of Tennessee Medical Center and join in recognizing National Orange Popsicle Week from noon to 7 p.m. May 19 at Pop Culture, Knoxville’s gourmet popsicle shop.

“I love the simple and straightforward idea of taking something I love doing and being a part of—making popsicles—and using it as a basis for education,” said Jason Mitchell, Pop Culture’s owner. “It’s so much easier to learn and be receptive to awareness when you hare having fun.”

National Orange Popsicle Week (NOPW) began as a way for a young woman who suffered a major brain stem stroke at age 24 to raise awareness of stroke in young people. One in five strokes occurs in adults age 22 to 55. Stroke is the fourth leading cause of death in America and a leading cause of adult disability, according to the National Stroke Association.

UT Medical Center, which the American Heart Association has recognized for improving stroke care by promoting consistent adherence to the latest scientific treatment guidelines, will be providing free blood pressure screenings and stroke education during the popsicle-based awareness event.

A stroke occurs when there is an interruption in blood flow from the heart to the brain, causing brain cells to die. The May 19 popsicle event at Pop Culture will raise funds to purchase iPads for the UT Stroke Center’s use in aphasia treatment. Aphasia is a disorder caused by damage to the parts of the brain that control language. Aphasia can result in difficulties reading, writing and speaking.

“Stroke is a devastating disease: it happens like a tornado and the lives of the survivor and their families are never the same,” said Jennifer Henry, BSN, RN, CNRN, director of the UT Stroke Center. “Many people mistakenly believe that stroke only happens when people are older, when in fact, stroke can happen at any age. It's critically important that people take a look at their own risk factors and take steps to reduce risk. Everyone, even children, can learn to recognize the warning signs of stroke and the importance of calling 911 when stroke symptoms happen. NOPW shares this message in a unique way.”

Amy Wooddell’s first symptoms were dizziness and nausea, which didn’t neatly fit the acronym FAST, which is used to recognize and act on stroke symptoms—Face: does one side of the person’s face droop? Arms: if the person raises both arms, does one arm drift downward? Speech: does the person’s speech seem slurred or strange? Time: if any of these symptoms are observed, call 9-1-1 immediately.

Wooddell went to the emergency room only to be given medication for vertigo and sent home. The next morning she felt worse. The cause was a dissected vertebral artery, one of the major arteries leading to the brain. Doctors were unable to treat the dissection, and Wooddell later that night suffered a brain hemorrhage and lapsed into a coma. When she woke up days later, she was paralyzed and unable to speak.

Wooddell’s recovery was arduous, including 30 days in the intensive care unit. As she became more vocal, she finally was able to tell her new husband that she loved him—and that she wanted an orange popsicle.

However, Wooddell wasn’t allowed solid foods—even a popsicle—until she passed a swallowing capability test while in an inpatient rehab unit. The day she did was a victory, and her rehab caseworker bought an entire box of orange popsicles for Wooddell and her family. The orange popsicle was a much craved delight after nothing but water and liquid nutrition and became a symbol of recovery.

Fellow young stroke survivor, Sarah E. Kucharski learned about National Orange Popsicle Week through social media. The mission and the method resonated with her. Like Wooddell, Kucharski had a stroke at age 27 that was first diagnosed as vertigo, despite having a complicated vascular history. She spent a week in the hospital with extreme dizziness, double vision, and the inability to walk unaided. Nonetheless she was told that her symptoms would go away as quickly as they had developed and sent home with a walker.

It wasn’t until the first night out of the hospital that Kucharski’s discovered that she had no temperature or pain sensation on the right side of her body. She consulted with her primary care doctor who referred her to a neurologist who immediately said that, given her symptoms and Horner’s syndrome causing her left eye to droop, her case was “a text book” stroke scenario.

Kucharski’s recovery was self-driven, and it took another four years for her to finally receive the diagnosis of fibromuscular dysplasia (FMD), a rare vascular disease that can cause narrowing of the arteries, arterial dissection, aneurysm, and stroke. Kucharski has a rare version of the rare disease, which has no cure, and no real treatment other than management of symptoms and surgical repair of the effected arteries. She has used her own experiences as motivation to found an international nonprofit organization dedicated to those affected by fibromuscular dysplasia—FMD Chat.

While Kucharski and Wooddell share similar stroke stories—and a love of popsicles—they don’t share geography. Wooddell lives in Kansas, and Kucharski lives in Western North Carolina. NOPW may be rooted in Kansas, but strokes strike all around the world, so once Kucharski learned of NOPW, she wanted to get involved.

As managing editor of magazine dedicated to the Southern Appalachian region, Smoky Mountain Living, Kucharski got to know Knoxville through her work travels. She had read about Pop Culture and visited the mobile popsicle vendor’s bricks-and-mortar shop on Walnut Street last year. With the goal of bringing NOPW to the region, she reached out to Pop Culture’s owner.

“You should check out this event. If there’s anyone who could make it happen in Knoxville, it’s you,” she wrote to Mitchell on the Pop Culture Facebook page.

Mitchell’s response was enthusiastic. He immediately offered up the Pop Culture shop where he makes and sells his famous popsicles using ingredients from local vendors, milk without rBGH growth hormones, and sweeteners such as organic cane sugar, honey, or agave. He’s even put extra effort into making the color orange.

“It took me months to find something natural, and a company out of Louisville, Ky. formulated some orange coloring out of Beta-Carotene for me to use, and it's odorless and tasteless,” Mitchell said.

For NOPW, Mitchell will be serving up his Orange Cream and Mango popsicles, but he isn’t afraid to get creative.

“I may make something else that is orange, but I have to play around a bit with the ingredients and their respective colors to see if something else ‘Orange’ is possible,” Mitchell said. “The bright red of Strawberry Lemonade or the robust purple of Blueberry Vanilla would be immune to adding natural orange color.”

Pop Culture is located at 706 Walnut Street next to the Knox County Public Library, Connect via Facebook at facebook.com/popcultureknox. To learn more about National Orange Popsicle Week, visit nopw.org or facebook.com/nationaorangepopsicleweek.

Wednesday, May 8, 2013

Waesuck Wednesday: Bringing It Back Edition

I'm terrible with brevity. If there's not time for a long, drawn out blog post, I tend not to write, which means that my blogging can be rather sporadic. Back in 2011, I created two tools to encourage myself to at least put something out there, Terrible Twos-day and Waesuck Wednesday. Tuesday brought bad things in twos (a relic of my days spent haggling with a fellow reporter on press day) and Wednesday brought things that, well, sucked—or to appropriately reflect the Scottish origin of the word, things that reflected causations of pity, grief, or woe. Neither Terrible Tues-day or Waesuck Wednesday is particularly uplifting, but they both give me a chance to complain and my readers an opportunity to grouse right along with me.

Waesuck Wednesday: Bringing It Back Edition

What shouldn't ever have come back? Punk. At least not in fashion form at the Met Gala. Sure there's an exhibit that gives the evening's epic disasters some kind of context but Hollywood's playing dress up did nothing more than mock the cultural movement. Check out some of the night's fashion courtesy of NY Mag.

Monday, April 8, 2013

Whichever Way You Swallow It - A New Medication Adherence Method

I bought a pill box.

It is a box — for pills.

It is not small, or trendy, or cute, or ironic. It's not some repurposed cigarette case in which I keep Midol and Band Aids. It's a giant, plastic, albiet somewhat colorful, rectangle. Forget pocket-sized. This is a portfolio of pills, a veritable Advent calendar of pharmacology.

Each morning, I snap open a color-coded translucent lid marked with a time and respective day of the week and turn the entire ratting contraption over to dole out a pre-selected handful of medicine. The morning brings lots of colorful ovals—purple, green and blue, white, among others. In the evening I repeat the process, distributing pink, beige, and aquamarine. Saturday brings the cobalt blue sheen of Vitamin D. Snap, shake, pop, swallow. In only a matter of days, my medication process has become a thoughtless process of repeated motions, and I think I like it that way.

I've resisted buying a bill pox for years. "They're for old people," I said. "They won't hold all my medications," I said. "I'll just have to refill it every week," I said. I spent hours — yes, HOURS — shopping online for the perfect bill box. I wanted something that didn't scream "geriatric." Many seemed too much like those automatic pet feeders with rotating lids such that only one dose at a time would be revealed. More sophisticated ones cost a small fortune and featured alarm bells for audible reminders. Quaint little pretty boxes in designer colors wouldn't hold a day's worth of pills, much less serve any truly useful purpose. No, the only option that featured compartments large enough to hold a daily vitamin and then some with enough capacity to store a week or more's pills were the dowdy plastic boxes with S M T W T F S in raised black lettering across the day's lids.

I refused to go there.

"I can remember to take my medications," I said. "I know what day it is," I said. "I never get yesterday mixed up with today," I said.

And as luck would have it, my health improved, or at least the pharmacological treatments for my conditions lessened. "Two pills. I can take two pills," I said. "I'll even add some supplements for good measure," I said. So I did. Sort of. A daily vitamin was easy enough. Pro-active, I tried the Vitamin E, the Flax Seed Oil, the Red Rice Yeast... there was aspirin that came and went. I never knew exactly how to answer the nurses as they updated my medications list. "Yes, no, maybe, sometimes," I said.

After enough time, the medications list began to grow again. When I packed for an overnight trip, my duffle bag doubled as an unwieldy maraca. Bottles of pills inevitably worked their way below the shirts and underwear to hide. In September, while souvenir shopping in San Francisco's Chinatown, I relented that perhaps a small bag would be useful in corralling my mobile medicine cabinet and purchase one in purple brocade.

The bag was charming enough. In addition to my pills, it could hold a toothbrush, travel-sized toothpaste, digital thermometer, and a few bags of tea. I was pleased. However by late winter, the little purple bag was a struggle to zip. There were the rounds of antibiotics for the bout of pneumonia and cough medicines to suit. A new diagnosis meant the addition of new tools with their own carrying case. Additional lab tests meant an old med once discontinued came back into the mix, and finally so did another old med. The bare minimum of what I was to take no longer fit in my pretty purple bag, much less the "just in case" drugs I carried, well, just in case.

So while standing in line at the drug store, the giant, plastic, albiet somewhat colorful, rectangle pill box caught my eye. It was on sale, and I was tired. I'd noticed that over the past few weeks it had become considerably more difficult to remember exactly what I had taken and when. Furthermore, managing side effects and possible interactions was trickier. I feared missing a dose less than the possibility of doubling a dose, which was a distinct concern given that my methodology of remembering what a pill looked like in my hand before I took it seemed not to be quite as accurate as it once had been before.

The giant, plastic, albiet somewhat colorful, rectangle box wasn't perfect. Technically it was designed for a patient taking medications four times a day; however, it was somewhat divided in the middle such that I could easily make the top half — morning and mid-morning — into a week's worth of day and night and the bottom half — afternoon and evening — into another week's worth of day and night. I wouldn't have to worry about reloading for two whole weeks, a factor that greatly appealed to the scatterbrain in me. The downside was that at any given time, I could be carrying around two whole weeks of pills with me, which would still be less than my habit of carrying entire bottles of pills, the loss of which would amount to well over $100 in co-pays much less the hassle of having refills authorized. With two weeks of pills on hand, I could reasonably leave the pill bottles of medication at home; however, without the pill bottles, no one would have access to the names and dosages of my medications in the event of an emergency.

Upon unwrapping the giant, plastic, albiet somewhat colorful, rectangle pill box at home, I found that the designers of it had considered of this identification problem. Included was a self-stick label to be filled in with just the sort of information as one would find on a pill bottle, which while woefully inadequate, was at least a step in the right direction.

And I too am headed in the right direction, as what I have labeled a personal defeat — buying a pill box — has, in fact, improved my medication adherence. When I failed to take my medication properly, it wasn't because I didn't want to take it properly, it was because I was too arrogant to admit that I might need help doing so. Such is a continually critical battle in being a patient — learning when to make use of the resources available rather than sticking out the old way of doing things simply out of resistance to change. Illness changes us whether we are accepting of it or not. It is up to us to face change in a manner such that it may be incorporated into our lives with the least amount of disturbance to the things that we want to actually want to do. Rather than spend five to ten minutes every morning and evening peering at pill bottle labels trying to remember what I have and haven't taken, I now only have to spend five to ten seconds swallowing my pride.