Thursday, January 30, 2014

Freezing in Parkinson's Disease

Not all patient’s with Parkinson’s experience “freezing” (a temporary inability to move); but in patients who are prone to freezing episodes, FALLING is a risk. 

Parkinson's disease message design(Freezing does not only occur when walking, but can also be observed when eating, lifting a cup, or trying to remember something.)         
 What triggers a freezing episode? 
It’s unpredictable, but freezing usually happens when something interrupts the usual flow of movement or normal sequence of events—it can happen during walking, eating, lifting a cup—or trying to remember something . . .

Patient’s who experiencing a freezing episode literally feel “stuck” to the floor or to their chair. 
Some of the typical triggers for a "freezing" episodes that occur while walking include:

  • Walking towards doorways, chairs, or around obstacles
  • Turning or changing directions, especially in a small space
  • Entering an elevator
  • Becoming distracted by another task or conversation when walking
  • Crowded, cluttered spaces or a highly patterned floor
  • Parkinson’s medication wearing off or not working very well
  • Walking from one texture of flooring to another (for example: going from smooth floor to carpet, or vice versa)

Many patients who experience "freezing" may notice that different tricks (or "cues") can help them "unfreeze."  Here are some ideas to consider:

·  Remain calm, take a deep breath, and think it through.(No one should prod or pull the patient—they could fall.)
·  Concentrate on shifting the weight to one leg—THEN take a step.
·  Change direction:  step sideways first, THEN go forward
·  Shift the focus to another movement (raise an arm, point to the ceiling, etc.); THEN restart.
·  Say: “One, Two, Three—STEP”:  THEN restart  (or start humming a rhythmic tune)
·  Carry a laser pointer—shine it in front of the foot and step on the light—this is a “restart cue” (there are actually special canes made with lasers embedded for Parkinson’s patients.)
·  Tape the floor of trouble spots in the room (corners or furniture or door thresholds) as a visual cue (step on or over the tape).
·  March in place when coming to a halt at a trouble spot to keep moving and avoid a "freeze."
·  Step over an imaginary line to take the first step.

Check out these links for more information about "Freezing" in Parkinson's Disease (or just learn more about Parkinson's in general:

Freezing in Parkinson's (pdf version from the UK Parkinson's webpage)

Thursday, September 19, 2013

Happy 12th Birthday, Jamie Sue Turner!! (Dense Deposit Disease Follow-Up)

It’s been a few years since I wrote a blog post about cute little Jamie Sue Turner, an Iowa girl with a rare kidney ailment called “Dense Deposit Disease.”  She is still a cutie, but she is growing up, and in fact, today she is celebrating her 12th birthday. 
Jamie Sue and her pink .22 birthday gift.  

Jamie Sue’s original blog post gets a lot of traffic from all over the world, so I thought it would be nice for readers to see that this young girl is thriving, living her life, dealing with what she needs to deal with medically, and maintaining a positive outlook. 

Jamie Sue performs peritoneal dialysis at home.  Eventually, a kidney transplant will provide some respite for Jamie Sue from this autoimmune kidney disease.  Meanwhile, as you can see in one of her birthday pictures below, she is ready to hunt with her birthday gift—a pink .22 rifle.  Yes, she is an all-American girl. 

God bless you, Jamie Sue!!  Wishing you an abundance of happy birthdays to come!!

Read my original blog post about Jamie Sue "here" to familiarize yourself with the basics of Dense Deposit Disease.

Jamie Sue and sister, Bethany
The University of Iowa Kidneeds page is an excellent resource for more information on Dense Deposit Disease and you will definitely want to check out their page and the additional links they provide about this rare autoimmune condition.

Learn more about Kidneeds and how to find opportunities to participate in their research on Dense Deposit Disease here.

Bethany, Misty (mom), and Jamie Sue

Wednesday, September 04, 2013

Patients with "Bad" Veins Can Prepare in Advance for IV Starts or Blood Draws

          Frequently I have cared for patients with challenging veins.  I prefer to call them "challenging," rather than "bad."  No one wants to be poked and prodded to have their blood drawn or have their IV therapy initiated.  It can be both painful and scary, as a patient, being advised that your veins are "bad" can actually be taken as an insult.  The patient may just feel that the nurse is "bad" at doing the sticking.  To  me, psychologically, it's better to begin with the right terminology to put the patient at ease.

          I have some techniques that have allowed me to have an extremely high rate of IV start success with challenging patients, but as a patient--there are some things that you can also do.  Here is my advice . . .

1.  Push fluids 24 hours prior to your blood draw or IV therapy.  Of course this is not always possible.  But many patients DO know that they will be needing a blood draw or a scheduled infusion on a regular basis. In such cases, really pushing oral fluids the day prior to the IV stick will make a difference.  UNLESS you are on fluid restriction, for some reason, try to take in at least three full glasses of water the day prior.  That extra fluid can make a wonderful difference in plumping up challenging veins.

2.  "Dangle" your hand or arm prior to the IV stick.  Gravity is your friend when it comes to dangling your hand or arm.  Instead of sitting with your hand or arm on the armrest or your lap, if you lower your arm straight down at the side of your chair while waiting for the nurse or technician to assemble the equipment, your veins in that extremity will be a bit plumper, due to gravity pooling some of your blood there.  This can really help.

3.  Apply heat to your veins. Nurses and phlebotomists know that heat applied to the skin above the vein will dilate the vein, making it plump up with blood and helping you have an easier stick.  However, you can't rely on a heating pad or any such helpful device actually being available to the staff.  (I have seen some really creative ways of trying to "make" some applied heat--not always a safe thing to do).  What you can do as a patient is use a hot water bottle that you have prefilled at home--keep it applied to your typically "best" veins to encourage a successful experience.  As an infusion nurse, I always had a heating pad tucked away for a particular patient--or on a day when the weather was so cold that "everyone" seemed to have hiding veins.  Again, that is not something you as a patient can depend on . . . Do ask if there is a blanket warmer available wherever you happen to be (ER usually has those)--wrap a pre-warmed blanket around the arm, and you can get some very good results.

4.  Suggest a vein, but allow your nurse to give a professional opinion.   When I get blood drawn, I usually point and say, "Right there."  But I have great veins, so no problem.  When an experienced provider starts looking at your veins, they make pretty quick judgments about where to go for the IV stick.  I have had situations where I've made my decision and have my needle poised, only to have the patient pipe up with, "You'll never get it there, no one ever does."  Well, actually I may well get it there, but I want every patient to have the right to tell me what works for them--but I'd prefer they tell me right up front.  

5.  Just breathe.  Some patients are better than others about relaxing during their venipuncture.  Some patients go so stiff and tense when the needle touches their skin, that it feels as if their arm has turned to stone.  When very anxious, doing some deep cleansing breaths (getting oxygen to the brain) can only help.  The easiest way to to this is breathe slowly and steadily IN through the nose for a count of 5 and then slowly releasing the breath--on another count of 5.  

6.  Be cautious with the IV.   It seems ridiculous to have to recommend caution, but I have seem some patients who have a hard time with the IV start, soon after start rummaging through their purse and dislodge the catheter!!  Please, don't be that person.  I'm not suggesting you sit completely still--just suggesting that you are extra careful for the duration of your infusion.

Later I'll post some of my favorite tips for the nurse starting an IV on a patient with challenging veins.

If you have a tip to share for patients with difficult veins--please feel free to share that in the comments section below.

Monday, January 03, 2011

Glucose Test Strip Recall, December 2010

Abbott Labs Blood Glucose Test Strip Recall

Abbott Laboratories produces a variety of blood glucose test systems--most of their strips have names that include Precision, Optium, ReliOn and Medisense.  A recall of 359 million of Abbott's blood glucose test strips (359 lots) was announced in December of 2010.  Abbott reports that the affected test strips, which were produced from January through September 2010, are reading blood glucose results incorrectly.  The fault is not with the glucometer, but with the test strips that are included in the recall. 

What is wrong with the strips?

Abbott's press release warns that the faulty strips can cause a blood glucose reading that is too low.  A press release from the FDA further explains that the strips do not absorb enough blood to correctly read the true blood glucose result. A low reading can result in a false sense of security--this is particularly dangerous for individuals with Type 1 Diabetes who rely on accuracy in order to keep from experiencing diabetic ketoacidosis (dka) when blood glucose goes too high.  Harm can result when an individual tries to raise their blood sugar to a higher level (because the reading on the machine is falsely low), or an individual may delay properly intervening to correct a blood glucose that is actually too high.

Prolonged storage and/or exposure to warm temperatures pose an even greater risk of these strips producing a false reading.

What lot numbers are included in the recall?

MediSense® Optium™ Blood Glucose Electrodes

45001A133, 45001A137, 45001A226, 45001A252, 45001A257, 45001A277, 45001A285, 45001A817, 45001A835, 45001A921, 45001C001

OptiumEZ Blood Glucose Test Strips

45358, 45369, 45377, 45504, 45677, 45678, 45681, 45789, 45841, 45848, 45849, 45999, 46000, 46008, 46061, 46067, 46102, 46104, 46117, 46159, 46179, 46201, 46202, 46211, 46230, 46247, 46311, 46312, 46341, 46368, 46369, 46371, 46395, 46399, 46401, 46436

Precision G3b Smartblue Blood Glucose Test Strips


ReliOn® Ultima Blood Glucose Test Strips

45358, 45369, 45377, 45379, 45466, 45504, 45511, 45608, 45613, 45641, 45642, 45644, 45672, 45674, 45675, 45676, 45677, 45721, 45734, 45736, 45739, 45742, 45743, 45789, 45790, 45800, 45801, 45840, 45841, 45849, 45850, 46008, 46009, 46061, 46067, 46069, 46072, 46103, 46105, 46148, 46201, 46202, 46214, 46215, 46232, 46313, 46332, 46336, 46338, 46341, 46368

MediSense® Optium™ Blood Glucose Test Strips

45001A159, 45001A195, 45001A228, 45001A233, 45001A236, 45001A243, 45001A247, 45001A249, 45001A250, 45001A255, 45001A279, 45001A285, 45001A295, 45001A298, 45001A306, 45001A317, 45001A318, 45001A327, 45001A346, 45001A398, 45001A449, 45001A469, 45001A578, 45001A693, 45001A697, 45001A747, 45001A790, 45001A795, 45001A839, 45001A917

Optium™ Blood Glucose Test Strips

45001A484, 45001A486, 45001A512, 45001A514, 45001A517, 45001A519, 45001A527, 45001A541, 45001A544, 45001A552, 45001A558, 45001A564, 45001A572, 45001A598, 45001A665, 45001A677, 45001A709, 45001A713, 45001A732, 45001A771, 45001A819, 45001A852,

45455, 45516, 45708, 45709, 45737, 45738, 45777, 45778, 45783

Precision Xceed Pro® Blood Glucose Test Strips

44535H, 44545H, 44565H, 445A5H, 44645H, 44665H, 446E5H, 44725H, 44745H, 44755H, 44925H, 44945H, 44945H, 44975H, 44995H, 449A5H, 44A15H, 44A35H, 44A75H, 44A85H, 44C65H, 44C75H, 44CE5H, 44CH5H, 44CP5H, 44CR5H, 45025H, 45035H, 450A5H, 450C5H

Precision® Point of Care Blood Glucose Test Strips

45515, 45517, 45701, 45791, 45963, 45964, 46367

If Your Current Strips are Part of the Recall:

Get free replacement strips.  Call Abbott Diabetes Care Customer Service for replacement of your affected strips at no charge: 1-800-448-5234.  Abbott will send you unaffected Precision Xtra, Optium, OptiumEZ, and ReliOn Ultima Blood Glucose Test Strips.
  • While waiting for the replacement strips to arrive, use an alternate method to measure blood glucose (such as a different test system) or purchase at least two weeks worth of new, unaffected strips while waiting for replacement strips.
  • When purchasing from a store or online, be sure you are purchasing strips that are not included in the recall.  You can ask your pharmacist to make certain that the strips they have available are from  unaffected lots.
What to do until you get new strips

If the only test strips available to you are from affected lots, do not stop testing your blood glucose. But do take the following two precautions to reduce the chance of erroneous reading:
    • Precaution 1: Check the amount of time it takes for your blood glucose meter to start the “countdown” after you first apply blood to the test strip. Start timing immediately after blood first makes contact with the test strip.
      • If your meter takes longer than five (5) seconds to start the countdown that test strip is defective and the result should not be used.
      • Check the time for each test strip you use because all of the strips in a package may not be affected to the same degree.
    • Precaution 2: If any reading from a strip appears lower than you would expect or does not seem to match the way you are feeling, you should contact your health care provider.
Pay special attention to signs and symptoms of high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia).
  • Symptoms of high blood sugar include excessive thirst, excessive urination, blurred vision, weakness, nausea, vomiting and abdominal pain. If you are experiencing any of these symptoms or are not feeling well, contact your health care professional immediately.
  • Symptoms of low blood sugar may include trembling, excessive sweating, weakness, hunger, confusion, and headache. Some individuals may have no symptoms at all before they develop unconsciousness or seizures. It is important to treat low blood sugars promptly to avoid loss of consciousness or a seizure. If you are unable to obtain unaffected strips, you should contact your health care provider for advice on how to treat these symptoms before they occur.
In Health Care Settings (Hospitals, Nursing Homes, Doctor's Offices)  

Precision Xceed Pro is a point-of-care glucometer used in some health care settings. If your facility uses this system, check the lot numbers of your test strips against the recalled lots (above).

If your facility has affected strips,the FDA recommends the followingIf available, immediately switch to using test strips from lots that are not part of the recall.
  • If your facility only has test strips that are part of the recall, switch to an alternate blood glucose system (if you have one readily available) and stop using the Precision Point of Care system until you obtain strips that are not part of the recall.
  • If your facility only has test strips that are part of the recall and you do not have an alternate blood glucose testing system available, the FDA recommends the following procedures:
    1. Verify any critical glucose test results (e.g., test results that may be used to adjust insulin therapy in vulnerable patient populations) generated on the Precision Xceed Pro Blood Glucose Test System using a central laboratory blood glucose method. Medical judgment should be applied when deciding whether to act on results prior to verification.
    2. Verify any Precision Xceed Pro Blood Glucose Test System results that do not match a patient’s symptoms, or seem unexpected for the patient’s clinical status, using a central laboratory blood glucose method.
    3. When using the Precision Xceed Pro Blood Glucose Test System, take precautions to reduce the chance of an erroneous reading. Limited evidence suggests that results may be accurate using strips from affected lots if fill time does not exceed five seconds. Monitor the amount of time it takes for the Precision Xceed Blood Glucose Meter to start the “countdown” after blood is first applied to the test strip. If the amount of time exceeds five (5) seconds, discard that test strip immediately because the blood glucose result may be erroneously low. In addition, if this occurs:
      • i. Note the specific lot number of that test strip.
      • ii. Notify Abbott Diabetes Care to report the observed problem with that lot by calling 1-877-529-7185.
      • iii. Make sure to check fill time on each individual strip during use and do not assume if one strip in a package/lot appears to be unaffected, that all strips in that package/lot are unaffected.

. . . .

Monday, June 07, 2010

Which Vaccines are Live?

A patient posed an excellent question when she pointed out that the literature she received about her intravenous rheumatoid arthritis medication recommended that she avoid individuals who have recently received a live vaccine. Because she has many grandchildren who are in the age-range for various vaccinations, she was wondering--just which vaccines are "live?"

"Live" vaccines contain a weakened version of the disease. It is possible for individuals with weakened immune systems (due to disease, long-term steroid use, or because of medications such as chemotherapy or biological drugs that intentionally weaken the immune system) to become ill after being exposed to a live vaccine. A "live" vaccine could unintentionally cause a mild case of the illness that it is intended to prevent.

List of Live Vaccines
(These are "Not OK" for those with weak immune systems):

Influenza (Intranasal Mist):  Don't be confused--the intra-nasal flu mist vaccine is live--this is the one that is squirted directly into the nose. (The injected flu vaccine ("flu shot") is an inactivated or "killed" vaccine and not usually dangerous.)
Polio (Oral vaccine):  Note, only the polio vaccine that is taken by mouth is live; the injected polio vaccine is now the vaccine of choice for most patients.
Rotavirus (Oral and Injectable)
Rubella (German Measles) 
Smallpox (Vaccinia):  After vaccination the risk to persons with vulnerable immune systems is so great, that the vaccinated person is told not to have household or personal contact with pregnant women, infants, individuals with compromised immune systems until the vaccine scab has healed and fallen off. Check out the link for details.
Typhoid (Oral vaccine):  There is also a "killed" (inactive) injected version of the Typhoid Vaccine.
Varicella (Chickenpox)
Yellow Fever
Herpes Zoster vaccine (Shingles)
BCG (Tuberculosis):  This vaccine is rarely given in the U.S.; however, it is still administered in Mexico and in Europe.  (Please note this vaccine should NOT be confused with the TB skin test that is NOT a vaccine, but rather a screening test; the TB skin test, (PPD), is perfectly acceptable for anyone with a weakened immune system.)

List of Inactivated or "Killed" Vaccines
 (These are OK for most patients):

Influenza Injection ("Flu shot"):  Note that the injection is a killed vaccine, but the nasal flu mist vaccine is a live vaccine.
Haemophilus influenzae type b (Hib)
Diptheria Toxiod (included in the DTAP vaccine)
Tetanus Toxoid (Lock Jaw):  Typically combined with the diptheria vaccine
Pertussis (Whooping Cough)
Polio (Injection)
Hepatitis B
Typhoid Injectable: Note that there is also an oral version of the Typhoid vaccine available which is "live." The link gives information about both versions of the vaccine.
Meningococcal (Meningitis)
Japanese Encephalitis (Adult) and Japanese encephalitis (Pediatric)
Tick-Borne Encephalitis (TicoVac) (Not available in the U.S)
Rabies (see also National Network for Immunization Information: Rabies)
Pneumococcal polysaccharide vaccine (“Pneumonia Shot”)

 Sources of Information for Vaccines:

Vaccine Information Statements (VIS): Available in many languages.
CDC Vaccine Information Statements: Available in an audio version and in Spanish
National Vaccine Information Center
National Network for Immunization Information

Tuesday, May 25, 2010

Humanitarian Health Volunteers in Haiti

It's been nearly 6 months since the Haitian earthquake tragedy

The need for humanitarian assistance in Haiti persists.  I wrote a blog in January than pondered the issues and challenges likely to face "first world" caregivers responding to the unfolding medical needs in Haiti.

Recently, Priscillia Patterson, an old friend and a retired Army colonel and registered nurse kindly shared some highlights of her experiences as a civilian volunteer (nurse anesthetist) with the University of Miami Global Institute Medishare Haiti Project. Reflecting on her experience as an Army nurse with two separate tours of duty in the war zones of Iraq, versus civilain humanitarian disaster volunteer nursing, Priscilla wrote, "Traveling with the Army is living large: hot food, cold water, hot showers, flushing toilets, ample staff, supplies, equipment and blood, and even shopping opportunities."  Her experience in Haiti, on the other hand, was in sharp contrast.  The harsh conditions there resulted in "nurse" becoming "patient" one day when 103 temperatures and a 14-hour-day in the spartan operating room left Priscilla (and others among the staff) so dehydrated that she required treatment in Medishare's ER.   

Priscilla kindly granted permission for me to publish excerpts of her emails in my blog:

"We worked everyday from 7:30 am to about  [7 pm] and then were on call for emergencies. Each day was pretty much the same, very busy:  lines and lines of patients, very sick children, traumas, ladies in labor. We tried to care for all who came . . . We managed everything from the routine, to very sick, to trauma, to burns, to labor and delivery . . . There were Haitian interpreters available to translate for us. Some patients understood French but most only knew Creole.

"At eleven in the morning we got mystery meat sandwiches and at five in the afternoon we got a scoop of rice and a fatty, gristly knuckle from an unknown mammal. These meals were cooked somewhere in Port au Prince and brought in on the back of a pick up truck. I do not know who paid for the food, perhaps a charity. The U.S. Army left some MREs behind so we also had these to pick through. Most volunteers brought food like nuts, dried fruit, tuna packets, peanut butter. I preferred the MREs and the dried food I took.

"The U of M Medishare volunteers shared one huge tent. There were probably 100 cots side by side. Some sort of water filter was installed a few months ago, so we got our water from two water faucets. The water supply was limited and the faucets went dry from time to time. We had cold showers and were limited to 60 seconds of water flow . . . We had port-a-potties which were cleaned every morning and supplied with toilet paper. An enterprising Haitian-American businessman has a hot dog/burger wagon which visited our compound on Mon, Wed and Fri. I was more than happy to pay $8.00 for a hamburger and coke.

"There have been tens of millions of dollars given to charities for Haitian relief efforts. I’m not sure where that money is, as I saw little signs of it. Perhaps some charity money was used for the meals of rice and mystery meat, cleaning the port-a-potties and toilet paper. Maybe there is a grand plan for all that money, who knows. All I can say is that if you give or have given to a charity ask lots of specific questions about what the money is going to be used for."

Priscilla shared a few lessons learned: 
Take toys, goodies for the children.
Have at least two water bottles and keep them full at all times.
Take lots of electrolyte drink mix.
Take food.
Go with a buddy
Final Thoughts

I have to admit that Priscilla's description of the warm-hearted spiritual Haitians she encountered who were so greatful for the care they received and accepting their grave situations with grace and humility has inspired me to contribute to the Medishare Haiti Project in some way.  It's wonderful to hear first-hand of a humanitarian aide success story.

. . . .

Friday, April 30, 2010

May 2010 Multiple Chemical Sensitivity Awareness Month

Multiple Chemical Sensitivity awareness is one of the health observances for the month of May.  MCS is also variously known as Environmental Illness, Idiopathic Environmental Intolerance, and 20th Century Disease.  Over the course of the last 8 years I have become acquainted with a number of individuals who are afflicted with this often misunderstood condition.  MCS causes many of those who are severely affected to isolate themselves in order to take refuge from the synthetic fragrances and fumes that are ubiquitous in industrialized nations. 

My interest in MCS resulted from experience caring for one of my hospital patients who is severely afflicted.  (Read about my patient's experience with MCS in my blog post from May of 2009).  Recognizing the lack of scholarly published literature to inform health care providers about the specific needs of the chemically sensitive in the health care setting, I eventually wrote a feature article published by the American Journal of Nursing (AJN) in 2007, Multiple_Chemical_Sensitivity_in_the_Clinical Setting. (At times this article can be read free of charge on the AJN website, but I've noticed sometimes they charge a fee to read it).

Another of my MCS acquaintances is Toni Temple, President of the Ohio Network for the Chemically Injured.  As an severe MCS-sufferer, Toni has written widely about this condition.  Her published work includes the book, Healthier Hospitals, a publication with a wealth of suggestions for accommodating the chemically sensitive in the hospital setting.  Toni is president of the Ohio Network for the Chemically Injured and in this capacity she advocates and lobbies on behalf of the chemically sensitive. 

In recognition of MCS month, I'm including the latest press release issued by Toni Temple on behalf of the Ohio Network for the Chemically Injured:

Ohio Network for the Chemically Injured (ONFCI) Urges Adoption of CDC Fragrance-Free Policy to Protect Health

"The U.S. Centers for Disease Control (CDC) is on record affirming that some building conditions have the “potential to adversely impact the health of building occupants. Potential hazards include chemicals, biological agents, fragrant products, and physical conditions that may cause irritation, illness, or exacerbate existing health conditions.”

"The CDC’s June 2009 internal Indoor Environmental Quality Policy protects employees from many harmful health effects by: controlling VOC emissions that are found in many buildings and commercial products; using integrated pest management to ensure the least possible hazard to people, property, and the environment; utilizing a safety official with qualifications to assess indoor air quality; using biodegradable, low toxicity, fragrance-free cleaning products; and other preventive measures.

"In conjunction with Multiple Chemical Sensitivity (MCS) Awareness and Education Month during May, the Ohio Network for the Chemically Injured (ONFCI), a not-for-profit corporation that educates about and advocates on behalf of those who have been harmed by toxic chemicals in our everyday environment, urges all employers, businesses, and homeowners to review and adopt the CDC policy in order to reduce illness, disease, and disability.

"Readily achievable policies include prohibiting the use of any air fresheners, air wicks, plug-ins, incense, candles, reed diffusers, fragrance-emitting devices of any kind, plug-in or spray air fresheners, and toilet blocks. Encourage fragrance-free personal care and laundry products and request employees to be as fragrance-free as possible. The CDC Policy prohibits applying personal care scented products on any CDC premises. The use of “green” cleaning chemicals and building materials along with monitoring for appropriate ventilation will not only reduce indoor air contamination, but will reduce employee absenteeism as well.

"In a letter to Governor Strickland, Senator Dale Miller asked for the Governor’s “…consideration to develop and put forward an Indoor Environmental Quality Policy for use in all state facilities. The model proposed by the Centers for Disease Control would be an excellent starting place for development of this policy. We need to make every effort to provide work environments that are clean, comfortable, and safe. We also should pay particular attention to protecting those who are particularly sensitive to chemical irritants.”

"Cuyahoga County Public Library’s 28 branches and their administrative office building will participate in MCS Awareness Month. Some branches will display related books and provide other information. A copy of the CDC Policy will be available for copying. The Downtown branch of Cleveland Public Library will again have an MCS Awareness Month display in the Science and Technology Department.

"Many mayors including Cleveland Mayor Frank Jackson, Berea Mayor Cyril Kleem, and Strongsville Mayor Thomas Perciak, will again issue Proclamations supporting MCS Awareness and Education Month in May.

"An MCS article appears in the 2010 Environmental Briefing Book on the Ohio Environmental Council’s website. . For further information about MCS and the ONFCI visit our website at or contact ONFCI at (440) 845-1888.

"For Further Information Contact:  Toni Temple, ONFCI President (440) 845-1888."

. . . .

Wednesday, March 10, 2010

OneTouch Ultra Test Strips Recall

Recall of Some OneTouch Ultra Blood Glucose Test Strips 

 I just received a letter from LifeScan , the Johnson & Johnson Company that manufactures the OneTouch Ultra glucose meters and test strips,  The company has launched an "Urgent Medical Device Correction" --which amounts to the same thing as a recall--of approximately 900 packages of OneTouch Ultra Test Strips.  

The Problem 

The wrong test strips were packaged in certain lots of OneTouch Ultra Test Strips.  Your test strips should be light blue with the name "OneTouch Ultra" printed on them. Like the one on the right.   The strips under recall that were packaged by mistake are of a dark blue color without any writing on them.  These incorrect strips will fit into your OneTouch meter, but they won't turn it on, and they won't give you any result.  All of us who must purchase test strips know that they are expensive at about $1 for each strip, so you will certainly want to take advantage of the opportunity for a refund or replacement from LifeScan.

Check Your Strips

The mislabelled test strips are only contained in boxes that have 100 strips (4 bottles of 25 strips each) and all of them have the same lot number.  Check your boxes of strips (and your loose bottles of strips as well).  The affected lot has this number: 

Lot # 2964512 

Where to Find the Lot Number

The lot number can be found on the side of your box of strips and on the label of your individual 25-count bottles.  (My supplies which are pictured, do not have the lot number in question, but I'm including the snapshots with the lot numbers circled to show you where to look).

What to do? 

If you have any of the test strips from the affected lots, check the strips in the packages.  If you find any of the dark blue strips do not use them.  Instead visit the manufacturer's website to apply for a replacement of your products:  OneTouch Ultra Strips Recall Form You can also call Lifescan's special telephone number that is specific for this problem: 1-866-247-1029. According to their letter, Lifescan will have representatives available to speak with you at this number 7 days a week from 5 a.m. to 7 p.m. Pacific Time.  

Keep up on Product Information about Your OneTouch

To make sure you receive important product information about your OneTouch meter and supplies directly from the manufacturer, visit to register your meter and update your contact information.

. . . All rights reserved for photos and written content, Carolyn Cooper, MPH, RN, March 2010.