The Botsford Rapid Assessment Team, or BRAT, springs into action the instant subtle signs of decline are noticed in a patient. Their goal: Quickly assess and intervene to prevent a code blue, sepsis and even death.

You’ve probably seen TV shows where someone is in the hospital and he “codes.”  Doctors and nurses come running and try to save the patient — sometimes it works, sometimes it doesn’t.

“Code Blues,” as they’re called, happen in real life too.  A code blue is a term used by hospital staff to alert rescue personnel that a patient’s heart has stopped.  Only in real life, doctors and nurses at Botsford Hospital are trained to prevent a code blue in the first place, greatly increasing a person’s chances of survival.

How is a code blue prevented?

Doctors and nurses are trained to recognize even the most subtle signs of decline in a patient.  The earlier a decline can be recognized, the sooner intervention can be made and the more likely a patient can avoid more serious outcomes such as a code blue or organ failure.  If something looks amiss, a highly specialized team of critical care-trained nurses and respiratory therapists are called to assess the patient.

Enter the BRAT (Botsford Rapid Assessment Team)

Within minutes, the team arrives with advanced critical care equipment and is able to determine whether intervention is necessary.  The patient’s doctor is summoned when appropriate and the entire team takes steps to prevent further decline such as a code blue.

What does it mean to have the BRAT?

Having the rapid assessment team available at all times means every bed in Botsford Hospital can be quickly turned into a critical care bed as soon as the need arises.  More importantly, patients may avoid the need for critical care in the first place.

For at least one Botsford patient, it also meant a second chance at life — both in and out of the hospital.  “God sent an angel,” he wrote in a thank you card to the team after he was was discharged.  He explained that not only did the team save his life, but the fact that they cared so much and tried so hard to save him gave him the drive to get better.  In his case, his nurses and the BRAT caught him in the first of three phases of sepsis, aggressively treated him and prevented him from entering more dangerous stages of sepsis, where the survival rate drops to only 10%.

Judith, a participant in Botsford's cardiac rehab program, chooses from the breakfast bar while program manager Donna Binns-Gordon, RN, BSN, MS helps out with heart-healthy eating tips.

Eating healthfully is good for your heart.  So much so, that Botsford’s cardiac rehabilitation team today treated their program participants to an oatmeal and yogurt breakfast bar with plenty of fixings like fresh fruit, granola and low fat milk.

The cardiac rehab team says they’re doing it to demonstrate healthy eating practices to participants, who are all recovering from a cardiac event such as a heart attack, stent placement or even open heart surgery.  Because of their recent cardiac event, the participants need to change their diet.

But there’s really more to it than that.  “We wanted to give something back to [our patients] because they’re such nice people and we get so attached to them,” said Donna Binns-Gordon, the rehabilitation program’s manager, registered nurse and exercise physiologist.  Donna’s team and several cardiology practices at Botsford chipped in to host special educational events for the cardiac rehab patients throughout February, which is American Heart Month.  Other events include a smoothie day and a heart healthy recipe exchange.  The groups also purchased a stereo for the workout area.

The goal of Botsford’s cardiac rehabilitation program is to get participants back to where they were before their cardiac event — improving their endurance and strength — and to help them make positive lifestyle changes.  Lifestyle changes such as eating right and getting exercise are vital to recovery from a cardiac event.

Nurses, exercise physiologists and even dietitians are involved in giving participants hands-on education.  They monitor workouts and review the weekly food diaries kept by the participants.  A one-on-one review of a food diary gives the participant customized suggestions to improve their eating habits and helps them understand how food can improve their lifestyle and recovery process.

As a result, cardiac rehabilitation participants learn how to eat healthfully as part of a new routine, rather than just having to endure another “you have to eat better” lecture from a doctor.  Oatmeal and yogurt were chosen for the breakfast bar to demonstrate how you can incorporate protein, fruit and carbohydrates into a balanced meal that will promote heart health, energy and strength.

For more information

For more information about heart care at Botsford, search for a Farmington Hills area cardiologist or call 1-877-DOC 1 (1-877-3621) Monday through Friday 9 a.m. to 5 p.m.  For more general information about cardiology services at Botsford or heart health articles, visit Cardiology services on our website.

By making better choices and taking appropriate steps, the facts provided by NHTSA (National Highway Traffic Safety Administration) will aid in having a safe and enjoyable Super Bowl celebration.

Let a Sober Designated Driver Be The Key to Your Super Bowl Safety:  Fans Don’t Let Fans Drive Drunk

Impaired Driving Can Be Deadly

• The NHTSA along with the National Football League (NFL) and Techniques for Effective Alcohol Management (TEAM) Coalition, want to remind everyone who will be drinking while watching the Super Bowl to create a game plan to get home safely.
• Designated drivers should be well rested and prepared to drive any distance that is required to get their impaired passengers home safely.
• Over 175,000 NFL fans pledged to be designated drivers this season – a new record.
• In 2010, 10,228 people were killed in motor vehicle traffic crashes that involved at least one driver or motorcycle rider with a blood alcohol concentration (BAC) of .08 grams per deciliter or higher.
• One way to avoid impaired driving crashes is when everyone huddles up and designates a sober driver to safely transport their friends and family, who have been drinking, home.
• Designated drivers should be over the age of 21 have a valid driver’s license, and promise to not drink alcohol before or during the game.

Do You Know the Cost?

• Having your driving privileges taken from you is not worth a night of drinks.
• Some past drunk driving offenders have also received additional penalties like:

1. Higher insurance rates;
2. Having their vehicle towed; and
3. High repair costs.

If you are hosting a Super Bowl party, take appropriate steps to prevent anyone from driving
while impaired:

• Make sure all of your guests designate their sober drivers before kick-off or help arrange ride-sharing with sober drivers.
• Find unique ways to reward the designated drivers at your party:
  • Give them a great spot to watch the game.
  • Whatever non-alcoholic beverage they are drinking, make sure their glass is always full.
  • Let them have the first pass at the buffet table.
  • Make sure their cars are easy to access when it is time to start driving people home.
• Serve plenty of food.
• Offer a variety of non-alcoholic choices like soft drinks, juice, and water.
• Serve one drink at a time and serve measured drinks.
• Only serve alcohol to guests over 21 years of age.
• Determine ahead of time when you’ll stop serving alcohol, such as one hour before the end of the party or at the end of the third quarter of the game and begin serving coffee and dessert.
• Add the numbers of local cab companies into your phone so they are just one touch away.
• Be prepared for guests to spend the night if an alternative way home is not available.

If you are attending a Super Bowl party or watching at a sports bar or restaurant:

• Designate your sober driver before the party begins and leave your car keys at home if you plan to drink.
• Avoid drinking too much alcohol too fast. Pace yourself—eat enough food, take breaks and alternate with non-alcoholic drinks.
• Find unique ways to recognize the designated drivers when you are out at a bar or restaurant:
  • Offer to be the designated driver the next time you go out.
  • Cover the cost for parking or even pay for a tank of gas.
  • Whatever non-alcoholic beverage they are drinking, make sure their glass is always full.
  • Pick up the tab for their food and drink.
• Before you go out, add the numbers for local cab companies in your cell phone.
• Always buckle up – it’s your best defense on the road.

Remember, Fans Don’t Let Fans Drive Drunk

Additional information can be found on NHTSA’s Super Bowl XLVI page

Rhonda Thompson, RN, Injury Prevention Coordinator, Botsford Hospital Trauma Services, 28050 Grand River Avenue, Farmington Hills, MI 48336. rthompson@botsford.org

How to reduce stress

Try these relaxation techniques to help reduce stress and improve your overall health.

1.  Breathing in Peace and Exhaling Stress:  Inhale through your nose to the count of seven.  Then, with lips puckered, exhale very slowly through your mouth to the count of 14. Concentrate on the long-sighing sound and feel tension dissolve.

2.  Diaphragmatic (Deep) Breathing helps to reverse the stressful breathing pattern.

• Inhale slowly and deeply through your nose pushing your abdomen out as far as possible.  (Count to four)
• Let your shoulders and neck muscles relax.
• Begin to exhale slowly and comfortably
• Focus on any awareness of relaxation (ocean)
• Repeat steps 1 to 4, 5 times

3.  Mini Vacation: Think of a place in nature that represents relaxation to you.  It may be a place you have been before, or a place you would like to visit.  It may be by a body of water, or in a quiet meadow or forest or perhaps in the mountains.  Step into that experience, just like it is happening now.  See what you see.   Hear what you hear.  Feel what you feel.  Is there something you smell or taste?  Make all the colors brighter, closer, more clear..  Make all the sounds more pleasant. Enhance all the good feelings and sensations.  Stay there until you are ready to come back to this time and place. Bring the peaceful, pleasant feelings back with you.

4.  Thought Shifting:  Thoughts create feelings. Choose thoughts that bring you relief and make you feel better. Ask yourself: 

• What could I appreciate right now? Look around you (a flower, a supportive person, a baby, your comfortable surroundings.
• What is working in my life right now?
• How else could I look at this, so I can feel better?
• What music could I listen to that would lift my spirits?
• What can I think of now that would make me smile, or laugh?

5.  Mental Relaxation or Meditation:  Take a few deep, relaxing breaths.  Allow all of your muscles to feel warm, loose, and relaxed.   Follow the path of your breath.  Think “in” on the in breath and “out” on the out breath.  When thoughts occur, and they will, just return to your focus on your breathing.  Let your thoughts slow down. Quiet your mind and body.  Give your mind a rest from thinking and mind chatter.

6. The Quick Calming Response can be used to offset a stress reaction.  Stress reactions produce feelings of being tense, irritated, anxious and angry; whereas a calming response produces relaxed, open-minded, calm and friendly reactions within the body.

• When you begin to feel a stress response within your body, take a few seconds to turn on your “quick calming response” by saying to yourself:  “My mouth will smile, my eyes will sparkle, my mind will be alert, my body will be calm.”
• Then take a slow easy deep breath and then slowly let your breath out allowing your body to relax as you exhale.
• Allow a feeling of heaviness, like a wave of warmth, to flow throughout your body all the way down to your toes.
• Then resume your normal activity.

Try a few of these techniques to see which works best for you. When you begin to practice them regularly, eventually they will become second nature to you and virtually automatic.  You will become in control of your body and let go of the stress response.

To learn more about managing stress and stress reduction techniques, attend our free Stress Management seminar on February 9th, 2012.  There, a Botsford Hospital nurse will explain coping and adaptation techniques for adults. Also discussed will be various stressors and circumstances of life such as aging, depression, general changes in health and well being.

What stress reduction techniques work for you? Share them with us in the comments below.

Marketing Intern Kimberly Ivey shares her experience at Botsford Hospital to give you a sense of what it's really like within the walls of a hospital.

Most people find hospitals to be a scary place… a place that’s cold and full of tears. Not me, and definitely not Botsford. My name is Kimberly Ivey, Botsford’s new Marketing Intern, and before I started here last Monday I was nervous, scared, excited, basically any emotion that exists. I was nervous that I wasn’t going to fit in, scared that I would fail, but excited about the place that I would soon call my employer. And as an intern, I was worried that I would get treated like an intern and not like a team member. But since the day I started here at Botsford I have been welcomed with open arms by every single person I have come into contact with and have been treated like family.

I truly do believe that I could not have found a better internship even if I tried. I have already learned so much in the last two weeks that I can’t even begin to imagine what the next few months will have to offer. I have already been able to write news releases, attend several meetings, met Dr. LaCasse, the president of the hospital, a couple of times, and of course stuffed some envelopes too.

Yesterday, I pushed around a snack cart to everyone on the first floor and as awful as that may sound to some people, it was pretty amazing. I have never been greeted with so many smiles in my entire life. Everyone was in a good mood and genuinely seemed happy to be there. But by far the coolest thing I have experienced so far was to hear the sound of a baby’s first cry while working the snack cart in Labor and Delivery.

So when I look at a hospital I see the hope and warmth behind every single doctor’s, nurse’s, and even valet driver’s eyes. I don’t see a cold and scary place. I see a place of smiles, encouragement, and life.

Have you ever worked for, visited or been admitted to a hospital? How has your experience compared? Please share in the comments below.

However, now chronic sinus sufferers have another option called balloon sinuplasty.  Balloon sinuplasty is minimally invasive, causes less pain and requires less recovery time (most patients can return to normal activity within 24 to 48 hours.)  This is possible because rather than using rigid surgical instruments and removing tissue from sinus passageways, the balloon sinuplasty procedure uses flexible materials and a balloon to simply widen those passageways.

If you suffer from chronic sinusitis symptoms, it might be worth your time to learn more about this new procedure.  Discuss it with your doctor or come to Botsford’s free balloon sinuplasty seminar tomorrow (1/17/12).  Botsford ear, nose and throat specialist Dr. Matthew Farrugia will explain the procedure in more detail.

Balloon sinuplasty seminar details:

• Tuesday, January 17 6:30 p.m.
• Free
• Pre-registration required by calling 1-877-477-DOC1 option #1
• Botsford Hospital A&E Center, Community Room
• Share the event with your Facebook friends

During cancer treatment it may be difficult to eat due to loss of appetite or other side effects. Our registered dietitian offers tips to help you eat well.

One of the most common questions when a patient is seen at the Botsford Cancer Center is “What should I be eating, or not eating?” It is encouraged to maintain a balanced diet, which includes: lean proteins and lots of whole grains, fruits, and vegetables.  Also, avoid foods that are high in fat and sugar.

When you have cancer it is extremely important that you eat well to keep up your strength and help cope with side effects that you may experience from treatment; whether it is radiation, surgery or chemotherapy. When you are healthy, eating enough food is not often a problem. But, when you are dealing with cancer treatment, this can be a real challenge.

Generally speaking, the body needs a balance of calories and protein to function at its best.

Prior to treatment it is important to prepare your body by eating a healthy diet. This can increase your strength, prevent your muscle mass from breaking down, and help you fight infection. It may even help you withstand the side effects of treatment.  While cancer treatments are designed to kill cancer cells, these treatments can also damage healthy cells. Side effects may present themselves when these healthy cells become damaged, which can lead to eating problems.

Common eating problems during cancer treatment include: appetite loss, changes in sense of taste or smell, constipation, diarrhea, dry mouth, lactose intolerance, nausea, sore mouth, sore throat and trouble swallowing, vomiting, weight gain and weight loss.

Each patient is different and assessed on an individual basis. For this reason, there is no way to know if you will experience eating problems and, if so, how bad they will be.  Side effects and eating problems will depend on the type of cancer you have, where it is on your body, what kind of treatment you are receiving, how long treatment lasts, and the doses of treatment you receive.  Sometimes side effects from cancer or its treatment can make eating a difficult task. When this happens it becomes increasingly difficult to follow general nutrition guidelines, and you may need to consider changing your eating plan.

If you start to have eating problems and are unsure of what to eat, tell your doctor, nurse or dietitian right away.

Tips for getting the most from your meals

While undergoing cancer treatment, large meals can seem overwhelming. They may also seem unappealing. This may be due to a decreased appetite and early fullness during meals. The following suggestions might help you get enough calories and protein:

1. Eat small meals 5-6 times daily instead of 3 large ones.  Eat larger meals when you feel well and are rested
2. Serve your reduced portions of food on salad plates instead of dinner plates
3. Drink liquids that are high in calories such as hot chocolate, fruit juices and nectars.
4. Avoid low-calorie drinks such as water, coffee, tea, and diet drinks.
5. Keep snack foods that appeal to you readily available at home and at work
6. Eat your favorite foods at any time of the day
7. Use a variety of colors and textures to make food appealing.  Change the form of food-for example, make a fruit milkshake instead of eating a piece of fruit.
8. Make dining a good experience. Do this by creating a pleasant and relaxed atmosphere
9. Aromas such as bread baking or bacon frying may help boost your appetite
10. When it is hard to eat, drink a liquid or powdered meal replacement such as: Ensure, Boost or Carnation Instant Breakfast
11. Drink liquids throughout the day, even when you do not want to eat

The special preview of the new Botsford Trauma Center commercials was held at the Farmington Civic Theater in downtown Farmington, MI.

Last night we began airing our new ads for the Botsford Trauma Center.  We wouldn’t normally blog about a hospital advertising campaign, but we think this one is pretty special.

The new ads feature real patients telling their real stories. Like Ruth, who suffered instant cardiac death and not only survived, but was one of the few to do so without permanent brain damage.  And Steve, who fell 25 feet and was able to walk out of the hospital after several surgeries.  The new ads are emotional and tell the Botsford story from the only perspective that matters — that of the patient.

So far the response has been great!  Last night, the commercial’s stars, their friends and family and others were treated to a special preview at the Farmington Civic Theater. As viewers made their way out of the theater they gave some great feedback.  One viewer even said the ads gave her goosebumps.  You can see photos from the event on our Facebook page.

What do you think about the new Botsford Trauma Center ads? Watch them below and let us know by leaving comments here or on our Facebook page. We look forward to hearing your feedback.

“Michigan’s seniors are especially vulnerable during the cold Michigan winter months. Topping the list of issues seniors are most susceptible to are influenza, hypothermia, and slips and falls,” said Kari Sederburg, Director of the OSA. “It’s important to draw attention to these risks so that every family can have a warm, safe and happy winter.”

OSA has a few tips for residents preparing for the winter:

●  Get your flu shot if you haven’t already done so. The flu can wreak havoc on older adults and anyone with a weakened immune system, respiratory issues, or heart disease.
●  Wash your hands often with soap and clean running water for at least 20 seconds. Stopping the spread of germs is especially important in the winter.
●  Bundle up to stay dry and warm. With age, the body becomes less able to respond to long exposure to very cold temperatures, sometimes resulting in hypothermia – a drop in internal body temperature – that can be fatal if not detected or treated.  When going outside, dress appropriately for comfort and safety. Wear a hat, gloves, light layers of clothing, a coat, and proper footwear.
●  For homeowners, make plans with a neighbor, friend, or family member to have porches, sidewalks, and driveways cleared of snow and ice. Falls, a concern for older persons, are more likely when ice and snow are present. Further, the strain that shoveling snow can place on the heart during cold weather increases the risk of heart attack.

While these common sense approaches will go a long way toward staying safe, comfortable, and healthy during Michigan’s cold weather months, calling 9-1-1 is almost always the fastest way to get lifesaving treatment should you need it. Emergency medical services staff can begin treatment when they arrive, up to an hour sooner than if taken to the hospital by car.

For more information or assistance, residents can contact their local Area Agency on Aging or OSA at (517) 373-8230 or www.michigan.gov/miseniors.  You can also learn more about older adult services provided by Botsford Hospital.

For cancer patients

• improved attention, awareness and emotion
• increased ability to recognize and accurately label emotions
• increased and refined self-awareness
• a positive influence on some other specific stress-related medical conditions including psoriasis, type 2 diabetes, fibromyalgia, rheumatoid arthritis, chronic low back pain and attention-deficit disorder
• greater meaning and peace in one’s life as well as enhanced relationships with others which allow measurable freedom from suffering

Much of the research regarding meditation for cancer patients has focused on the outcomes of patients with breast cancer. Nidich, et all published a 2009 study comparing the outcomes of breast cancer patients who incorporated transcendental meditation into care with those who did not. The group who meditated demonstrated improved emotional well-being, social well-being, and better overall mental health.

Another 2010 study supported the use of a psychological program developed at The University of Massachusetts Medical Center entitled Mindfulness-Based Stress Reduction (MBSR) for breast cancer survivors. This program was shown to assist cancer survivors as they completed treatment and transitioned to their “normal” lives. The study focused on cancer survivorship, an area of cancer care that is receiving more and more attention. The authors found that after cancer treatment, “when patients are ‘discharged’ from medical care, they may be faced with may unresolved existential questions pertaining to the meaning of life and its manageability and comprehensibility” (Matsousek and Dobkin 2010). Meditation for this group of breast cancer survivors demonstrated positive outcomes including openness to change, self-control through self-awareness, embracing shared experience, personal growth and increase spirituality. The MBSR was felt to fill “a health service gap, possibly allowing the patients to learn to navigate and stay afloat in what may seem to be the large and small waves of their transformed lives” (Matsousek and Dobkin 2010).

Meditation has been described as “a wakeful hypometabolic physiologic state” allowing one to relax and reach an increased sense of focus at the same time. Controlled, deliberate breathing and purposeful thinking are generally key skills for all levels and forms of meditation. Meditation has sub groups, or styles, defined as; attention training, focused meditation, and mindfulness or insight meditation.  The specific style and frequency of meditation varies depending on one’s schedule and desired outcomes. For oncology patients, meditation may not be convenient during times of intensive treatment but may be valuable upon treatment completion.

The Botsford Cancer Center leadership and staff recognize the health benefits of several therapies and cancer patient support services including meditation, Reiki therapy, and massage therapy for our patients. We receive positive comments and observe the successes of these treatments as they compliment our medical care and therapy. These therapies assist patients and their loved ones throughout their cancer care journey.

To learn more about the Botsford Cancer Center or any of its patient support services, contact us any time.

References;

Matousek, R. H. PhD, and Dobkin, PhD; Weathering storms: a cohort study of how participation in a mindfulness-based stress reduction program benefits women after breast cancer treatment. Current Oncology 2010

Nidich, Sanford, Fields, Jeremy, Rainforth, Maxwell, Pomerantz, Rhonda, Cella, David, Kristeller, Jean, Salerno, John, and Schneider, Robert; A randomized controlled trial of the effects of transcendal meditation on quality of life in older breast cancer patients. Integrated Cancer Therapies 2009

Greeson, Jeffry PhD, MS; Mindfulness research update, NIH Publications 2009

Biegler, Kelly, Chaoul, Alejandro, & Cohen, Lorenzo; Cancer, cognitive impairment and meditation. Acta Oncologica 2009