Celeste Conn - Chestertown Spy

Red Eyes

January 15, 2013 by Celeste Conn

This seems like a good time of year to talk about red eyes. Certainly mine are! My excuses might be staying up late at night, or having one glass of wine too many. But my cat’s eyes are red too, and I’m sure he does not share those extravagances. Red eyes come from so many different causes.

We think of blepharitis – an inflammation of the lids. Or conjunctivitis, where the delicate tissue surrounding the eye is irritated. Then there’s Cherry Eye, the protrusion of the third eyelid gland which gets stuck out of place in breeds like cockers or English Bulldogs. We all know what bloodshot eyes look like and many of the causes – fatigue, allergy, or irritants on the surface of the eye.

Sometimes we catch a glimpse of the shimmering red/gold/green reflection of an animal’s tapetum, the reflective part of the retina. That demonic glow is normal anatomy in lightly pigmented individuals.

As you can see, many structures in and around the eye can be red. But it’s rarely normal. With the exception of the retina, eyes should not be red. So what are the causes of the color change?

Every one of us has rubbed his or her own eyes when we shouldn’t have, creating or responding to an irritation. Wind-blown particles can damage delicate ocular tissues. So please don’t drive down the road with your dog’s head all the way out of the car window! Road debris can act like projectiles striking the eye. We’re all aware of the havoc pollen can wreak on conjunctival membranes. And this time of year, with our houses closed up and windows rarely open, indoor air can stagnate.

Whether from cigarette smoke, perfumes, scented candles or plug in fresheners, indoor air can be heavy with particulates. Carpets also trap dust mites and dirt, which exacerbate allergies. Hepa filters and humidifiers go a long way to restoring the freshness of the air quality and assuage irritated ocular and respiratory tissues.

My cat Chewbacca’s eyes are red because of allergy. He suffered no such distortion when he lived in New England. After his arrival in Maryland, his allergies started: his eyes became red, his ears produce more wax, he sneezes and snorts. All allergic symptoms in cats. Topical steroids will ameliorate these signs and give comfort.

When it comes to cherry eye however, the treatment is surgical. Since the problem often appears when pups are less than one year old, the repair can be combined with spay or neuter surgeries. Effecting the repair is a good idea since an everted third eyelid can cause decreased tear production and dry eye later in life. Cherry eye rarely occurs in cats, but when it does the Burmese typically is the affected breed.

The gorgeous tapetum is a colorful area of the retina which improves low light vision. That’s the reason it’s more prominent in cats who are more nocturnal than people or dogs. It allows them to see better at night.

There are many reasons for color variations in eyes. But red is one we shouldn’t see too often.

Dr Celeste Conn has a house call practice in Kent County. She lives in Worton with an old lab and an old Maine Coon cat.

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Senior Pet Care

November 6, 2012 by Celeste Conn

I’ve been fielding lots of questions lately regarding senior pet care. Clients have concerns that their elder pets are comfortable, that their pet’s health is as optimal as possible given his or her life stage and that as owners, they are doing all they can to maximize a cat or dog’s longevity. So I thought I’d share some insights about a subject dear to my heart.

Dr Celeste Conn with her Maine Coon Cat, Chessie

My dad used to say, “It takes a lean horse for a long race.” Don’t know if he made that up, but I do know what he meant. To live a long life, shed those extra pounds!

Pet food manufacturers all market senior diets. These foods are limited in calories and often restricted in minerals like phosphorus for kidney health. Most are also beefed up with antioxidants. Depending on breed, many consider 7 years and over to be senior and the appropriate age to switch diets.

Another maxim of my dad’s was that you had to keep old dog legs moving. These adages certainly echo what we know to be true in human medicine. Dog bodies too are meant to move, and to do so, they should be free of excess weight.

We all lose muscle mass as we age. Exercise helps minimize muscle loss. And movement of any type circulates joint fluid, stretches tendons and keeps ligaments loose. In short, it reduces stiffness. We often forget that cats get arthritis too. Owners complain that their cats don’t jump up on things anymore or make several attempts and fall. This can be a sign of osteoarthritis. Joint supplements like glucosamine and chondroitin help repair damage from arthritis and are available for both dogs and cats. Contact your vet about appropriate dosages.

Senior pets very often benefit from proactive blood testing. Routine screening frequently detects altered thyroid states (hypo in dogs, hyper in cats), anemia or all too commonly kidney disease. Many of these problems can be addressed with medicine or dietary change. Vets recommend seeing a senior pet twice yearly to monitor changes in blood pressure, weight loss or gain and to keep owners informed of subtle changes in an animal’s physical condition. Remember that vision and hearing deteriorates as pets age. Dogs develop cataracts and don’t see well in low light situations. Keep that in mind when letting a dog out at night as he may be momentarily blinded. Ramps or carpet runners help an old dog traverse treacherous steps or slippery floors. Simple things like keeping nails trimmed can help an older dog take better purchase on the ground and ensure good footing.

Consider a heated bed or certainly one raised off a cold floor.

Dogs get more lumps and bumps as they age. Some lumps are malignant, but if caught early, can be safely removed.

So frequently the quality of life for a senior pet is dependent on the observation skills of his or her owner. My Maine Coon cat Chessie is 18 ½ years old. His excessive water drinking prompted me to do blood work. That revealed failing kidneys. So I changed his diet. Because his urine is dilute, he is prone to urinary tract infections. He started urinating outside his box. I put him on antibiotics. His arthritic legs can’t go down stairs to the litter box so I moved it closer. Colder temperatures make his joints stiff. Now he has a heated bed.

So how is your senior pet today?

Dr Celeste Conn has a house call practice in Kent County. She lives in Worton with an old lab and an old Maine Coon cat.

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Rock Hall Village: An Experiment with Small Retail Spaces

December 11, 2011 by Celeste Conn

One man’s vision for a town of value has brought a breath of fresh air in the midst of a stagnant economy.

After seven months of hard work, the Rock Hall Village Project was completed in October; giving the town of Rock Hall a much needed Main Street makeover. This project is the first of its kind for the Brawner Company, known locally as the operators of the Haven Harbour Marina.

“There is a charitable undercurrent to the whole project in that we are providing the town a new centerpiece and gazebo in which a farmer’s market, concerts, and anything oriented to the community can be hosted,” said Bill Brawner Jr., company president. “Prior to the emergence of the gazebo, there was no real gathering place in the town of Rock Hall, something that really gives a town identity. By creating this project we thought perhaps we could solve a few problems for the town economically, and work towards helping regenerate a fairly sluggish economy.”

The Rock Hall Village Project is comprised of 14 different buildings, two of which are uniquely geared to the public. There are a total of 12 structures geared toward retail operations, and of those 12, six businesses have already made a commitment to sign a lease. The Village will house everything from from artists, to clothing retailers, and finally brokers.

[slideshow id=85]In addition to building the cluster of retail shops, the Brawner Company also wanted to accommodate the public by making one of the buildings available for a Visitor’s Center with public restrooms. The town’s old Visitor’s Center was seldom used and located away from Main Street, where most tourists and visitors gather.

“So now they have a small Visitor’s Center as a gateway to the community. People can stop and get literature and learn about local happenings around town, and in the process it’s improving exposure for the town and broadening the community at large,” said Brawner in a telephone interview on Tuesday. “This is located in a very central area that everyone sees, at (the corner of) Main Street, so it is a very important piece of property. We kept this thought at the forefront of our minds and knew we wanted to create something extremely attractive to improve upon the fabric of Rock Hall and to help stimulate new business activity at a time when things are in decline economically.”

Why Rock Hall? The answer is simple. The Brawner Company has been invested in the town for almost two decades, from a business-related standpoint as well as a personal standpoint. Brawner resided in Rock Hall when he was a student at Washington College and for several years afterward. He graduated in 1997

“We have homes there and other businesses that are operating in Rock Hall, so we knew there were these deficiencies and that this would be an optimal time to fill some of those gaps – one being with the gazebo and a public restroom facility,” he said.

The opportunity for the Rock Hall Village presented itself when a fire completely destroyed some buildings on the 1.14 acre property. Instead of restoring the old buildings, the Brawners decided to start from scratch and the concept for the Village was born.

Feedback for the most part has been positive; 80 to 90 percent of the public is in favor of the project.

“Now that it is completed I think people are just delighted and blown away with the outcome. I believe we have exceeded people’s expectations. It definitely seems to be a step in the right direction,” he said.

The goal is to have all units in full operation by this spring in time for the tourist season crucial to the success of these local businesses. Brawner hopes that this project will inspire further improvements to enrich Rock Hall.

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Chester River Health Gets Plugged In with Meditech

October 24, 2011 by Celeste Conn

October 1 marked an important day in at Chester River Health System and its advancement in healthcare technology. Thousands of hours and innumerable amounts of planning and training went into the recent transition to Meditech, a standardized computer based health information system.

Changes in technology seem to happen overnight and the previous hospital-wide computer system, QuadraMed Affinity, was phased out. Even though the transition to Meditech was not required, it was highly recommended for Chester River Hospital in order to unite it with the health systems along the Eastern Shore. The new computer system is part of a multi-million dollar investment in technology and infrastructure by the University of Maryland Medical System at Chester River.

The implementation of Meditech is meant to improve operations, patient safety, and better coordinate care. The new system has several features, including bedside barcoded medication administration. This feature works just like scanning your groceries in the check-out line. Each medicine is in its own package with its own barcode unique to the drug, strength, and form. The nurse scans the patient barcode located on their hospital wristband and the computer system pulls up the patient’s specific drug record and makes sure everything matches while also checking for any possible drug interactions. The time of drug administration must even correctly match. The bedside barcoded medication administration is the gold standard in health care right now; approximately 2,000 hospitals nationwide are utilizing Meditech in their patient services.

“The system is another layer of double check for the hospital,” said hospital pharmacist Becky Schulkowski. “Since Oct. 1 we have administered over 5,000 doses of medicine to patients. That is 5,000 opportunities to have something go wrong. The new system reduces risks for error tremendously.”

Meditech is another step towards the future of medicine. The biggest excitement of it is in the patient safety enhancement features and advancements in data portability, known as electronic medication administration record.

“We hope it to be a benefit,” said Josh Barnes, RN, coordinator of clinical education. “With all the hospitals on the Eastern Shore under the same system if a patient had a test in Easton, we can access that same data here automatically without the patient having to carry test results and forms around with them. It is a much easier transfer of patient information from hospital to hospital.”

Meditech also includes a community wide scheduling module which provides centralized management of departmental schedules. With just one phone call, the patient or physician office can schedule various appointments with one visit to the hospital arranged in desired timeslots. Lynda Bigelow, a front desk registrar at Chester River, has been working with patients daily to get everyone placed into the new system.

“Overall the transition has been fine. As with all technology there are a few places that need some fine tuning. After the initial implementation two weeks ago things are starting to mellow out. We understand the transfer of information is quite a process and once that is passed in about two months and all patients are in the new system, registration will begin to go much smoother,” she said.

In the previous weeks Chester River has been working to make the transition as comfortable for patients as possible. Free food and giveaways as patients waited to be registered was one of the offerings as well as having several administrators and volunteers on hand to explain the new system. Additional staff has also been scheduled for the first few weeks of October to assist with the transition to Meditech. Everything about the transition has been secure and documented.

Every department of the hospital has been affected by the transition in the way they function, streamline workflow, eliminate duplicate manual processes, and complete the standard-based documentation. Multiple departments have been trained on the new system and sessions were also arranged for physicians.

“The nurses are adapting very well despite the new steps and added changes in their work flow that comes with this system. Everyone is completely on board and embracing it, they understand its benefits,” said Schulkowski.

The implementation is currently underway at Chester River Hospital and those portable carts carrying laptops throughout the halls will soon be a normal sight for the community. For more information about Meditech or for questions or concerns, please call 410-778-7654 or email [email protected].

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Dylan Dean’s New Diabetic Alert Dog and Best Friend

October 3, 2011 by Celeste Conn

Dylan Dean with Jasper

At the age of six, lives every day in the face of a threatening obstacle known as Type I Diabetes. In his young age, he is already two years into this rollercoaster journey and has experienced 8,760 finger sticks, 1,200 insulin injections, and 290 infusion sets. After much research and experimentation, he now has a friend to help him along each day, potentially even saving his life.

Jasper was delivered to the household of Matt and Roxanne Dean in Church Hill on July 14. The black Labrador puppy is being trained as Dylan’s Diabetic Alert Dog, scent trained to alert when a human has rapid blood sugar fluctuations. These dogs are capable of alerting 40 minutes prior to a human reaching dangerous blood sugar levels and are proven to be more accurate than a continuous Glucose Monitor.

“Within the first week, Jasper alerted us that Dylan was dropping to a low blood sugar level at only 11 weeks of age. Dylan’s blood sugar had actually dropped from 148 to 41 during his nap,” said Roxanne Dean, Dylan’s mother, who has had Type I Diabetes since she was 8 years old.

The Dean’s youngest son, Trevor, is 4 years old and so far has not tested positive for Diabetes. Both children have been checked once a month since birth. Dylan’s Diabetes was actually caught by accident in pediatric testing; there were no visible symptoms upon first diagnosis.

“It’s a learning game in controlling Diabetes because each person is different, but we’re getting used to it,” said Mom, as she helped Dylan with his blue insulin pump connected to his arm.

The Dean family is only the second family in the state of Maryland to receive a Diabetic Alert Dog. Countless fundraisers and several very generous donations from the community helped raise the $18,000 needed to cover the cost of this Diabetic Alert Dog.

Jasper is currently being trained by Guardian Angel Service Dogs to alert to a low blood sugar level by pawing and a high blood sugar level by touching with his nose. He is even learning to retrieve Dylan’s testing kit, a juice box, and another member of the household. Jasper is expected to be fully trained upon reaching 18 months of age.

This faithful companion can be found sleeping beside Dylan’s bed every night and continually by his side, ready to alert of any changes to avoid an extreme high or low blood sugar level.

“What we fear the most is a severe low blood sugar level because of Dylan’s age. His brain is still developing and a seizure or any loss of consciousness could leave permanent brain damage,” said Roxanne.

Dylan Dean is one of the youngest children in Queen Anne’s County to battle Type I Diabetes. In Kindergarten this year at Church Hill Elementary, Dylan has brought a new challenge to the school. Jasper does not currently attend school with Dylan, but Church Hill Elementary has been open to the idea.

“Though this is new to them, the school nurse takes very good care of Dylan and keeps him on track throughout the day the best she can,” said Roxanne.

Recently, Dylan and Jasper appeared as this month’s special guest at the Diabetic Support Group held at the Chester River Hospital. The Diabetic Support group meets every fourth Tuesday of the month at 7 p.m. in the hospital’s conference center. The purpose of the support group is to provide current information to patients and families and give the opportunity to socialize and gain emotional support from other members.

Four years ago Lois Dixon was an employee with the Chester River Hospital when she joined the Diabetic Support Group.

“The group is so informative, and I absolutely love that,” said Dixon. “We have guest speakers every month and we get lots of up to date information that I would otherwise not know about. We even get recipes and share ideas amongst ourselves. You meet so many nice people and we all have that one thing in common right away. I am sure to tell other people about the group, it is just wonderful.”

As members of the support group raised questions one after another, Dylan stood beside his mother mature beyond his years, as she once again told the story of her son’s journey thus far.

“Our family is confident that Jasper will help to tighten Dylan’s diabetes control and protect his life,” said Roxanne.

Despite it all, this little boy is quick to flash a smile and to hug the puppy who is sure to be a lifelong friend, perhaps even a saving grace.

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