http://www.cherokeephoenix.orgThis Centers for Disease Control shows a map with 2010 incidence rates for ehrlichiosis in the United States. Oklahoma had a rate of 3.3 to 26 cases per million, one of the highest. CENTERS FOR DISEASE CONTROL
This Centers for Disease Control shows a map with 2010 incidence rates for ehrlichiosis in the United States. Oklahoma had a rate of 3.3 to 26 cases per million, one of the highest. CENTERS FOR DISEASE CONTROL

Nice weather can bring tick illnesses

This Centers for Disease Control shows a map with incidence rates for Rocky Mountain spotted fever shows Oklahoma with an incidence rate of 19 to 63 cases per million, one of the highest in the United States. The American dog tick, Rocky Mountain wood tick and brown dog tick can carry the disease. CENTERS FOR DISEASE CONTROL This Centers for Disease Control shows a map with incidence rates for tularemia. Most incidences occur in the Midwest and Plains states as well as the Rocky Mountain areas. CENTERS FOR DIESEASE With warmer weather here, ticks such as this lone star tick can carry different diseases such as ehrlichiosis and tularemia. COURTESY
This Centers for Disease Control shows a map with incidence rates for Rocky Mountain spotted fever shows Oklahoma with an incidence rate of 19 to 63 cases per million, one of the highest in the United States. The American dog tick, Rocky Mountain wood tick and brown dog tick can carry the disease. CENTERS FOR DISEASE CONTROL
BY STAFF REPORTS
05/25/2017 12:00 PM
TAHLEQUAH, Okla. – People tend to spend more time participating in outdoor activities in warmer weather. But it’s important to remember that warmer weather brings ticks and the illnesses they can carry.

Oklahoma ranks among the states with the highest rates of ehrlichiosis, Rocky Mountain spotted fever and tularemia, and May through August are the months when ticks are most active.

Ehrlichiosis

Human ehrlichiosis is caused by Ehrlichia chaffeensis, Ehrlichia ewingii and a third Ehrlichia species provisionally called Ehrlichia muris-like.

Ehrlichiae are transmitted to humans by the bite of an infected tick. The lone star tick is the primary vector of both Ehrlichia chaffeensis and Ehrlichia ewingii in the United States. Typical symptoms include fever, headache, fatigue, chills, nausea, vomiting, diarrhea, confusion, rash and muscle aches. Usually, these symptoms occur within one to two weeks following a tick bite.

Ehrlichiosis is an illness that can be fatal if not treated correctly. The estimated fatality rate is 1.8 percent. Patients who are treated early may recover quickly on outpatient medication, while those who experience a more severe course may require intravenous antibiotics, prolonged hospitalization or intensive care.

The severity may depend on the patient’s immune status. People with compromised immunity caused by immunosuppressive therapies, HIV infection or splenectomy appear to develop a more severe disease and may also have higher fatality rates.

Doxycycline is the first line treatment for adults and children of all ages and should be initiated immediately whenever ehrlichiosis is suspected.

Use of antibiotics other than doxycycline and other tetracyclines is associated with a higher risk of fatal outcome for some rickettsial infections. Doxycycline is most effective at preventing severe complications from developing if it is started early in the course of disease. Therefore, treatment must be based on clinical suspicion alone and should always begin before laboratory results return.

Rocky Mountain spotted fever

RMSF is caused by the bacterium Rickettsia rickettsia and is transmitted to humans by the bite of infected ticks. In the United States, these include the American dog tick, Rocky Mountain wood tick and brown dog tick.

Typical symptoms include fever, headache, abdominal pain, vomiting and muscle pain. A rash may also develop, but is often absent in the first few days, and in some patients, never develops. RMSF can be severe or even fatal if not treated in the first few days of symptoms. Doxycycline is the first line treatment for adults and children of all ages, and is most effective if started before the fifth day of symptoms.

The first symptoms of RMSF typically begin two to 14 days after the bite. The disease frequently begins as a sudden onset of fever and headache and most people visit a health care provider during the first few days of symptoms. Because early symptoms may be non-specific, several visits may occur before the diagnosis is made and correct treatment begins. It is a serious illness that can be fatal in the first eight days of symptoms if not treated correctly.

A classic case involves a rash that first appears two to five days after the onset of fever as small, flat, pink, non-itchy spots (macules) on the wrists, forearms, and ankles and spreads to include the trunk and sometimes the palms and soles. Often the rash varies from this description, and people who fail to develop a rash, or develop an atypical rash, are at increased risk of being misdiagnosed.

The red to purple, spotted (petechial) rash is usually not seen until the sixth day or later after onset of symptoms and occurs in 35 percent to 60 percent of patients with the infection. This is a sign of progression to severe disease, and every attempt should be made to begin treatment before petechiae develop.

Doxycycline is the first line treatment for adults and children of all ages and should be initiated immediately whenever RMSF is suspected.

Tularemia

The bacterium that causes tularemia is highly infectious and can enter the human body through the skin, eyes, mouth or lungs. In the United States, ticks that transmit tularemia to humans include the dog tick, the wood tick and the lone star tick. Deer flies have been shown to transmit tularemia in the western United States.

The signs and symptoms of tularemia vary depending on how the bacteria enter the body. Illness ranges from mild to life-threatening. All forms are accompanied by fever, which can be as high as 104 degrees Fahrenheit. Main forms of this disease are:

• Ulceroglandular. This is the most common form of tularemia and usually occurs following a tick or deer fly bite or after handing of an infected animal. A skin ulcer appears at the site where the bacteria entered. The ulcer is accompanied by swelling of regional lymph glands, usually in the armpit or groin.

• Glandular. Similar to ulceroglandular tularemia but without an ulcer. Also generally acquired through the bite of an infected tick or deer fly or from handling sick or dead animals.

• Oculoglandular. This form occurs when the bacteria enter through the eye. This can occur when a person is butchering an infected animal and touches his or her eyes. Symptoms include irritation and inflammation of the eye and swelling of lymph glands in front of the ear.

• Oropharyngeal. This form results from eating or drinking contaminated food or water. Patients with oropharyngeal tularemia may have sore throat, mouth ulcers, tonsillitis and swelling of lymph glands in the neck.

• Pneumonic. This is the most serious form of tularemia. Symptoms include cough, chest pain, and difficulty breathing. This form results from breathing dusts or aerosols containing the organism. It can also occur when other forms of tularemia (e.g. ulceroglandular) are left untreated and the bacteria spread through the bloodstream to the lungs.

• Typhoidal. This form is characterized by any combination of the general symptoms (without the localizing symptoms of other syndromes).

Tularemia is a rare disease, and the symptoms can be mistaken for other, more common, illnesses. It is important to share with your health care provider any likely exposures, such as tick and deer fly bites, or contact with sick or dead animals.

Antibiotics used to treat tularemia include streptomycin, gentamicin, doxycycline and ciprofloxacin. Treatment usually lasts 10 to 21 days depending on the stage of illness and the medication used. Although symptoms may last for weeks, most patients completely recover.

Preventive Measures

While it is a good idea to take preventive measures against ticks year-round, be extra vigilant in warmer months when ticks are most active.

• Avoid wooded and brushy areas with high grass and leaf litter.

• Walk in the center of trails.

• Use repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours.

• Always follow product instructions. Parents should apply this product to their children, avoiding hands, eyes, and mouth.

• Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks and tents with products containing 0.5 percent permethrin. It remains protective through several washings. Pre-treated clothing is available and may be protective longer.

• Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off and more easily find ticks that are crawling on you.

• Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.

• Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats and day packs.

• Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors.

• If the clothes are damp, additional time may be needed.

• If the clothes require washing first, hot water is recommended. Cold and medium temperature water will not kill ticks effectively. If the clothes cannot be washed in hot water, tumble dry on low heat for 90 minutes or high heat for 60 minutes. The clothes should be warm and completely dry.

Health

BY BRITTNEY BENNETT
Reporter – @cp_bbennett
05/25/2018 08:30 AM
SALINA – Proper diets reflecting the onset of puberty and growth for children ages 9-12 and teenagers should be a critical focus for parents, said Cherokee Nation Clinical Dietitian Tonya Swim. “Encouraging healthy choices to help provide adequate energy for growth and development should be the focus,” Swim said. “There is a change that not getting adequate nutrients can result in deficiencies, which could lead to loss of height, osteoporosis and delayed sexual maturation.” Swim recommends establishing healthy habits early for children, including breakfast. “Having a healthy breakfast enhances brain function related to memory, testing and school attendance. Having a high-fiber breakfast with protein, fruit and a low-fat dairy is a great way to start the day off. An example of this could be a whole-grain English muffin with an egg patty prepared using a cooking spray and sliced avocado – the perfect quick breakfast sandwich.” As children mature into teenagers, Swim said they need diets that provide proper nutrients and fuel. “Many teens will double their weight and can add up to 20 percent in height, and they need to make sure and get enough nutrients like calcium to support healthy bone growth. Teens will continue to have growth spurts, and it’s important for them to remember that their body needs food to help fuel healthy growth, especially if they are an athlete. But food for fuel is also important for those active with music or art. Their brains are working to hardwire their ability to process the skills needed for all activities.” Parent should keep taste and appearance in mind when preparing meals, Swim said, as they seem to be important factors to teens. “Health and energy needs don’t matter so much to (teens), so as parents we need to provide those healthy choices in a way that is pleasing to eat and look at.” Staying hydrated is also important as children and teenagers begin participating in sports and other activities. Swim recommends drinking two, 8-ounce glasses of water two hours before an event, as well as sports drinks during and after an event as a way to stay hydrated. “Sports drinks provide fluid, carbohydrates and electrolytes during extreme exercise,” she said. “This helps provide fuel for muscles, help maintain blood sugar levels and quench thirst. They also help to prevent dehydration. For specifics on what you or your student-athlete need contact a registered dietitian who is a board-certified specialist in sports nutrition.” For families on the go to, Swim said planning is a way to keep eating healthy. “Every sporting event has a schedule. Take time once a week to map those out on a calendar and then sit down with the family to see who can help out where. Also, think about preparing extra on nights that you can cook. Then you just need to heat something up. Using the crockpot can be a lifesaver, then dinner is ready when you get home.” For late night events, she said prepare sandwiches when possible and keep snacks handy such as whole fruit, apples, bananas, oranges, walnuts, almonds and skim mozzarella string cheese. Swim said parents must also keep in mind that males and females mature differently and to alter their diets accordingly. “Because girls and boys mature at different ages and their growth spurts occur at different times, there are separate calorie needs. For example, as girls mature one place to focus would be on getting enough iron. The body uses iron to make hemoglobin, the part of the red blood cells that carry oxygen.” Swim said multi-grain rice with salmon and dark green salads are ways to add iron into meals, but recommends contacting a pediatrician or registered dietitian for diet needs.
BY STAFF REPORTS
05/22/2018 12:00 PM
TAHLEQUAH, Okla. – Sequoyah High School is once again participating in the U.S. Department of Agriculture Summer Food Program. It will run May 29 through June 28, Monday through Thursday, at the SHS cafeteria. The program provides nutritious meals at no charge to children during summer vacation. Children aged 18 and under regardless of race, color, national origin, sex, age or disability are eligible to receive meals. Breakfast will be served from 8 a.m. to 9 a.m. and lunch will be from noon to 1 p.m. Adults may eat breakfast for $2.25 and lunch for $4. The cafeteria is at 17091 S. Muskogee Ave. For more information, call 918-453-5190.
BY STAFF REPORTS
04/27/2018 04:00 PM
TULSA – Cherokee Nation clinical dietitian Tonya Swim was awarded “Outstanding Dietitian of the Year for Outstanding Career of Contributions to the Dietetics Profession” on April 19 at the Oklahoma Academy of Nutrition and Dietetic Convention. Swim, who works at the A-Mo Health Center in Salina, is involved with the OkAND organization as public relations and communication chairwoman and has helped increase its social media presence by promoting registered dietitians as nutrition experts and renewing a partnership with Oklahoma City Fox News by coordinating weekly cooking segments. She also served as chairwoman for the 2018 OkAND convention and chaired the event in 2016. As chairwoman, she worked to provide Oklahoma’s registered dietitians and dietetic technicians with opportunities for continuing education. “It was an honor and I am humbled to have received this award. I give most of the credit to the amazing group of dietitians in our state for helping my ideas become reality and to the wonderful company I work for in allowing me to grow as a dietician. I am so blessed with a supportive family who push me to be the best I can. Thank you to everyone,” Swim said.
BY BRITTNEY BENNETT
Reporter – @cp_bbennett
04/25/2018 09:30 AM
SALLISAW – When Cherokee Nation citizen Shacotah Sanders lost his hair after undergoing chemotherapy for Stage 2 Hodgkin lymphoma last year, his mother, Tammie Simms, shaved her head in solidarity. “Chemotherapy is a really long process. It’s painful. It’s stressful. It’s really emotional because I lost all my hair,” Sanders said. “That was something I was really scared of right there, but the main thing that keeps me going is my mom. She’s like the only one that really keeps me going.” This familial support is once more a shoulder for Sanders to lie on because while his hair has grown back, so too have the cancerous spots in his neck. It is a possibility that he had accepted after going into remission in October. “I had prepared myself for it because there’s always that possibility that it could come back,” Sanders said. “Every three months I have a checkup, a PET scan, and we decided to do one in early March this year. We did it, waited about two weeks to get the results. We went back to my oncologist doctor, and he said that it came back, but it wasn’t as big as last time and not as bad. He said it was in the same spot and at the same stage, Stage 2.” Sanders began undergoing 22 rounds of radiation on April 3 to again battle the cancerous disease, which starts in the white blood cells called lymphocytes. It causes uncontrollable cell reproduction that can potentially invade other tissues throughout the body and disrupt normal tissue function, according to the American Cancer Society. Sanders travels from Sallisaw to Tahlequah’s Northeast Oklahoma Cancer Center five days a week for his radiation sessions and will have checkups every three to six months after the treatments. “The radiation, they take you to a back room with a really big machine and you just lay on it, like a flat surface, and then they put a mesh mask over your face and tilt your head back so they can get to the spots where the cancer is. There’s no needles involved or anything. It’s just a big machine shooting radiation down on your body,” he said. The first time Sanders noticed something amiss with his health was in March 2017. “Every time I went running I noticed my breathing was off quite a bit, so I was just feeling around on my neck and I found these lumps on the right side of my neck, below my jaw. It was just affecting my breathing a lot, so I went to the doctor and had them check it out,” he said. After a PET scan and surgery, doctors removed two of Sanders’ lymph nodes. “They sent them off to be tested and they came back cancerous. They told me it was Stage 2 Hodgkin lymphoma and we started treatment last year in April,” Sanders said. Doctors prescribed Sanders four rounds of chemotherapy at Warren Clinic Medical Oncology in Tahlequah. “I was supposed to do four, but three rounds did it,” Sanders said. “During that time, I still went to work, and I didn’t feel good at all going to work, but I still worked my eight hours a day. I still went to work, put a smile on my face. I had a really good attitude about it.” Though the cancer has returned and forced Sanders to put classes at Carl Albert State College on hold while continuing to work, he remains positive and recommends anyone going through a diagnosis to do the same. “Just have a positive attitude about everything. Surround yourself with positive things, people, family and friends,” he said. Sanders has a GoFundMe account to help with expenses. To donate, visit <a href="http://www.gofundme.com/hodgkins-lymphoma-fight" target="_blank">www.gofundme.com/hodgkins-lymphoma-fight</a>. <strong>Symptoms and Info</strong> Possible symptoms of Hodgkin ymphoma include fever, drenching night sweats and weight loss constituting at least 10 percent of a person’s body weight over the course of six months, according to the American Cancer Society. For more information, visit <a href="www.cancer.org/cancer/hodgkin-lymphoma.html " target="_blank">www.cancer.org/cancer/hodgkin-lymphoma.html</a>.
BY LINDSEY BARK
Reporter
04/20/2018 08:30 AM
TAHLEQUAH – Northeastern State University’s Oklahoma College of Optometry goes back 39 years in its relationship with the Cherokee Nation and in providing Cherokees eye care. NSUOCO works with nine CN clinics, also known as Rural Eye Programs, in Tahlequah, Sallisaw, Stilwell, Jay, Salina, Vinita, Nowata, Muskogee and Ochelata and services 40,000 to 60,000 patients annually. Its first graduating class was in 1983 and has since averaged 28 graduates annually from its four-year doctorate program. The NSU campus clinic contains 20 exam rooms and specialty clinics for dry eye, contact lenses, low vision, vision therapy and infant vision clinic. If a REP is unable to provide a type of eye care, patients are sent to the NSU clinic for further evaluation and treatment. Nate Lighthizer, NSUOCO Continuing Medical Education director and doctor of optometry, said the college has seen patients from 2 months old to 102 years old. “We all have different vision needs. That’s one of the beauties of having a college is we have 35 faculty members that are either here, in (W.W.) Hastings (Hospital) or in the REPs, and a lot them have different interests. We have doctors that specialize in infant vision and vision therapy. They’re the expert in the 6-month-old and the 2-, 3-, 4-, 5-year-old. Other doctors, they’re the expert in the 80-year-olds,” Lighthizer said. He said students begin in “didactically heavy” classes, building foundations and learning about systemic diseases, eye diseases, procedures when giving primary care, looking at the eye with microscopes and other program aspects. He said students begin seeing patients at the end of the second year and into the third year. CN citizen and fourth-year student Seth Rich said he applied for the NSU program because of the experience it would give him treating patients by the time he graduates. “I’m from this area, so I wanted to serve basically in the population that I grew up in. Here at NSU we see more patients compared to any other optometry school by the time we graduate. We have more patient interactions that any other optometry school is going to have and more clinical experience because we start seeing patients a year early than most other schools,” he said. Rich said he also has experience using the REPs and seeing the eye care needs among Cherokees. “We deal with a lot of diabetic patients here at Cherokee Nation, and that has a really large effect on the eyes. Being able to be in this area and serve a population that has a huge need for us is a big deal because I personally have a lot of family ties to this area want to be in a community where I feel like I’m going to be contributing and giving back and helping the overall health of the population with health and exams,” he said. Rich said the program prepares students to “go out into the real world” and treat patients of any need. “I feel very confident going out into the population and serving basically anybody that walks in the door.” CN citizen Tara Comingdeer Fields, who is in her first year at NSUOCO, said she chose the program because of her area ties. “It’s not specifically just Cherokee Indians that I want to serve, but overall Native Americans. My background is I grew up in a traditional family, so the medicines and traditions that we did just kind of stuck with me, and now I want to help people.” Comingdeer Fields and Rich are recipients of Indian Health Services scholarships for optometry and will work under an IHS contract upon graduation. Lighthizer said CN citizens make up between 10 to 15 percent of the NSUOCO’s students and that it’s usually rewarding for a Cherokee to grow up using CN eye care services and then go through the program and become a provider. “It’s just a very mutually beneficial relationship between Cherokee Nation to be able to have all of these patients seen and then obviously for the education for students to be able to see patients and hone their skills.”
BY STAFF REPORTS
04/19/2018 04:00 PM
SANTA ANA PUEBLO, N.M. – The Notah Begay III (NB3) Foundation, with a grant from the Comcast Foundation and in partnership with Cultivating Coders, is accepting applications for a national competition for Native youth to design a mobile app focusing on improving the health and nutrition of Native youth – designed by Native youth. The competition is open to individuals or teams of Native youth, ages 13-18, experienced in coding, design and digital media and/or mobile technology. Participants must submit a completed application with supporting documents that includes a four-page outline and video of the app. Contest applications will be accepted until July 1. Learn about the contest criteria, eligibility and application process at: <a href="http://www.nb3foundation.org/healthy-kids-healthy-futures-app-contest/" target="_blank">http://www.nb3foundation.org/healthy-kids-healthy-futures-app-contest/</a>. “The NB3 Foundation recognizes that more and more Native youth are using their mobile devices and APPs to track their physical activity, nutrition and even water intake. This competition is an integral step for the Foundation in the direction of connecting youth with technology to build healthier lifestyles,” NB3 Foundation President and CEO Justin Kii Huenemann, said. The contest’s intent is to engage and challenge creative and tech-savvy Native youth from across Indian Country to think creatively, culturally and digitally about their diet, nutrition, exercise and fitness; and turn that knowledge into a solution or problem-solving mobile app that may be used by the NB3 Foundation. A panel of NB3 Foundation staff and experts will choose a first-, second- and third-place winners. The first-place winner will proceed to work with Cultivating Coders, a software company and social enterprise focused on priming the next generation of coders to develop, design and implement their own solutions to address their local challenges, to further develop the app into a minimum viable product. For more information or questions about the application process, email Simone Duran, NB3 Foundation program assistant, at <a href="mailto: simone@nb3f.org">simone@nb3f.org</a> or call 505-867-0775, ext. 104.