Date Your CPAP

I have mild-moderate sleep apnea for which I was prescribed a CPAP machine to help control my breathing by forcing air into my nose as I sleep.  CPAP masks come in different shapes and my particular machine has two soft "pillows" that fit snuggly over my nostrils. The mask is connected to a long hose that is itself connected to a machine.  Try talking while you have the CPAP on and you will no doubt sound like Darth Vader, but other than the occassional slippage of air, the machine is pretty quiet.  Unfortunately, it is still a bit awkward and can take some time to get used to.

Two days after trying out a CPAP I had to go on a Complete Care Leadership site visit and I must have looked pretty wiped out from not sleeping because the CPAP was so awkward.  Tim Ho gave me some excellent advice though after asking me a couple personal questions.  The first question was... "Would you sleep with someone you just met or would you wait to get to know them?"  Of course I said "NO" (my husband can confirm that response).  His next question was "How would you get to know them better?"  "Dinner, movie, cuddled up on the couch, etc."  Dr. Ho's advice then followed... "You need to DATE your CPAP.  Get to know how it feels by using it during the day or the evening while watching TV, reading a book, etc.  Don't go to bed with it for at least 7 dates (one week)." 

I did as Tim instructed and have found great success.  Now it doesn't feel awkward or like a stranger to me. 

Improving Quality, Setting Records, Having Fun

On Friday, November 5th, 2011 our Complete Care Leadership team had our monthly site visit with Kaiser San Diego, starting off the morning reviewing the operational challenges, opportunties, and successes at our Rancho San Diego MOB with Dr. Michael Moreno and his new Medical Office Adminstrator (MOA), Noreen Bristow.  This MOB has definitely had it's share of challenges over the past several months with a vacant MOA position and a few MD turn overs, but that didn't curtail their enthusiasm.  Noreen, having worked in PCM (Population Care Management) is well versed at pulling CSG and POE numbers to see where they need to make improvements and Dr. Moreno has challenged her to put that knowledge to use to help drive Rancho San Diego to be in the top sixty mob rankings within the next few months.  The staff were all aware of their current MOB ranking and seemed determined to climb that ladder together.  They were especially excited to share with us that they recently were given access to a mobile mammography unit which comes to the clinic 1 day a week which has allowed them to close mammography care gaps on the spot instead of sending the patient to the medical center or to a near by clinic to complete the mammogram since their clinic doesn't own a mammo machine.  It was also great to hear that this MOB has abondoned the idea of sending letters to their patients who are active members on Kp.Org and instead send them emails to their Kp.Org account to remind them of overdue care gaps.  They are also using the registration staff to contact members through live phone calls to members due for cervical and breast cancer screenings.  These are great examples of using the right staff to do the right work and taking advantage of the most cost effective, patient preferred communication. 

In our afternoon visit with the San Diego Leadership and Complete Care team after discussing our MOB visit and San Diego's overall performance, along with opportunties and successes, their leadership team distributed crazy sunglasses and asked us to take a group picture to help celebrate with them KP's success of reaching for the STARS.

The San Diego leadership team has a way of bringing people together to make the hard things easier to do by making them fun while staying focused on the end result.  One such way of unifying the staff to achieve great outcomes while making things fun is shown by San Diego's passionate obsessions with setting Guinness Book of World Records.  Below is a picture of their Guinness Book of World Record's Wall - less their lastest record which will bring the total to 11!!!

You can read about their latest record set for Breast Cancer Screening here. The new World Record will be Kaiser Permanente San Diego’s 11th World Record since 2010 to prevent illness and promote health and well-being.  You can also check out George Halvorson's July "Be Well" article on world records.

Other records set by KP San Diego:

Most vaccinations in eight hours by almost double

Most skin cancer screenings in an 8 hour period

Largest exercise class on a physio ball

Most number of blood pressure screenings

Most Diabetic Foot Exams

Most Cervical Cancer Screenings

Most Colon Cancer Screenings

Most Hands Washed

Seeing STARS

Celebrating success in seeing STARS at our KP San Diego Complete Care Site Visit - San Diego Leadership and Complete Care team reminds us it's okay to have fun while working on reaching stars.

A Script for Chewing Gum???

Here's a prescription my daughter would actually take!

Chewing Gum Cuts Ear Infection Risk in Kids

In a review and meta-analysis of four studies: three randomized controlled trials in 1,826 Finnish children, and another among 1,277 Finnish children in day care who had a respiratory infection researchers saw a reduced risk of acute otitis media in children who were given 8 to 10 g/day of xylitol in any form -- either as gum, a lozenge, or syrup - Gum working the best.

Potentially... two pieces of chewing gum five times a day after meals for at least five minutes -- can prevent acute otitis media in kids without acute upper respiratory infection.

Reading this article brought up a fond childhood memory of our family vacation trips where we would have to go over the grapevine.  My sisters and I all had bad ear problems when we were young, three of us requiring surgery, so changing elevations where our eardrums would pop was a very painful experience.  My parents didn't like us chewing gum on a normal basis, but they always gave us gum before we crossed the grapevine.  What a treat that was!  As a child, I associated the gum as part of the vacation experience and didn't know there was some other possible medical reason for giving the us gum.  Maybe the gum didn't actually do anything for us medically, but it sure got us to focus on blowing bubbles instead of popping eardrums.

Now when I fly, I always carry gum.  Not just for me, but for the crying kid sitting next to me. 

We have a pretty popular neighborhood for trick or treating and get people that will literally pull in to our driveway in a van and have 12 little kids pour out to come get our treats.  Kids of all ages, shapes, and sizes hike up our steps to see what treat awaits.  My family teases me because I give out glow sticks and glow bracelets to trick or treaters instead of candy. I do this because 1) I think there is too much diabetes in the world, 2) you need to be able to see the kids and parents who are darting across a busy street in dark clothing for someone else's candy, and 3) because, well... it's just cheaper than buying candy. $15 dollars will buy me 300 glow bracelets!  My husband thinks I'm cheating those kids because I don't give candy and always goes out and buys some tootsie rolls to pass out, like a drug pusher sneaking a piece of candy in some other person's territory.  Not cool...  The funny thing is, my older daughter was handing out my glow bracelets with me this year and after one particularly chubby child walked away, she whispered... "Yep... he'll have diabetes one day".  I had to laugh because it told me that my kids really do listen to me (even if they pretend they don't).  This morning my 16 year old text me the following picture and said... this sounds like something you would say.  Unfortunately, she is right.  So... here is a little math and medicine for you.