THE EXAMINER

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Did you know?...

Robert E. Bush Naval Hospital

“Serving with Pride and Professionalism since 1993”

You have the right toexpress your concernsabout patient safety and

quality of care.There are several avenues opento you:* Through the ICE website.* The Hospital CustomerRelations Officer at 760-830-2475, or any of the CustomerRelations representatives in theHospital clinics, or directly tothe Joint Commission via: E-mail at complaint@jointcommission.orgFax: 630-792-5636

The Joint CommissionOak Renaissance BoulevardOakbrook Terrace, IL 60181

To report Fraud, Waste andAbuse contact one of thebelow offices by calling:

Naval Hospital: 760-830-2344Combat Center: 760-830-7749NavMedWest: 1-877-479-3832Medical IG: 1-800-637-6175DoD IG: 1-800-424-9098

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

An Award Winning Publication

Patients seen in April -- 12,142Appointment No Shows in April -- 1,148In April we had an 8.6 percent no show rate. We need to keep trendingdownward by keeping the appointments we make, or by canceling in enoughtime for someone else to use the slot...To help patients obtain appointments, the Naval Hospital now shows thenumber of open appointment slots each day on the hospital Facebook site,check it out. On Facebook, search: Naval Hospital Twentynine Palms.

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

Navy Nurse Corps Celebrates 106th BirthdayBy NHTP Public Affairs

Naval Hospital TwentyninePalms celebrated the NavyNurse Corps’ 106th anniversaryMay 13 with cake, awards andspeeches. Genevieve Salisbury,84, guest of Capt. SandraMason, spoke about her experi-ences as a Navy nurse in the1950s. She served from 1954 to1956 earning the rank of lieu-tenant, junior grade. In thosedays, Salisbury said, if youwanted to start a family, you leftthe service. Salisbury met herfuture husband, Edward, duringan atomic-bomb drill in front ofNaval Hospital San Diego. TheSalisburys raised six childrenand have lived in TwentyninePalms since 1974. Capt. EdwardSalisbury spent 31 years as aNavy internist. Ms. Salisburybrought her Navy Corps cape toshow to younger nurses whowere impressed by its weight (6pounds) and elegance.

Ms. Salisbury recounted howher husband, Edward, during hisinternship at Naval MedicalCenter Oaknoll in 1960, won-

Genevieve Salisbury (seated) poses with NHTP nursing staff following award ceremony and reminis-cence marking the 106th anniversary of the Navy Nurse Corps.

dered why the nursing staff wasin awe of an elderly, ambulatoryfemale patient. He later learnedshe was the last remainingmember of the Sacred Twenty,the original 20 female nursesaccepted into the Navy NurseCorps.

The following is from NavyMedicine, Office of theHistorian:

By AndrÈ B. Sobocinski

On May 13, 1908, PresidentTheodore Roosevelt signed theNaval Appropriations Billauthorizing the establishment ofthe Nurse Corps as a uniquestaff corps in the Navy.

Initially, all Nurse Corps candi-dates were required to travel toWashington, D.C., at their ownexpense and take an oral andwritten examination. Sincemany applicants expressedreluctance to travel at their ownexpense, U.S. Navy SurgeonGeneral Presley Rixey orderedthat applicants be allowed tosubmit an original essay on thetopic of “nursing practices” by

mail, in lieu of an onsite writtenexamination.

The nucleus of this new NavyNurse Corps was a superintend-ent Esther Hasson, a chief nurseLenah Higbee, and 18 otherwomen--all would forever beremembered as the “SacredTwenty.”

Beatrice Bowman, one of thesepioneering nurses, and latersuperintendent of the NurseCorps, recalled that these “nurs-es were assigned to duty at theNaval Hospital, Washington,D.C. There were no quarters forthem but they were given anallowance for quarters and sub-sistence. They rented a houseand ran their own mess. Thesepioneers were no more welcometo most of the personnel of thePlease see Nurses, page 7.

2 -- The Examiner -- June 2014

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 pre-pared by the Public Affairs Office, Naval Hospital, Twentynine Palms, Calif.

Commanding OfficerCapt. Jay C. Sourbeer, MC, USN

Executive OfficerCapt. Angela S. Nimmo, NC, USN

Command Master Chief HMCM (FMF/AW/SW) Carol Merricks, USN

Public Affairs Officer/EditorDave Marks

Command OmbudsmanBright Opoku (760) 910-2050 email: nhtpombudsman@yahoo.com

The Examiner welcomes your comments and suggestions concerning the publication. Deadline for submission of arti-cles 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: 230-2362E-mail: david.marks@med.navy.milHi-Desert Publishing Company56445 Twentynine Palms HighwayYucca Valley, CA 92284Com: (760) 365-3315FAX: (760) 365-8686

NHTP Recognizes Asian/Pacific American Heritage

Som Harz performs a classicalThailand dance called, “TheDreamer.”

Joyce Teo (left) demonstrates a traditional Hawaiian dance with thehelp of her student, Tootsie Melei.

HM3 Ian Lawler (left) and Nick Wang demonstrate mixed marshalarts.

MCAGCC Sgt. Maj. KarlVillalino, guest speaker,recounted the many accom-plishments of AmericanAsian/Pacific service membersthroughout the history of theUSA.

No Asian/Pacific celebrationwould be complete without theattendance of the traditionalroast pig.

HN Dennis Roxas performssongs by Bruno Mars who isoriginally from Honolulu,Hawaii.

Vaitupu Melei demonstratesa traditional Tahitiandance.

The Examiner --June 2014 -- 3

2X3Smith’s Family

Properties

Preventive Medicine CornerSubmit Questions/Concerns and Tanya Will Provide Answers

Tanya StuckeyPreventative health screeningsand self-monitoring are anessential part of maintaininggood health and increase earlydetection when problems arise.For example, one patientwrote:

Dear Tanya,

I am a 50-year-old man andI'm concerned about myprostate. When I talk to mydoctor about it, he doesn't seeminterested and says new guide-lines recommend not doinganything. But when I readabout Gen. David Petraeus, thenews articles frequently men-tion his prostate cancer and thefact that he received radiationtherapy for it. Is there a two-

tiered system? Does a personhave to have high enough rankto receive a thorough diagno-sis?

Signed,Troubled Down Under

According to the AmericanCancer Society, Starting at age50, men should talk to a doctorabout the pros and cons of test-ing so they can decide if testingis the right choice for them. Ifthey are African American orhave a father or brother whohad prostate cancer before age65, men should have this talkwith a doctor at age 45. If mendecide to be tested, they mayopt to have the Prostate-Specific Antigen (PSA) bloodtest with or without a rectalexam. How often they are test-ed will depend on their PSAlevel.

Research has not yet proventhat the potential benefits oftesting outweigh the harms oftesting and treatment. TheAmerican Cancer Societybelieves that men should not betested without learning aboutthe risks and possible benefitsof testing and treatment. Askyour healthcare provider aboutyour risks and benefits anddecide together what the bestcourse is to take for your spe-

cific health plan.

Each patient is different andmust be treated to the extenthis/her symptoms and diagno-sis suggest is the right courseof action as discussed andagreed upon by the patient andmedical team. This is often anarea of confusion and frustra-tion when patients with similarconcerns are prescribed differ-ent instructions. Family histo-ry, diet, activity level, othermedical issues may contributeto different prescriptions ofcare.

For this concerned gentlemanand others, I continue to saythat you are your best advo-cate. It is important that youare a part of the team when itcomes to your healthcare. Ifyou have a concern regardingwhat a provider has advised,ask him/her to schedule moretime to sit and talk with youabout how he/she came to thatconclusion. If you still want orneed more information, feelfree to contact your clinic'snurse educator, NHTPOmbudsman at 760-910-2050/NHTPombudsman@yahoo.com or the HospitalCustomer Relations Officer at760-830-2475, or any of theCustomer Relations representa-tives in the Hospital clinics.

If you want to know moreabout Health and Wellness pro-grams or would like to see aparticular health topic featuredin the Examiner, give me a callor send an email and I wouldbe glad to do the research andreport back to you about what Ifound!

.........................Summer Safety

Summer, Summer,Summertime... Definitely a timeto sit back and unwind. Yes, Iwas a teen of the 90s, a hugeFresh Prince fan and I stilllook forward to the sun andfun of summer! What are yourplans for this beautiful time ofyear? Are you up for a cool dipin one of the Combat Centerswimming pools? A movie inthe cool Sunset Cinema? Ormaybe you are planning to par-ticipate in early morning orlate evening hikes, runs or rockclimbing through our desertterrain.

I have heard from several staffand patients that their summersare full of off-roading, trips tothe river and beaches, PCSmoves to cooler climates, and“just chillin’.”

No matter what your plans are,you are in need of some sum-mer safety planning. No kid-ding, it gets H-O-T here in thesummer! With temperatureshitting the 100s, we all have tothink about hydration, heat and

sun protection, critter care andtravel safety.

Soon the kids will be out forthe summer and family tripsand PCS moves will commence.The great outdoors calls andwe will answer. SouthernCalifornia is home to some ofthe best theme parks and out-door activities! As you partakein the opportunities that awaityou, make sure you drink plen-ty of water, watch out for desertcritters who are also seekingshade and cooler temperaturesand apply sunscreen (even ifyou don’t think you will burn).A quality sunscreen will keepout the UV rays that cause aburn without clogging poresand will still allow enough sunto achieve a tan. The AmericanAcademy of Dermatology sug-gests that at least an SPF 30 beused year-round for all skincolors and types.

Summer travel often meanshours of family time in a vehi-cle. If you are planning to trav-el with pets or small children,please do not leave them in thecar; not even for a short time.Did I mention how hot it getshere? Unattended children andpets are at risk for heat illness,drowning and wandering off.

For more information on theprograms listed above, call(760)830-2173 or emailTanya.stuckey@med.navy.mil.

HM3 Ryan Stephen shows off the Certificate of Appreciation presented to his wife, Amanda, followinghis reenlistment ceremony on May 2. Stephen reenlisted for 2 more years and has been a laboratorytechnician at NHTP for the past 4 years. He’s been in the Navy 6 years and is on track to make the Navy

his career. Originally from KeyWest, Fla., Stephen will reportto Navy Hospital CampPendleton in July. NHTPExecutive Officer AngelaNimmo (left), Stephen’s sonKolston, 2 1/2 (red shirt), andNHTP Director for Clinical

Support Services, Lt. Cmdr.Stacie Milavec (right) were onhand to congratulate HM3Stephen with a “job welldone!”

4 -- The Examiner -- June 2014

Super Stars...

Hospitalman Kevin Lestagereceives a Letter ofAppreciation for his “outstand-ing performance as a SurgicalTechnician, Main OperatingRoom, NHTP, on August 23,2013. You performed yourduties in an exemplary andhighly professional mannerduring a routine surgical pro-cedure when the patient beganto experience unexpectedbleeding. Your exemplary pro-fessionalism and outstandingperformance of duty reflectgreat credit upon yourself andwere in keeping with the high-est tradition of the UnitedStates Naval Service. I com-mend you for a job “WellDone” and wish you continuedsuccess in your future endeav-ors.” Signed, J.C. Sourbeer,Captain, Medical Corps, UnitedStates Navy.

Lt. Cmdr. Joshua E. Blackburnreceives a Navy and MarineCorps Commendation Medalfor meritorious service whileserving as Head, PharmacyDepartment, NHTP, fromAugust 2011 to May 2014. Lt.Cmdr. Blackburn implementedthe new Navy enterprise-widepharmacy standard operatingprocedure exceeding Bureau ofMedicine and Surgery targetedcompletion goals by 2 monthsand ensured 100 percent com-pliance. He supervised the con-struction of two new dispensingwindows and implemented newpatient queuing software whichstreamlined the outpatient waitprocess and reduced wait timesfrom 45 minutes to 15 minutes.Lt. Cmdr. Blackburn’s distinc-tive accomplishments, unrelent-ing perseverance, and steadfastdevotion to duty reflect greatcredit upon himself and are inkeeping with the highest tradi-tions of the United States NavalService.”

Hospitalman Christopher J.Moran receives a Letter ofAppreciation for his outstand-ing performance as a SurgicalTechnician, Main OperatingRoom, NHTP, on August 23,2013. You performed yourduties in an exemplary andhighly professional mannerduring a routine surgical pro-cedure with an unanticipatedintra-abdominal hemorrhage.As a member of the attendingsurgical team, you immediatelyrecognized the potentially criti-cal nature of the situation andacted quickly to assemble threeadditional surgical sets neces-sary for the surgical control ofbleeding. Your actions werenoteworthy to the success ofthe surgical team’s quick anddiffinitive intervention. Yourexemplary professionalism andoutstanding performance ofduty reflect great credit uponyourself and were in keepingwith the highest tradition of theUnited States Naval Service. Icommend you for a job “WellDone” and wish you continuedsuccess in your future endeav-ors.” Signed, J.C. Sourbeer,Captain, Medical Corps, UnitedStates Navy.

Petty Officer First Class LiliaA. Gardner receives a Letter ofCommendation for her selec-tion as Senior Sailor of theQuarter for the first quarter,fiscal year 2014. “She achievedthis distinction by demonstrat-ing exceptional leadership, ini-tiative, and dedication to duty.This prestigious recognitionsets her apart as a true profes-sional and personifies theenlisted community’s reputa-tion of high standards of per-formance and conduct. Herenthusiasm and contributionsepitomize the navy MedicalDepartment’s motto, ‘WorldClass Care... Anytime, any-where!’ and provide tangibleevidence of the vital role thatthe enlisted community plays intoday’s Navy. Petty OfficerGardner’s exceptional profes-sional ability and loyal devo-tion to duty reflect great creditupon herself and are in keep-ing with the highest traditionsof the United States NavalService. I take great pleasurein commending her for a job,‘Well done.’” Signed, Bruce L.Gillingham, Rear Admiral,Medical Corps, United StatesNavy.

Lt. Derek L. Owens receives aNavy and Marine CorpsAchievement Medal “for pro-fessional achievement in thesuperior performance of hisduties while serving as admin-istrative officer, Exercise ArcticCare, for April 2013, 4thMedical Batallion, 4th MarineLogistics Group. Lt. Owensperformed his duties in anexemplary and highly profes-sional manner. as the Director,Flight Operations, he trackedBlack Hawk helicopters fortransport into the region andsuccessfully completed a totalof 76 flight operations with amovement of 342 personnel. Heled multi-service teams thatprovided medical, dental, andveterinary care to 12 remoteAlaskan villages with a com-bined population of 10,000Inupiat and other Alaskannatives. Over the 9 days theteams treated over 2,870patients and performed over11,580 medical, dental, and vet-erinary procedures resulting ina total cost production of over$1,061,999, a total of 116 train-ing hours performed on publichealth matters, and cost sav-ings of $134,500 in travel forspecialty services. Lt. Owens’exceptional professional ability,initiative and total devotion toduty reflect great credit uponhimself and are in keeping withthe highest traditions of theMarine Corps and the UnitedStates Naval Service.”S

The Examiner -- June 2014 -- 5

Charlie Jansen (far left) poses with the NHTP CBRN team and NHTP Executive Officer Capt. Angela Nimmo (center) and Branch Clinic Director, Capt. Lisa Morris (far right)following its 2-day semi-annual training May 1. The BUMED First Receiver Training is designed to educate U.S. Navy Medical first receivers on the life-saving skills that arerequired for triage, field treatment, and decontamination procedures. The training is designed to give first receivers the skills necessary to decontaminate victims of chemical, bio-logical, radiological/nuclear (CBRN) or hazardous material contamination. The first day of training involves classroom instruction. On day two, first responders engage in atimed exercise, dressing in protective gear, erecting the decontamination unit and decontaminating and preparing an exposure victim for medical evacuation.

“My first name is Master Chief!”

HMCM Craig A. Hodges has his new rank pinned on by daughters Abbey (left) and Tayleur (right)during his pinning ceremony May 19. In his remarks, NHTP Commanding Officer Capt. Jay Sourbeerrecounted a social event at which his wife, Shelly, asked a gruff master chief for his first name. “Myfirst name is Master Chief,” the senior NCO repeatedly replied.

Lt. j.g. Devon Cassidy is promoted to her present rank during a pro-motion ceremony May 13. Cassidy’s home town is Mendham, N.J..She’s been in the Navy 2 years and is a staff nurse on the NHTPMulti-Service Ward.

6 -- The Examiner -- June 2014

Sub Offer5X3

Introducing New Staff -- Welcome Aboard!

Lt. Cdr. Charles Dickerson Fa’afiuloto NadorJessica Wofford HM1 Jimmie ThomasHM2 Mario Acosta Morales

Lt. Cdr. Charles Dickersonarrived at NHTP from NavalMedical Center San Diegowhere he spent the last 2 yearsin his anesthesiology creden-tialing tour. Originally fromDetroit, Michigan, Dickersonhas extensive medical experi-ence and training. He joinedthe Navy in 1993 in an enlisted,undesignated capacity. After 18months, he was picked up bythe BOOST Program (officertraining program). After gradu-ating from the Univ. ofMemphis with an RegisteredNursing degree, he returned toNavy medicine as an officer.He’s deployed “many times”but says the most interestingdeployment was when heentered Iraq on the second dayof the invasion. Dickerson isaccompanied by his wife,Brandi, and daughters, Halle,10, and Briana, 14. Dickersonenjoys gaming, web design,working with Microsoft Accessand reading.

YNSN Fa’afiuloto Nadorenlisted from Anchorage,Alaska, immediately followinghigh school graduation. She’sbeen in the Navy 3 years andhas spent most of that time onthe U.S.S. Pearl Harbor. Sheexplains her unusual name asoriginating from her AmericanSamoan mother and her Figianfather. She likes being a yeo-man and says her dutiesinvolve “a lot of paperwork.”At NHTP she’s assigned toHuman Resources Department.She describes her experienceon the U.S.S. Pearl Harbor as“amazing.” She said she enjoystraveling overseas and particu-larly liked the Middle East.Nadore says Twentynine Palmsis “beautiful” and she expectsto enjoy her tour of duty in thehigh desert. She enjoys playingfootball, volleyball, basketball;and she enjoys singing anddancing.

Jessica Wofford spent the last13 1/2 years in the Air Forceworking as an ultrasound tech-nician. She arrived here fromher most recent duty station,Langley, Virginia. Wofford isassigned to NHTP RadiologyDepartment where she’salready working as an ultra-sound technician. She is herewith her daughter, 19 months,and son, 9, and they are await-ing the arrival of husband anddad, Dwight, currently a civil-ian employee at Hill Air ForceBase. Wofford received herradiology and ultrasound train-ing in the Air Force and is cur-rently working on herBachelor’s degree in Radiologywith the Adventist University ofHealth and Sciences. Woffordenjoys playing sports, watchingsports, and playing with herchildren. Wofford likes thehigh desert. “We lived inTucson for a while and wewanted to move back to thedesert, so here I am.”

HM1 Jimmie Thomas justarrived from Balboa, but he’sno stranger to TwentyninePalms. He spent 3 years withthe 7th Battalion, 7th MarineRegiment, here on the CombatCenter with whom he deployedto Japan and “a couple oftimes” to Iraq. He describesthose experiences as “lifechanging.” Thomas is original-ly from Little Rock, Ark., wherehe enlisted. His wife, Hollie,and two sons, ages 9 and 2, andtwo daughters, ages 5 and 4,are still living in the San Diegoarea until Base housingbecomes available. Thomasenjoys volunteering for worthycauses, football, sports, watch-ing TV. When asked how hisfamily feels about moving tothe high desert, Thomas said:“The don’t mind it. They justwant to go wherever I’m at.”

HM2 Mario Acosta Moralesarrived to NHTP from BranchHealth Clinic Groton,Connecticut, where he wasAssistant Leading Petty Officerin the pharmacy. AcostaMorales has been in the Navy 8years and will be a PharmacyTech in the NHTP Pharmacyas well. He counts a 10-monthKuwait deployment among hisNavy tours of duty. “It wasquite an experience,” he said.Hometown is Wallingford,Conn. On an unaccompaniedtour, Acosta Morales enjoysmotorcycles and soccer whenhe’s not on duty. In soccer heplays defense and says he willdefinitely check out the cham-pionship NHTP team. He planson living in Twentynine Palmsbut hasn’t yet found a place.

The Examiner -- June 2014 -- 7

MBTA2X8

Navy than women are wheninvading what a man calls hisdomain.”

In October 1908, the first por-trait of these plank owner nurs-es was taken in front of NavalHospital Washington, D.C.(main hospital building). Thisbuilding would later becomethe U.S. Navy Bureau ofMedicine and Surgery’s“Building Three.” The picturefeatured one current and twofuture superintendents of theNurse Corps. Collectively,Esther Hasson, Lenah Higbeeand Beatrice Bowman wouldaccount for 27 years of NurseCorps leadership.

Rank

In 1908, the Navy MedicalDepartment was comprised ofMedical Corps Officers andHospital Corpsmen (thenreferred to as Hospital Stewardsand Hospital Apprentices).Unlike their physician counter-parts, the first nurses did nothold rank. Navy nurses werenot granted “relative rank” untilJuly 3, 1942. Nurse Corps offi-cers were finally granted “fullmilitary rank” on February 26,1944.

Roles in Navy Medicine

Until 1909, all Navy nurses hadthe choice of one duty station,Naval Hospital Washington,D.C. (sometimes referred to asthe Navy Medical SchoolHospital). In 1909, BUMEDbegan detailing its Navy NurseCorps to medical facilities out-side of Washington, D.C.Naval Hospitals Annapolis,Md., Brooklyn, N.Y., and MareIsland, Calif., were among thefirst hospitals to receive nurses.In spring 1909, Surgeon JamesLeys, commanding officer,Naval Hospital Norfolk, Va.,requested BUMED to send“nurses” to his hospital. Whenthree female nurses (LenahHigbee, Ethel Swann, and MaryNelson) reported for dutySurgeon Leys was aghast.

He had fully expected toreceive male hospital corpsmenand did not know how theycould work in a hospital with-out a single female patient.

Their original quarters werelocated in a rented house on21st Street, N.W., only a fewblocks away from the NavalHospital.

NurseChampions!

Lt. Ashley Robertson Annual 2014 Senior Nurse

Corps Clinical NursingExcellence Award.

Ms. Dinah OliveraAnnual 2014 Clinical NursingExcellence Award for Licensed

Practical Nurse.

Ms. Jennie Pyle2014 Annual Contract Clinical

Nursing Excellence Award

Lt. j.g. Brent Edwards2014 Annual Junior Nurse

Clinical Nursing ExcellenceAward

Original “Sacred Twenty” nurses.

(Left) Capt. Sandra Mason, NHTPDirector of Nursing Services, holdsthe Nursing Corps cape. (Top)Genevieve Salisbury, 84, shares herexperiences as a Navy Nurse.

8 -- The Examiner -- June 2014

5X3VIP

COLOR

Flag Conditions Color TrainingBy NHTP Preventive Medicine

It’s Getting Hot Out Here!

The weather in the MorongoBasin has a history of taking usby surprise. In recent weeks,our temperatures have fluctuat-ed by more than 20 degrees in aday. Crisp desert mornings andcool evenings can lull us into afalse sense of security makingus believe that we are not atincreased risk of heat injuries.

There are several factors to con-sider when working or exercis-ing outside; hydration, acclima-tization, exposure, appropriateattire, personal history and bev-erage and dietary supplementconsumption.

Proper hydration begins 24 to48 hours in advance of longmarches or strenuous outsideactivity. Drink fluids frequentlyand throughout the day. Largevolumes of relatively clear urineindicate proper hydration. Smallvolumes or dark urine indicatesdehydration. Acclimatization is the ability toundergo physiological adapta-

tions to function in a hot envi-ronment. According toNAVMED P-5010, “A period of3 weeks is optimal for acclima-tization, with progressivedegrees of heat exposure andphysical exertion. A minimumof 2 weeks is necessary for theacclimatization process.”

No amount of acclimatizationwill change the body’s require-ment for hydration.

The wet bulb globe temperature(WBGT) that is used to deter-mine flag conditions andwork/rest cycles is an effectiveway to identify the risk of exter-nal heat stress on the body.Flag-warning conditions can befound in the chart (below).

You should protect your skinwith loose, light colored cloth-ing and sunscreen. Inform med-ical personnel of known familyhistory of medical conditions, orprior heat related fainting or ill-ness. Those with a history ofheat illnesses are at higher risk.Avoid alcohol and dietary sup-plements before extended expo-

sure, and be aware of warningson prescriptions as they mayincrease sensitivity.

Mission readiness requirespreparation both on and offduty. Adopting a healthylifestyle with proper exercise,nutrition and adherence to per-sonal safety increases perform-ance, presence and well-being.

Green flag condition

Exercise Brings BoneBenefits that Last

Building bone as a young adultcan have benefits that last a life-time, a new study showed. Theresearch also confirmed thatphysical activity as we get oldercan help us maintain bonestrength.

Bone is a living tissue. Itresponds to physical activity bybecoming heavier, bigger, andstronger. It does this best whenwe’re young. Bone mass usuallypeaks when we’re in our 20s.After that, we often begin tolose bone.

Studies of animals have shownthat exercise during periods ofrapid growth can lead to life-long benefits in bone size andstrength.

To see if the same holds true forhumans, a team of NIH-fundedscientists studied more than 100professional baseball players atdifferent stages of their careers.Baseball players were ideal sub-jects, because their throwingarms get a lot more action thantheir non-throwing arms.Baseball players also tend toretire from stressful throwingactivities once they stop profes-sional play. This allowed thescientists to look at the effectsof physical activity long afterintense throwing had ended.

The researchers found that theupper bones in the throwingarms of players were nearlytwice as strong as the bones innon-throwing arms. Throwingarm bones had about 50%greater mass, size (total cross-sectional area), and thickness.

As players got older, the bonemass benefits from throwingwere gradually lost. But abouthalf the bone size benefits andone-third of the bone strengthbenefits were maintained life-long. Players who continuedthrowing during aging lost lessbone and kept even more of thestrength benefits.

“Exercise during youth addsextra layers to the outer surfaceof a bone to essentially makethe bone bigger,” says studyleader Dr. Stuart J. Warden ofIndiana University. “The biggerbone generated by physicalactivity when young has ameans of sticking around longterm to keep the skeletonstronger.”

This article is a reprint from theNational Institutes of Healthwebsite: NIH.gov. To read thisand other health-related arti-cles, please visit the website andclick on News in Health, amonthly newsletter from theNational Institutes of Health,part of the U.S. Department ofHealth and Human Services.

Call 1-800 TRICARE (874-2273) Option #124 hours a day, 7 days a week