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How To Protect Yourself From Lyme Disease

With the fall season nearly upon us, the crisp, cooler weather provides a great time to enjoy outdoor activities such as hiking and camping. However, wooded areas are prime spots for ticks to thrive. Dr. Raghavendra Tirupathi Govindaraju, Medical Director of Keystone Infectious Diseases, shares some important information about Lyme disease and how you can help to keep you and your family safe.

What is Lyme disease?

Lyme disease is an infection most commonly caused by a bacterium called Borrelia burgdorferi. In the United States, people are more likely to be infected during the summer and fall months. Pennsylvania is one of the states where the disease is most prevalent.

How does someone get Lyme disease?

Lyme disease is spread to humans through the bite of infected blacklegged ticks (also known as deer ticks). In order for a tick to transmit the infection to humans, it needs to be attached to a person’s body for at least 24 hours. Ticks attach to a person or animal by crawling; they cannot fly or jump. They can attach to any body part, but are more commonly found in areas such as the scalp, groin, and armpits.

What are the initial symptoms?

Typical early symptoms include fever, headache, fatigue, muscle and joint aches, swollen lymph nodes, and a bullseye-like skin rash called erythema migrans. This rash can appear 7 to 30 days after the tick bite and can reach a size of up to 12 inches or larger. The rash is rarely itchy or painful.

What are the long-term effects?

If left untreated, the infection can spread to joints, the heart, and the nervous system. It can cause additional rashes on other areas of the body, inflammation of the brain and spinal cord, facial paralysis, nerve pain, joint pain, heart palpitations or an irregular heartbeat, and swelling — particularly in the knees and other large joints.

How is Lyme disease diagnosed?

Lyme disease is diagnosed by a physician based on a person’s signs and symptoms, and history of possible or known exposure to infected blacklegged ticks. Laboratory blood tests can also be helpful in some cases.

How is it treated?

Lyme disease is treated with antibiotics. Patients with certain neurological or cardiac illnesses may require intravenous treatment with drugs such as ceftriaxone or penicillin.

How can people protect themselves against Lyme disease?

The best way to prevent Lyme disease is by preventing tick bites. Avoid wooded and brushy areas as much as possible. If you are planning to spend time outdoors, use a tick repellent that contains 20% or more DEET, picaridin, or IR3535 on exposed skin. This protection lasts several hours. When hiking, stay in the middle of trails and try to keep away from leaf piles, tall grass and brush. Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off any ticks that could be crawling on you.

Check your entire body for ticks after being in areas where they are common. While ticks are most often found in wooded, grassy or brushy places, they may also be present in gardens or lawns. Keep in mind that ticks can also attach to animals and be brought into houses by pets. Tick control products may be helpful in reducing the chances of your pet carrying ticks. Taking proper precautions can greatly reduce a person’s chance of being infected with Lyme disease.

 

This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Eligibility for Speech Therapy Services

Medical Model vs. Educational Model

By Greg Hoover, Speech-Language Pathologist at Keystone Pediatric Therapies

A common question I receive upon meeting a client and his/her parents for the first time is, “My child doesn’t receive school speech therapy services, does that determine if he gets speech therapy at Keystone?” Also, I have heard from parents, “My child already gets speech therapy services in school.  He doesn’t need outpatient therapy services.”  Is there a difference between a medical/mental health model and educational model when determining eligibility for speech therapy services?   The answer is “yes.”

Keystone Pediatric Therapies determines eligibility of speech therapy services using a medical/mental health model. When our speech therapy department gets a referral, the client’s physician sends our office a prescription for a speech and language evaluation with a medical diagnosis commonly using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).  Common diagnoses we receive may include, but are not limited to: Expressive/Receptive Language Impairment, Verbal Apraxia, Attention Deficit Hyperactivity Disorder, Autism, Cerebral Palsy, Downs Syndrome, etc.

After review of the medical diagnosis and parent’s concerns, our speech therapists determine the direction of the evaluation process based on potential communication impairments related to the medical diagnosis and supplemental paperwork that was submitted by the parents. After the speech and language evaluation, we discuss the results with the parents.  If a child presents with a speech and language impairment, a communication impairment diagnosis is reported on the evaluation, which is sent to the physician for review. The physician can either approve or disapprove the plan of care. If approved, the plan of care with the physician’s signature is submitted to the client’s payor source, his/her medical insurance. The eligibility of speech therapy services in the medical/mental health model is based on a medical need as indicated by the client’s medical diagnosis.

The educational model in the school system provides different eligibility criteria when determining the appropriateness of speech therapy services. Rather than a medical physician being the referring provider, a school professional may ask the school’s multidisciplinary team to evaluate the student to see if he/she has a disability.  Also, parents may ask the student’s teacher or other school professionals to evaluate their child for a potential disability should the parents have concerns.

Once the request is made, the multidisciplinary team (i.e. teacher, school psychologist, special education teacher, speech therapist, etc.) completes a thorough and comprehensive evaluation. Parents may provide additional medical information from the student’s physician or outside medical providers; however, this information does not impact eligibility for school-based services, including speech therapy.  Once the results are obtained from the multidisciplinary team, the results are presented to the parent and the appropriateness of special education services, including speech therapy, is determined based on the definition of ‘disability’ provided by the Individuals with Disabilities Education Act (IDEA).  As established by the IDEA, a child may fall into the following special education categories:  autism, blindness, deafness, emotional disturbance, hearing impairment, intellectual disability, multiple disabilities, orthopedic impairment, other health impaired, specific learning disability, speech or language impairment, traumatic brain Injury, and visual impairment.

In order to qualify for speech therapy school-based services, the found impairment must have an adverse effect on the student’s academic performance.  If the disability has a negative impact on the student’s academic performance, an Individualized Education Program (IEP) is developed to meet the student’s unique and appropriate needs in the classroom.

In summary, the medical/mental health model and educational model of services differ when determining eligibility of speech therapy services for your child. Both have their unique abilities to meet the needs of your child in their own distinct way; however, eligibility criteria varies depending on which model your child is assessed.  If you have any questions or concerns about the eligibility of your child for speech-language pathology services provided by Keystone Pediatric Therapies, please contact us by phone at: 717-709-7997.

Employee Spotlight – Stephanie Strickler

The Employee Spotlight for September shines on Stephanie Strickler, Keystone Purchasing Department’s Lead Buyer!

Stephanie began her career at Keystone in 2009 in the medical records department of our Pediatrics office, which was then known as Franklin County Pediatrics. In 2011 she moved to the purchasing department, and has worked her way up from Purchasing Assistant, to Buyer, and now to Lead Buyer.

“I was looking to challenge myself and use some of the skills I learned in school which is what I found in the purchasing department,” she said.

It’s her and her colleagues’ responsibility to get Keystone the lowest price on equipment, products and services without sacrificing quality or delivery. She purchases items that vary from medical, dental, office and janitorial supplies, promotional items, pharmaceuticals, and more.  The purchasing department also runs and maintains the 340B program so that qualifying patients can get access to affordable medication.

“Everyone loves getting a great deal and that’s what I get to do for a living,” Stephanie said. “I always keep in mind that our department affects Keystone’s bottom line and we need to stretch our funding as far as possible. Every dollar saved is one that can be put back into caring for our patients. Even though I don’t have direct patient contact, it makes me happy to know that my work aids all our staff in providing the best patient care possible.”

On a typical day, Stephanie works with vendors by requesting quotes, negotiating prices and placing orders. She gets to work with staff in each practice, helping them find products or services that they need. She spends a lot of time working in Excel doing comparisons and price analysis, and also takes calls from Keystone’s Pharmacy to verify patient eligibility in the 340B program, do referral checks, follow-up on outpatient notes, and process overrides.

“The passion and compassion I see from the staff in our small department is amazing, inspiring and spreads throughout the entire organization,” she said. “I am proud that from the top down everyone is involved with upholding Keystone’s mission statement.”

Stephanie grew up in Lancaster and attended college at West Chester University, but now calls Franklin County home. She lives in Shippensburg with her husband Yancey and their fur baby, Tela. When she’s not at work, Stephanie enjoys visiting golf courses with her husband, and taking their dog for walks in different neighborhoods and parks, as well as hiking in the mountains.

Something people may be surprised to learn about her is that she is a Licensed Massage Therapist and practiced in Shippensburg for 12 years.

“I no longer have a practice but I do keep my hands in it by working on friends and family,” she said. “It’s incredibly satisfying to know that the relief people experience is provided by the physical manipulation I can do with just my hands, forearms, elbows, and yes sometimes knees. I also enjoy taking continuing education courses to learn new techniques.”

Thank you Stephanie, for all that you do for Keystone and our patients!

Bad Habits That Can Lead To Bad Teeth

Are you guilty of a bad habit that can lead to dental problems? Dr. John Palm, dentist and Medical Director of Keystone Dental Care, shares some of the things people do every day that can send them to the dental office.

Chewing Ice

Chewing on a chunk of ice puts tremendous strain on the crystal structure of your teeth. The hardness and cold temperature of ice can actually cause teeth to fracture. It can cause microscopic cracks in enamel, which can lead to bigger cracks over time. Teeth with large fillings are especially vulnerable, and large pieces of tooth may eventually break away. In some cases, a tooth may split in half and be impossible to save. Other culprits are popcorn kernels, sunflower seed shells and the pits of fruit such as cherries, peaches and plums, which can also put undue stress on a tooth and cause it to fracture. Some people put these in their mouths to suck on and then crunch on. Avoid these practices when you eat or drink.

The solution: Drink chilled beverages without ice, or use a straw if you must use ice. The risk of chewing ice is greater than any pleasure that comes from chewing it. Another option is letting ice slivers melt in your mouth. This may help satisfy the need to crunch down. Also, when eating snacks, eat something that’s healthier and softer to chew, such as small tender pieces of baby carrots, broccoli, apples, celery and other fresh fruits and vegetables. If you feel the need to chew on something, try sugar-free gum. It will keep your breath fresh and is much gentler on teeth. Research has shown that chewing gum sweetened with 100% xylitol helps prevent tooth decay. Xylitol inhibits the growth of the bacteria that cause cavities.

Using Teeth As Tools

People often do not recognize the dangers of using their teeth to open things. Your teeth were made for eating, not as a substitute for scissors or holding things when your hands are full. Do not use your teeth to crack open nuts or shellfish, as the shells are like sandpaper on your teeth. When you do this, you put yourself at a higher risk of cracking your teeth, injuring your jaw or accidentally swallowing something you shouldn’t. Some people use their teeth to uncap a bottle, pull out a watch stem, or rip a price tag off a piece of clothing. This can be hard on your teeth, traumatizing them or causing the edge of a weakened tooth to chip off. Using your teeth to grasp objects like these can cause malocclusion (poor jaw alignment), and wear down your teeth unevenly. Malocclusion can lead to a type of jaw pain known as TMD (temporomandibular joint disorder).

The solution: Stop and find something or someone to give you a hand. Think about what you’re putting in your mouth before you use your teeth as tools. Take a few seconds to get a bottle opener or nutcracker and save your teeth for their intended use.

Snacking And Sipping Sugary Drinks Throughout The Day

Frequent snacking on carbohydrate-containing foods can be an invitation to tooth decay. When you eat, the bacteria convert the sugar and starch that remain in the mouth to acid, and that attacks tooth enamel. The longer sugars are retained in your mouth, the longer the acids attack. Sipping sugary drinks throughout the day is another bad habit. The constant exposure to sweet and acidic beverages can foster tooth decay. When you eat, your saliva is breaking down the sugars that are in your foods and drinks. Your saliva is also working to protect your tooth enamel by providing the proper minerals to coat the surface of your teeth. If you’re snacking all day, you’re never giving your saliva enough time to protect your smile.

The solution: Eat balanced meals to feel fuller, longer. When you’re constantly snacking throughout the day, you’re most likely snacking on foods that aren’t so good for your diet or your teeth. And since you’re snacking on smaller portions of food, you’re more likely to be hungrier throughout the day, causing you to eat more and more. If you need a snack, make sure it’s low in fat and sugar. If you indulge in the occasional sugary treat, follow it with a big glass of water to wash away leftover food. Sip sweetened drinks through a straw to minimize sugar and acid exposure to your teeth. Be sure the straw is positioned toward the back of the mouth, not resting against your teeth. Drink water throughout the day. Water naturally rinses your teeth and washes away food particles and acids produced by the bacteria in your mouth. It helps to decrease the pH level in your mouth and helps alleviate the symptoms of dry mouth.

Biting Your Nails

Many people don’t realize this habit can cause your teeth to chip. Sometimes, when biting through a nail, the teeth hit together pretty hard which could cause damage. Repeated flexing of your teeth’s enamel occurs when you bite your nails and this can cause the enamel to fracture.

The solution: Keep in mind that biting your nails can lead to problems. While it may be a hard habit to break, it is worth it and your mouth will thank you. Next time you want to bite your nails, ask yourself if it is worth the dental problems that could accompany it.

Smoking And Chewing Tobacco

In addition to a long list of negative cosmetic effects including a reduced sense of smell and taste, bad breath and a receding gum line, tobacco use is a major cause of tooth loss in adults. Smoking can also lead to a delayed healing process following mouth and throat surgery and an increased risk of oral cancer. This hard-to-quit habit can increase your chances of developing a life-threatening illness, but the good news is that whether you’ve been a smoker for one year or for ten, quitting can quickly lower your risk of developing oral cancer, lung cancer, heart disease, emphysema and painful lesions in the mouth that do not heal. Are smokeless tobacco products safer? No. Like cigars and cigarettes, smokeless tobacco products contain many chemicals that have been shown to increase the risk of oral cancer and cancer of the throat and esophagus. In fact, chewing tobacco contains higher levels of nicotine than cigarettes, making it harder to quit than cigarettes. Electronic nicotine delivery systems such as e-cigarettes and vape pens have also been known to cause oral health problems. One harmful effect is that nicotine inhalation inhibits your ability to produce saliva, which can leave you susceptible to bacteria buildup, dry mouth and tooth decay. Nicotine may contribute to dry mouth by reducing blood flow to the salivary glands. Propylene glycol, an ingredient in some e-liquids, can extract water from your mouth and cause dry mouth as well.

The solution: If you’re looking for another reason to quit, the threat of a missing tooth might persuade you to pass on purchasing your next pack. To stop using tobacco, your dentist or doctor may be able to help you calm nicotine cravings with medications, such as nicotine gum and patches. Some of these products can be purchased over the counter; others require a prescription. Smoking cessation classes and support groups are often used in combination with drug therapy. These programs are offered through local groups in the community and sometimes through your employer or health insurance company. Counseling and medication together has often been found to be more effective than using either one alone. Ask your doctor or dentist for information on programs they may be familiar with.

Brushing Too Hard Or Using A Hard Toothbrush

Some people think the firmer the brush, the better. This isn’t so. Vigorous brushing can wear down the outer surface of the teeth, making them more vulnerable to decay. Continuously brushing vigorously can also lead to receding gums. When your gum line recedes, the roots of your teeth are exposed. They are sensitive and susceptible to infection when left unprotected. If it goes untreated, the supporting tissue and bone structures become damaged which could lead to periodontal disease. Unfortunately, receding gums do not grow back and exposed root surfaces often lead to decay. You can talk to your dentist or periodontist about the treatments available to correct the issue and prevent it from getting worse. The people most at risk for tooth or gum damage from over brushing are those who are particularly diligent about their oral care and those who use medium- or hard-bristled toothbrushes. In cases of severe toothbrush abrasion, your dentist may be able to fill in the grooves with bonding material.

The solution: Use a soft-bristled toothbrush with the American Dental Association seal of acceptance. Plaque is soft, so use a gentle massaging pressure and save the hard toothbrush for cleaning the grout in the bathroom tile. Place the head of your toothbrush with the tips of the bristles at a 45-degree angle to the gumline when brushing. Move the toothbrush with short strokes with bristles directed toward the gums. Use small circular motions performing the plaque removal. Don’t saw back and forth across the teeth. You shouldn’t be forcefully pushing the bristles against your teeth until they bend. Brushing for two minutes twice a day is one of the best habits you can get into. Brushing regularly is considered vital for healthy teeth and gums. Ask your dentist or hygienist what toothbrush might be best to maintain your dental health. Replace your toothbrush every three months or sooner if it shows signs of wear. If your toothbrush looks frayed, this can be a sign that you are brushing too hard or that it needs to be replaced. Don’t forget to floss every day, as this is critical to removing bacteria and plaque between your teeth, where even the best brushing can’t reach.

 

This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Bad Habits That Can Lead To Bad Teeth – Part Two

Are you guilty of a bad habit that can lead to dental problems? Dr. John Palm, dentist and Medical Director of Keystone Dental Care, shares some of the things people do every day that can send them to the dental office.

Biting Your Nails

Many people don’t realize this habit can cause your teeth to chip. Sometimes, when biting through a nail, the teeth hit together pretty hard which could cause damage. Repeated flexing of your teeth’s enamel occurs when you bite your nails and this can cause the enamel to fracture.

The solution: Keep in mind that biting your nails can lead to problems. While it may be a hard habit to break, it is worth it and your mouth will thank you. Next time you want to bite your nails, ask yourself if it is worth the dental problems that could accompany it.

Smoking And Chewing Tobacco

In addition to a long list of negative cosmetic effects including a reduced sense of smell and taste, bad breath and a receding gum line, tobacco use is a major cause of tooth loss in adults. Smoking can also lead to a delayed healing process following mouth and throat surgery and an increased risk of oral cancer. This hard-to-quit habit can increase your chances of developing a life-threatening illness, but the good news is that whether you’ve been a smoker for one year or for ten, quitting can quickly lower your risk of developing oral cancer, lung cancer, heart disease, emphysema and painful lesions in the mouth that do not heal. Are smokeless tobacco products safer? No. Like cigars and cigarettes, smokeless tobacco products contain many chemicals that have been shown to increase the risk of oral cancer and cancer of the throat and esophagus. In fact, chewing tobacco contains higher levels of nicotine than cigarettes, making it harder to quit than cigarettes. Electronic nicotine delivery systems such as e-cigarettes and vape pens have also been known to cause oral health problems. One harmful effect is that nicotine inhalation inhibits your ability to produce saliva, which can leave you susceptible to bacteria buildup, dry mouth and tooth decay. Nicotine may contribute to dry mouth by reducing blood flow to the salivary glands. Propylene glycol, an ingredient in some e-liquids, can extract water from your mouth and cause dry mouth as well.

The solution: If you’re looking for another reason to quit, the threat of a missing tooth might persuade you to pass on purchasing your next pack. To stop using tobacco, your dentist or doctor may be able to help you calm nicotine cravings with medications, such as nicotine gum and patches. Some of these products can be purchased over the counter; others require a prescription. Smoking cessation classes and support groups are often used in combination with drug therapy. These programs are offered through local groups in the community and sometimes through your employer or health insurance company. Counseling and medication together has often been found to be more effective than using either one alone. Ask your doctor or dentist for information on programs they may be familiar with.

Brushing Too Hard Or Using A Hard Toothbrush

Some people think the firmer the brush, the better. This isn’t so. Vigorous brushing can wear down the outer surface of the teeth, making them more vulnerable to decay. Continuously brushing vigorously can also lead to receding gums. When your gum line recedes, the roots of your teeth are exposed. They are sensitive and susceptible to infection when left unprotected. If it goes untreated, the supporting tissue and bone structures become damaged which could lead to periodontal disease. Unfortunately, receding gums do not grow back and exposed root surfaces often lead to decay. You can talk to your dentist or periodontist about the treatments available to correct the issue and prevent it from getting worse. The people most at risk for tooth or gum damage from over brushing are those who are particularly diligent about their oral care and those who use medium- or hard-bristled toothbrushes. In cases of severe toothbrush abrasion, your dentist may be able to fill in the grooves with bonding material.

The solution: Use a soft-bristled toothbrush with the American Dental Association seal of acceptance. Plaque is soft, so use a gentle massaging pressure and save the hard toothbrush for cleaning the grout in the bathroom tile. Place the head of your toothbrush with the tips of the bristles at a 45-degree angle to the gumline when brushing. Move the toothbrush with short strokes with bristles directed toward the gums. Use small circular motions performing the plaque removal. Don’t saw back and forth across the teeth. You shouldn’t be forcefully pushing the bristles against your teeth until they bend. Brushing for two minutes twice a day is one of the best habits you can get into. Brushing regularly is considered vital for healthy teeth and gums. Ask your dentist or hygienist what toothbrush might be best to maintain your dental health. Replace your toothbrush every three months or sooner if it shows signs of wear. If your toothbrush looks frayed, this can be a sign that you are brushing too hard or that it needs to be replaced. Don’t forget to floss every day, as this is critical to removing bacteria and plaque between your teeth, where even the best brushing can’t reach.

 

This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Bad Habits That Can Lead To Bad Teeth – Part One

Are you guilty of a bad habit that can lead to dental problems? Dr. John Palm, dentist and Medical Director of Keystone Dental Care, shares some of the things people do every day that can send them to the dental office.

Chewing Ice

Chewing on a chunk of ice puts tremendous strain on the crystal structure of your teeth. The hardness and cold temperature of ice can actually cause teeth to fracture. It can cause microscopic cracks in enamel, which can lead to bigger cracks over time. Teeth with large fillings are especially vulnerable, and large pieces of tooth may eventually break away. In some cases, a tooth may split in half and be impossible to save. Other culprits are popcorn kernels, sunflower seed shells and the pits of fruit such as cherries, peaches and plums, which can also put undue stress on a tooth and cause it to fracture. Some people put these in their mouths to suck on and then crunch on. Avoid these practices when you eat or drink.

The solution: Drink chilled beverages without ice, or use a straw if you must use ice. The risk of chewing ice is greater than any pleasure that comes from chewing it. Another option is letting ice slivers melt in your mouth. This may help satisfy the need to crunch down. Also, when eating snacks, eat something that’s healthier and softer to chew, such as small tender pieces of baby carrots, broccoli, apples, celery and other fresh fruits and vegetables. If you feel the need to chew on something, try sugar-free gum. It will keep your breath fresh and is much gentler on teeth. Research has shown that chewing gum sweetened with 100% xylitol helps prevent tooth decay. Xylitol inhibits the growth of the bacteria that cause cavities.

Using Teeth As Tools

People often do not recognize the dangers of using their teeth to open things. Your teeth were made for eating, not as a substitute for scissors or holding things when your hands are full. Do not use your teeth to crack open nuts or shellfish, as the shells are like sandpaper on your teeth. When you do this, you put yourself at a higher risk of cracking your teeth, injuring your jaw or accidentally swallowing something you shouldn’t. Some people use their teeth to uncap a bottle, pull out a watch stem, or rip a price tag off a piece of clothing. This can be hard on your teeth, traumatizing them or causing the edge of a weakened tooth to chip off. Using your teeth to grasp objects like these can cause malocclusion (poor jaw alignment), and wear down your teeth unevenly. Malocclusion can lead to a type of jaw pain known as TMD (temporomandibular joint disorder).

The solution: Stop and find something or someone to give you a hand. Think about what you’re putting in your mouth before you use your teeth as tools. Take a few seconds to get a bottle opener or nutcracker and save your teeth for their intended use.

Snacking And Sipping Sugary Drinks Throughout The Day

Frequent snacking on carbohydrate-containing foods can be an invitation to tooth decay. When you eat, the bacteria convert the sugar and starch that remain in the mouth to acid, and that attacks tooth enamel. The longer sugars are retained in your mouth, the longer the acids attack. Sipping sugary drinks throughout the day is another bad habit. The constant exposure to sweet and acidic beverages can foster tooth decay. When you eat, your saliva is breaking down the sugars that are in your foods and drinks. Your saliva is also working to protect your tooth enamel by providing the proper minerals to coat the surface of your teeth. If you’re snacking all day, you’re never giving your saliva enough time to protect your smile.

The solution: Eat balanced meals to feel fuller, longer. When you’re constantly snacking throughout the day, you’re most likely snacking on foods that aren’t so good for your diet or your teeth. And since you’re snacking on smaller portions of food, you’re more likely to be hungrier throughout the day, causing you to eat more and more. If you need a snack, make sure it’s low in fat and sugar. If you indulge in the occasional sugary treat, follow it with a big glass of water to wash away leftover food. Sip sweetened drinks through a straw to minimize sugar and acid exposure to your teeth. Be sure the straw is positioned toward the back of the mouth, not resting against your teeth. Drink water throughout the day. Water naturally rinses your teeth and washes away food particles and acids produced by the bacteria in your mouth. It helps to decrease the pH level in your mouth and helps alleviate the symptoms of dry mouth.

 

This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Employee Spotlight — Keith Boyce

The Employee Spotlight for August shines on Keith Boyce, Registered Nurse and Director of Keystone Urgent Care!

Before becoming Director, Keith was hired as a staff nurse in November 2011 for the (then) brand-new Urgent Care practice. Right from the beginning, he knew he liked what Keystone does in the community.

“I believe in the mission of Keystone,” he said. “The main part of the Mission Statement to me is the last part: ‘Advocating for our patients and the medically underserved.’ It’s the main reason I love being a nurse.”

On a typical day, Keith arrives to the office around 7 a.m. and divides his time between rooming and caring for patients, and taking care of his administrative responsibilities.

“I’m a nurse first, and I don’t want to become detached to what the flow is in Urgent Care,” he said. “We have the ability to help people and make huge differences in their lives. There have been a few patients that we were part of a life-saving event.”

Keith enjoys the unpredictability that comes with working in an urgent care setting. But most of all, he enjoys the people he works with.

“The staff members make this place work, and I can’t sing their praises loud enough,” he said. “We have had everything from active heart attacks to sinus infections. We see and deal with so many out-of-the-ordinary circumstances in Urgent Care, and that keeps it pretty fresh!”

Keith lives in Chambersburg with his wife, Jessica, and they have two sons, Tyler and Jordan. He moved his family back to Franklin County in 2007 after living in Los Angeles for many years.

“I grew up in the area and lived in the projects for all my formative years; I’m very proud of where I came from,” he said. “I moved to Los Angeles in the 80s to make it in music – playing in long-haired rock bands. I even tried out for the Red Hot Chili Peppers in 1992. We moved back in 2007 for a better place for our sons to grow up.”

In his free time, Keith still enjoys being involved in music. He’s a guitar player and musician in a blues-rock band, which mainly plays original music that he has written over the years. They have recorded two CDs in the last couple years and are currently working on a third.

Thank you, Keith, for all that you do for Keystone and our patients!

What To Know About Child Eye Health

Having good eyesight is an important part of completing activities and daily responsibilities. Vision is used to gather information, trigger motor responses, and estimate distances. While adults may be able to detect a change in their vision, it is often difficult for children to identify and express.

Emily Mason, Occupational Therapist at Keystone Pediatric Therapies, shares what parents need to know about children’s eye health.

Are eye chart screenings enough?

Many children are required to have annual eye exams via school or the doctor. However, while these facilities are evaluating children’s visual acuity (clarity of vision), they are often not examining developmental eye movements, or how the eyes are working together. The prevalence of visual deficits and difficulties is increasing among children with special needs, affecting 75% to 90% of these children.

What are developmental eye movements?

Developmental eye movements include saccades, tracking/pursuits, and convergence.

Saccadic eye movements are quick movements of the eyes between two points in various directions (left and right, diagonally, up and down). These movements should be a short, quick movement between the targets, and the child should be able to do it without moving his or her head. These eye movements are important for tasks such as spatial awareness and reading.

Pursuits, or tracking, are eye movements that follow a moving object in various directions. The children’s eyes should be moving together, and they should not lose the target object. If the child’s eyes are jumping, or they are required to move their head to track, the child may be experiencing a visual impairment.

Convergence is defined as the inward movement of both eyes. This means that the eyes are coming together to focus on a target object. A child’s eyes should move inwards together, in a smooth movement. If one or both of the child’s eyes are not converging or if the convergence is delayed, the child will have difficulty focusing on objects and will have more difficulty participating in activities.

What are some signs a child may be having vision difficulty?

If a child is experiencing visual deficits, it can have a huge impact on their performance during daily activities. Children with visual impairment often experience increased difficulty with academic activities – often struggling with handwriting, math, reading and attention. In addition to academic activities, children may also struggle with dressing tasks such as tying shoes and fastening buttons or zippers, which limits overall independence. Vision also plays an important role in motor components of activities such as hand-eye coordination, balance and manipulating small pieces, which are all skills needed to engage in daily activities.

How can occupational therapy help?

Occupational therapists work to improve and sustain quality of life and independence of their patients during their daily lives. Since vision is an important aspect of participating in activities, occupational therapists can integrate vision activities into treatment sessions. By working to improve how a patient’s eyes work together, occupational therapists can, as a result, help to improve a person’s or child’s overall performance and participation in activities that are important to the patient.

 

This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Cards For Kids

Please consider participating in our card drive for National Health Center Week! We have supplies at each Keystone office, or you can use your own. Let’s help bring a smile to kids who need one the most.

Poison Ivy, Oak, and Sumac Tips

While there are many great things about spending time outdoors during the summer, poison ivy, oak or sumac rashes can put a damper on the fun. Shannon Fegan, Certified Physician Assistant at Keystone Urgent Care, shares some advice on what you should do if you come into contact with these plants.

What are the symptoms of poison ivy, oak and sumac contact?

The symptoms include developing a red rash within a few days of contact with the plant. This can develop as bumps, streaks, patches or even blisters that can leak a clear fluid (It is important to know the fluid is not contagious and does not further the spread of the rash).  Swelling and itching also usually occur.  When respiratory contact is made through the plants or vines being burned, you may experience a sore throat, shortness of breath and wheezing. Symptoms from exposure can last 1-3 weeks or more.

What should you do if you think you came into contact with one of these plants?

You should immediately rinse your skin with a degreasing soap (dish liquid), detergent or specialized poison plant wash and lots of water so the urushiol (the oil on the plant that causes the reactions) doesn’t spread further or dry on your skin. Do not scrub the skin vigorously.  Clean under your fingernails with a brush as well.  All clothing should be washed in hot water with detergent, separately from all of your other laundry items.  Also, clean any gardening tools that may have come into contact with the plants with rubbing alcohol, as the urushiol can stay active on the tools for up to five years.

How should you treat a reaction?

You can use cool compresses, calamine lotion, hydrocortisone topical cream, oatmeal baths and oral Benadryl (the topical antihistamine creams or lotions can sometimes cause a reaction that makes your skin more itchy or irritated). Always consult your primary care provider before giving a child Benadryl, as special dosing adjustments are needed.

Are there ways to prevent a reaction?

The most important way to prevent a reaction is avoiding contact with the plants in the first place, and if you think you have come into contact with one of these plants, following the above instructions as soon as possible. There are some skin creams that can be applied prior to exposure if you think you will be in an area you may come into contact with the plants.  Creams and lotions containing bentoquatam are very good at preventing the plant oils from getting on your skin and causing a reaction.  These creams must be thoroughly washed off and reapplied twice daily.  If you know you will be hiking, gardening or working in an area you could be exposed to one of these plants or their oils, be proactive.  Wear long sleeves, pants, boots and vinyl gloves (latex and rubber gloves do not always protect fully).  Do not burn the plants or vines.  If you must burn them, a particulate respirator mask is important to prevent lung irritation and severe reactions.

How can it be spread?

Poison ivy, oak and sumac are spread by contact with their oil, which is released when the leaf or other plant parts are bruised, damaged or burned. Just brushing up against a plant can cause this.  Exposure to an amount less than the size of a single grain of salt will cause a reaction in 80-90% of the population.  This oil can cling to tools, clothing, livestock and pets, so you can develop a reaction by touching one of these things as opposed to direct contact with the plant itself.  It is a myth that you can get “poison” from touching the rash or scratching at the areas; however, scratching the rash can increase the risk for secondary bacterial skin infections to occur.

When should you seek medical treatment?

You should seek medical treatment if your rash is severe, most of your body is affected, your face or genitals are affected, you have a lot of swelling, your rash oozes pus or shows any other signs of being infected or your rash does not get better in 2-3 weeks. If you are not certain whether or not your rash has been caused by poison ivy, oak or sumac, have it evaluated.  Your healthcare provider would much rather see and evaluate the problem for you and provide treatment options, rather than have you worry unnecessarily or allow the condition to worsen.  If you are unable to see your primary care provider, an urgent care or walk-in clinic is a good alternative.

 

This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.