Good Medicine for Pennsylvania: Aug. 2009

Got shots?
As many Pennsylvanians send their children back to school, we’re all reminded about the importance of immunizations. We often prioritize them for our children, but forget to stay up-to-date ourselves.

By staying up-to-date on recommended immunizations, you protect yourself, your family, friends and your community from serious, life-threatening infections. Yes, most immunizations are administered during early childhood, but others are recommended during adolescent or adult years and some require boosters throughout your life.

We’ve all seen how quickly bacteria and/or a virus can spread after the recent H1N1 outbreak. Vaccines save lives. They’ve eradicated smallpox, eliminated polio in our country and significantly reduced the number of cases of measles, diphtheria, rubella, whooping cough, and other diseases.

Worried about the safety of some vaccines? Medical evidence has proven that the risk of disease is higher than the risk of adverse effects from immunizations. Some parents fear that there is a link between autism and vaccines. So far, no scientific evidence has supported this concern, according to the Centers for Disease Control and Prevention (CDC).

Vaccines are tested and studied for as much as 10 years before they are made available to the general public, and most side effects are mild—swelling, redness, and tenderness at the injection site. As with any medication, vaccines can cause some side effects, or allergic reactions, in small numbers of people.

Your doctor can address any concerns you might have. And please make sure that you and those around you are up-to-date.

New hope for pain
Pain is a big issue. Every year during our statewide “Docs on Call” programs, hundreds of patients call in with questions about chronic pain. Pittsburgh-area physician Doris K. Cope, MD, isn’t surprised.

“People are living longer and eventually, their bones wear out. That means more pain. And those who live long want to live well. They don’t want to sit around; they want to enjoy life,” Dr. Cope says.

To an aging population, advances in pain management and treatment can significantly improve their quality of life.

“We have so much more to offer now—radio-frequency treatment, nerve blocks, injections, steroids, and implantation. For example, an intrathecal pump can deliver less than one-hundredth of a standard opioid dose, but it’s going directly to the spinal pain receptors, and it’s much stronger—with fewer side effects,” Dr. Cope says.

Dr. Cope encourages people with pain to seek help.

“There are so many options these days that fall somewhere between Tylenol and surgery. It’s definitely worth a discussion with your doctor. If you’ve had pain for three months or more and it impacts your lifestyle, then it’s chronic pain. Pain affects everyone, not just the patient. Once your pain is lessened, you and everyone around you can enjoy life that much more,” Dr. Cope notes.


Looking ahead
End-of-life issues are difficult to face. But the stress of coping with a terminal illness can be lessened by talking with your doctor and family members about options as the disease or condition progresses.

Pennsylvania Medical Society member physician Deborah Way, MD, medical director of the Hospice of Philadelphia, encourages terminally ill patients, their families, and their doctors to have that difficult discussion.

“Do you want to prolong life as long as possible? Or does quality of life matter more? The answer is different for everyone,” she says.

Hospice care focuses on quality rather than length of life. The goal is to enable patients to continue an alert, pain-free life and to manage symptoms so that their last days may be spent with dignity and quality, surrounded by their loved ones.

“Once a decision is made, if hospice care is chosen, then medical treatment shifts from curative to palliative, with comfort being first and foremost,” adds Dr. Way.

A hospice team—doctors, nurses, social workers, counselors, home health aides, clergy, therapists, and trained volunteers—work together to treat the physical, emotional, and spiritual needs of the patient. Care most often takes place at home but is also provided in freestanding hospice centers, hospitals, nursing homes, and other long-term care facilities.

“I wish more families would consider hospice sooner than later,” notes Dr. Way. “Frequently, we treat patients in their last two weeks of life. But we could do so much more to improve their quality of life if contacted earlier on.”

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Last Updated: 9/8/2009
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