Toward the end of sixth grade, Adrian Kiger Olmstead developed an unquenchable thirst.

“I was always asking to be excused from class to get drinks of water,” she said.

That, of course, would lead to more bathroom trips.

“It got to the point where I was embarrassed, so I said something to my mom about it.”
Her mother had an aunt and an uncle who had had type 1 diabetes. She knew the disease was a possibility because excessive thirst is a well-known symptom. And she was right.

Olmstead set about learning how to control the disease. She had no choice. Diabetes, according to the Centers for Disease Control and Prevention, is the No. 1 cause of kidney failure, lower-limb amputations and adult blindness. Before insulin was developed a century ago, the life expectation for someone diagnosed with diabetes was a few months. 

Olmstead’s regimen quickly included daily injections of insulin, as well as years of pricking her finger to check her blood sugar levels. She no longer does the latter, thanks to a patch she wears that measures her blood sugar levels automatically with a subcutaneous needle.

"I practically cried with happiness and relief that I didn’t have to poke my finger anymore.”

She still endures insulin shots in her stomach; however, “It’s like brushing my teeth.”

Often diagnosed in children, type 1 diabetes means that the pancreas isn’t making any or very much insulin, a hormone that enables blood sugar to enter the cells in your body so it can be used for energy.

More than 30 million Americans, or about 1 in 10, have diabetes, although about 1 in 4 have not been diagnosed. However, between 90%-95% of them have type 2 diabetes. That means the pancreas can still make insulin, but cells don’t respond to it. This is called insulin resistance. People with type 2 diabetes can improve their condition with better eating habits, exercise and sometimes medications.

But, as Olmstead noted, for those with type 1 diabetes, “We can’t live without insulin.”
And paying for insulin has become increasingly difficult. Although the scientists who created insulin about 100 years ago sold the patent for a token $1, insulin costs have skyrocketed in recent years.

Olmstead usually pays $200-$300 a month for insulin and supplies, on top of $500 out-of-pocket for health insurance. While hefty, other people with type 1 diabetes have posted even higher costs. 

Various sources note that the cost of insulin went up nearly 300% between 2002 and 2013. And it has continued to rise since then.

“We are literally fighting for our lives,” Olmstead said. “We have been priced out of taking care of ourselves. When I was diagnosed, I was told, ‘This is manageable.’ It’s manageable, but you have to be able to afford it to manage it. If you are a type I diabetic, if you don’t have insulin, you will die.”

These developments have turned Olmstead into a diabetes activist. Earlier this year, she learned about the group Insulin4All and saw that it didn’t have a West Virginia chapter, so she started one.

​According to information on Insulin4All’s webpage, since the 1990s, the cost of insulin increased more than 1,200%. 

Olmstead has teamed up with Monongalia County Delegate Barbara Evans Fleischauer. When the two met, Fleischauer had already gotten legislation nationally known as Kevin’s Law passed. The law allows pharmacists to provide a 30-day refill on lifesaving prescriptions such as insulin. It was named for a man who couldn’t get a refill over the New Year’s holiday and died after rationing insulin. 

Fleischauer announced the enactment of Kevin’s Law in West Virginia last June from Monongalia County Health Department. That’s where she also discussed plans with the media for a Dec. 8 bus trip to Canada, where insulin can be purchased much more cheaply. Olmstead will be on board. 

In addition to getting lower-priced insulin, Olmstead said, the caravan will be a way to offer hope to people with diabetes.

“And the fact that we’re literally having to drive to another country to buy affordable insulin is absurd. But it’s reality.”

Fleischauer is also working on legislation that would cap the monthly price of insulin at $50 for those with insurance. “Colorado, for example, passed a bill and now there is a $100 cap on insulin per month per person,” Olmstead said.

There is still room on the bus for anyone who is interested and who already has a passport. To reserve a spot or get more details, email Olmstead at WVInsulin4All@gmail.com.

And if anyone with diabetes needs general help managing the illness or navigating insurance, the MCHD Clinical Services Diabetes Clinic can help. It takes place from 9 a.m. to 1 p.m. every other Friday. Call 304-598-5119 to make an appointment.

It’s the time of year when people gather with their friends and families for holiday meals. 
With all of the holiday excitement and large amounts of food to cook, it can be hard to keep track of all of the tricks to cooking safely. Following these tips can ensure that you don’t spend your holiday season with an avoidable illness. 

The turkey is often the main event of holiday dinners, and it must be prepared very carefully. Never leave your turkey out on the counter to thaw. The Centers for Disease Control and Prevention recommends that you always use the refrigerator, a sink of cold water or the microwave. 

The general rule is that it takes 24 hours for every 4-5 pounds of turkey to thaw in the fridge. This method is best for turkeys that will not be cooked immediately. Turkeys thawed in the refrigerator can be safely stored there for one to two days before cooking. In cold water, it takes 30 minutes per pound, and the water should be changed every 30 minutes.

The turkey should also be in a leak-proof bag to prevent the turkey from absorbing water. The time it takes to thaw a turkey in the microwave depends on the microwave manufacturer’s instructions, but it should be cooked immediately after thawing. 

Cooking carefully can help prevent food poisoning, an illness caused when food has been contaminated with germs such as norovirus, salmonella or staphylococcus aureus, better known as staph. Symptoms of food poisoning include upset stomach, cramps, nausea, vomiting, diarrhea, and fever.

However, symptoms can differ based on the germ you encountered. Symptoms usually appear within 30 minutes to six hours after eating contaminated food. You should see a doctor if your symptoms last more than three days, you have a fever over 102 degrees Fahrenheit, are vomiting frequently or are dehydrated.
 
According to the CDC, certain people are more prone to food poisoning than others. Adults who are 65 or older, children under 5 years old, people with certain medical conditions, such as diabetes or HIV, and pregnant women have increased odds. This is because these people have weakened immune systems.

Pregnant women in particular must be extra careful during the holiday season. They should avoid products made with raw or unpasteurized milk, such as soft cheeses. Refrigerated seafood should also be avoided, as well as eggnog, unless it has been confirmed that there is no alcohol in it.

The most commonly known culprit of food poisoning is undercooked or raw meat. Meat should not be washed before cooking. Large pieces of meat should be cut into smaller pieces before storing so they chill quickly and prevent bacteria growth. The best ways to tell if your meat is safe to eat is by checking the color, its juices and its internal temperature.

Dairy products can also leave you feeling ill. Raw milk and products made with it, such as cheese and ice cream, can carry illness causing bacteria. Other sources of foodborne illness include raw or undercooked eggs, fish, shellfish, flour and sprouts. Many popular holiday recipes contain raw eggs, such as eggnog, tiramisu, hollandaise sauce and Caesar salad dressing; instead of using raw eggs, use pasteurized eggs. 

Food safety can sound complicated, but it comes down to four simple steps: clean, separate, cook and chill. You should clean your hands and kitchen surfaces often, and rinse fruits and vegetables before preparing them.

​Separate cooking surfaces should be used for raw meat, poultry and seafood, as well as separate storage in the fridge. Ensure that all food is cooked to safe temperatures to kill the germs. Leftovers should be kept below 40 degrees F, and all foods should be refrigerated within two hours.
 
If you follow these rules, it will go a long way to making your holidays healthy and happy.
Happy holidays!

When my dad quit smoking, he put the “cold” in cold turkey. After smoking for about 25 years, he got a cold 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. Research suggests that nicotine may be as addictive as heroin, cocaine or alcohol.

In spite of quitting, my dad developed chronic obstructive pulmonary disorder (COPD), which eventually took his life. Of course, smoking also increases the risk for heart attacks, lung cancer and stroke.

But he was lucky, in a way. He made it to 80. I can’t imagine what his quality of life and lifespan would have been had he continued smoking from middle to old age.

Coincidentally, he 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—tomorrow--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 has recently changed vendors and efforts are being made to improve services.

One new 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 person 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 a 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. 

Who knows? Maybe in a mere six weeks, you’ll enter 2020 needing to find a new resolution to make because you already quit cigarettes.

And maybe by the time the next Great American Smokeout rolls around, 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.

(This past summer, I was walking along the rail-trail near Marilla Park when I was pleased to see a new mural that Friends of Deckers Creek had painted on a nearby bridge abutment: a scene featuring a kayaker paddling through rapids. 

That happiness turned to frustration a couple of weeks later. Drug paraphernalia strewn over a large rock nearby marred the view. 

So when I heard Milan Puskar Health Right’s proposal to place three large metal biohazard containers around town in places where they would likely be used—but not necessarily seen by most members of the public—I thought it was a great plan.
 
As does my boss, Dr. Lee B. Smith, Monongalia County Health Department executive director and public health officer. 

“We support the placement of sharps containers in all public places,” he said. “I first encountered public sharps containers in a bathroom a decade ago in an airport restroom in Australia and thought, ‘What a wonderful idea.’ It’s not just for people with substance use disorder. There are diabetics and others who may have an indication for medication use via an injection.”

Laura Jones, executive director of Milan Puskar Health Right, said the idea came from other communities that have them, including Huntington. One is located in front of Cabell-Huntington Health Department.

“It’s been beneficial to have boxes to allow people to safely dispose of syringes,” she said. 

Data from Canada states that having biohazard boxes around a community increases syringe disposal by 98 percent. 

Health Right proposes to work with the city of Morgantown to find locations where disposed syringes are typically found and also for help installing the boxes.

“We’ve discovered that there are specific areas of downtown where needles seem to collect,” Jones said. “It’s not always in mainstream areas. Sometimes it’s off the beaten path.”

The boxes (pictured below) that Health Right would like to use are not your typical red plastic sharps containers. Instead, the metal boxes have a pipe used deposit the syringes. But no one could get their hands down in the box to try to steal them, Jones noted. It’s also double-locked. 

Health Right would empty the containers on a regular basis, emptying the used needles and running them through the current medical waste disposal pick-up service. They would pay for the boxes, $300 each, with a grant, and also for disposal.

Jones is familiar with the objections that some community members have put forth. She has a compelling reply for each one. 

“The first one is that it will encourage drug use,” she said. “That obviously makes no sense. We already have drug use. We don’t have to do anything to encourage it.

“And we’re not putting these in areas that most people would be. Those who need them would have access to them, but they would not draw a crowd.”

Another concern she has heard is what parents will tell their children. 

First, Jones noted, the boxes are nondescript and wouldn’t be that noticeable. 

Also, “If a child is 3, you say they are for garbage. If they’re 10 or 11 or 12 years old, this is the perfect opportunity to talk to them about drugs and alcohol.”

And even then, that might be waiting too long, she said. At a recent lecture presented by Huntington: City of Solutions, she learned that the average age of initial IV drug use is between 12 and 15 years old. 

That’s disturbing news in a state that has been grappling with the opioid crisis. It’s difficult to live in this community and not see the proof, including abandoned syringes. 

As someone in the thick of the fight, Jones knows what she’s talking about. Milan Puskar Health Right created a syringe access program in August 2015, the LIGHT Program, which stands for Living In Good Health Together. 

Having clean needles helps keep people who use drugs from getting a variety of diseases, including Hepatitis B, Hepatitis C and HIV. Huntington is currently experiencing an HIV cluster because of drug use; in Charleston, which did away with its needle exchange program, Hepatitis C rates have soared. 

According to the West Virginia Department of Health and Human Resources, the number of Hep C cases more than doubled in a year, growing from 20 acute and 458 chronic cases in 2017 to 41 acute and 1,114 chronic cases in 2018. The closure of the needle exchange program is considered a big factor.

When most people hear the word “diabetes,” they typically think that it simply means that someone can’t eat a lot of sweets.

While this is true, diabetes can cause a lot of health complications, and affects more than 30 million people in the United States alone.

To raise awareness of the disease and its effects, November is National Diabetes Month.

The Center for Disease Control and Prevention describes diabetes as “a chronic health condition that affects how your body turns food into energy.”

This happens when your body has problems making or using insulin, the hormone that the pancreas releases to let the blood sugar give your cells energy. Without insulin, your blood sugar can get too high, which can cause complications such as heart disease, kidney disease, and vision loss. 

According to the CDC, you should be checked for diabetes if you experience the following symptoms: frequent urination, extreme thirst or hunger, losing weight without trying,  blurred vision, dry skin that heals slowly, extreme tiredness or numbness or tingling in your hands or feet.

There are three types of diabetes: Type 1, Type 2, and gestational diabetes.

Type 1 diabetes occurs when your immune system mistakenly tells your body not to make insulin. This diagnosis is typically given to children, teens and young adults, and symptoms can develop quickly.

Currently, there is no known way to prevent or cure diabetes, and Type 1 diabetics must take insulin every day. In addition to the symptoms listed above, those with Type 1 diabetes may also experience nausea, vomiting or stomach pains.

Type 2 diabetes is when your body cannot use the insulin it produces to keep blood sugar at a safe level. This is the most common type of diabetes. About 90% of U.S. diabetes diagnoses are Type 2. This type develops over the years, and can have no symptoms. Luckily, you can decrease your chances of developing Type 2 diabetes by eating healthy, losing weight and exercising regularly.
​ 
Gestational diabetes occurs only in pregnant women, but typically goes away after the baby is born. The condition usually shows up in the middle of the pregnancy and does not have any symptoms. According to the CDC, having gestational diabetes not only increases the mother’s chances of later developing type 2 diabetes, but also increases the baby’s risk of developing diabetes later in their life. 

The remaining 84 million people who are at risk for diabetes but have not yet developed it are facing a condition known as prediabetes. This is when your blood sugar levels are regularly high, but are not quite high enough to be considered Type 2 diabetes. Having prediabetes increases your risk of having a stroke, Type 2 diabetes and heart disease. 

MCHD Clinical Services, in a partnership with the WVU School of Nursing, offers a clinic every other week to help people manage their diabetes. The clinic is open from 9 a.m. to 1 p.m. on the first and third Fridays of the month.

Nurse Kendra Barker, DNP, APRN, FNP-BC, can provide testing, insurance navigation, referrals, education and tips. To make an appointment, call 304-598-5119.