SUCCESS STORY

For the past 10 years, Dawn has managed her Chronic Obstructive Pulmonary Disease (COPD ) with the help of her doctor. However, last summer, Dawn’s disease worsened and she became oxygen-dependent. She was hospitalized for several days and came home to be cared for by a Natick VNA nurse. The nurse recommended that Dawn participate in the agency’s Telemonitoring Program. Dawn agreed, and the nurse placed a small electronic device in Dawn’s home. At a pre-determined time each day, Dawn is prompted by the monitor to take her vital signs: blood pressure, blood oxygen saturation and weight. The results are immediately transmitted to the Natick VNA by phone line and received by a nurse. If any results are out of the normal range determined by Dawn’s physician, Natick VNA staff swing into action. Several times throughout Dawn’s care, her blood pressure was out of normal range. The Natick VNA staff faxed the results to Dawn’s cardiologist, who immediately adjusted her medication. At other times, Dawn’s oxygen saturation and weight were out of range, and the Natick VNA sent a nurse to further evaluate Dawn’s condition. The physician was contacted and he and the Natick VNA nurse were able to prevent an exacerbation of Dawn’s illness, preventing her from going to the hospital.

The use of telemonitors enables the VNA to provide a complete circle of care for our patients. Dawn and her family are comforted by knowing her status is being monitored on a daily basis and that her entire health care team is working together to keep her healthy.

HEALTHY HABITS

Lions and tigers and bears, oh my! Lions and tigers and bears, oh my! That’s about how I feel when I try to read food labels in the supermarket. Trans fats and whole grains and carbs, oh my! Luckily, for those of us who find this all just a bit too confusing, the Center for Nutrition Policy and Promotion, an organization of the U.S. Department of Agriculture (USDA), has updated the food pyramid in an effort to help us figure out just what we should be eating to stay healthy.

The new pyramid reflects updated dietary guidelines and also incorporates physical activity. Ginger Hoffman, Registered Dietitian with the Natick Visiting Nurse Association, says that the “updates focus on tailoring calorie intake and portions to individuals, and incorporate general health recommendations as a means to improve the overall quality of the American diet. The recommended changes are meant to increase nutrient intake, decrease consumption of unhealthy fats and increase plant-food intake to prevent chronic diseases, and encourage healthy weight by monitoring calories and increasing activity.”

The USDA’s Dietary Guidelines describe a healthy diet as one that emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products; includes lean meats, poultry, fish, beans, eggs, and nuts; and is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars. The new pyramid creates a separate category for oils and gives specific guidelines for portions. Also, each group comes with specific recommendations:

• Grains – half should be whole grains
• Vegetables – including dark green and orange
• Fruits – fresh, canned, frozen or dried
• Milk Products – try to find low fat or fat free varieties
• Meat/Beans – including lean meats, poultry and fish, beans, seeds and nuts
• Oils – choose carefully

There are 12 versions of the pyramid, which take into consideration individual variations, including age, gender, and a person’s level of physical activity.

Hoffman points out that “by going to the website www.mypyramid.gov you can enter your age, gender and activity level and you will be given a calorie level to follow to maintain weight. The old pyramid had general ranges for each food group, but you had to guess how many calories and portions you would need. With the new pyramid, you can get customized guidelines, specific to you.” The recommendations are specifically for people over the age of two, but www.mypyramid.com also has a wealth of resources for parents, educators and kids, helping to make these concepts easy for kids to understand. So, don’t be afraid. Go ahead and read those labels.