Why We Love Junk Food and How to Kick the Habit

By David Martin, President and CEO of VeinInnovations

A trip to the grocery store can be a weekly challenge. The produce is clustered together in one corner; the meat and dairy line the perimeter of the store. These are the areas we should shop in, but we’re pulled into aisles filled with frozen meals, brightly colored cereal boxes, snacks, chips, crackers and candy. So-called “junk food” advertises a siren song of “convenience,” “reduced fat,” “diet” or “on the go.” In reality, the majority of the neatly arranged, smartly packaged food in the aisles is processed nonsense full of sugar, salt and fat.

The most dedicated “clean eaters” sometimes leave the store with a few servings of junk. Even those of us who can recite facts about the poor nutrition and empty calories in a bag of Doritos still take a handful when we see a bowl filled with dusty orange triangles at a party.

Junk food truly is junk, but it’s hard to resist. It’s hard to resist for a reason: the amount of engineering, science and research that go into the sour cream and onion Pringles you see on the grocery store shelf is astounding. Below are a few principles that make your brain crave what you know (rationally) is bad for you.

  • Dynamic Contrast. Bite into an Oreo. The first sensation is the crunch of the cookie, followed by the smoothness of the cream filling. Pairing dissimilar sensations in one bite sets your brain alight! The sensation is novel and enjoyable – though you may regret it later.
  • Calorie Density. Think about the big bowl of Doritos I described earlier. It’s sitting on the coffee table at a friend’s home while you watch football with friends. You start with a handful, and then take another and another until you eat half the bowl. The Doritos in that bowl contain enough calories to make your brain decide they’ll give us some energy, but not enough to signal that you’re full, so you kept eating. You probably know that was too much, but you won’t feel sated until after halftime.
  • Rapid Food Meltdown and Vanishing Caloric Density. How quickly does a thin Lay’s potato chip disappear after you put it in your mouth? The salty yellow chip is gone in seconds. This rapid food meltdown signals to your brain that you’re not eating as much as you are, which is why a whole bag is so easy to consume quickly. When food melts down like this, your brain thinks there are no calories in it. This leads to overeating.

More of the tricky (but fascinating) science is described in this Lifehacker article. It’s a great article; please read on!

We all have our favorite kind of junk, be it soft drinks, M&Ms, potato chips or packaged “fruit” snacks. Are you ready to kick your habit?

  • Don’t keep junk food in your home. When a box of Capri Sun sits in your pantry, you’re tempted to drink it. That box will be gone within a week or two. Skip the aisles at the grocery store that are dedicated to junk. Let your weekly trip to the grocery be the only time you have to resist temptation.
  • Throw away the junk food in your pantry and fridge. Don’t finish it, just let it go! Start clean so you can end clean. Think of it this way: the industry that created that food knows you’re on their hook. They would hate for you to leave them and find a new supplier in the produce aisle. Tell them to shove it!
  • Plan a week of meals and snacks ahead of time. Go to the store with laser focus. Stick to the produce section and the perimeter of the store. Try to use whole ingredients – if there are a litany of unpronounceable words on the side of the box, skip it. A great resource for “whole” recipes is the excellent blog, 100 Days of Real Food. The blog includes information about what “real” food is and ways to incorporate it into your life.
  • Don’t deny yourself everything. Sugar, even the raw, organic variety, is addictive. We humans have been trying to get our hands on it since the Paleolithic era. It is okay to treat yourself; just do it with whole ingredients (and in limited quantities.) This recipe for brownies is one of the very best on the web. It’s simple to throw together and enjoy on a weekend or after a trying Monday.

Changing the junk food habit may be difficult at first, but soon you’ll find you are rarely tempted by those brightly colored packages. And when you go to parties, station yourself away from the chip bowl!

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Effort of Nurses in Wartime Worthy of Recognition Too

By David Martin, President and CEO of VeinInnovations

Nurses are vital to any war effort, yet their service is often overlooked or only briefly mentioned in historical texts and media. The nurses and doctors who travel with soldiers, giving aid along the front lines and sometimes giving “the last full measure” during their service, deserve our consideration. Today, I’m continuing my series about nurses who served during times of war. This week, I’m writing about the thousands of army and navy nurses who saved lives during World War II.

Before the attack on Pearl Harbor, the Army Nurse Corps had fewer than 1,000 nurses. By the end of WWII, more than 59,000 nurses had served under the Army Nurse Corps. Fourteen thousand nurses served in the Navy Nurse Corps at home and abroad. Women – the only gender allowed to nurse during WWII – volunteered to nurse throughout the war but shortages were constant. The government recruited heavily and even passed a nurse draft bill in the House before the war was over. The draft bill stalled in the Senate and then was made unnecessary by German surrender in 1945.

In both the European and Pacific theaters of WWII, nurses served on the front lines. Nurses worked under enemy fire – 16 nurses were killed by hostile fire. In the Philippines, 67 nurses were taken as prisoners of war. Nurses were sent wherever they were needed. They traveled everywhere, often with just half an hour notice. They went without sleep for days and performed marathon surgeries on soldiers in need.

African-American women also served their country as nurses during World War II. They were reluctantly allowed into the Army Nurse Corps. Of the 59,000 women who served during the war, only a little more than 500 African-American nurses were allowed to serve. In the Navy Nurse Corps, only five African-American women were allowed to serve.

Considering the shortages that plagued the war effort, this stonewalling of qualified African-American nurses seems all the more foolish in retrospect. The military worried that African-American women caring for white soldiers was too large a breach of social norms. The African-American women that were able to serve fought to do so. This desire to serve is commendable, especially given the segregation and discrimination faced at home. To learn more about African-American nurses during WWII, please click this link.

The nurses who cared for the wounded and dying never forgot their experiences. Their stories are touching and poignant. My article can’t do them justice, so I’ve included links to stories told in their own words about the men they saved, the ones they lost, and the ones they strove to comfort in a time of great pain.

WWII Army Nurse to Celebrate 100th Birthday

They Called Them Angels: American Military Nurses of World War II

American Experience: Nurse’s Tales

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Nursing Forces in WWI Faced Harsh Conditions

By David Martin, President and CEO of VeinInnovations

World War I earned the moniker the “Great War” for good reason. The First World War ranks among the deadliest conflicts in recorded history. The total number of casualties, both military and civilian, was around 37 million. Sixteen million people died and 20 million were wounded. The majority of deaths were caused by combat, not disease, though Spanish flu caused a significant number of deaths for every participating military force. Many soldiers and civilians required care. American nurses played a vital role in WWI, serving our own soldiers and our allies throughout the conflict.

Although nurses had proven themselves indispensable (especially for the Union) in the Civil War, a reserve corps of army nurses wasn’t established until the Spanish-American War proved how necessary such a reserve was. The Surgeon General established criteria for the reserve nurses and in 1901 the Nurse Corps became a permanent part of the Army.

At the outset of WWI, around 400 nurses were on active duty. By the end of the war, the corps had more than 21,000 nurses, 10,000 of whom served overseas. The nurse corps was exclusively female and comprised of volunteers. One thing to keep in mind is that these nurses proudly served their country at a time when they were not allowed to vote.

During WWI, nurses worked in evacuation hospitals in Europe, on bases, transport ships, hospital trains and in mobile surgical hospitals in America. American nurses arrived in Europe before American troops did. The first nurses set sail in April 1917 and established six base hospitals in partnership with the British Expeditionary Forces.

These nurses worked long hours under harsh conditions. There was little respite from cold weather and water shortages meant bathing and laundered clothes were rare. There was little privacy and little time off. Nurses treated shrapnel wounds, bullet wounds, infections, mustard gas burns, exposure, medical trauma and the newly recognized “shell shock.”

“Shell shock” was initially thought to be caused by the powerful mortar shells exploding around soldiers. The force was thought to shock a soldier’s brain, shaking it in his skull. Doctors began to notice that symptoms of shell shock were appearing in soldiers that had been nowhere near the bombing. These included trembling hands, lost memory, confusion and trouble sleeping were symptoms of neurasthenia, or weakness of the nerves.

The numerous treatments used to care for shell-shocked soldiers can’t be aptly described in this column. The history of WWI’s defining injury is fascinating and heartbreaking. A thorough and compelling article by Caroline Alexander in the Smithsonian Magazine is well worth the read.

Though thousands of nurses served in the dangerous theater of war, there were relatively few casualties, most of which were caused by the Spanish flu. Around 200 nurses died while serving. Many were recognized for their dedicated service by both the United States and our allies. Three nurses were awarded the Distinguished Service Cross. Established by President Woodrow Wilson, the DSC is second only to the Medal of Honor. Three nurses were awarded the Distinguished Service Medal, given to those who provide exceptional meritorious service.

Lessons learned during WWI set the stage for nurses during the next great conflict. Come back next week to learn about the service of nurses in World War II!

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The Treatment of Chronic Pain

By David Martin, President and CEO of VeinInnovations

From a stubbed toe, to a sprained knee or back pain after overdoing it in the yard, many of us experience some kind of pain every day. Some pain, like a stubbed toe, is easily described (perhaps with a shouted four-letter word) and generally goes away on its own. Acute pain usually has a physical cause, like injury, disease, or surgery, and is resolved once you’ve treated the cause and healed. Most of us keep over-the-counter painkillers, like Tylenol and ibuprofen, in our medicine cabinet to deal with everyday pain.

Chronic pain is persistent, continuing for at least three months, and some people live with it for years. An estimated 76 million Americans suffer from chronic pain. Chronic pain may be the result of an initial injury, like a back sprain or a surgery, but there isn’t always a clear cause. Living with chronic pain is challenging, as the condition is often incurable. Management is possible and best accomplished by working in partnership with your physician.

One of the most common tools to treat pain is to prescribe painkillers. When used as recommended, prescription painkillers safely and effectively ease our hurts. In recent years, however, the dangers of prescription painkillers have become clear. In 2010, enough prescription painkillers were prescribed to medicate every American adult all day, every day, for an entire month. That same year, one in twelve people from age 12 used those same painkillers for non-medical use, many using the drugs recreationally.

The high produced by opioid painkillers such as hydrocodone, methadone, oxycodone and oxymorphone is strikingly similar to the high produced by heroin. Unfortunately, opioid drugs and heroin are also similarly addictive. In 2008, and in each year thereafter, more than 15,000 people have died by overdosing on painkillers. That is the loss of more than 90,000 people — roughly the population of Roswell, GA — in just six years.

Prescription painkillers are often an essential part of treating chronic pain. Anyone using opioids should be carefully monitored, although very few people who are prescribed opioids and use them as directed become addicted. Long-term users may become physically dependent on the drugs (this is not the same as an addiction disorder.)

If you are prescribed opioid painkillers, keep them safely stored and make sure that you are the only person with access to them. You can learn more about opioids on the NIH website.

Alternatives to prescription drugs can be used to successfully manage chronic pain. For some of us, the idea that acupuncture or meditation can ease pain seems farfetched. But many non-drug interventions can and do work as pain relievers.

Acupuncture is sometimes represented in pop culture as a trendy treatment used by the “far out.” The therapy that consists of pricking the skin with needles does work, though we’re still not sure why. It won’t work for every patient, but there are no side effects if it doesn’t.

Exercise is medicine. Though going out for a walk or a swim may seem impossible when you’re not feeling great, exercise may be just what you need. Physical activity improves mood and boosts energy. Health conditions may mean that you need to avoid certain types of exercise, so always check with your doctor before getting started.

Yoga, hypnosis, massage and biofeedback can all help manage chronic pain. Each activity is useful for reducing stress. Pain is stressful, and living in a state of stress increases pain. Breaking out of the painful, stressful cycle is very helpful when working to manage chronic pain.

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Don’t Overdo It in Pursuit of a Perfect Beach Body

By David Martin, President and CEO of VeinInnovations

What’s a better indicator that summer is coming: the first day you have to remove your jacket outside or the magazine headlines promising “The Ultimate Beach Body Workout” inside their pages? The pressure to be fit (but more importantly, thin) ramps up when the weather warms. Winter holidays centered on family and feasting contribute an extra pound or two every year. Sweater weather is a cover for weight gain, but the summer heat forces us to leave little to the imagination. Don’t jump into a crash diet or a masochistic exercise regimen in fear of the beach! Moderation is key, even when pursuing healthy activities.

A troubling tendency of those in a hurry to get fit is to push through the pain, heeding that outdated adage, “No pain, no gain.” There’s a distinct difference in using your last ounce of resolve to sprint at the end of your race and ignoring an aching joint in your knee so you don’t miss a morning run. You know your body. It’s there with you through everything from the winter nights spent on the couch to boot camp on a summer morning. Know the difference between good pain (the kind you should push through) and bad pain (your body’s way of saying it needs attention and a break.)

After a workout, good pain is indicated when there’s a general feeling of soreness throughout your body. That’s the best kind of tired. After a cool down and a shower, you’ll be ready for a good night’s sleep. If you feel pain in a specific place after a workout (be it your knees, shoulder, or back) take a break. You’ve overdone it.

Did your arm muscles start to burn while you did pushups? That heat is good pain and should dissipate soon after your finish your set. You might even be ready for another ten after your break! Did your shoulder feel pinched during your pushups? Does it hurt after you’ve stopped? Don’t attempt that next set.

Have you started taking runs around Chastain Park in the morning? You should feel tired and ready for a drink of water when you’ve finished the loop. Pushing past your fatigue to finish that last mile helps you get faster and stronger. If your knees are aching or your leg muscles feel as tight as rubber bands, you went past the point of healthy and veered into foolhardy.

I mention running in this list of good pain/bad pain because runners are trained to keep going. Mental tenacity is vital for a marathon runner. They’re aren’t many people who see mile 18 come and go and can still keep the pace until the end of mile 26. The same mental tenacity that keeps runners going until to the finish line is the same mindset that sometimes keeps them from acknowledging their body’s needs.

Remember that a small problem — like symptoms indicating the beginning of shin splints — can be treated easily when you catch it early on. Little problems won’t force you onto the sidelines, but ignoring them may!

When magazines and television and advertising send messages that we’re not good enough as we are, it’s hard not to feel pressured. Maybe it is a good goal for you to get in shape. But remember, the women and men on the magazine covers have been photoshopped. Be realistic about the goals for your body. By all means, use the warm summer weather to get outside and get exercising. Just to listen to what your body tells you so you can enjoy the whole season and not just the first three weeks!

Still feeling the pressure of the “Beach Body”? I highly recommend this article on “How to Get a Perfect Beach Body.” It should help you ignore the frantic messages of perfection at any cost!

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What Happens to the Uninsured Now That The Health Insurance Marketplaces Are Closed?

By David Martin, President and CEO of VeinInnovations

After a lot of fretting and fussing on 24-hour news channels of both political bents, the health insurance marketplaces opened, did business, and closed. More than seven million Americans purchased insurance while the marketplaces were open, despite a very rocky rollout and multiple protest campaigns. The Obama administration celebrated in public and likely breathed a sigh of relief in private. This week, I’ll cover the “death spiral” and what the uninsured will face until the marketplaces open again in November.

The “Death Spiral”

The term “death spiral” is used in several industries, from accounting to figure skating. In the insurance industry, a death spiral is responsible for the demise of a company. A death spiral is created when the pool of insured people isn’t a healthy blend of healthy and sick people. When people are sick, they use more services. Without enough healthy people paying into the system through premiums, costs rise for the insurance company. The following year, the company is forced to raise premium costs to cover the needs of the sick. When the costs rise, only the truly sick sign up. Costs continue to rise until the system falls apart.

The Obama administration focused a lot of attention on young people. Generally, they’re the healthiest and least likely to need care. What the healthy pay in premiums makes affordable care possible for us when we get sick – it’s what keeps the death spiral at bay. The administration partnered with FunnyorDie, a comedy website with lots of appeal among the young. President Obama even appeared in an episode of Between Two Ferns, a fictional talk show hosted by the painfully awkward Zach Galifianakis. The help of Galifianakis and LeBron James, who also joined in promoting the health insurance marketplaces, was credited by the administration as two of the most effective means of enrolling young people.

Still Uninsured?

If the goal is to insure everyone, some might wonder why the marketplaces close at all. If the marketplaces were available year round, there would be no incentive to buy insurance until you needed it. You’d buy insurance when you were diagnosed with cancer or broke a leg, taking from the pool of money collected through premiums without ever having paid into the system. If you want to buy insurance on the marketplace, you have to do it during the months it’s open for business. This year, there was a surge of last minute applications. (Incidentally, those were the enrollees that pushed the number of newly insured past the seven million person goal.)

The marketplaces will open again on November 15, 2014 and close on February 15, 2015. Until then, the uninsured will be responsible for all of their own health care costs and have to pay a tax penalty.

There are exceptions to the rule, of course. If you lose your job and thus your current coverage, you can use the marketplace. If you get married or divorced, have a baby or adopt a child, you’re able to enroll during the marketplace’s “off season”. The full list of exceptions is available here.

Last week, I wrote about advance directives and how to put one together in Georgia. NPR’s Planet Money covered advance directives and released an informative podcast about the difference directives can make by visiting a town where almost everyone has planned for their death. The podcast is short and well worth the listen! You can listen to the story here.

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Spare Your Loved Ones By Making Your Final Care Wishes Known

By David Martin, President and CEO of VeinInnovations

Today, I’m going to write about a subject most of us find unpleasant — death. Starting a conversation about death, especially when we’re discussing our own death or the death of a family member, is often so difficult that it doesn’t happen. Avoiding discussions about death doesn’t make it any less inevitable, but it can make the eventuality less peaceful.

If we could plan our deaths, we would all gently pass in our homes surrounded by loved ones. The reality is never as easy as we hope, and the burden of final care decisions often falls on family members or a loved one. Without a clear understanding of your wishes for end-of-life care, those decisions can become stressful and painful.

When we take time to decide for ourselves (and put our wishes in writing) we spare our family and the people who love us the unfortunate task of guessing about what we would want. Make your wishes clear and ensure that your decisions about end-of-life care are respected by setting up a living will and appointing a health care proxy. You do not need a lawyer to create a living will or appoint a health care agent, though you may wish to consult with one.

Living Will

A living will is a document that states your wishes when you are no longer able to represent yourself. A living will makes clear the types of medical treatments and-life sustaining measures you want as part of your end-of-life care. The will does not go into effect until two physicians certify that you are unable to make medical decisions in the medical condition specified in your state’s living will law. (This could include terminal illness or permanent unconsciousness). Other stipulations may exist — living will laws vary from state to state. In Georgia, living wills go into effect when we have a terminal condition or are in a persistent comatose condition or persistent vegetative state.

When creating a living will, you will determine what medical intervention you do and do not want. As technology has progressed, we have more choices and must make complex decisions about our death. Do you believe that any and all measures should be taken to keep you alive? Do you believe that when the time comes you would rather abstain from life-sustaining measures? Most religions support the use of living wills, but some are very opposed. You may want to discuss your decisions with a counselor from your religious community such as a priest, rabbi, imam or minister.

Appointing a Health Care Proxy

Just as important as a living will is appointing someone to make health care decisions for you when you are unable to do so. This person should know your wishes and have discussed them with you in-depth. They should be comfortable acting as your agent. You should be able to trust that they will make decisions in accordance with what they know you would want.

Choose a health care agent carefully. Take the time to have the uncomfortable discussion about end-of-life care. When the time comes, your loved ones will be grateful — you’ve made your decisions, which means they aren’t forced to do so for you.

Once you’ve made decisions about end-of-life care, talk to your family, doctor and friends. Let them know your wishes, especially if they may be called on by medical staff. Help them understand why you’ve chosen the care you did and why it matters to you. Don’t leave loved ones guessing!

To learn more about end-of-life care in Georgia, please refer to the following websites:

Understanding the Georgia Living Will
Georgia Advance Directives
Living Wills and Advance Directives for Medical Decisions
Advance Directives

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Spring is Here, and So Are Allergies

By David Martin, President and CEO of VeinInnovations

Temperatures are climbing as the weather begins to reflect what the calendar declared in mid-March – it’s spring! Along with azaleas come allergies, and this year experts anticipate a harsher than usual allergy season. Thank the infamous polar vortex. Winter weather has continued on longer than normal, setting the stage for a sudden, shortened spring. If trees have to make up for lost time and a shorter spring, pines, oaks, and maples eager to reproduce will release higher than average amounts of pollen.

A quick Google search for “2014 allergy season” will show headline after headline decrying this year to be the “worst ever”. Take those headlines with a grain of salt. The same headlines appear when you Google “2013 allergy season”. Still, it’s good to be prepared. The side effects of allergies to mold, pollen and grasses are certainly miserable. We’re all familiar with the sneezing, itching, and stuffed and runny nose that accompanies the burst of plant growth and reproduction each year. If you’re worried about this year and anticipate an extreme (or just annoying) bout with allergies, start taking your allergy medication now.

Allergy Tests

Many common allergies are easily diagnosed and treated by over-the-counter medication. The majority of us know when the pollen count or ragweed is the cause of mild allergic reactions. Mild allergic reactions include hives, itching, watery eyes, runny nose, nasal congestion or a rash. If you treat your symptoms with over the counter medicine and it has no effect, it may be time to contact your doctor. A variety of tests are available to help determine your specific allergies, from dust mites to pet dander.

The most common allergy tests are the scratch test and the patch test. The scratch test is administered in a doctor’s office – one of the (very) rare risks of the test is an extreme allergic reaction, so the staff will want to keep you close to appropriate emergency equipment and medications. The scratch test is simple. A numbered grid is drawn on your inner arm or upper back, then extracts of common allergens are placed on your skin. A tiny needle is used to prick the skin, scratching it into the surface of the skin. The procedure sounds painful, but it isn’t. The needles used are so small, and the prick so tiny, you barely feel it. If you are allergic to a specific allergen, a red wheal (a bump that resembles a mosquito bite) will form.

The patch test is used to determine if a particular substance is causing skin irritation. Patch tests are used to determine your reaction to things such as latex, metals, hair dye or fragrances. The test’s name is its best description. Allergens are placed on patches, then placed on your skin for about 48 hours. Irritated skin at the end of the test indicates a potential allergy.

Every family has an at home remedy favorite. For some, spicy food is the ticket to clear nasal passages. For others, it’s breathing in the steam from a bowl of hot water mixed with horseradish. Your best bet is over-the-counter medication, although spicy food can help if you’ve got the constitution for it!

Update: HB 885 (legalizing limited use of medical marijuana in Georgia) failed last month. The bill’s supporters point to a last minute addition of an unrelated autism mandate. You can read about that issue here and here.

I wrote about the bill, named Haleigh’s Hope, and the bill’s namesake, Haleigh Cox, last month. Since then, Haleigh and her mother have moved to Colorado, where Haleigh has been able to use the cannabidiol oil (CBD) she needs. According to her mother’s Facebook page, the medicine is already helping Haleigh. You can follow their story here.

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When the US Fought, Nurses Were There

By David Martin, RN, CRNFA, President and CEO of VeinInnovations

Certain wartime images become fixed in the American memory. These famous images, like the flag raising at Iwo Jima and the V-J kiss in Times Square, capture the bright moments in dark times. Surrounded by the suffering and privations of war, human compassion takes on a brighter hue. The courage and perseverance of the soldiers at Iwo Jima and the exuberance and relief evident in the kiss in Times Square have secured those images in American memory.

Shining moments during wartime deserve to be remembered and celebrated, but so too does the dangerous, sometimes deadly, work performed behind front lines. In this spirit, this article is dedicated to remembering the role of nurses in American conflict. Today, I’m writing about the American Revolution and the Civil War. Nurses played a vital role supporting military efforts in both conflicts. In these two wars, at least, the history of nursing is also (in part) a history of the role American women played in wartime. Banned from fighting, women were able to contribute through the socially acceptable role of caretaker.

I can’t hope to cover all the accomplishments and details of nursing here, but at the end of this article you’ll find links to more reading material. Please read on! Researching this topic was an enjoyable lesson in American history, especially since I am a nurse, and am also the son of a nurse.

The American Revolution

During the Revolution, the ragtag American army of farmers-turned-foot soldiers brought an entourage along with them. Women and children, now known as “camp followers,” marched in unison with the army hoping for food and safety. The women were often, but not always, wives of soldiers fighting on the front lines. (The front line was usually only a mile or so from where the troops made camp.) Though military resources were strained, even George Washington was loathe to send the followers away. Too often, soldiers would abandon the war to tend to their families.

Camp followers had to earn their keep if they expected rations. In the early days of the war, women washed clothes, cooked, carried water for the troops and worked as seamstresses. Very few were willing to work as nurses. In those days, working with the sick was often the cause of your own demise. Congress and the army preferred female nurses to male ones – with women tending to the sick, dying and injured, men were freed for service in the battlefield.

Reluctance to take up work as a nurse was common. Nursing was possibly the dirtiest job during the war. Much of what nurses did during their long hours of work was clean the hospital and patients. Chamber pots were to be promptly emptied, new patients bathed, old patients given a face and hand wash, linens changed, the hospital swept and finally cleaned with vinegar. All duties were performed, it should be added, amidst the real fear of contracting smallpox or a camp fever.

In 1777, a nurse’s wage was raised to eight dollars a month. Even with good wages, nurses were in short supply throughout the war, and women were often bribed or threatened into a nursing role. Regiments across the colonies struggled to find enough nurses to meet demand throughout the war.

The Civil War

Since the founding of our nation, Americans have struggled with the issue of slavery and how to be a truly united country. In 1861, we began the bloody fight that ended slavery and united our nation. By 1865, the South was defeated. Four million men had fought in the war. It’s estimated that 750,000 perished.

Both the Confederate and Union armies employed nurses. Dorothea Dix was appointed Superintendent of Women Nurses by the Union in 1861. Under her leadership, 3,200 women served. Requirements were stringent. Nurses had to be married, over 30, matronly in appearance, and have two letters of recommendation. Nurses were also expected to pay their own way. For their service, they were paid 40 cents and day and provided one ration.

The Union army was unprepared for the treatment of casualties, a fact the Union nurse Clara Barton recognized early in the war. In 1862, Barton successfully petitioned the military to provide supplies and personal aid on the battlefield, which she and others delivered to the front for the next two years. She was dubbed “The Angel of the Battlefield” after surprising Union surgeons with wagons of much-needed medical supplies while the battle of Antietam was still being fought. Barton’s commitment to care continued after the war was over. She went on to found the American Red Cross. Barton’s life and work is, put simply, incredible. There is not enough space to properly discuss her accomplishments here. Please follow this link to the American Red Cross to learn more.

In the Confederacy, women were also called upon to minister to the wounded. Kate Cumming, a native Scotswoman who immigrated to North America as a young child, felt called to nursing in 1862. Most nurses only served short tours. Cumming worked from 1862 until the end of the war. Her life in Civil War hospitals is chronicled in her book, A Journal of Hospital Life in the Confederate Army of Tennessee from the Battle of Shiloh to the End of the War. Her work is an important primary resource shedding light on the conditions endured by medical professionals and patients alike.

On both sides on the war, nurses faced danger, privation and exposure to disease. Though germ theory (which states that specific diseases are caused by specific microorganisms) was developed beginning in the 1850s, it was not fully accepted until the 1920s. Many lives might have been saved in the Civil War had germ theory been more widely accepted. Two-thirds of the casualties in the war were caused by disease, not mortal injury. The most infamous treatment (and also likely overused) was amputation. Soldiers under the knife faced more than the risk of bleeding - few surgeons understood the necessity of sterilization and the risk of infection.

Civil War nurses tended to the wounded where they fell. For Union nurses like Barton, that meant travelling to the front. For Confederate women, it meant tending to the wounded in their homes and on their fields. Soldiers on both sides of the war owed a debt of gratitude (and often, their lives) to the nurses that risked their own lives to care for them.

Further Reading

Thomas Jefferson: Quotations on Slavery and Emancipation

The Roles of Women in the Revolutionary War

Women’s Service with the Revolutionary Army

New Estimate Raises Civil War Death Toll

American Red Cross Founder Clara Barton

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Debunking the Myths of Heart Disease

By David Martin, President and CEO of VeinInnovations

The statistics surrounding heart disease are shocking. Heart disease is behind one of every four deaths in the United States, about 600,000 deaths a year. Our cultural image of a person having a heart attack is almost exclusively a middle-aged man clutching his arm and asking for a doctor, but in reality women are more likely to suffer a heart attack.

One in three women die of heart disease. Too often, women ignore the warning signs of a heart attack because they subscribe to the popular myths that heart disease primarily affects men and older people, and women only if they are obese or unfit. Another popular misconception is that the only real symptom of a heart attack is chest pain.

Although many assume heart disease is a man’s disease, more women die from heart disease than men. One of the reasons this assumption exists? Marketing. Think back: how many ads and PSAs have you seen promoting breast cancer awareness or a walk “For the Cure”? While breast cancer (and general cancer awareness) are overall positive influences, women should know that the most pressing risk to their health stems from heart disease. Happily, the same practice — regular, strenuous exercise — can reduce your risk of both breast cancer and heart disease!

Cultural narrative and media influence also lead most Americans to believe that a heart attack only affects older individuals. Most of us believe that a heart attack is caused by the wear and tear of life — clogged arteries caused by overeating, sedentary lifestyle and high cholesterol. While risks of a heart attack do increase with age, young women should know that they are not immune to having one. Use of birth control and smoking can increase the risk of heart disease by 20 percent. Underlying heart conditions are a risk factor many women don’t know about until they’ve already suffered a heart attack.

Obesity and a sedentary lifestyle are risk factors for many diseases and a cause of early death for many Americans. However, fit women who exercise regularly and pride themselves on twice-weekly visits to the gym should be aware that they are still at risk for heart disease and heart attack. Family history plays a large role. If your family is prone to heart disease, the American Heart Association recommends you start requesting a cholesterol check at age 20 and that your provider keep an eye on your blood pressure as well.

We imagine that the overwhelming majority of people who have heart attacks are obese or overweight. Heart disease affects everyone. Our overwhelming tendency to equate slim with healthy is damaging to everyone, regardless of body shape. Hopefully, those with faster metabolisms and slimmer figures know that if they don’t exercise and eat properly they’re no better off than people carrying a few extra pounds.

Finally, let’s discuss symptoms. On television, the symptoms depicted are chest pain and a funny, awful feeling in the left arm, but there are many more signs. One of the reasons women are more likely to die of a heart attack than men is that they fail to recognize the symptoms. Some signs of heart attack are more pronounced in women. Below is a list of heart attack symptoms common for both men and women followed by symptoms that are more common in women.

Symptoms of Heart Attack in Men and Women

  • Shortness of breath
  • Feelings of anxiety, fatigue and weakness that can’t be explained but worsen with exertion
  • Stomach pain
  • Dizziness
  • Nausea
  • Severe chest pain
  • Pressure and tightness in the chest, usually lasting for a couple minutes, sometimes coming in waves
  • Paleness and clammy sweat

Pronounced Symptoms of Heart Attack in Women

  • Pain in your back, neck, ankle, shoulder blades or stomach
  • Jaw pain
  • Lightheadedness, sweating
  • Nausea or vomiting
  • Overwhelming/unusual fatigue

Heart disease is a major killer of both men and women in the United States. The facts deserve space in the media and in our cultural narrative. Lives hang in the balance, so spread the word!


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