Health Articles From Our Providers

Flu Season is Here!


Flu season is upon us! As we approach fall it’s time to think about getting a flu vaccine. At the Pawnee County Rural Health Clinic we have both the high dose vaccine and the quadrivalent vaccine. As you grow older your immunity weakens. The high dose gives you more antibodies to fight the flu. So those over 65 with multiple medical conditions may benefit from this vaccine. The quadrivalent is for those 6 months and older. It covers two types of the A virus and two types of the B virus, versus the trivalent which only covers one type of the B virus and two types of A.


Flu or influenza is a contagious respiratory virus. Symptoms of flu include; fever, cough, sore throat, runny nose, headache, tiredness and in some cases vomiting and diarrhea. Antibiotics do not treat the flu, but in some cases secondary infections like sinus infections and pneumonia can occur as the flu weakens your immune system. There is an antiviral medication Tamiflu that can help if taken in the first 48 hours of your illness. This can shorten the duration of the flu and lessen the severity of symptoms.


The providers, nurses, and staff at the Pawnee County Hospital and Rural Health Clinic are happy to serve your medical needs. Upcoming flu clinics:


Monday, October 3rd, Pawnee Village 8:30am-10:30am

DuBois Community Center 11:00am-12:00pm


Thursday, October 5th, Lewiston School 8:30am-10:00am

Burchard Community Center 10:15-11:30am


Monday, October 10th HTRS Humboldt School 7:30am-9:30am


Thursday, October 12th, Steinauer Firehall 9:30am-10:30am

Table Rock Senior Center 11:00am-12:00pm


Thursday October 19th, Pawnee City School 7:30am-8:30am


Please bring Insurance Card, Medicare Card or $25.00 payment


Chewing Tobacco Can Cause Cancer


Tobacco companies are targeting teenage males. Not surprisingly, chewing tobacco has become more popular among school-aged athletes in recent years. Its use has increased considerably in young males as well as adult men. Professional athletes are often seen with a big chew in their cheek, and advertisements promoting its use are seen in sports magazines and at sporting venues.


The nicotine in chewing tobacco is absorbed quickly and the amount a person gets is equal to smoking cigarettes. Although this nicotine may have a stimulant effect, it has not been shown to improve the skills of athletes.


Another reason for its popularity is that it has not acquired the stigma of causing cancer that cigarettes have. Yet it is known to be associated with a number of different forms of cancer, including cancers of the mouth, throat, larynx and esophagus. The chances of developing oral cancer are many times higher in men who chew compared to men who do not. There are also reports that chewing tobacco is associated with cancer of the colon and bladder.


The risk of cancer is a big concern with so many people starting to use it at younger ages—half of the users are under 19—and it is just as hard to kick the habit of chewing as to quit smoking.


Using alcohol along with the tobacco will further increase the risk of developing cancers in the mouth and esophagus. For cancer of the esophagus, the combined use of alcohol and tobacco increases the risk many-fold.


Chewing tobacco does cause cancer and even great athletes are not immune. Babe Ruth died of oral cancer.




Young Bikers Need Helmets


Biking is a high-risk activity for children. Biking accidents often result in head injuries and they are often very severe.


Young bikers can have falls and accidents for many reasons. They can lose control on a sandy or wet patch, hit pot-holes or other bikers, or they may be struck by a car.


A number of factors contribute to making biking injuries more serious. One is the increased velocity. Bikes go faster than a child can run, and high speeds often contribute to children losing control.


In children, especially younger ones, their heads are proportionately larger than their bodies and their weak neck muscles provide less support and stabilization for the head. This allows greater head impact and greater bouncing and rotational head movement when their heads strike the ground. These factors make falls more likely to cause concussions, skull fractures, and neck injuries in younger children.


Finally, the surface they land on is often an unforgiving concrete or asphalt road or sidewalk, not the comparatively softer ground of lawns, playgrounds and athletic fields.


These factors make bike helmets exceedingly important for children, even when they are biking at home. Most accidents happen close to home.


Properly fitting helmets will drastically reduce the deaths from head injuries. Studies have shown that perhaps 75% of deaths from head injuries could have been prevented if a helmet had been used. Be sure the helmet is level, not tilted back.


Helmets are available in a variety of colors and graphics that will please any youngster, and at very reasonable prices. Do not accept excuses for children not wearing helmets. Wear them yourself and you will set a good example for youngsters and protect yourself as well.

What is a Pap Smear? 


Pap smears are the primary method of detecting early cancer of the cervix (the tip of the uterus).  In fact, the test is so useful and sensitive, it can detect changes as they are occurring, years before they ever become cancerous. 


Pap smears are graded on a scale, depending on how severe the changes are.  The range is from perfectly normal to cancerous.  When a woman is found to have an abnormal Pap smear, it is often just a very low-grade abnormality.  These minor changes can be rechecked in a few months.  Often these changes are due to inflammation, such as from an infection with yeast or trichomonas, or hormonal changes.  These possibilities should be checked out and treated before the Pap smear is repeated. 


More severe changes call for a prompt evaluation.  These changes are usually evaluated with a microscope called a colposcope which magnifies the cervix 16-fold or more.  This allows the doctor to see the changes in the blood vessels and tissues that are associated with cancer and to biopsy the most abnormal areas. 


Researchers have found that most abnormal Pap smears are due to the woman having been exposed to a virus called the human papilloma virus, usually at an early age.  The cells of the cervix are most susceptible to the harmful effects of this virus during a woman’s teenage years.  It is not uncommon for women in their early 20's to develop severe changes or even cancer.  This is especially true for smokers, because smoking decreases a woman's folic acid and reduces the cells' resistance to these changes. 


A woman should have a Pap smear each year along with a general exam.  After three normal Paps, their frequency can be reduced. 





The harm caused by concussions is coming under greater scrutiny in recent years. A concussion is diagnosed if a head injury causes a temporary change in brain function, which can range from confusion to loss of consciousness after an injury.


The most common concern is the damage that is done to the brain by repeated concussions. Even a single concussion is harmful, but when there are multiple concussions, the damage can increase exponentially.


Doctors do not have a good way to measure the harm done by a single concussion or from subsequent concussions, nor do they have a good way to predict who will have the greatest problems. Some studies show that genetics may play a role. In one study, carriers of a certain gene were found to have the most damage from concussions.


More studies need to be done to determine who is the most susceptible to the harm from concussions and who, if anyone, is spared from the complications.


Concussions are most common in contact sports such as football. Statistics show that 10-20% of high school football players have a concussion during the season, making it a very important problem. Many athletes have more than one per season. Unfortunately, no one knows how many concussions is too many, so safe standards can not be determined yet.


Many doctors believe that three or four lifetime concussions should be a maximum number before an athlete is disqualified from high risk sports, especially if each concussion becomes increasingly severe or if it takes less and less trauma to cause a concussion.


Prostate Cancer is Common


Cancer of the prostate is one of the most common cancers—one in eleven men will eventually develop it.


Its incidence increases with age and it is more common in men of Northern European descent and in African Americans. It is also more common in men who have diets high in red meat or a family history of prostate cancer.

Prostate cancer causes few symptoms and when it does, they are similar to the symptoms of other prostate or bladder diseases. There may be difficulty starting or stopping a stream of urine, frequency of urination (especially during the night), bloody urine, pain with voiding and pain in the back or thighs.


These symptoms are the same as those caused by infections or benign enlargement of the prostate. The best way to find the cancer early is to see your doctor annually for an exam. Of course, a man should see his doctor sooner if there are symptoms or any changes in urination.


Consider a rectal exam and PSA after you turn 50 (40 for African Americans or those with a positive family history).


When a lump is felt in the prostate, your doctor will likely order a PSA (a blood test specific for the prostate) which may help with the diagnosis and prognosis as well as provide a baseline level to assess treatment. Other blood tests and an ultrasound of the prostate are also very helpful. Normal PSA is considered over 3.5 or 4, depending on the age of the patient. Urologists aslso evaluate the PSA “velocity” – a PSA that rises more than 0.3 per year is more worrisom than a PSA which is borderline high but stable. An elevated PSA can be due to infection or trama, such as a bicycle accident. Later, a biopsy should be done to determine if the lump contains cancer cells. If there are cancer cells, further studies may need to be done to determine the extent of the cancer.


If the cancer is in an early stage, surgery and radiation will cure it in many men. At other times hormone therapy is used. The outlook is generally quite good, especially when the cancer is found early in a routine exam; deaths from prostate cancer are declining.


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