the examiner

By Dan Barber,Public Affairs OfficerRobert E. Bush Naval Hospital

The Robert E. Bush NavalHospital is currentlyexperiencing a shortage of

providers in the Pediatric andFamily Medicine and MentalHealth Clinics; in addition, weare seeing an increase inpatients with acute respiratoryand gastrointestinal illnesses.

Also, the hospital has a short-age of clerks in the Call Center.Beneficiaries trying to call in tomake appointments are experi-encing longer wait times in thequeue until they can speak to alive operator.

We apologize for these incon-veniences, and want to assureyou that we are aware of theseissues and are working hard toalleviate the obstacles in provid-ing appropriate medical care to

our patients.If you just need some over-the-

counter meds without having tosee a provider, the NavalHospital offers an Over-the-Counter (OTC) medication dis-pensing program for your con-venience. OTC medications maybe obtained for family membersbetween 2-18 years old and onlyby a parent or guardian. Patientswho are not eligible to receiveOTC medications are pregnantor breastfeeding mothers, chil-dren less than two years old, andthose who are currently in flightstatus or in the PersonalReliability Program.

All patients must have a validmilitary identification card intheir possession at the time ofdispensing. Each family memberwill be eligible to receive amaximum of four different itemsin a three-month period.

These medications will beentered into each person’s com-puterized prescription record toscreen for allergies, overlappingmedications and duplications.

A request form must be com-pleted, which includes a briefquestion-and-answer assessmentof your medical condition(s) andcurrent medication(s) you are

taking. You will receive a hand-out discussing the proper use,dosages, cautions and sideeffects associated with the med-ications you request and receive.

If your medical condition doesnot improve or if it worsenswithin 48 hours, you shouldseek advice from a medical pro-fessional. (Our EmergencyMedicine Department is open24/7 (but during this period oftime you may have an extendedwait to be seen.)

This program is designed tooffer access to many commoncough and cold, sore throat,fever, headache, stomach upsetand minor gynecological condi-tions that are listed below:

* Acetaminophen (Tylenol)325mg tablets & elixir

* Ibuprofen (Motrin) 200mgtablets & suspension

* Diphenhydramine (Benadryl)capsules & elixir

* Pseudoephedrine (Sudafed)tablets & syrup

* Triprolidine w/ pseu-doephedrine (Actifed) tablets &elixir

* Guaifenesin (Robitussin)syrup

* Guaifenesin w/ detromethor

THE EXAMINER

Volume 19, No. 3 March 2011C

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Did you know?...

Robert E. Bush Naval Hospital

“Serving with Pride and Professionalism”

You have the right toexpress your concerns

about patient safety and qual-ity of care.

There are several avenuesopen to you:

* Through the ICE web-site.

* Through the NavalHospital Customer CommentCards.

* The Hospital’s CustomerRelations Officer at 760-830-2475, or any of the CustomerRelations representatives inthe hospital’s clinics.

Or Directly to the JointCommission via:

E-mail [email protected]

Fax:Office of Quality Monitoring630-792-5636

Mail:Office of Quality MonitoringThe Joint CommissionOak Renaissance BoulevardOakbrook Terrace, IL 60181

http://www.med.navy.mil/sites/nhtp/pages/default.aspx

An Award Winning Publication

Patients seen in January -- 11,653Appointment No Shows in January -- 933

One in ten patients do not show up for their appointments atthis hospital. If an appointment is no longer needed, please callso another patient can be seen.

To make an appointment call -- 760-830-2752To cancel an appointment call -- 760-830-2369

Hospital Faces Access Issue; Personnel Shortage

Continued on page 7

Continued on page 7

Dangerous Creatures of Morongo Basin

By Martha Hunt, MA Health PromotionsRobert E. Bush Naval Hospital

Most of the dangerous creatures of Morongo Basin have beentucked away hibernating for the last few months. However,as spring is quickly approaching, the desert and its creatures

will be re-awakening to begin the cycle of life again.

Captain Ann Bobeck, Commanding Officer, Naval HospitalTwentynine Palms speaks to a group of executives from Hi-DesertMedical Center during a visit. From left to right are Lionel “Chad”Chadwick, CEO, left, Judy Austin, CNO/COO; Cmdr. Maria Young,Director Nursing Services, behind Capt. Bobeck is Dan McClure,Hi-Desert’s Director of Information Systems.

HDMC Visits NHTP...

By Terri Moon Cronk American Forces Press Service

WASHINGTON, Feb. 3, 2011 -Smoking cessation, annual phys-icals and routine screenings arethe best ways to decrease therisks of cancer, said a Navy doc-tor who routinely sees active-duty and retired military person-nel and family members forchemotherapy.

“We see a lot of lung cancerpatients who have never smokedin their lives,” said Navy Lt.Cmdr. (Dr.) Erin Larkins, anoncologist and hematologist atthe National Naval MedicalCenter in Bethesda, Md. “Butit’s known that smokers, espe-cially heavy smokers, are defi-nitely at increased risk for lungcancer.”

And cancers of the head, neck,mouth, throat and voice box --and the numbers of those casesthought to be linked to smoking-- have increased, Larkins said.

“When [smoking is] combinedwith drinking the numbers goeven higher,” she added.

The most common cancers inthe United States, Larkins said,

are breast cancer in women andprostate cancer in men. Coloncancer rates No. 2 for men andwomen, she added.

“Lung cancer has been No. 3for a long time,” she said, not-ing lung cancer has the highestdeath rate of any cancer.

“We’re expanding treatments,but it’s still an aggressive cancerusually found in advanced cases,which makes it difficult totreat,” Larkins said.

Routine preventive screenings,such as mammograms andcolonoscopies, have createdhigh rates of early cancer detec-tion, Larkins said, adding thattreatment at early stages increas-es chances of survival.

When to start getting mammo-grams is a decision usuallymade between the doctor andthe patient, the doctor said.“There’s some debate now aboutwhether to start mammogramsat 40 years old or 50 years old,”she explained. “The opinions arevaried throughout the medicalfield right now.”

Women with a mother or sisterwho had breast cancer at age 40should start getting mammo-

grams 10 years earlier, Larkinsadded.

Colonoscopies are recom-mended after age 50 and areknown to be a very effectivescreening for colon cancer,Larkins said.

Another procedure for detect-ing colon cancer is the “virtualcolonoscopy.” Similar to a CATscan, she said, this procedurecan detect tiny polyps and otherconcerns.

Prostate cancer is the mostcommon cancer that occurs inmen, Larkins said. A test forprostate-specific antigen mole-cules in the blood -- commonlyknown as “PSA screening” -- isrecommended for men olderthan 50, Larkins said, and stud-ies indicate that African-American men should start PSAtests at 40.

Cervical cancer in women hasbecome relatively rare, the doc-

tor said, thanks to early detec-tion by Pap smears. No screen-ings exist for pancreatic andovarian cancers, she said, but“studies are being done all thetime to finds screens” for thosecancers and others that are diffi-cult to treat because a patientoften has no symptoms until thecancer is advanced.

Vaccine therapies are understudy, Larkins said, but are notin common use to prevent cer-tain cancers. “The main thing isbe aware of screening and knowit’s something you should do,based on your age [or] familyhistory,” she said. “Be aware ofyour own health.”

Meanwhile, studies and trialsto detect and treat different can-cers remain an ongoing process,the doctor said.

“One of the biggest changes inthe last several years has beenlooking at tumors individually

as much as we can,” she said.“We know not all breast tumorsbehave the same -- some aremuch more aggressive than oth-ers.”

World Cancer Day is observedFeb. 4. It was established by theInternational Union AgainstCancer to raise awareness andencourage cancer prevention,detection and treatment. TheIUAC is a global consortium of350 cancer-fighting organiza-tions in more than 100 coun-tries.

The World HealthOrganization estimates thatwithout treatment, 84 millionpeople will die of cancerbetween 2005 and 2015.

“If cancer spreads,” Larkinssaid, “it is mostly still incurable.If we can prevent it, rather[than] treat it, that”s a much bet-ter option.”

2 -- The Examiner -- March 2011

Published by Hi-Desert Publishing, a private firm in no way connected with the Department of Defense, the UnitedStates Marine Corps, United States Navy or Naval Hospital, Twentynine Palms under exclusive written contract withthe Marine Air Ground Task Force Training Command. The appearance of advertising in this publication, includinginserts or supplements, does not constitute endorsement by the Department of Defense, the United States MarineCorps, the United States Navy or Hi-Desert Publishing of the products or services advertised. Everything advertisedin this publication shall be made available for purchase, use, or patronage without regard to race, color, religion, sex,national origin, age, marital status, physical handicap, political affiliation, or any other non-merit factor of the pur-chaser, user or patron. If a violation or rejection of this equal opportunity policy by an advertiser is confirmed, thepublisher shall refuse to print advertising from that source until the violation is corrected. Editorial content is preparedby the Public Affairs Office, Naval Hospital, Twentynine Palms, Calif.

Commanding OfficerCaptain Ann Bobeck, MSC, USN

Executive OfficerCaptain Michael Moeller, MC, USN

Command Master Chief (acting) HMCS (FMF) Rodney Ruth, USN

Public Affairs Officer/EditorDan Barber

Command OmbudsmanValatina Ruth

Care Line 830-2716Cell Phone (760) 910-2050

The Examiner welcomes your comments and suggestions concerning the publication. Deadline for submission ofarticles is the 15th of each month for the following month’s edition. Any format is welcome, however, the preferredmethod of submission is by e-mail or by computer disk.

How to reach us...Commanding Officer Naval HospitalPublic Affairs OfficeBox 788250 MAGTFTCTwentynine Palms, CA 92278-8250Com: (760) 830-2362DSN: 230-2362FAX: (760) 830-2385E-mail: [email protected] Publishing Company56445 Twentynine Palms HighwayYucca Valley, CA 92284Com: (760) 365-3315FAX: (760) 365-8686

Doctor Emphasizes Prevention in Cancer Fight

Troops Urged to Quit Smokeless Tobacco From a Tricare News Release

FALLS CHURCH, Va., Feb. 10, 2011 - When the Defense Departmentweighs in on kissing and spitting, it’s with good reason -- two goodreasons, in fact: love and health.

Using smokeless tobacco can pose a stinky, unsavory obstacle tosharing a kiss with a loved one, parent, child or sweetheart. It alsomay cause a slew of serious health problems. That’s why TRICAREwanted military personnel to participate in the Great American SpitOut and kiss the spit goodbye for a day.

About 19 percent of 18- to 24-year-old men in the armed forces usesmokeless tobacco -- that’s more than double the national rate. TheDoD Quit Tobacco -- Make Everyone Proud campaign at www.ucan-quit2.org focused on helping those who spit and chew tobacco todevelop a personalized cessation plan.

“Many of our servicemen started using smokeless tobacco at a youngage due to peer pressure and became addicted before realizing thenegative effects it could have on their personal relationships andhealth,” said Navy Cmdr. (Dr.) Aileen Buckler, a U.S. Public HealthService officer and chairman of the DoD Alcohol and TobaccoAdvisory Committee.

Throughout the month of February the DOD website hosted a specialGreat American Spit Out page, www.ucanquit2.org/facts/gaspo/,where service members publicly posted their pledge to quit.

Also on the website, Navy Capt. (Dr.) Larry Williams, public healthemergency officer, answered questions about smokeless tobacco.

Installations planning cessation events can also find ideas, an eventregistration page, pledge cards, and downloadable promotional materi-als.

Those planning to quit can get a “Kiss me, I’m Tobacco Free” badge

Continued on page 7

By Kristen WardTriWest Healthcare Alliance

TRICARE West Region benefi-ciaries can assist military fami-lies and help save the environ-ment with a simple click of amouse.

Now through March 31, 2011,when a TRICARE beneficiarychooses to ‘Go Green’ and opts-in for paperless statements,TriWest will contribute $5 toone of the following militarysupport organizations: ArmedServices YMCA (ASYMCA),Operation Homefront, TragedyAssistance Program forSurvivors (TAPS) or the USO.

Giving GreenEach of the eligible military

charities support active dutyservice members, veterans, mili-tary families and survivors indifferent ways.

* Operation Homefront --Provides emergency and moraleassistance for service members,the families they leave behind,and for wounded warriors whenthey return home, and has filledthe needs of more than 267,000military families since 2002.

* Armed Services YMCA(ASYMCA) -- Delivers qualitysocial, educational and recre-ational programs and services toactive duty military and familymembers. Its programs includechildren’s waiting rooms at vari-

ous military hospitals andOperation Hero.

* Tragedy Assistance Programfor Survivors (TAPS) -- Offershope, healing, comfort and careto families grieving after thedeath of a service memberthrough programs such asSurvivor Seminars and GoodGrief Camps.

* USO -- Entertains and pro-vides educational programs toservice members and their fami-lies.

Going GreenBy registering at www.tri-

west.com/GoGreen, TRICAREWest Region beneficiaries canopt-in to receive paperless TRI-CARE communications, such as

referral and authorization letters,claims and explanation of bene-fits statements.

Since launching the ‘GoGreen’ program more than ayear ago, TriWest has alreadysaved hundreds of thousands ofsheets of paper from being

printed and mailed. The ‘GoGreen’ option for TRICAREWest Region customers is con-venient, secure and simple.

For more information, visitwww.triwest.com/GoGreen orwww.facebook.com/TriWest.

The Examiner -- March 2011-- 3

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Military Charities See Green When You ‘Go Green’

By Shari LopatinTriWest Healthcare Alliance

The next time you’re laughing with yourfriends at a funny joke, you’re helpingyour heart -- literally. Your body’s arter-ies -- the blood vessels which carry oxy-

gen-filled blood from the heart to the rest of yourbody -- respond to laughter in a positive way,according to a Harvard Health Letter published inNovember 2010.

In fact, laughter could improve blood flow andlong-term, overall health. Studies are also showinghow laughter not only improves your mental well-being, but makes your heart smile too.

Heart Disease Patients Laugh Less?In 2000, the University of Maryland Medical

Center published the first study stating that laugh-ter may help prevent heart disease. In it,researchers found that people with heart diseasewere 40 percent less likely to laugh, in any situa-tion, than people of the same age without heart dis-ease.

Those with heart disease were actually less likelyto recognize humor at all. They also tended to dis-play more anger and hostility in general.

Laughter and Stress ReductionPsychology experts commonly agree that laughter

and humor are great ways to help reduce stress.According to a 2005 report published in theJournal of the American College of Cardiology,stress can cause one’s blood pressure to rise. Highblood pressure is at least twice as strong a predic-tor of death as smoking or high cholesterol.

That’s why relieving stress on a regular basis isimportant to keeping one’s blood pressure down.

“Humor is absolutely a coping strategy for deal-ing with stress and adversity,” said Dr. BlakeChaffee, a psychologist and the vice president ofIntegrated Health Care Services at TriWestHealthcare Alliance. “If you can see the humor insomething, you can mitigate the stress and the neg-ative effects it has on you.”

Chaffee said if not dealt with, stress can put peo-ple at an increased risk of:

* Heart disease* Sleep problems* Digestive problems* Depression* Obesity

Need Additional Help De-Stressing?If the stresses of life are getting to you, and you

find yourself struggling to cope, you may be eligi-ble for the TRICARE Assistance Program, orTRIAP. This program offers non-medical, but pro-fessional counseling via chat, phone, or the Web.With an Internet-connected computer and aWebcam, you can talk to licensed therapists aboutissues such as stress or relationship problems.These discussions are completely non-reportable(unless required by law) and are available24/7/365...so you can make an appointment thatworks with your schedule.

Think you want more information? Curious to ifyou’re eligible? Visitwww.triwest.com/OnlineCare.

By Elaine Wilson American Forces Press Service

WASHINGTON, Feb. 9, 2011 -The Defense Department hasjoined forces with the nation tocombat a childhood obesity epi-demic that not only is a matterof health or nutrition, but also isa national security issue, aPentagon official said.

“When the nation as a wholelacks in this issue, it’s perva-sive,” Barbara Thompson, co-chair of DoD’s working groupto combat obesity, toldAmerican Forces Press Service,noting obesity’s impact oneverything from recruiting tothe nation’s health system.

Today, First Lady MichelleObama marked the one-yearanniversary of her “Let’s Move”campaign, a nationwide initia-tive to promote making healthyfood choices and increasingphysical activity within homes,schools and communities. Theaim, Obama has said, is to solveAmerica’s childhood obesityepidemic within a generation.

“The physical and emotionalhealth of an entire generationand the economic health andsecurity of our nation is atstake,” Obama said at the Let’sMove launch last year.

America’s childhood obesityrates have tripled in the past 30years, according to the Let’sMove website. Today, nearlyone in three American childrenand about one in four militarychildren are overweight orobese. This issue has a tremen-dous impact on the health sys-tem, and from a military stand-point, it can affect everythingfrom recruiting and retention tothe force’s ability to fight, saidThompson, who also serves asthe director of the Pentagon’soffice of family policy, childrenand youth.

Thompson cited a report called“Too Fat to Fight,” which statesthat 75 percent of Americansages 17 to 24 are unable to jointhe military for various reasons,with being overweight or obesethe leading medical cause.

“When you take into account

Release Stress with this Everyday Activity

DOD Takes Steps to Combat Childhood Obesity

Life’s Lesson...

I finally get my head togetherand my body falls apart!

Continued on page 6


Super Stars...

PS2 Felvin Bundalian, Manpower,receives an end of tour Navy and MarineCorps Achievement Medal for his supportto the staff of the Robert E. Bush NavalHospital.

Lieutenant junior grade Anne Dasilva,Adult Medical Care Clinic, receives anArmy Commendation Medal for herrecent service in Afghanistan.

HN Avery Hall, Adult Medical CareClinic, was honored for completion of therequirements to join the hospital’s ColorGuard program. He is now authorized towear the command’s Honor GuardAiguillette.

HM3 Jonathan Randall, Multi-ServiceWard, was honored for completion of therequirements to join the hospital’s ColorGuard program. He is now authorized towear the command’s Honor GuardAiguillette.

HM1 Janette Holmes, Leading PettyOfficer in the Nursing ServicesDirectorate, receives a Letter ofCommendation for being selected as theSenior Sailor of the Quarter for the peri-od from Oct. 1 through Dec. 31, 2010.

Lt. William Johnson, Mental HealthDepartment, receives a Navy and MarineCorps Commendation Medal at the endof his tour of duty at the Robert E. BushNaval Hospital.

Lt. Alistair McLean, Chief InformationOfficer of the Robert E. Bush NavalHospital, receives a Navy and MarineCorps Commendation Medal as an endof tour award at the hospital.

HMC Terry Morocco, Leading Chief inthe Health Care Operations Department,receives his sixth Good Conduct Award.

The Examiner -- March 2011 -- 5

Reid Middleton, Inc., of Everett, Wash, gives the hospital a momento of their visit inrecognition of their work to field a state-of-the art disaster preparedness and responseprogram for the hospital facilities, known as REAP (Rapid Evaluation and AssessmentProgram). According to Ensign Matthew Christopher, this program will significantlyenhance the efficiency and effectiveness of our responsefollowing a significant seismic event. Similar programs have been fielded atBremerton and Balboa.From left to right is Michael Moeller, Executive Officer, Naval Hospital TwentyninePalms; Dave Swanson, principal and Lance Lum, Project Engineer, both from ReidMiddleton; Ensign Matthew Christopher; Captain Ann Bobeck, Commanding Officer,Naval Hospital Twentynine Palms; Dick Schwartz, Facilities Manager; and LCDRMichael Klemann, Director for Administration.

Command Ready for Seismic Event...

Eliza Russell, left, Clerk inCentral Files, retires from FederalService after 20 years.

HMC Thomas Tennison,Command Physical Fitness

Coordinator, right, receives aGold Star in lieu of his fifth Navy

and Marine Corps AchievementMedal.

HM2 Jeremy Walton,left, Bio-Med RepairTechnician, receives aNavy and Marine CorpsCommendation Medalfor his support to theRobert E. Bush NavalHospital.

LCDR FitzgeraldWheeler, Naval HospitalTwentynine PalmsComptroller andDirector of ResourceManagement, receives aGold Star in lieu of hisfifth Navy and MarineCorps CommendationMedal for his end oftour award.

that 50 percent of military youthenter the military or considerentering the military, that's ahuge pool we need to be focusedon,” Thompson said.

Spurred on by the first lady’sefforts, the Defense Departmentformed a childhood obesityworking group in August, with acommittee of nearly 30 helpingprofessionals from a variety ofmilitary backgrounds andexpertise, Thompson said. Thegroup includes pediatricians,family medicine physicians,dietitians, nurses, public healthprofessionals, military and civil-ian personnel experts, familyand child and youth profession-als, and representatives from theDefense Commissary Agency,the Department of DefenseEducation Activity, and morale,welfare and recreation.

To tackle a daunting task, thegroup divided into four subcom-mittees: nutrition and health forchildren from birth to age 18,the Military Health System,food and fitness environmentsand education and strategiccommunications.

The committee then set out ona mission to improve the healthand nutrition of military fami-lies, Thompson said.

“We’re developing a strategicaction plan that cuts across theDoD's food environment,” sheexplained. “We have to look atour food courts, our schoolmenus, how physically friendlyis the installation so children canwalk to school and bike toschool to increase their physicalactivity, for example.

“It’s a very comprehensivelook at what we can do as a

department to help our familiesmake the right choices for theirfamilies,” she added.

They’ve already made consid-erable progress, Thompsonnoted. With the Army taking thelead, officials are creating stan-dardized menus for child devel-opment centers to ensure thecenters are meeting children’s

nutritional needs. They’re alsoworking with vendors who sup-ply the centers’ food to ensurethey’re getting the freshest veg-etables, lower-fat cuts of meatand less processed food ladenwith fats, salt and sugar.

Since children receive abouttwo-thirds of their daily nutri-tion requirement while in mili-tary child care centers, theseefforts are poised to have a sig-nificant impact, Thompson said,also noting that military youthand child development centersserve about 700,000 militaryyouth on any given day.

“It’s a wonderful opportunityto impact the way they thinkabout healthy lifestyles,” shesaid.

Additionally, the committee isworking to develop communitygardens, healthy cooking classesand classes on the relationship

between finances and food.Eating at home, for example,generally is less expensive thaneating out, Thompson said.

Thompson also cited progresswithin the civilian sector that themilitary can adopt. The firstlady is working with a major“super store” chain to reduce thenumber of products high in fat,salt and sugar and to boost thenumber of fruits and vegetablesit offers, she explained, and

commissary officials are lookinginto this as well. Commissariesalready have increased the salesof fresh fruits and vegetables,she noted.

Additionally, the department isworking to offer more healthychoices in vending machines,schools, dining facilities, clubs,bowling centers, food courts,and any other on-base localethat offers food, she said.

These changes not only willaffect children in the short termwith better stamina and well-being, but also will have a sig-nificant impact on their long-term health, Public HealthService Cmdr. (Dr.) AileenBuckler, working group co-chairand TRICARE population healthphysician, told American ForcesPress Service.

When a child is overweight orobese, particularly obese, she

explained, they’re at a muchhigher risk of cardiovascularrisk factors such as high bloodpressure and elevated choles-terol, as well as increased bloodsugars, which can lead to higherrates of Type 2 diabetes atyounger ages than what wasseen in the past.

Weight issues often followchildren through the years,Buckler noted. Studies showthat about 85 percent of children

ages 10 to 15 who were over-weight became obese by age 25,she said. And children who areobese before age 8 are morelikely to have more severe obe-sity as an adult, which can leadto greater risks of cardiovasculardisease, stroke, certain types ofcancer, osteoarthritis and eveninfertility, she added.

To keep these health issuesfrom snowballing, Buckler’sMilitary Health System subcom-mittee is taking action withinhealth care offices nationwide.Members are working on a poli-cy memo aimed at helping pedi-atricians, family physicians andcivilian health care providersproperly diagnose overweightand obesity in children, tracktrends and offer parents ideas ofhow they can help at home.

They’re also evaluating civil-ian and military toolkits onchildhood obesity so they candevelop a standardized toolkitfor military and civilianproviders, she added. This willensure they reach the widestscope of children, includingthose of National Guard andReserve families.

Along with new initiatives, thecommittee is taking current,effective programs into account,Thompson said. The committeehas gathered an inventory ofcurrent service programs tolearn from effective practiceswith an aim to expand thoseprograms across the department,she said.

But the department can’taccomplish this alone,

Thompson noted. “It takes a vil-lage to make good change,” shesaid. “We need to bring the mes-sage to the important adults intheir lives. And as adults, weneed to be good role models forour children.”

Thompson summed up ahealthy family goal with the aidof a few numbers: five-two-one-zero. People, she explained,should aim for five servings offruits and vegetables a day, twohours or less of screen time, onehour of physical activity andzero sugary drinks.

About 40 percent of children’scalories are empty ones, shenoted. “That is a real concernthat they’re not getting enoughvitamins and fiber,” she said.

The working group is factoringin the additional challenges mil-itary families face, Bucklernoted, such as multiple deploy-ments and frequent moves.During a deployment, for exam-ple, the at-home parent may findit more difficult to find time toshop for healthy foods or takechildren to physical activitiessuch as soccer or basketball, shesaid.

“It probably makes eatinghealthy and getting activity intoyour life harder,” she acknowl-edged.

But military parents can takesmaller steps toward change tostart, she noted. They canchoose skim milk instead ofwhole or reduced-fat milk ortake a family walk or bike rideafter dinner rather than turningon the TV.

“You can go play kickball orthrow a ball around,” she sug-gested. “The goal is to get out ofthe house, get moving and awayfrom the television.”

Thompson said she’s opti-mistic about the changes thathave occurred and what is yet tocome.

“The committee’s members arevery passionate and committedto making positive changes,”she said. Thompson said thegroup plans to publish a fullreport with the group's progressand recommendations in thespring.

Meanwhile, for more informa-tion on a healthy lifestyle, peo-ple can visit a service health andwellness facility, check in with abase fitness center or visit theLet’s Move campaign website athttp://www.letsmove.gov orMilitary OneSource athttp://militaryonesource.com.


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Combat Childhood Obesity...Continued from page 3

...To keep these health issues from snowballing, Buckler’sMilitary Health System subcommittee is taking actionwithin health care offices nationwide...

If you have been inTwentynine Palms for a while,some of these creatures may notbe so scary anymore.

If you are new to TwentyninePalms, you think that everythingthat crawls, slithers, creeps orflies is going to either kill youor leave you maimed for life.

Here is a brief overview ofsome of these critters, which inthe end are not so scary after allwhen you learn how to avoidthem.

The best form of critter pre-vention is to stay away fromthem, to eliminate all inviting,homey spots around your homesuch as piles of lumber anddebris, and to seal all cracks andcrevices that they can use tocrawl into your home. A littlespackle and paint does wondersas far as sealing tiny cracks andholes where the critters canenter your home.

Most critters, either poisonousor semi-poisonous, prefer nicedark, quiet, undisturbed placessuch as out buildings, wood ordebris piles, closets, attics, etc.and they usually only wanderout of these spaces when theyare hungry. In fact, most critterto human contact is purely acci-

dental on both parts, resulting inthe critter biting out of fear.

The two scariest spiders in thisarea are the Black Widow andBrown Recluse spiders. Whileit’s correct that there are no trueBrown Recluses here inMorongo Basin, their firstcousins live here, and at firstglance can be mistaken for atrue Brown Recluse. This cousinof the Brown Recluse also caus-es necrotizing bites and soshould also be viewed as poten-tially dangerous. A necrotizingbite is a bite that doesn’t healand continues to fester andspread from the original bitespot. Brown Recluse bites cantake up to two months to healand need to be kept clean likeany open wound.

Spider and scorpion bites arerarely fatal, and when handledproperly, can be easily treated aswell.

Black Widow bites and scorpi-on stings feel like a pin-prickand progresses in pain andswelling until the whole area isred, warm, and swollen. Thepain may spread to other partsof the body and symptoms mayalso include nausea, sweating,convulsions and, in rare cases,

death.The only people seriously at

risk from Black Widow bitesand scorpion stings are the veryyoung or old and those individu-als with compromised immunesystems. If you are bitten orstung, call your health careprovider or poison control num-ber immediately and seek help.

A bite from a Brown Reclusemay go unnoticed for severalhours before turning red,swelling and beginning to blis-ter. On rare occasions, a severebite from a Brown Recluse cancause the skin to not just blisterup, but to die back and leave anopen sore. Heeling may take amonth or longer and may leavea scar where the sore was. Aswith the Black Widow bites,Brown Recluse bites should bepromptly treated to prevent fur-ther health risks. And whateveryou do, never scratch a BrownRecluse bite. That makes thewound worse and leaves youopen to infection.

Regarding snakes, don’t teasesnakes... they bite to defendthemselves and the snake usual-ly ends up paying for your teas-ing with its life.

It has been estimated that asmany as half of all snakebitesare provoked by humans pur-posely scaring the snakes.

Of those bites that are not pro-voked by people, most arebelow the knee and half are dry(meaning that no venom wasinjected).

A good rule to follow inMorongo Basin is -- “if it rat-tles, it’s poisonous.”

Snakes who do not have rattlesin Morongo Basin are eithernon-poisonous or semi-poison-ous (they’ll just make you ill ifbitten, not kill you).

If any snake bites you orsomeone you are with, seekmedical help immediately. Keepthe victim calm, do not ice thewound and do not try to suckthe venom from it. This onlymakes the bite more dangerousand can result in the victim fac-

ing an amputation of the limbthat has been bitten.

Snakebites are rarely fatal, butall snake bite victims need med-ical assistance.

If you or someone around youis bitten, call 911 immediately.

Remember that the best way toavoid the dangerous creatures ofMorongo Basin is to steer clearof them.

Clean up the debris in youryard and get rid of those comfyhiding places that they live in.

Seal all openings to your homeand watch where you walk inyour yard or when hiking. Thesecreatures will try their best toavoid you and they are hopingyou do the same as well.

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Access Issue... Continued from page 1

phan (Robitussin DM) syrup* Saline nasal spray/drops* Cepacol throat lozenges* Maalox (regular) 5 ounce

bottle* Clotrimazole (Gyne-

Lotrimin) 1 percent vaginalcream (not for the patient's first

yeast infection and only oneissue every 6 months)

For Mental Health issues, fam-ily members of active duty per-sonnel or retirees have theoption of self-referral to a civil-ian mental health provider.

You should check with theTRICARE Service Center at theRobert E. Bush Naval Hospital

for TriWest participatingproviders, or call 1-888-874-9378 for this information.

The Naval Hospital’s MentalHealth Clinic and DeploymentHealth Center only sees activeduty personnel by walk-in andappointment.

Dangerous Creatures...Continued from page 1

to post on their Facebook page. The website showcased graph-

ic photos of the devastatingeffects of surgery for oral can-cer, which has been linked tosmokeless tobacco use. Thosewho use smokeless tobacco aremarked by bulging cheeks, gunkstuck in teeth, permanently dis-colored teeth, and spitting cups -- all universally unappealing.Visitors will also find hard-hit-ting facts that dispel the myththat smokeless tobacco is a safealternative to smoking. Forexample, almost half of thosewho contract oral cancer diewithin five years, and one

American dies from oral cancerevery hour.

“Don’t let spitting and chew-ing get in the way of your per-sonal relationships,” Bucklerurged. “Take this opportunity todo something for yourself andthose you love. Kiss smokelesstobacco goodbye and experiencethe benefits to your social lifeand health.”

Enrolling in the website's com-prehensive support system,Train2Quit, can be the first stepin the journey to saying good-bye to smokeless tobacco. Thesystem features interactive com-ponents such as quit tools, self-

assessment questionnaires, andquizzes.

Service members can create acustomized quit plan with a cal-endar to track progress and learnhow to beat cravings, overcomeweight gain and cope with nico-tine withdrawal. The site alsohas personal quit coaches, avail-able 24/7, to get answers toquestions about becomingtobacco free.

Editor’s Note: The Robert E.Bush Naval Hospital has aHealth PromotionsSpecialist/Health Educatorstanding by to assist those wish-ing to quit tobacco... just call760-830-2814 for help.

Quit Smokeless Tobacco... Continued from page 2

From a White House News Release WASHINGTON, Feb. 9, 2011 -The Veterans AffairsDepartment is launching thefirst of a series of new andenhanced services supportingfamily caregivers of seriously illand injured veterans.

President Barack Obamasigned the Caregivers andVeterans Omnibus HealthServices Act of 2010 legislation

in May, authorizing VA to estab-lish a wide range of new servic-es to support certain caregiversof eligible post-9/11 veterans.

“Caregivers make tremendoussacrifices every day to help vet-erans of all eras who served thisnation,” Veterans AffairsSecretary Eric K. Shinseki said.“They are critical partners withVA in the recovery and comfort

of ill and injured veterans, andthey deserve our continuedtraining, support and gratitude.”

In addition to the new benefitsand services for eligible veter-ans who were disabled in theline of duty since Sept. 11,2001, VA also will begin provid-ing enhanced benefits and serv-ices to caregivers of veterans ofall eras who already are enrolledin VA care, including:

-- Access to VA’s toll-freeCaregiver Support Line at 1-855-260-3274;

-- Expanded education andtraining on caring for Veteransat home;

-- Other support services suchas counseling and supportgroups and referral services; and

-- An enhanced website forcaregivers.

Some of the new benefits ofthe Caregivers and VeteransOmnibus Health Services Actare restricted by law to the care-givers of the most seriously illand injured post-9/11 veterans.Those additional benefitsinclude:

-- A monthly stipend; -- Health care coverage; -- Travel expenses, including

lodging and per diem, whileaccompanying veterans under-going care;

-- Respite care; and -- Mental health services and

counseling. VA will report to Congress in

the future on the feasibility ofexpanding the enhanced servicesto family caregivers of veteransof all eras, officials said.

While some of these enhancedbenefits are available now, manyof the other significant newlyenacted benefits will require theissuance of regulations. Theseadditional benefits includemonthly stipends, pay for travelcosts, medical coverage, train-ing, counseling and respite care

designed to prevent institution-alization of veterans wheneverpossible.

The law requires detailed regu-lations for determining eligibili-ty, designating and approvingcaregivers, and providingstipends and health care cover-age to primary family care-givers. The complex processrequired to implement these reg-ulations will provide veterans,caregivers and the public theopportunity to provide com-ments before those regulationsare finalized.

“VA has supported caregiversof veterans of all eras for almosteight decades,” said DeborahAmdur of VA’s CareManagement and Social WorkService, “and we know from ourexperience and research thatveterans are best served whenthey can live their lives as inde-pendently as possible surround-ed by caring family andfriends.”

Each VA medical center hasdesignated caregiver supportcoordinators who will assist eli-gible veterans and caregivers inunderstanding and applying forthe new benefits. VA also has acaregiver support website,http://www.caregiver.va.gov,which will provide generalinformation once final regula-tions are published, officialssaid.


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Captain Ann Bobeck, Commanding Officer Naval Hospital Twentynine Palms, at thetable signs the People Goal Charter. The focus of this group will be to focus on familysupport, and to orient newly reporting family members to the command and the MarineCorps Air Ground Combat Center. From left to right is Lt. Gillian Claveria-Ooms;Debbie Johnson; HMC Tamara Marks, team facilitator; Lt. Stephanie Clapper, assis-tant team leader; Terena Hartly; Therese Weseman; and HM2 Jeremy Walton.

People Goal Group gets Charter...

VA Provides Benefits to Veterans’ Caregivers

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