June2017Oral1On June 1, NHOHC held its annual Legislative Breakfast at the NH State House cafeteria. With over 100 in attendance including NH Senators, Representatives, policy-makers, legislative staff, and an advisor from the Governor’s office, twelve state-wide Coalition member programs provided displays, information, and policy highlights on the non-traditional, community-based oral health programs that provide care to low resource, Medicaid-covered, and dentally underinsured residents of NH.

Highlighting the programs that exist outside of the traditional dental office, member displays focused on programs providing care within local schools, senior centers, child-care and nutrition programs, nursing homes, public housing sites, and more.

While each program is unique, the need and service exists across the lifespan from pregnant women to children to adults and seniors. Services may be held in “brick and mortar” and mobile settings including vans and portable equipment transported in automobiles.

Legislative attendees expressed great interest in the oral health needs of NH’s children, uninsured adults and seniors, understanding that oral disease has a significant impact on the June2017Oral2overall health and function of both children and adults. Dental decay is cause by bacteria and is the #1 chronic disease for children both in NH and nationally. Yet, decay is preventable.

Key oral health policy priorities for NH include the alignment of oral health reimbursement with authorized services, especially for the NH certified public health dental hygienist (CPHDH) that can provide lower cost, community-based care; the consideration of a Medicaid adult dental benefit that provides a return on investment in health, productivity, and corrections costs; and increased opportunities for medical-dental integration – “putting the mouth back in the body.” More information on policy considerations can be found in the report from the NH Legislative Commission on Pathways to Oral Health. The full report can be found at: http://nhoralhealth.org/blog/wp-content/uploads/2015/11/FINAL_SB_193_Oral_Health_Pathways_Commission_Report.pdf.

For more information on community-based oral health care programs in NH, see the NH Baseline Survey and GIS map at: www.nhoralhealth.org. You can contact the Coalition at: info@nhoralhealth.org.

Section Convenes First Annual Meeting

Nurses Annual Meeting 2017

On June 5, 2017, the NH Public Health Nurses' Section of the NH Public Health Association held its inaugural annual meeting.

Dr. Rosemary Taylor PhD, RN, CNL was the key speaker and gave a presentation titled: "Any one of us on a bad day: Making sense of nurse bullying, tough-love, hoarding, and other unprofessional behaviors."

Twenty-six nurses attended the presentation, which was well received. An excellent discussion took place and several issues close to NH nurses were discussed.

Meeting organizers wish to send sincere thanks to Dr. Taylor for sharing her expertise with the group.

This has been an eventful year for the NHPHA Nurses' Section. It has been one of finalizing its bylaws and developing its vision and mission for the group.

We look forward to developing public health priorities for the coming year. Please join us.

Terry Johnson was recently honored by the Governor's Council on Physical Activity and Health with the 2017 Outstanding Achievement Award for making a difference in New Hampshire's health. Terry Johnson

The Outstanding Achievement Award for Physical Activity and Health is awarded annually to organizations and individuals who have made a significant impact on the health of NH residents by promoting healthy lifestyles through physical activity and fitness programs. Johnson has nearly 25 years of experience developing and directing health promotion and clinical programs in community, medical and work-site settings to lead the New Hampshire Healthy Eating Active Living (HEAL) Initiative. He works with many state and community partners to establish policies and programs that support healthy eating and active living where New Hampshire's residents live, learn, work and play.

Johnson served as the Director of Healthy Eating Active Living (HEAL) NH at the Foundation for Healthy Communities since 2008, and upon the program's conclusion, assumed the role of Director for the NH Comprehensive Cancer Collaboration on June 19th.

There is a new initiative in New Hampshire, Tick Free NH (TickFreeNH.org), with a goal of educating everyone about the risk of being bitten by a tick and how to prevent tick encounters and tick bites.

May is Lyme disease awareness month. Lyme disease is caused by a bacteria (Borrelia burgdorferi ) and is transmitted to humans through the bite of infected blacklegged ticks (aka the deer tick). Lyme disease can be debilitating if not identified very early and treated by antibiotics. Children ages two through 13 are at particular risk for tick encounters and contracting Lyme disease. In late Spring, nymph (baby tick) season starts - these nymphs are so tiny, they may appear to be a speck of dirt, like a poppy seed.

What are the top six things you can do to prevent a tick bite?
  1. Protect with permethrin (for shoes and clothing only, use as directed) or insect repellent with DEET (20-30%).
  2. Tuck your pants into your socks - don't let ticks crawl up your pants!
  3. Inspect yourself, children and pets when you come in from the out of doors - every time.
  4. Shower, do a tick check (with a mirror) and put your dry clothes directly into the dryer on high for 6-10 minutes.
  5. Remove all ticks immediately and properly (use a tick spoon or tweezers - don't twist, pull straight up). Wash site with alcohol.
  6. ID your tick, save in tape or plastic bag, and if you've been bitten visit a doctor.
The blacklegged tick can transmit Lyme disease in 24 hours and the Powassan virus in 15 minutes. Doing a tick check (on you and children) and showering after coming indoors are two of the best prevention methods you can add to your habits.black legged tick

Tick Free NH is an initiative supported by a New Hampshire funder, local businesses, and a group of New Hampshire public health, environmental health, and childcare professionals who share the mission of providing the most up to date information to New Hampshire residents about how to prevent tick encounters and protect themselves from tick bites.

Tick Free NH offers no-cost and low-cost resources for order or download. We encourage you to visit their website www.TickFreeNH.org and review the prevention information. You can order hard copies of their materials through the web site and online order form.

Contact them at: tickfreenh@gmail.com

Check out what they've done so far at www.TickFreeNH.org or find them on Facebook and Instagram.
Submitted by Allison Power Bernal, Prevention Coordinator, New Hampshire Coalition Against Sexual &Domestic Violence (NHCADSV)

April is Sexual Assault Awareness Month, and this year’s theme is Engaging New Voices. At NHCADSV, we are working to engage youth-serving institutions, educators, the health care field, policymakers, and public health practitioners in recognizing how sexual violence impacts the health of individuals, families, and communities. NHCADSV is a statewide network of 13 independent member program crisis centers that provide services to vicNHPHA 195 of 225for webtims of sexual assault, domestic violence, and stalking. Member agency services are free, confidential, and available to all victims regardless of age, race, gender, religion, sexual orientation, physical ability or financial status. In 2015, the 13 member programs served 13,000 victims in NH. In addition to supporting services at local crisis centers, NHCADSV leads in statewide policy advocacy for victim’s rights, ssexual violence prevention programming, and runs the Sexual Assault Nurse Examiner Program, which has placed trained nurses in 23 out of 26 hospitals in the state; SANEs improve prosecutions of sexual assault by ensuring that exams are conducted competently, collecting appropriate evidence and providing testimony at trial.

Sexual violence is one of the most pressing, under-reported, and underfunded public health problems facing our state, and is a silent driver behind other public health epidemics, including the opioid cri
sis. According to the CDC’s National Intimate Partner and Sexual Violence Survey, the lifetime prevalence of sexual violence victimization other than rape for NH women is 51%, and the lifetime prevalence of rape is 23.5%. The lifetime prevalence of sexual violence victimization of NH men is 28%. Victims of sexual and intimate partner violence experience significantly higher rates of depression and anxiety, asthma, irritable bowel syndrome, frequent headaches, chronic pain, difficulty sleeping, and substance misuse disorders. Recently published the Journal of Preventative Medicine, “Lifetime Economic Burden of Rape Among U.S. Adults,” concludes that the lifetime cost per victim is $122,461. Nationwide, this accounts for an economic burden of nearly $3.1 trillion, which includes $1.2 trillion (39% of total) in medical costs and $1.6 trillion (52%) in lost work productivity. (Peterson, DeGue, Florence, & Lokey, 2017)

In particular it’s important to highlight the connection between the epidemic of sexual violence and the opioid epidemic in this state, and the key role the healthcare and public health infrastructure has in connecting
 victim to services. On April 17, U.S. Representative Annie Kuster held the Voices for Change panel, which follows the launch of her Bipartisan Congressional Task Force to End Sexual Violence. During the panel, Rep. Kuster recounted meeting with women in Sullivan County living with addiction to opioids, and each one said the trauma of sexual abuse was a major factor driving their addiction. This anecdote is a just a snapshot of how sexual violence underscores so many of our public health problems in New Hampshire.

This April is also a chance to highlight how sexual assault intersects heavily with other issues facing youth, including bullying and suicide. For example, the new Netflix series 13 Reasons Why is the story of a girl who documents the events, including sexual harassment and sexual assault that lead up to her suicide. The series is generating enormous response from suicide prevention and anti-bullying advocates and the public health community wanting to support youth who watch the series. The culture of sexual violence, impunity of the perpetrator, lack of support from school staff that drives the tragedy. Unfortunately, crisis center advocates and educators support victims with similar stories every day in New Hampshire, but continue to be committed to working with youth, schools, and parents to respond to and prevent sexual violence perpetrated against and by youth. 

Sexual violence prevention is about social norms change, and it works: the CDC Rape Prevention Education program is in 50 states and 4 U.S. territories, and here in New Hampshire crisis center educators focus on reducing risk factors like toxic masculinity and homophobia, exposure to sexually explicit media, family violence, lack of institutional support from community and judicial system, and societal norms that tolerate sexual violence while increasing protective factors like community connectedness, empathy, respectful peer relationships, and gender equity. NHCADSV staff are so appreciative of NHPHA for the Friend of Public Health Award, and we are excited to continue building partnerships with the public health community to prevent and respond to domestic and sexual violence in the Granite State Institute, and the American Public Health Association.

Submitted by Keryn Bernard-Kriegl, New Hampshire CHildren's Trust 

As Child Abuse Prevention Month ends, we reflect on our shared responsibility to provide children with safe, stable, and nurturing environments.

"We all have a role in strengthening our families and communities to give children the great childhoods they deserve," said Keryn Bernard-Kriegl, Executive Director of NH Children's Trust. "The good news is it's not as hard as it sounds."

March 28 served as a kick-off for Child Abuse Prevention Month as almost 300 participants gathered at Grappone Conference Center in Concord for NH Children's Trust's widely-anticipated event, "Resilient Communities: The Prevention Connection," a summit aimed at inspiring action that strengthens policies, culture and behaviors that prevent child abuse and neglect and promote health and well-being. In April, many supporters raised awareness for prevention efforts. NH Children's Trust distributed 950 pinwheels, a symbol for great childhoods. Organizations across the state set up pinwheel gardens in their communities, and on April 7th, hundreds of people raised awareness by wearing blue and standing in solidarity for great childhoods.

The effects of child abuse and neglect impact individuals, families, and communities for decades. We can all have a hand in preventing child abuse by making sure parents and communities are equipped with the supports and skills needed to raise thriving children. From sharing educational social media posts, to offering help to a stressed parent, to advocating for family-friendly policies, there are many opportunities to be a part of the solution.

NH Children's Trust thanks all of our supporters and partners for doing their part this Child Abuse Prevention Month - because great childhoods begin with all of us.

GFWC Dover for webThe River CenterNH Public Health Association for web


Figuring Our Work in the Upcoming Legislative Session
Submitted by JJ Smith, NHPHA Public Policy Co-Chair

A week has passed since the elections and now we need to adjust our policy work for the upcoming two years. Much has changed even though the partisan make-up of the NH legislature remains nearly the same as of this writing (some recounts are still in progress). With many new Representatives and Senators elected we will struggle to know what issues will come to the forefront for us and how the newly elected officials will decide on issues that are important to advancing public health. We need help from all of you, our members, to monitor and contact the legislators who represent your districts and in following introduced legislation once it is known what policies are in the bills that are being filed. Be alert for updates from us as this is a long process while the legislative services office slowly helps write up hundreds of bills that may exist just as concepts in the legislators’ minds.

One important change is in New Hampshire’s Governor. We agreed with many of the vetoes issued by Governor Hassan. Since the legislature was not able to override those vetoes, we expect similar pieces of legislation to be introduced again. Whether any of them will then become law will depend on the issue and the attitudes and beliefs of many people but most of all of Governor Sununu. Since he was not a part of the last legislature, we don’t know where he will come down on many things we care about. It is likely he will agree with legislation that is sent to him after passing the House and Senate since they majorities of both chambers come from his political party. But there is some uncertainty about that, especially since he has said he favors reproductive rights, including access to abortion.

Governor Sununu’s attitude on reproductive rights issues may become the deciding factor because of the changes in the State Senate. Nine of the twenty-four Senators are new and did not participate in the Senate 12 to 12 deadlock on the attempt to repeal the NH law that puts protections in place for access to facilities that provide abortion. Those in favor of this repeal present this as a free speech issue for protesters. However, many believe that the law is helping keep those protesters from hostile behaviors that could discourage women from getting care even when pregnancy termination is not the reason for the visit to the facility. There was also a difficult battle over an attempt to add “fetus” to the definition of “another person” in our state homicide laws. By a narrow vote, the Senate replaced the House bill language to change it to “viable fetus” and excluded any pregnancy termination done by or at the request of the woman carrying the fetus. The House did not concur with that change so it ended there.

The nine new Senators include four that are replacing those who voted to maintain current law. It seems clear that three of those replacements will support reproductive rights but there is no information on this issue from the fourth in campaign literature or reporting. Another new Senator replacing a vote on the other side of these issues also does not have a position publicly articulated. Those two are Ruth Ward and Scott McGilvray.  We will need to reach out to them and perhaps to others whose minds can be changed by cogent reasoning on the negative consequences of such proposed changes in our laws. And the new Governor’s attitude to such changes is not a foregone conclusion either even though he has said he is in favor of maintaining reproductive rights.

The likely outcomes in the legislature on many other issues will be even more difficult to ascertain. Having more of our members making themselves available to contact their Representatives and Senators on issues is one important step. Another is to be available to come to the State House and testify on issues where you have expertise or passion for public health solutions. This can be difficult for some since times listed in the legislative calendars for testifying to committees are only accurate for the earliest possible start on a particular bill. But the State House does have open wireless connectivity so it is possible to bring a laptop or tablet and do work while waiting. If you have trouble knowing who represents the place you live, find the links to search by location at www.gencourt.state.nh.us
An article from the November 2016 issue of the NHPHA e-Newsletter
Submitted by Keryn Bernard-Kriegl, MS, Executive Director, NH Children's Trust

More than 140 people attended NHPHA’s Team Up, Take Action conference last week to build on existing tools and evidence to bolster population health efforts in New Hampshire. I had the pleasure of co-presenting on Adverse Childhood Experiences and Resilience with Linda Douglas, M.S.Ed. from the NH Coalition Against Domestic and Sexual Violence and Dr. Janessa Deleault from Riverbend Community Mental Health, Inc. Although the original Adverse Childhood Experiences (ACE) Study occurred 20 years ago, we are just beginning to implement public health strategies to prevent the occurrence and treat the consequences of toxic stress.

“There are 10 types of childhood trauma measured in the ACE Study. Five are personal — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. Five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment.” http://acestoohigh.com/got-your-ace-score/. There are many other adverse childhood experiences, and some of them are now being studied.

What the original study taught us was that when children experience toxic stress over a period of time, it changes their biology and puts them at risk for a variety of health consequences such as obesity, diabetes, depression, heart disease, stroke, cancer and broken bones. We know that more than half of the population has had at least one adverse childhood experience. We also know that the higher your ACE score, the greater your risk for health consequences.

Adverse Childhood Experiences is a public health issue that requires a public health response. In order to make significant progress in preventing the health consequences of toxic stress, New Hampshire needs strategies in the four social ecological domains. Public policies need to support services to parents battling addiction, mental illness, incarceration, domestic violence and parental abandonment. Communities need to have systems and norms that support health and wellbeing, such as parks and playgrounds, health centers and schools, employers and safety nets. Neighborhoods and families need to build trusting supportive relationships, and individuals need to increase their knowledge and skills to manage their histories and life’s challenges.

It's an exciting time to be working in public health. The “root causes” of so many health problems can be traced back to early childhood experiences. I’d like to invite you to learn more about preventing adverse childhood experiences and building resilience. New Hampshire Children’s Trust is hosting a conference on March 28 entitled: Resilient Communities: The Prevention Connection. More information can be found at http://www.nhchildrenstrust.org/summit2017

In addition, there are several national leaders who have emerged to provide us with ongoing research and educational tools to help our public health system prevent and treat toxic stress. You can learn more about ACES at theses websites:

Robert Wood Johnson Foundation, http://www.rwjf.org/en/library/infographics/the-truth-about-aces.html,

Center for Disease Control and Prevention, http://vetoviolence.cdc.gov/apps/phl/resource_center_infographic.html,

Center for the Developing Child at Harvard, http://developingchild.harvard.edu/science/key-concepts/toxic-stress/,

ACEs too High, https://acestoohigh.com/ , and

ACEs Connection Network, http://www.acesconnection.com/  

Together we can make a difference in the lives of New Hampshire children and families and improve the population health of our state.

An article from the November 2016 issue of the NHPHA e-Newsletter
Submitted by Christin D"Ovidio, Marketing & Communications Coordinator, Community Health Institute

In celebration of the 39th Great American Smoke Out (GASO), the New Hampshire Department of Health and Human Services (DHHS), Division of Public Health Services (DPHS) began offering nicotine replacement therapy patches, nicotine lozenges, and nicotine gum through (800) QUIT-NOW and www.QuitNowNH.org at no cost to residents who are trying to quit tobacco. Additionally, DPHS re-invigorated their current campaign to raise awareness around the health consequences of exposing children to secondhand smoke. DHHS is encouraging tobacco users to quit for at least one day in the hope that this might challenge them to stop permanently. The secondhand smoke ads carry messaging about protecting kids from secondhand smoke exposure where they live, travel and play, and encourages viewers to not smoke around children and to consider quitting.

“The Great American Smoke Out is a perfect time to consider making a plan to quit tobacco use,” said Marcella Bobinsky, acting Director of the Division of Public Health Services. “NH residents can call 1-800-QUIT-NOW for confidential coaching plus medications to increase their chances for success.”

In 2015, 17.5% of New Hampshire adults reported smoking but almost 65% reported wanting to quit. Ninety-nine percent of New Hampshire adults who smoke report having their first cigarette before the age of 26. Reducing the exposure of children to tobacco smoke is a priority of the Department’s, additionally the Department is concerned with youth and young adult tobacco use initiation, and this includes electronic nicotine delivery systems (ENDS), like e-cigarettes, e-hooka, and vape products. In New Hampshire, it is illegal for youth under the age of 18 to buy or possess any type of tobacco product (including ENDS). Nicotine is addictive and has been shown to affect a young person’s developing brain by preventing normal cell development. It is also illegal for tobacco products to be used on public educational properties. In spite of this, 25 percent of high-school-age youth reported using some type of ENDS, according to the 2015New Hampshire Youth Risk Behavior Surveillance survey.

The New Hampshire Public Health Association (NHPHA) recognizes that tobacco use is a major cause of chronic disease and premature death. Thousands of illnesses and deaths from tobacco use can be prevented and billions of dollars in medical expenses can be saved through longterm investments in a sustained campaign to prevent and control tobacco use. For this reason, NHPHA emphasizes the need to commit Tobacco Settlement Funds and/or dedicated funds to be used to promote programs and policies designed to:

·       Reduce youth access to tobacco products;

·       Decrease the population’s exposure to second hand smoke;

·       Promote quitting among tobacco users;

·       Counter pro-tobacco influences

·       Prioritize efforts to reach vulnerable populations affected by tobacco use

For more information about the New Hampshire Department of Health and Human Services visit www.dhhs.nh.gov. For information about the Great American Smoke Out visit www.cancer.org/healthy/stayawayfromtobacco/greatamericansmokeout/index. If you or someone you know would like free help quitting, visit www.QuitNowNH.org . The campaign runs through March 2017 and the nicotine replacement products are available while supplies last.
Submitted by Shasta Jorgensen, Affilliate Representative to the Governing Council

APHA Annual Meeting – Who’s going?
Hey, NHPHA Members! Who’s going to the APHA Annual Meeting in Denver this year? Are you presenting a poster, on a panel, and/or attending? Please email me at Shasta.jorgensen@gmail.com and let me know if you are going. I will plan an informal night for NHPHA members to get together, have dinner and share stories from the conference.

New Public Health Quality Improvement Exchange (PHQIX) Drawing Begins!
PHQIX is excited to announce the launch of our latest drawing! To enter the drawing to win one of our great prizes, submit a new QI initiative or update an existing in-progress initiative by November 1st, 2016. You must register on PHQIX to submit a QI initiative. By submitting your QI initiative on PHQIX, you will receive many benefits, including an AMA-style citation in phqix.org  that you and others can reference. Your initiative can help inform similar initiatives being conducted by other PHQIX community members and contribute to the evolving science of public health quality improvement. You will also receive excellent feedback from Expert Panel Members. Click here to learn more about how to submit a QI initiative and click here to submit a new QI initiative. Email us at contact@phqix.org if you have any questions or concerns.

Rural Health Information Hub’s (Formerly the Rural Assistance Center) New Funding Page
This newly updated topic guide provides tips on searching for rural-specific funding, grant proposal preparation, building successful funding relationships, and planning for program sustainability. The guide was created with input from Kassie Clark, National Organization of State Offices of Rural Health and Brad Gibbens, UND Center for Rural Health, and is maintained by RHIhub's funding specialist, Jana Reese. Click here to go directly to this funding page.

Submitted by Jeanie Holt, Former Policy Committee Co-Chair

NHPHA’s Public Policy Committee is in the midst of some transitions. First, we expect to soon have a new Co-Chair. As we have previously mentioned, Jeanie Holt takes on new APHA leadership responsibilities in November so we have needed someone to work with JJ Smith in leading the Public Policy Committee. Donna Asbury has volunteered to take on organizing the committee work and leading the meetings while JJ Smith continues to use her expertise in legislative processes to lead our work with the NH House and Senate.

Second, the election will happen soon! Once that is over, the work pace will pick up—double time. Currently 126 Legislative Services Requests (LSRs—the first step in proposing a bill) have been filed. Any of those submitted by legislators who are re-elected will move forward while new legislators will quickly begin to file LSRs as well. Over the next two months, the Public Policy Committee will be assessing the results of the elections, and reading LSR titles and eventually bills. From this we will draft a list of legislation to follow as we prepare for January and the opening of the 2017 Session.

In preparation for 2017, we have been recruiting topic leads for our priority issues: Access to Quality Care, Alcohol and Other Drugs, Child Health and Safety, Climate Change and Health, Mental Health, Public Health Infrastructure, and Social Justice and Health. We also hope to add someone with budget expertise to help us evaluate biennial budget proposals and advocate for critical public health resources. These leads along with Committee and NHPHA leadership will hold a short weekly phone meeting during the session to look ahead a week or two and plan any needed NHPHA actions.

Meanwhile we are working to finish up policy statement writing and revising started during the summer. By the opening of the 2017 Session we hope to have new position statements on Child Health and Safety, Tobacco, Infectious Diseases, and Sexual and Reproductive Health. We also must finish up work on selecting and honoring Public Health Champions from the 2016 Session.

Never a dull moment! Want to join the fun? Send an email to info@nhpha.org

An article from the October 2016 issue of the NHPHA e-Newsletter
Submitted by Jessica Morton, Health Promotion Advisor and Health Officer Liaison
Healthy Homes and Environments Section, DPHS, NH DHHS and the NH State Fire Marshalls's Office

Two very important Safety Campaigns take place every fall.  The fall of 2016 is no exception.   New Hampshire State Fire Marshal, J. William "Bill" Degnan, has requested that Governor Maggie Hassan sign two  proclamations.  One is to declare October as Fire Prevention Month. This year's theme for Fire Prevention is Don't Wait - Check the Date! Replace Smoke Alarms Every 10 Years.  “Time and again, I’ve seen the life-saving impact smoke alarms can have in a home fire, but I’ve also seen the tragedy that can result when smoke alarms aren’t working properly,” says Marshal Degnan.  “That’s why we’re making a concerted effort to educate the residents of New Hampshire about the overall importance of smoke alarms, and that they do have a life limit.”  The second is to declare November as Carbon Monoxide Awareness Month.  Often called the Invisible Killer because carbon monoxide (CO) is an odorless, colorless poisonous gas that you cannot see or smell.   It is created when fuels -gasoline, wood, charcoal, natural gas, propane, oil and methane - burn incompletely. The Carbon Monoxide Alliance, a New Hampshire/Vermont collaborative effort was formed to educate the public on the preventable causes of CO incidents and to help them understand how to take action to remedy them. 

Learn more about the NH Department of Safety, Divison of Fire Safety here

Submitted by Debbie Manus Love, Two Months and Counting, Breast Cancer Survivor


I was diagnosed with breast cancer on April 20th of this year. Nothing can prepare you for those three words, “YOU HAVE CANCER”. It’s a moment that reprioritizes your life in an instant. There is no history of breast cancer in my family. I didn’t have a lump or experience any pain leading up to my scheduled mammogram. I had a routine screening and was called back for a biopsy less than a week later to confirm what the doctor suspected was probably only “calcification”.

concordstrides2016In hindsight I realize that having been asked at every doctor’s visit, “Does breast cancer or uterine cancer run in my family?” and repeatedly answering “no” lead me to feel a false sense of security that I was not at risk for this disease. I should know better than to think I would be immune – but I had no family history of breast cancer. This diagnosis blindsided me. What bits of the conversation I did retain that fateful day was that I wouldn’t need a mastectomy.  My breast cancer was Stage 1. I didn’t even know what that meant other than assuming a higher stage meant the survival rate diminishes. The only thing I did know was my diligence of screening annually was the reason I caught my breast cancer early enough to beat it.  So, surgery was scheduled and then the “wait” began.

Nothing prepares you for the “waiting”. I had to wait a month for surgery with cancer in my body. I had to wait two weeks after surgery to hear if the cancer had spread to my lymph nodes. I had to wait another month to start radiation to kill any possible cancer cells that may have (as the doctor explained) “escaped” during surgery.  It’s probably one of the biggest mental challenges you face as a cancer patient – waiting to get better, waiting for your body to heal from the paces you put it through so you can proceed to the next attack on your body while juggling the many doctor visits in between. And while that is going on – you are suddenly more attuned to others battling the disease, finding comfort with the patients you sit with while you wait your turn for radiation and hearing of those who lost their battle while trying to keep life as normal as possible for you and your family.

This is truly when the reprioritization of your life begins – starting with constantly reminding yourself “you will be okay” before you start each day. Deciding you’ll do whatever it takes to survive, take whatever medicine is necessary for as long as necessary, and willingly expose your body for months to daily radiation in a room, separating you from the medical staff viewing your treatment,  by a foot-thick steel door. Then managing the side effects that come with the exposure to that treatment and pushing through your day reminding yourself this is helping you live so you can watch your children grow up.

When I rang the bell at the Payson Center signifying the completion of my radiation treatment this past August, a ten-year survivor approached me and gave me a hug, handed me flowers and said to remember on this day that I conquered this disease, but I will always have cancer. I understood as only a cancer patient could. The cancer may be out of my body – but my fear that every ache or pain I experience from this day forward could be my cancer returning -- is a part of my life now.  I can live with that, because even though my story may have started with three words, it’s ending with one, “SURVIVOR”.

Debbie Manus Love
Two months and counting Breast Cancer Survivor

An article in the October issue of the NHPHA e-Newsletter

The NH Oral Health Coalition is pleased to announce the keynote speakers for the 2016 NH Oral Health Fall Forum scheduled for November 11 at the Concord Holiday Inn.  Registration is now open at:  www.nhoralhealth.org.   The time of the event is 8:00 am to 4:30 pm.   This annual event is geared for physicians, nurses, dentists, hygienists, program managers, policy makers, and others interested in oral health, its role in systemic health, and the availability of community-based services for children and adults.  Speakers, Drs. Caswell Evans and Jane Grover will present keynote addresses and moderate local panels.

Dr Evens OHCCaswell Evans, DDS, MPH, coordinator for the 2002 Surgeon General’s Report on the Silent Epidemic and the 2003 “Call to Action,” was an active member of the original Coalition for NH’s Oral Health work team that developed and published the New Hampshire Oral Health Plan: A Framework for Action.  He will provide the morning’s keynote address and facilitate a conversational retrospective that includes many of the state’s oral health leaders from 2000 through 2016 addressing public-private partnership, public health oral health initiatives, medical-dental integration, and the evolution of community-based prevention. 

Dr. Evans is the Associate Dean for Prevention and Public Health Sciences at the University of Illinois, Chicago College of Dentistry; he is also a faculty member in the UIC School of Public Health.   Previously he served as the Executive Editor and Project Director for Oral Health in America: A Report of the U.S. Surgeon General.  For twelve years, Dr. Evans was Director of Public Health Programs and Services, for the Los Angeles County Department of Health Services.  He is a member of the National Academy of Medicine, National Academy of Sciences.  He is a past president of the American Public Health Association, the American Association of Public Health Dentistry, and the American Board of Dental Public Health.  Dr. Evans is Chairman of DentaQuest Foundation Board.  He also serves on the Chicago Board of Health and the boards of the Institute of Medicine of Chicago, Oral Health America and the Children’s Dental Health Project.  

Dr. Grover for OHCJane Grover, DDS, MPH, has supported NH’s Federally-Qualified Health Centers and dental community by providing expertise and consultation to help build strong community-based oral health programs.  She will be the afternoon’s keynote speaker and will moderate a future-looking prospective of innovative programs and strategies that are moving our state into the future including oral health care in the right place at the right time, new community access points, emerging financing models, community-based oral health disease management and Interprofessional education. 

Dr. Grover is the Director, Council on Access, Prevention and Interprofessional Relations (CAPIR) in the division of Government/Public Affairs at the American Dental Association (ADA).  Dr. Grover served as the dental director for the Center for Family Health, a federally qualified health center in Jackson, Michigan.  She is an adjunct faculty member of the University of Michigan School of Dentistry and Lutheran Medical Center of New York.  She has been active in organized dentistry, first as a trustee of the Michigan Dental Association, and also on the ADA Strategic Planning Committee in the 1990s. She completed five years on the ADA Political Action Committee, serving 2003-2005 as chair. She served as vice-president of the ADA from October 2006 until October 2008.  Dr. Grover received her D.D.S. degree from the University of Michigan School of Dentistry and her M.P.H. degree from the University of Michigan School of Public Health.

For more information:  www.nhoralhealth.org or email info@nhoralhealth.org


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