NOAH 2014 North Omaha Area Health
-
Upload
noah-clinic -
Category
Documents
-
view
213 -
download
0
description
Transcript of NOAH 2014 North Omaha Area Health
NOAH North Omaha Area Health page- Spring Issue 2012
This Publication Made possible by support from
University of Nebr. Med Center. 5050 Ames Ave
Omaha, Nebraska 68104
Nonprofit Organization
U.S. Postage
PAID
Omaha, Nebraska
Permit NO. 454
Health and
Spirituality Page 5
Black Family
Health and
Wellness Page 6
Champion Page 8
Spring 2014
“From the cradle to the grave” The effects of having it or not having it, healthcare
NOAH North Omaha Area Health page-3 Spring Issue 2012
Diabetes, Insulin
Overdose, and Other
Complications Cold sweats, trembling hands, intense anxiety, a
general sense of confusion -- no, it's not the night
before final exams. These are the signs of low
blood sugar or hypoglycemia, which can result
from an insulin overdose, a potentially danger-
ous complication of diabetes.
Hypoglycemia happens to many people with dia-
betes. And it can sometimes be serious. Thank-
fully, most episodes related to insulin are avoida-
ble if you stick with a few simple rules. WebMD
takes a look at how to prevent and treat insulin
overdose.
When Insulin Works too Well Insulin stimulates the cells of the body to absorb
sugar (glucose) out of the blood. It also inhibits
the production of glucose by the liver. In type 1
diabetes, the body does not make insulin. In type
2 diabetes, the body is resistant to the insulin the
body does make, and with time the pancreas may
make less insulin.
All people with type 1 diabetes need to take in-
sulin injections. Many people with type 2 diabe-
tes -- those whose blood sugar can't be controlled
with oral medication, diet, and exercise -- take
insulin injections.
There are several ways you can get too much
insulin in your system and have a drop in your
blood sugar:
You inject too much insulin because you
have difficulty reading the syringes or vials or
are unfamiliar with a new product.
You inject the right amount of insulin but the
wrong type. For instance, you normally take 30
units of long-acting and 10 units of short-acting
insulin. Injecting 30 units of short-acting insulin
is an easy mistake
to make.
You inject in-
sulin, but then
didn't eat. Short-
acting insulin in-
jections should be
timed with meals.
Blood sugar rises
after meals, but
without eating,
insulin lowers
blood sugar levels
to a potentially
dangerous level. You inject the right amount of insulin but inject
it into an arm or leg just before exercise. Physi-
cal activity can lower blood sugar levels and also
affect insulin absorption:
Don't Symptoms of an Insulin Overdose It doesn't matter how it happens. An insulin
overdose always has the same effect: low blood
sugar levels, or hypoglycemia. Symptoms of hy-
poglycemia include:
Anxiety
Confusion
Extreme hunger
Fatigue
Irritability
Sweating or clammy skin Trembling hands If sugar levels continue to fall during an insulin
overdose, serious complications --
seizures and unconsciousness -- can
occur.
Low blood sugar is defined as less
than 70 mg/dL. Hypoglycemia is
defined as a low blood sugar that
leads to symptoms. Some people
with poorly controlled diabetes can
experience the symptoms of "low"
blood sugar at normal blood sugar
levels (70 to 120 mg/dL).
On the other hand, some people
with diabetes won't experience
these symptoms even at low sugar
levels. For unclear reasons, some
people have few warning signs
when their blood sugars drop. This unawareness
of low sugar is more common in people with
type 1 diabetes.
Being unaware of low sugar levels means you're
at higher risk for insulin problems. You may not
have a warning that your sugar is low until you
become too confused to correct the situation or
become unconscious. Family and friends need to
know what to do if the situation becomes seri-
ous.
NOAH North Omaha Area Health page-4 Spring Issue 2014
UNMC on a Mission of
Sharing SHARING Clinic Mission
It began as a medical
student's vision of providing
quality care to Omaha's
underserved. With the help of a
small group of medical and
nursing students, and under the
guidance of Jim Medder, M.D., a
family physician, and Kathryn
Fiandt, a nurse practitioner, the
SHARING clinics were born.
The UNMC SHARING
clinics strive to enhance the well-
being of the greater Omaha
community by providing high-
quality, low-cost health care and
human services to those in need. In
a multidisciplinary educational
setting, the SHARING clinics
empower patients and instill the
values of service and compassion
in UNMC students.
The SHARING
organization oversees four clinics:
SHARING,
RESPECT,
GOODLIFE
and VISION.
Spanish
interpreters are
available at all
clinics. The
UNMC
SHARING clinic is also
partnered with a dental clinic
operated by the College of
Dentistry in Lincoln, Neb. More
information about SHARING
Dental can be found online at:
http://www.unmc.edu/sharing/
VISION Clinic The VISION Clinic was founded in
March 2011. It provides ophthalmology
services upon referral from the SHARING
and GOODLIFE clinics.
SERVICES: Ophthalmology, diabetic eye
screenings
HOURS: 1 p.m. to 3:30
p.m. on the first
Wednesday of each
month.
ADDRESS:
UNMC Truhlsen Eye
Institute
3902 Leavenworth St
Omaha, NE 68105
PHONE: 402-559-2020
GOOD Life Clinic The GOODLIFE
Clinic opened in
October 2002 to
address the primary
care needs of those
living with type 2
diabetes in the
Omaha community.
Patients must
demonstrate
financial need to be
seen at the GOODLIFE clinic. Those
who attend the clinic receive
comprehensive type 2 diabetes
examinations, laboratory evaluations,
and medications.
SERVICES: Treatment of type 2
diabetes mellitus
HOURS: 5:30 p.m. to 7 p.m. on the
second Wednesday of each month.
ADDRESS: Baker Place
5050 Ames Ave.
Omaha, NE 68104
PHONE: 402-595-2280
RESPECT Clinic The RESPECT Clinic opened in
October of 2001. The clinic provides
confidential testing, treatment, and
counseling for sexually transmitted
diseases. RESPECT is proud to
partner with the Nebraska AIDS
Project. The RESPECT Clinic is open
each Monday of the month from 5:30
p.m. to 7 p.m.
SERVICES: Sexually
transmitted disease
testing and treatment,
HIV testing and
counseling
HOURS: 5:30 p.m. to 7
p.m. Mondays
ADDRESS: Baker Place
5050 Ames Ave.
Omaha, NE 68104
PHONE: 402-595-2280
NOAH North Omaha Area Health page-5 Spring Issue 2012
Health Spirituality staying healthy with Spirituality
What can you do, today, to make yourself healthier?
This can be more difficult to answer than it sounds. There is a lot of pho-
ny advice on the internet that only creates confusion. Sometimes there is
just enough time to get the kids to school safely let alone time to make any
decision. The bottom line, however, is that in order to be healthy you have
to make healthy decisions. If you never decide to eat right or exercise
more, you will end up as an overweight coach potato.
A Health Spirituality helps us to make and carry out healthy decisions.
Over 2500 years ago, Isaiah said that when you have spirituality you
have”the Spirit of wisdom and of understanding, the Spirit of counsel and
of might, the Spirit of knowledge.” This Spirit of Wisdom helps you de-
cide what you need to do and gives you the strength to carry out these de-
cisions.
If you look at all the futile New Year’s resolutions to get more exercise or
quit smoking you may wonder why so many decisions to get healthy fail.
Failure or success is a battle between short term and long term thinking
and short term usually wins.
You have a big role in deciding how healthy you are. Smoking, drinking
too much, and eating the wrong foods all must be initiated by your deci-
sions. All these health decision have short term benefits. Eating a Twinkie
makes you feel good now. Deciding that you won’t eat a Twinkie does not.
You only have to over eat once in a day to gain weight. You have to not
over eat all day to lose weight. Unhealthy decisions give quick results,
healthy decisions take longer.
Spirituality, or the belief in something greater than yourself, makes you less
frightened and less likely to make impulsive decisions. This is the Spirit of
Wisdom that is spoken about in Isaiah. Studies have shown that prayer,
meditation, scripture and church based interventions are effective ways to
improve health by providing a deeper meaning to the effort.
Suppose two people are trying to lose weight. One person is trying to lose
weight to fit into a smaller dress size and the second sees losing weight as a
decision they have made after prayer and meditation. Who will be more
likely to be successful?
Before you answer imagine that both people are driving on Ames St from
72nd to 30th street. How many fast food joints, restaurant, convenience
stores and billboards selling quick and tasty food are there? At each and
every one both people will have to make a decision to follow their diet. It
is a fact that people eat more when they see more fast food signs. To lose
weight a person will have to say No to each and every fast food joint, res-
taurant or convenience store.
In the face of such temptation, it is more likely that the dress size motivat-
ed person will fail. People who have a deeply held belief about what they
are doing will tend to do better.
Now I am not saying that it is wrong to go to Burger King or get some re-
ally good ribs. Far from it, no food is bad. Nor am I saying that all over-
weight people are not good folk who go to Church. However, when a per-
son decides to lose weight they are more likely to carry out that decision
successfully when Health Spirituality is used.
Of course there is more to Health Spirituality than prayers and meditation.
As a preacher friend of mine says, “You have to put the feet to your pray-
ers.” Health Spirituality has to be combined with effective interventions
and behaviors. For example when I use Health Spirituality and weight loss
I recommend people do the following:
Every day decide what you want to eat for the following 24 hours
Keep a written record of what you eat even if it exceeds what you
planned to eat
At the end of the day, review what you ate. Look for feelings of stress,
fear or impulse. Complete this review without shame or remorse.
Weight yourself weekly, again without shame or remorse
Number 1-4 are the most essential to start with. Try and implement these
all at one time. If you feel like you are able, then add the next two. If you
can’t add them immediately then add them when you feel able. The last
two steps are:
Do some physical activity three times a week. Try to increase the
amount slowly with the goal of some physical activity for 30 minutes
three times per week.
Learning something new about healthy eating weekly
These interventions take the focus away from following a diet with it
shame of failure and increasing your awareness of what you eat. They
seem to help the person follow their body’s natural hunger signals.
At the NOAH clinic we are going to run a 6 week weight loss program
using Health Spirituality and these steps. We hope to start
this in April when the weather is nicer. If you would like to be a
part or this call 933-0737 or you can find out more information on
Health Spirituality on my website www.healthspirituality.com
NOAH paper is compiled and distributed by North Omaha Area Health Inc. Black Family
Health and Wellness Association/The University of Nebraska Medical Center and the
Methodist Foundation are one of the many sponsors that support the publication of this
paper. Questions or comments please write the Editor Ira Combs at 5050 Ames Ave Omaha
Nebraska 68104, or email [email protected] or call 402-250-2370.
A Spiritually Based Approach to Weight
Loss/Diet in an African American
Community-The North Omaha Area Health (NOAH) Clinic provides
holistic health screenings in a medically underserved area of Omaha. The clinic
has noted a need for weight loss and dietary
counseling in the client it serves this new
programs pilot project will address weight
loss and diet needs using a holistic approach
including Spirituality. The approach will
focus on the use of Spirituality to make and
carry out healthy decisions. If you are
interested participating in this program
please call us at 402-933-0737 to sign up,
classes will start in May.
NOAH North Omaha Area Health page-8 Spring Issue 2014
By Nick Schinker
Reprinted from New Horizon Newspaper a publication of Eastern Nebraska Office on Aging
If you
Google the word “clinics” in Omaha on the Internet, a map appears covered by colorful dots and markers
that signify health clinics, counseling services, physical therapists
and doctors’ offices. But if you look more closely, the dots aren’t
spread very evenly. Some neighborhoods have fewer dots than oth-
ers.
North Omaha doesn’t have many at all.
“There are more veterinary clinics in north Omaha than peo-
ple clinics,” says Ira Combs, RN, community nurse liaison in the
Center for Reducing Health Disparities at the University of Nebraska
Medical Center (UNMC) College of Public Health. “Pets have better
access to health care than people.”
For many people, when we see something we consider to be
wrong or an injustice to ourselves or others, we complain.
Not Ira Combs. For him, another word comes immediately to
mind: Change.
As one man, he can’t cure all the sickness and disease in
north Omaha. But he can save lives. His medical specialty? Preven-
tion.
“Most hospitals originally were missions run by nuns and
clergy,” says Combs, 62. “Today, a hospital is a business, and the
bottom line of any business is to make
money.”
Combs is concerned by recent
developments in the medical communi-
ty, such as the news that Alegent
Creighton Health System is moving its
trauma center from 30th and California
Streets to Bergan Mercy Hospital at 78th
and Mercy Road.
“I’m a realist,” he says. “It’s my
fear that medical services are moving to
where the money is. So how do we take
care of that? We use prevention and ed-
ucation to keep people healthy.”
Combs’ efforts to educate the
public in healthy habits have earned
him recognition as a Public Health Prevention Champion of Change
by the White House and President Obama. He was one of eight peo-
ple cited this year for “helping communities focus on prevention . . .
to move us towards a healthier America.”
On Sept. 10, Combs was honored at a White House reception
and participated in a panel discussion describing his work.
In the ceremony and on the Champions of Change website,
the White House noted Combs’ many prevention activities:
“Mr. Combs’ work emphasizes inspiring young African-
Americans to become involved in public health. He created a youth
organization, Youth Expressions of Health, which includes an annu-
al Youth Summer Internship Program in partnership with UNMC. It
has helped more than 45 young people prepare for and start college
with a focus on entering the field of health care.
“Mr. Combs also coordinates health screenings and interven-
tions for minority and underserved populations. He is the founding
director of North Omaha Area Health Inc. (NOAH), an agency that
addresses the needs of the underserved in Omaha.
“Working with a handful of dedicated community volunteers,
he is helping to meet the needs of the community including produc-
ing health-oriented materials for kids and sponsoring and maintain-
ing websites and social media networks that link the community
with information about healthy living and health screenings.”
Combs tries to shrug off the accolades. “I’m just doing my
job,” he says. And he has much more work to do.
Ira Combs is one of four children born to the late Virgil
Combs and his wife, Willietter (Ware) Combs, now 94. Originally a
farmer in Missouri, Virgil Combs and his brothers moved to Omaha
to work in the packing houses.
After attending Howard Kennedy Elementary School, Ira
Combs went on to Horace Mann Junior High and Central High
School, where he graduated in 1969.
He was a member of Boy Scouts’ Troop 23 and worked to
become an Eagle Scout. “Our troop master put out seven black Eagle
Scouts,” he says.
It was a turbulent time for the city and the nation as people of
all races demonstrated peacefully and sometimes violently in the ef-
fort to gain civil rights for African
Americans.
“We threw rocks at George Wallace’s
motorcade in 1968 when he spoke at the
Civic Auditorium,” Combs says. “And I
remember people throwing rocks at us.
“I lived at 32nd and Miami Streets, and I
remember going with my friends to 32nd
and Ohio sitting on the hill looking
down at 24th and Lake and seeing the
fires burning during the riots.”
Combs says it was difficult to under-
stand why violence had come to his
peaceful neighborhood.
“Part of me was really rebellious and
resentful,” he says. “But part of me
thinks the community did really well on its own.
“When I was a kid, we had four black doctors in the commu-
nity. Dr. Johnson even made house calls. We had the Ritz Theater
and we had grocery stores and our own churches. Because of segre-
gation, we had our own places. During the time of integration, that’s
when we started having problems.”
He says that when it comes to securing better healthcare, the
black community needs to rekindle a bit of the independent spirit
that fueled the civil rights movement.
NOAH North Omaha Area Health page-9 Spring Issue 2012
“We need to make some changes,” he says. “We need to
change the way our community thinks. We need to be able to look at
our street corners and see stores that don’t just sell liquor and cup-
cakes and cigarettes.
“We have to get that feeling back again, that we are masters
of our own destiny, “ he says, “and not sit back and wait for some-
one to do it for us.”
Education has been a lifelong expe-
rience for Combs.
He earned a bachelor of arts degree
from Grace College of the Bible in 1974
and a Child Development Associate certi-
fication from Iowa Western Community
College.
“After that, I opened a children’s
home,” he says. “That’s where I met my
wife.”
He and Victoria have been married
34 years. They have two daughters, Antoi-
nette and Jimeta, and a son, Caleb.
Ten years after opening the chil-
dren’s home, Combs went back to school.
He received an EMT-Paramedic certificate
from Creighton University and went to
work for an ambulance service.
He continued to explore his options as a health care provider,
earning a bachelor of science degree in health care management
from Trinity University and an Associate Degree in Nursing (AND)
from Metropolitan Community College in 1991.
Combs received advance nurses training in the intensive care
unit at St. Joseph Hospital, where he also received his peritoneal di-
alysis nurse certification in 1993. He is Basic Life Support (BLS)
certified, as well as certified in chemotherapy administration/
oncology nursing and Advanced Cardiac Life Support (ACLS) , and
was an ACLS instructor from 1992 to 1995.
Two days each week, Combs assumes the title of Health Pro-
motion Coordinator and hosts a wellness and medical screening clin-
ic at the Lighthouse Wellness & Community Center, operated at
5404 Ames Avenue by Lighthouse founders and directors Haskell
and Shirley Lee.
In the year that he has been at the Lighthouse, Combs has
screened 280 people for everything from high blood pressure and
diabetes to prostate cancer, sexually transmitted diseases and HIV.
“We are trying to do these screenings in a comprehensive way
and document everything we do, especially when it comes to preven-
tion, “ he says, “because if you do it right, you never know about it.”
As founder and volunteer director of the all-volunteer health
organization, Omahealth, Inc., which also offers free health screen-
ings and education programs, his responsibilities include coordinat-
ing operations; editing the NOAH newsletter; designing the web
page; and producing a monthly cable health program, “Dr. Jesse &
the Prevention Gang” based on one of his puppet characters.
Besides Dr. Jesse, Combs’ puppets include Dr. Healthy (a
woman doctor) and Mr. Jones, who never does anything right. He
also has created a variety of African-American superheroes such as
Prevention Man, Medical Dude and Vernon the Vegetarian Veggie
Bird, and has produced comic books and coloring books with the
characters to make it fun to learn about health.
“To get people to listen, you have to have a marketing plan,”
he says. “You have to be able to get people’s attention. There is
nothing more boring than standing in front of a room full of people
and reading a list of numbers and statistics.
But everybody listens to puppets.”
The puppets are especially helpful
teaching children.
“The best time to talk to a person about
their health is when they are young,”
Combs says. “Habits are easier to make
than to break.”
He tells children about the dangers of obe-
sity and the advantages of eating lots of
fresh fruit and vegetables – and is an exam-
ple of practicing what he preaches.
“I’ve lost 30 pounds in eight months,’ he
says, “all through diet, a better regimen and
cardio-training to burn off the calories.”
It isn’t just to look better. This time, the
nurse is trying to save his own life.
Ira Combs has kidney disease and has been on dialysis for
two years. “There are five stages of renal disease and I am stage
four,” he says. “My kidneys still function, but I need a transplant.”
In order to get on the transplant list, he must lose weight and
prove to be a viable candidate.
As an oncology nurse, Combs saw how devastating it can be
to combine disease and desperation. The battlefield isn’t just in the
body but also the mind.
“I have a lot of friends I have met who are on dialysis, and it
does get depressing,” he says. “To sit in that dialysis chair three
times a week, three or four hours at a time, that’s probably the most
torture for me.”
His work helps by providing purpose, he says.
“I try to prepare everyone to be part of the solution,” he says.
“I tell the kids I teach that I may not always be around but it’s a joy
to me knowing they will be able to pick up where I left off.
“When I teach a young person how to take someone’s blood
pressure, I tell them to go out and not only use that skill but also
teach it to someone else. It’s like Scouts. I learned a lot of leadership
skills teaching others to help others.”
It also goes back to working on his grandfather’s farm in Mis-
souri.
“As a family, we’d go down and help out,” he says, “because
he couldn’t do it alone. And if there was a storm coming, the neigh-
bors would all come over and help, too.
“We need to do a better job of spreading that idea,” he says,
“that we are all neighbors and friends.”
Good advice. Good health. Ira Combs is doing his part to
make certain the Omaha community gets plenty of both.
NOAH North Omaha Area Health page-10 Spring Issue 2014
THE
CRITICAL lack of quality and affordable health
care is devastating for African
Americans. Twice as likely as whites to
go without insurance, African
Americans suffer chronic illnesses such
as high blood pressure and diabetes at
an escalating rate. The root of the
problem is not inferior Black — or
better white — health care. It’s
because only the wealthy can afford
“the best medical care in America.”
Everyone else’s care is rationed by the
employer or private plan that
each can afford to buy, or if
uninsured, by the use of “free”
clinics and emergency rooms.
The debate over the broken
health care system and what to
do about it is one of life and
death. Following many from
the cradle to the grave literally.
The facts don’t lie. The
United States is the only
industrialized country that
refuses to provide health care
for all its citizens on principle.
Health care is considered a privilege,
not a right. The words “preventive
care” and “cradle to grave” are
demonized as “socialistic” and anti-
capitalist — against the American way
of life.
Unlike hundreds of billions spent
on U.S. wars of occupation in Iraq and
Afghanistan, the cost to provide quality
health coverage for all Americans is
considered “too expensive.” The
“right” of the medical groups that make
profits off the backs of sick people is a
foundation principle of the free market
health care system.
It’s not new. In the 1940s the
same forces fought President Truman’s
call for national health care. In the
1960s Ronald Reagan, led the charge
against “socialized medicine.” Reagan
attacked a government-run health care
system for the elderly (Medicare) as
being the sure-fired road to socialism.
He aggressively opposed the
establishment of Medicare.
Thanks to Medicare most retirees
have better health care than younger
citizens who can’t afford high
insurance premiums. In fact, fewer than
10% of Americans with Medicare
coverage say they don’t like it. Not
surprisingly, the right refuses to openly
call for its elimination even as they
attack the Affordable Care Act. The
Veterans Administration is another
successful government-run health
program. It provides a program that is
superior to most private for-profit
plans. Yet it came under attack by
President Bush who sought to gut the
VA and shut hospitals. This was only
stopped by scandal when the public
learned how our veterans were not
getting the treatment they expected.
The problems with Medicare and
veterans care are mainly about money,
as privatization hawks seek to starve
the programs to get the private sector
back. Both Medicare and the VA
programs provide better health care
than the private sector — and,
significantly, equal care to all racial and
social groups.
With the profit motive taken out
by the government, the service is more
“socialized.” The limitations of these
programs are primarily due to
Congressional attempts to underfund
them, not administrative inefficiencies
that are comparable to the private
sector and much cheaper to taxpayers.
These two government programs could
be the basis to build fair medical
coverage and provide universal
care. Most importantly, they show how
a government solution could begin to
close the racial gap in the type of care
provided to Blacks and Latinos. By
closing the gap we would
then reduce the broad
health disparity margins
between minorities and the
rest of the American
population and increase the
years that minorities live
between the “cradle-to-the-
grave”. The Affordable
Care Act , as wounded and
beat up as it is by
politicians, is still by far the
best news the uninsured
and underinsured have
received in a long time.
From the
cradle to the
grave black youth
in North Omaha experience a set
of circumstances that are rooted in
a segregated set of circumstances.
Not that kind of "for whites only
restroom" type of segregation, but
a set of conditions that make it
clear that North Omaha's social,
economic and political context has
an impact on their lives that they (Continued on page 11)
Ira Combs-RN
Editor NOAH
Matthew Stelly
Triple-one
Neighborhood
Association
NOAH North Omaha Area Health page-11 Spring Issue 2012
have to deal with on some level.
But whatever the situation, one
thing is clear: the negatives cannot
be avoided and the positives have
to be pursued. There is little
ascribed status (that which they
inherit), only that which is
achieved (and that is controlled by
outside forces and sources).
There are groups that are
working for empowerment in the
North Omaha community. They
are doing it in a holistic manner by
bringing in all the groups, and all
the stakeholders. But linked to an
empowerment effort has to be a
survival part because the latter is
much more important than the
former. Without a need to survive,
empowerment efforts won't and
can't be appreciated.
Empowerment is a luxury for
those who can appreciate it;
survival is a concrete need. The
Empowerment Network has done a
great job in addressing both .
From the cradle we have an
infant mortality rate that is almost
triple that of the rest of the city.
That means that black babies have
a higher rate of death - before they
even get to the cradle - than other
kids do. The lack of transportation
oftentimes makes prenatal health
care difficult, and even when it is
accessible, the funding to afford
what is needed means that the
mother is going to be a ward of the
state in some capacity. And in
Nebraska, being a ward of the state
does not protect that child from
being abused: the foster care, day
care and social service programs,
as recognized by the Federal
government on a number of levels,
has a long way to go before it
practices the kind of cultural
competence that can have a direct
and positive impact on that family
and as a result, that child. Older
Black men are twice as likely to
die from prostate cancer as their
white counterparts, but do you see
any local medical institutions
putting together a comprehensive
programs to address this
disparity?
(Continued from page 10)