Usually this time of year, the focus of Monongalia County Health Department’s Thanksgiving column centers around food safety and how to correctly prepare a turkey and all the fixings.

To that end, if you do have plans to serve a bird and the trimmings — to what we hope is a small group that only includes members of your household — cook the turkey and stuffing to 165 degrees Fahrenheit. 

The Centers for Disease Control and Prevention also has handy tips for handling the turkey safely while thawing it and before cooking, as well as for storing any leftovers you might have.

Perhaps you will have more leftovers than usual. Because this holiday season, as we all know, is different. You still want your food to be safe, but this year requires extra precautions, as the county, state and country experience yet another surge in COVID-19 cases. 

We know everyone wants a sense of normalcy after a heartbreaking year. For Thanksgiving, that usually means gathering together, sometimes traveling to a relative’s home to do so.

The CDC has something to say about that too:

“Travel may increase your chance of getting and spreading COVID-19. Postponing travel and staying home is the best way to protect yourself and others this year.”

Dr. Lee B. Smith, MCHD executive director and county health officer, also recommends that only members of individual households celebrate the Thanksgiving holiday this year.

“We completely understand that these aren’t easy decisions to make, because we’re having to make them too,” Dr. Smith said. “But if we don’t modify our Thanksgiving plans, COVID cases will only continue to rise, and then we will see another surge just in time for Hanukkah and Christmas.” 

My family is dealing with this too. My mother has spent a good portion of the year on lockdown in the senior living community where she resided. When she moved into her own apartment a couple of months ago, a bright spot was the idea of being able to spend the holidays with her. 

But COVID cases keep rising. West Virginia is seeing record numbers of cases. It’s not uncommon for more than 10-plus deaths to be reported statewide on a daily basis. In fact, it’s usually more than 10, and rarely fewer. On Friday, it was 16. 

My family finally realized that a phone call or a Zoom chat will constitute our Thanksgiving visit. 

For those who do plan to get together with outside members of your family, you know the drill. Wear masks. Wash your hands. Maintain a social distance. Yes, two of those make hugging difficult. That’s the point.

When it comes time to eat, it also would help not to be in close quarters around a table. Because you obviously have to take your masks off. Perhaps have a buffet and stagger times among family members who can spread out as they dig into their meals. It’s supposed to be 55 degrees Thanksgiving afternoon. Some families might think that’s warm enough to eat outside, which would be the safest option.

And remember, COVID testing prior to gathering together can be a good idea, but unless you quarantine and then take extra precautions while traveling, the test is only going to reveal what your status was on the day you were swabbed.

There are no perfect solutions. But there are manageable ones. Yes, it’s a bitter pill to take. However, you can still communicate with your family members and you can still eat a lovely meal. 

This will help to ensure that everyone is still around to celebrate the new, and hopefully brighter, year that begins five weeks later. 

Antibiotics are recognized as one of the most important medical innovations we have at our disposal. They are a life-saving treatment for reversing both common and serious infections. But they need to be used carefully so that we can continue to use them in the future. 

Antibiotic Awareness Week is held to promote just that. Held annually, this year from Nov. 18-24, this observance is dedicated to highlighting safe prescription methods and usage.

Over-prescription of these drugs have raised serious concerns in recent years. The Centers for Disease Control and Prevention estimates that approximately one in three prescriptions are unnecessary. 

The most common cause for this is doctors prescribing them to treat common respiratory illnesses such as the common cold or sinus and ear infections. Excess antibiotic treatments put patients at risk for allergic reactions, but most importantly, it contributes to resistant bacteria.

Antibiotic resistance occurs when germs develop the ability to overcome the drugs designed to kill them. Each time the drugs are used, there is a potential for some bacteria to survive. Surviving bacteria become stronger as a result and are eventually able to grow stronger populations that render antibiotics useless.

Also, antibiotics only work against infections, not viruses, such as the common cold or influenza. Sometimes they might be prescribed to treat an infection that developed from a virus, but antibiotics will do no good toward healing a viral illness.

So what can we encourage in our communities to prevent resistance? The CDC lays out four methods to help defend from it:

Prevent infections — This may seem like an obvious step, but its importance cannot be understated. Fewer infections in the population mean less uses of antibiotics. This reduces the possibility for resistant colonies to develop and spread to other communities. If you suffer an injury, keep the wound clean and dressed. Wash your hands. Prepare food safely.

Tracking -- Encourage doctors to report serious infections. The data can help officials track causes of infections and resistance of bacteria. Proper tracking ensures powerful bacteria and illnesses from spreading to other communities.

Improving antibiotic prescribing — Possibly the most important action is to change how antibiotics are used. The CDC estimates that in humans and animals combined, almost half of prescriptions/treatments are unnecessary. This again presents the risk of allergic reactions, and more importantly bacterial resistance. Antibiotics need to be used only when necessary.

Developing new drugs and tests — Antibiotic resistance is ultimately a natural occurrence. Plants and animals evolve and become stronger over time. Resistance can never be fully stopped, but it can be slowed. As we develop new antibiotics, we can stay ahead of bacteria and the infections they cause.

Antibiotics are an incredible medical treatment that have saved countless lives. They prevent life-threatening infections and keep harmful bacteria from spreading, but their effectiveness can only remain if we use them appropriately. This week, and all of the time, keep antibiotics in the back of your mind as a treatment only to be used when necessary.

When my dad quit smoking, he put the “cold” in cold turkey. After smoking for about 25 years, he got an upper respiratory virus and put down the cigarettes for the duration of his sickness. 

In that short time frame, he completely lost the urge and never started back up. It ended up being a pretty easy way to quit, considering the immensely powerful addictive qualities of nicotine.

According to the Centers for Disease Control and Prevention, more people in the United States are addicted to nicotine than to any other drug. 

The CDC also notes that smoking is a risk factor for getting a more severe case of COVID-19.

So if you are thinking about quitting, now is a really good time to try.

And luckily, there are resources available to help you, as well as an event to provide motivation.

Coincidentally, my dad quit smoking around 1977, the same year the Great American Smokeout began.

Created and promoted by the American Cancer Society, the Great American Smokeout, held on the third Thursday of November — Nov. 19 — is a simple idea.
 
Encourage people to give up smoking for just one day. If they’re lucky, they’ll feel better and see that it’s doable. 

And maybe they will not smoke the next day, and the next.
 
And maybe a week later, on Thanksgiving, that turkey dinner will taste a little bit better, because smoking dulls your taste buds.

As the American Cancer Society points out: 20 minutes after quitting, your heart rate and blood pressure drop. After 12 hours, carbon monoxide levels in your blood drop to normal. 

After two weeks to three months, circulation improves and lung function increases. 

After one to nine months, coughing and shortness of breath decrease. Cilia start to regain function in your lungs, increasing their ability to clean the lungs and reduce the risk of infection.

If you want to quit, there is help out there beyond the promise of a healthier body and a tastier holiday meal.

The West Virginia Tobacco Quitline changed vendors last year and services have been more accessible.

One newer component is the ability to enroll online via a new website , said Lindsy Hatfield, program director.

That saves participants the time of calling and answering questions — or having to wait for a call back. The individual is assigned to a coach, who connects with the individual to offer products — the scope of which depends on insurance — as well as unlimited coaching calls.

Anyone who has insurance seeking Quitline help is considered underinsured, Hatfield said, because that means the person’s insurance doesn’t offer another cessation program. The West Virginia Bureau for Public Health handles clients who are underinsured or uninsured.

These clients receive an eight-week supply of nicotine patches, lozenges or gum, delivered in four shipments, in addition to coaching calls. A client can enroll once every six months.

Medicaid clients receive a smoking cessation prescription such as Chantix via a physician prescription. “If they have Medicaid, we get it approved for them and they pick it up at a pharmacy,” Hatfield said.

Four coaching calls are included for everybody to assist during the quitting process, as well as unlimited reactive coaching calls. 

“If you need more coaching than that, you are welcome to call as much as you need,” Hatfield said.

The first coaching call includes questions about the client’s smoking habits. This allows the program to be tailored to each individual, Hatfield said. 

“If you smoke two packs a day, we will not start you on 7 mg patches a day,” she said. “You’ll receive 21 mg patches and do a step-down process.”

To get started, go online or call 1-800-QUIT-NOW. 

Maybe by the time the next Great American Smokeout rolls around next year, you will be celebrating how your risk of coronary heart disease is half that of someone who still smokes, and your heart attack risk will have dropped dramatically.

And the Thanksgiving turkey will taste really great, too.

In the state of West Virginia, we experience the beauty of our beloved country roads, mountains, caverns and rivers. However, we also experience some things that are not so beautiful. Although known for our mountains and John Denver songs, our home is also known for leading the country in diabetes rates. 

As of 2018, the Centers for Disease Control (CDC)  reported that West Virginia had the highest diabetes death rate at 36.2%. And as of 2019, the United Health Foundation found that West Virginia was also the leading state in diabetes diagnoses. 

With such alarming statistics, it’s crucial for West Virginians to become knowledgeable about the aspects of diabetes. November is American Diabetes Month, which is a great time to review this disease that affects so many people, many unknowingly.

Unfortunately, the symptoms of diabetes aren’t as well known as they should be. Because of this, many aren’t able to recognize their condition, leading to millions remaining undiagnosed. 

In fact, the American Diabetes Association (ADA) estimates that more than 7 million Americans have undiagnosed diabetes. Even doctors can miss the symptoms of diabetes, which is exactly what happened to Jennifer, a Morgantown health care worker. 

Several years ago, Jennifer began feeling incredibly lethargic. “My biggest complaint was fatigue. I was really tired. I was complaining to my physician, but I didn’t really get connected to testing for diabetes.”

It wasn’t until Jennifer began to think about how fatigued she felt 19 years ago when she had gestational diabetes, which is high blood sugar during pregnancy, that she thought to test her blood sugar. 

Jennifer’s possible diabetes diagnosis became clear upon seeing her numbers. “I got a monitor at a drug store and tested my blood sugar. I thought, ‘This is not looking too good,” and realized this is why I was feeling so lousy.”

Although Jennifer’s main complaint was fatigue, there are various symptoms someone with diabetes can feel. The ADA lists the most common symptoms as being:
● Frequent urination
● Extreme fatigue
● Feeling very thirsty
● Increased hunger
● Blurry vision
● Slow healing of cuts and bruises
● Weight loss
● Tingling, pain, or numbness in the hands/feet

Jennifer’s discussed her blood sugar numbers with her primary physician, who discussed diet and exercise, which were lifestyle practices she thought she was already addressing.

“When see people their numbers and they aren’t moving the way we would expect, you assume that they are not following those lifestyle changes.”

Eventually, Jennifer realized she needed more specific guidance on nutrition, which she was able to get through the WVU Diabetes Education Center as well as an endocrinologist she was referred to by the Diabetes Education Center.  

“The nutritionist looked at my food intake and was shocked. I was really not eating enough,” she said. “No one has ever said that to me in my entire lifetime. It slowed down my metabolism. That was a big change for me. I could eat more, but I definitely make healthy choices. I could eat more and improve my blood sugars along with medication.”

Another source Jennifer found greatly helped her was utilizing a FreeStyle Libre, a continuous glucose monitor. She details her positive experience with the device state, “Now I can get a good idea with how certain foods will trigger me, so you can really eat a meal and scan glucose monitor and track the sugars.”

There are several risk factors and causes for diabetes that people need to be aware of. 

Type 1
Risk factors and causations for type 1 diabetes are much less understood than type 2. According the AD, type 1 diabetes is thought to occur when the body wrongfully attacks itself and doesn’t produce insulin. The CDC states that is often genetic and diagnosed in adolescence and young adulthood.

Type 2
The risk factors and causes for type 2 diabetes is much more understood. According to the ADA, type 2 diabetes occurs when the body is unable to product insulin correctly. The risk factors and causes are listed by the CDC as being:
● 45 or older
● Having family members with the disease
● Having prediabetes
● Little physical activity
● Having had gestational diabetes
● Being overweight
● Having non-alcoholic fatty liver disease

To prevent diabetes, the CDC states that it’s important to keep active, eat healthy and stay in a healthy weight range. 

And also, be aware of diabetes symptoms and be willing to have a candid discussion with your physician if you begin to exhibit any of them. As Jennifer notes, if someone who already works in the health field can overlook, just about anyone can.

“Sometimes we really need to advocate for ourselves,” she said. “We know our body and know ourselves. I feel like I was doing things and it still wasn’t working. When I got to the specialist, that’s what they do. It was a big game changer for me it really was.”