Mid-State Health Center is pleased to welcome the Alpine Clinic’s Dr. Dan O’Neill to its Plymouth location.

Dr. Dan O’Neill, MD, Ed. D, FAAOS, ABOS

Plymouth, NH – Mid-State’s New Visiting Specialist Program is excited to partner with Littleton Regional Healthcare and the Alpine Clinic. Orthopedic surgeon from LRH and the Alpine Clinic Dr. Dan O’Neill will see patients at our Plymouth office on Tuesdays and our Bristol office on Wednesdays.

Dr. O’Neill earned his Bachelor’s degree in Chemistry at Bard College in New York and his Medical Doctorate at the Stony Brook School of Medicine in New York. He also completed his Doctorate in Education specializing in Sport and Exercise Psychology at Boston University.

Dr. O’Neill has been serving the Plymouth Community for over thirty years. With special interests in sports medicine and psychology, and orthopedic surgery, Dr. O’Neill has worked with kids in elementary school to professional athletes. He continues to serve the community by participating in local schools as a Team Physician. He also serves as an adjunct professor at Plymouth State University where he serves on the Institutional Review Board, as well as at the University of New Hampshire.

Join us in welcoming Littleton Regional Healthcare and the Alpine Clinic to Mid-State’s Visiting Specialist Program!

Mid-State is looking forward to expanding the Visiting Specialist program, exploring offering a variety of specialties to meet community needs in a convenient location close to home.

For questions about Mid-State Health Center’s Visiting Specialist Program, please call us at (603) 536-4000.

Poison Prevention Week is March 18 – 24, 2018 and it is a great time to raise awareness about the dangers of poisons found in and around our homes.  According to the American Association of Poison Control Centers, more than 2 million poisonings are reported each year across the country. More than 90 percent of these poisonings occur in the home. The majority of non-fatal poisonings occur in children younger than six years old. And, poisonings are one of the leading causes of death among adults.

A poison is any substance that is harmful to your body when ingested (eaten), inhaled, injected, or absorbed through the skin.  Any substance, including medications, can be poisonous if too much is taken.  Here are some poisoning prevention tips for you, your family, and friends.

Drugs and Medicines:  Follow directions on the label when you give or take medicines. Read all warning labels.  Some medicines cannot be taken safely when you take other medicines or drink alcohol.

Turn on a light when you give or take medicines at night, so that you know you have the correct amount of the right medicine.   Keep medicines in their original bottles or containers.  Never share or sell your prescription drugs.  Keep all prescription medicines (especially opioid pain medications, such as those containing methadone, hydrocodone, or oxycodone), over-the-counter medicines (including pain or fever relievers and cough and cold medicines), vitamins and herbals in a safe place that can only be reached by people who take or give them. Monitor the use of medicines prescribed for children and teenagers, such as medicines for attention deficit disorder (ADD). Dispose of unused, unneeded, or expired prescription drugs following the federal guidelines for how to do this or find a local Drug Drop Box. Visit the State of New Hampshire Environmental Services for detailed information about proper disposal and list of drop box locations at www.nh.gov/medsafety

Household Chemicals:  Always read the label before using a product that may be poisonous. Keep chemical products in their original bottles or containers. Do not use food containers such as cups, bottles, or jars to store chemical products such as cleaning solutions or beauty products.  They may leak or be mistaken for something they are not. Never mix household products together; they can cause chemical reactions that can be harmful. For example, mixing bleach and ammonia can result in toxic gases.  Wear protective clothing (gloves, long sleeves, long pants, socks, shoes) if you are working with strong chemicals or sprays. Turn on the fan and open windows when using chemical products such as household cleaners.

Preventing carbon monoxide exposure tips: Have your heating system, water heater and any other gas, oil, or coal burning appliances serviced by a qualified technician every year.  Install a battery-operated CO detector in your home and check or replace the battery when you change the time on your clocks each spring and fall. If the detector sounds, leave your home immediately and call 911.  Be sure to seek prompt medical attention if you suspect CO poisoning and are feeling dizzy, light-headed, or nauseous. Don’t use a generator, charcoal grill, camp stove, or other gasoline or charcoal-burning device inside your home, basement, or garage or near a window.  Don’t run a car or truck inside a garage attached to your house, even if you leave the door open.  Don’t burn anything in a stove or fireplace that isn’t vented.  Don’t heat your house with a gas oven.

Keeping children safe from poisoning is something we all should consider, especially households with young children.  Here are a few tips on keeping children safe from poisoning.  Be smart about storage – store all medicines and household products up and away and out of sight in a childproof cabinet where a child cannot reach them.  Be aware when you are taking or giving medicines or are using household products.  Do not put your next dose on the counter or table where children can reach them—it only takes seconds for a child to get them.  We are all so busy, if you have to do something else while taking medicine, such as answer the phone, take any young children with you.  Be sure and secure the child safety cap completely every time you use a medicine.  After using them, do not leave medicines or household products out.  As soon as you are done with them, put them away and out of sight in a childproof cabinet where a child cannot reach them.   Be aware of any legal or illegal drugs that guests may bring into your home. Ask guests to store drugs where children cannot find them.  Children can easily get into pillboxes, purses, backpacks, or coat pockets.  Keep your pets in mind as well!

Sometimes even with all the best prevention, poisoning happens.  Please be prepared!  Put the poison control number, 1-800-222-1222, on or near every home telephone and save it on your cell phone. The line is open 24 hours a day, 7 days a week.

This article was adapted from the CDC’s “Injury Prevention & Control: Home and Recreational Safety: Tips to Prevent Poisonings”, “Carbon Monoxide Poisoning – Prevention Guidelines” and “Policy Impact: Prescription Painkiller Overdoses” web pages which can be in their entirety on the CDC’s website  or visiting poisonprevention.org  for more information.

Colorectal cancer is a cancer that develops in the large intestine or rectum. In New Hampshire, about 35 out of 100,000 people develop this cancer each year. Both the incidence and mortality from this cancer have decreased 3% over the last decade. Around 75% of 50 to 75 year old people in New Hampshire are up to date with getting screened. Catching the cancer early means less extensive treatment is needed. Even better, detecting precancerous polyps can prevent the development of colon cancer.

Symptoms of colorectal cancer include bright red rectal bleeding, black tarry stools, unexplained anemia, abdominal pain, weight loss, change in bowel habits (diarrhea or constipation, change in size or caliber of stools), tenesmus (feeling of incomplete emptying) and rectal pain.

All adults should undergo colon cancer screening starting at age 50 or earlier, depending on their risk of developing this cancer. The optimal screening depends on your preferences and risk of developing colon cancer. Let’s review the types of screening tests available.

The simplest, least invasive, least expensive, but not necessarily the most effective, test is screening the stool for blood. These stool cards (called guiaic tests) are designed to detect microscopic amounts of blood in the stool. Once a year guiaic testing reduces the risk of dying from colorectal cancer by up to one-third. But, because polyps seldom bleed, they are not likely to pick them up. Also, only 2 to 5% of people with a positive stool test actually have colon cancer. A positive guiaic test should be followed by a colonoscopy to check for cancer or polyps.

Colonscopy involves using a thin, lighted tube to directly see the lining of the rectum and large bowel. Your colon needs to be “cleaned out”, ie, prepped, by consuming medication that causes diarrhea. You receive a mild sedative drug before the procedure. Polyps and some cancers can be removed during the procedure. Colonoscopy detects most small polyps and all large polyps and cancers, and greatly reduces your risk of developing and dying from colon cancer. Disadvantages are the cost, the inconvenience of the prep, and the small risk of having serious bleeding or a tear in the colon wall during the procedure. Because the procedure requires sedation, you will need someone to drive you home afterwards, and you should not plan to return to work the day of the test.

What about virtual colonoscopy – will this test save you from the discomfort of having colonscopy? This test uses a CT scanner to take images of the entire bowel, and the 2- and 3-D images allow the radiologist to see if polyps or cancer is present. Its advantages are that it does not require sedation, is noninvasive, the entire bowel can be checked, and polyps are found about as well as with regular colonoscopy. But, you have to “prep” your bowel just like for the regular test, and it exposes you to radiation that may have long term effects. If abnormal areas are seen, you will need to have “real” colonoscopy to check them out and take a tissue sample (biopsy). Virtual colonscopy may also find abnormalities other than polyps or cancer, and these may require further testing. Also, not all insurance companies cover this test. So, virtual colonscopy may not be the answer to your prayers to avoid regular colonscopy.

People with an average risk of colon cancer should begin screening at age 50. Colonscopy can be done every 10 years, unless something is found that requires follow up sooner. “Virtual” colonscopy can be performed every 5 years. Stool testing every year is your other options.

For those at increased risk of colorectal cancer, screening may need to start at an earlier age, occur more frequently, and include colonoscopy as a higher priority test. People with a first degree relative (parent, sibling or child) with colorectal cancer or adenomatous polyps before the age of 60 should begin screening at age 40 or 10 years younger than when their relative was diagnosed. Colonoscopy, repeated every 5 years, is recommended. Some families have genetically based colon cancer syndromes , such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colon cancer (HNPCC or Lynch syndrome). People with this family history need aggressive screening and are best managed by a physician with clinical expertise in these syndromes. People with inflammatory bowel disease (ulcerative colitis or Crohn’s disease) also are at increased risk, with screening dependent on how much of the bowel is involved and how long they have had the disease.

So, remember that everyone who has a colon is at risk of colorectal cancer and get screened!

Dr. Diane Arsenault, MD, FAAFP, HPM, HMDC
Family Medicine, Mid-State Health Center