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Welcome to the August edition of the Quality Insights Renal Network 4 (QIRN4) Network Notes patient e-newsletter. In this issue, we bring you information about pet therapy, vaccinations, sepsis, inspirational quotes, ESRD events, resources and much more. We encourage you to contact us with any questions, concerns or suggestions. 
PetTherapyPet therapy interview:
Camille Coiro, DCI Yorktown* 

Many people who are on dialysis experience depression and/or anxiety. Research suggests that there are many benefits that come from being around a pet during this time.

We recently talked to Camille Coire, a social worker at DCI Yorktown. Camille has been a social worker for more than 30 years and
 has a caseload that averages around 80 in-center hemodialysis patients.   Camille is a pet therapy advocate. 

Pet therapy is known to provide comfort and emotional support for patients and is also beneficial to families, visitors and staff. 

"I became interested in pet therapy after reading a research article on the method," she said. "I love dogs and in September 2015, I was able to initiate a dog therapy program in my clinic."

Camille says it took two years to get the program started at DCI. She first gained approval from corporate leadership. The next step involved working with the Department of Health and a local hospital that already had a pet therapy program, which helped her write DCI's policy and procedures. 

"You need a dedicated staff to make the program work, but it's very beneficial," she continued. "There have been no negative effects and I love seeing the smiles on patients' faces." 

Camille graduated from  Hunter College School of Social Work in New York City in 1986. She has been a Licensed Clinical Social Worker in the state of NY since the onset of licensing in 2004.
She has worked in her current dialysis clinic with DCI and has been a member of CNSW for the last 15 years. 

*This is the second in a series of three interviews with dialysis providers who are pet therapy advocates. Read our first interview with Rachel Peck in the July issue. 
VaccinationsWhat you need to know about vaccinations 
Pneumococcal Conjugate Vaccine
Vaccination can protect both children and adults from pneumococcal disease. Pneumococcal disease is caused by bacteria that can spread from person to person through close contact. It can cause ear infections, and it can also lead to more serious infections of the:
  • Lungs (pneumonia),
  • Blood (bacteremia), and
  • Covering of the brain and spinal cord (meningitis).
Pneumococcal pneumonia is most common among adults. Pneumococcal meningitis can cause deafness and brain damage, and it kills about 1 child in 10 who get it. Anyone can get pneumococcal disease, but children under 2 years of age and adults 65 years and older, people with certain medical conditions, and cigarette smokers are at the highest risk.
Before there was a vaccine, the United States saw:
  • more than 700 cases of meningitis,
  • about 13,000 blood infections,
  • about 5 million ear infections, and
  • about 200 deaths
Learn more about Pneumococcal Conjugate Vaccine

Hepatitis B Vaccine
Hepatitis B is a serious infection that affects the liver. It is caused by the hepatitis B virus.  In 2009, about 38,000 people became infected with hepatitis B.  Each year about 2,000 to 4,000 people die in the United States from cirrhosis or liver cancer caused by hepatitis B. Hepatitis B can cause:
  • Acute (short-term) illness, which can lead to:
    • loss of appetite
    • tiredness
    • pain in muscles, joints, and stomach
    • diarrhea and vomiting
    • jaundice (yellow skin or eyes)
Acute illness, with symptoms, is more common among adults. Children who become infected usually do not have symptoms.
Chronic (long-term) infection. Some people go on to develop chronic hepatitis B infection. Most of them do not have symptoms, but the infection is still very serious, and can lead to:
  • liver damage (cirrhosis)
  • liver cancer
Learn more about Hepatitis B Vaccine.

Influenza (Flu) Vaccine (Inactivated or Recombinant)
Influenza ("flu") is a contagious disease that spreads around the United States every year, usually between October and May. Flu is caused by influenza viruses, and is spread mainly by coughing, sneezing, and close contact. Anyone can get flu. Flu strikes suddenly and can last several days. Symptoms vary by age, but can include:
  • fever/chills
  • sore throat 
  • muscle aches 
  • fatigue 
  • cough
  • headache 
  • runny or stuffy nose
Flu can also lead to pneumonia and blood infections, and cause diarrhea and seizures in children. If you have a medical condition, such as heart or lung disease, flu can make it worse.
Flu is more dangerous for some people. Infants and young children, people 65 years of age and older, pregnant women, and people with certain health conditions or a weakened immune system are at greatest risk. Each year thousands of people in the United States die from flu, and many more are hospitalized.
Flu vaccine can:
  • keep you from getting flu,
  • make flu less severe if you do get it, and
  • keep you from spreading flu to your family and other people.
Learn more about Influenza (Flu) Vaccine (Inactivated or Recombinant).
Sepsiswhat you need to know about sepsis 
What is sepsis? Sepsis is:
  • A serious medical condition caused by an infection which is usually occurring in the blood 
    • Blood vessel dilation, low blood pressure, and inflammation as seen with sepsis can lead to organ malfunction
    • Sepsis can lead to shock (often called septic shock) and multiple organ failure
  • Often unpredictable and can progress fast 
What causes sepsis? Sepsis can stem from another medical condition such as an infection in the lungs, urinary tract, skin, abdomen or other part of the body, or from infection in an a-v graft or long-standing catheter.

Who gets sepsis? Anyone can get sepsis, but some are at higher risk. These include:
  • People with weakened immune systems 
  • People with chronic illnesses, such as kidney disease 
  • People who have had a severe burn or physical trauma 
What are the symptoms of sepsis? Common symptoms of sepsis include:  
  • Fever 
  • Chills 
  • Rapid breathing and heart rate 
  • Confusion and disorientation (sometimes) 
Report any symptoms to your healthcare provider right away.  
More information about sepsis is available in English and Spanish at the National Institutes of Health website.  

QuotesandJokesQuotable Quotes and a Few Jokes 

Q: What goes "Tick-Tock-Woof?"
A: A watch dog.

"The world's most deadly disease is hardening of the attitudes."
- Zig Ziglar

Thought for the Day: 
Life is not always fair. Get used to it.

Q: What has one horn and gives milk? 
A: A milk truck.

"Optimism supplies the basic energy of civilization."
 - Norman Cousins

Fun Fact: The Statue of Liberty wears size 878 shoes.

Fun Fact: The Magnolia flowers have been here for over 100 million years.

Be on the lookout
Starting next month, we will supply you with a link to a few word puzzles that we are developing for patients within the QIRN4 network. Stay tuned!

FacebookHave you found us on facebook? 
QIRN4 posts the latest happenings and interesting insights for the dialysis community on our Facebook page. If you haven't already, please check us out and "like" our page to make sure our posts find their way to your news feed.  
BeatingSummerHeatBeating the summer heat is important for kidney patients
Summer heat brings challenges for us all and fluid control is a specific challenge that kidney patients face. Check out these sites for information on how to stay cool, manage your fluids and recognize when you could be overheating.
An article recently published on News Medical talks about a new program designed to allow living donors to donate a kidney in advance of when a friend or family member might require the transplant. Read the article.

LifeChangingTreatmentLife-Changing Dialysis Treatment Option Now Available for Elderly Patients in Skilled Nursing Facilities
The vast majority of dialysis patients currently receive their treatments in an outpatient dialysis facility.  Treatments are usually 3 times a week, with treatment times averaging 5 to 6 hours per visit, including travel time, equipment preparation and wait time.  This regimen can be hard on a patient, but especially grueling for patients who are elderly and frail.  Many elderly dialysis patients are residents of a skilled nursing and rehabilitation centers for some duration of time. Read more of this article from Reliant Renal Care. 
GolfTournamentjoin the Kidney foundation
of Central PA's 9th Annual kidney classic golf tournament
Join the Kidney Foundation of Central PA (KFCP) on Monday, September 19 at the prestigious West Shore Country Club in Camp Hill, PA for a fun golf-filled day to benefit a great cause. The tournament will include individual and team challenges, a putting contest, raffle prizes, and a sports memorabilia silent auction. Proceeds from this event help support essential KFCP programs such as the nationally-recognized Patient and Family Partner Program, the Patient Emergency Assistance Fund, and Camp Kydnie. Learn more

DonorDash3rd Annual Delaware Donor Dash to be held august 6
Gift of Life Donor Program, along with Christiana Care Health System and Nemours Alfred I. duPont Hospital for Children announce the 3rd Annual Delaware Donor Dash 5K benefiting organ and tissue donation and transplantation initiatives in Delaware. The Donor Dash will take place on August 6 at the Wilmington Waterfront. Learn more and register

Registration is now open for the American Association of Kidney Patients (AAKP) National Patient Meeting on September 23-25 in Nashville, TN. Three major themes at this year's Convention will be:
  • Increasing Living Organ Donation (including a workshop on "Having Your Donor Find You" on September 22)
  • Engaging Patients: How Voices and Choices Shape Your Future
  • Food, Drugs and Safety
Eight Continuing Education credits are available for social workers, dietitians, and registered nurses. If you would like to display a poster or exhibit in the exhibit hall at the meeting, you must apply by September 1.  For all details, including agenda, registration, lodging, visit the  AAKP website
PatientResourcesPatient resources  
How - And How Not - to Stand Up for Yourself
A useful article written by Leon F. Seltzer Ph.D. and featured in  Psychology Today about distinguishing assertiveness from self-righteous defensiveness.  

10 Tips to Help You Become Active in Your Care
A resource from the End-Stage Renal Disease National Coordinating Center (ESRD NCC) provides advice for ways to become more active in your kidney care. 

5 Drugs You May Need to Avoid or Adjust if You Have Kidney Disease
Medications save and improve lives, but it can be easy to overlook their risks and side effects, especially if you don't think they apply to you. Learn these tips from the National Kidney Foundation. 

CKDintercept Provides Knowledge and Tools to Improve Outcomes
CKDintercept is a new initiative to provide the knowledge and tools to alter chronic kidney disease (CKD) outcomes, improve patients' quality of life, and have an impact on CKD healthcare spending nationwide. Early diagnosis and treatment can slow or stop the progression of CKD as well as avoid outlays of billions in healthcare dollars for end-stage renal disease (ESRD) care. Learn more.

Gift of Life Family House Offers Temporary Lodging and Support for Organ Transplant Patients and Families
Gift of Life Family House serves as a "home away from home" for transplant patients and their families by providing temporary, affordable lodging and supportive services to those who travel to Philadelphia for transplant-related care. Learn more

Consider Your Dialysis Choices: Peritoneal Dialysis (PD)
*Taken from the ESRD NCC Patient Toolkit

Support Groups

Do find this newsletter helpful? Are there things you'd like to see changed? Please take this short survey to provide your feedback. Please submit any items of interest for this newsletter to Deborah Knight ( 

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This material was prepared by Quality Insights Renal Network 4 under contract with the Centers for Medicare & Medicaid Services (CMS). The contents do not necessarily reflect CMS policy. 

Publication No. ESRD4-071316