NOAH 2014 North Omaha Area Health

NOAH North Omaha Area Health page- Spring Issue 2012

This Publication Made possible by support from

University of Nebr. Med Center. 5050 Ames Ave

Omaha, Nebraska 68104

Nonprofit Organization

U.S. Postage

PAID

Omaha, Nebraska

Permit NO. 454

Health and

Spirituality Page 5

Black Family

Health and

Wellness Page 6

Champion Page 8

Spring 2014

“From the cradle to the grave” The effects of having it or not having it, healthcare

NOAH North Omaha Area Health page-2 Spring Issue 2014


Diabetes, Insulin

Overdose, and Other

Complications Cold sweats, trembling hands, intense anxiety, a

general sense of confusion -- no, it's not the night

before final exams. These are the signs of low

blood sugar or hypoglycemia, which can result

from an insulin overdose, a potentially danger-

ous complication of diabetes.

Hypoglycemia happens to many people with dia-

betes. And it can sometimes be serious. Thank-

fully, most episodes related to insulin are avoida-

ble if you stick with a few simple rules. WebMD

takes a look at how to prevent and treat insulin

overdose.

When Insulin Works too Well Insulin stimulates the cells of the body to absorb

sugar (glucose) out of the blood. It also inhibits

the production of glucose by the liver. In type 1

diabetes, the body does not make insulin. In type

2 diabetes, the body is resistant to the insulin the

body does make, and with time the pancreas may

make less insulin.

All people with type 1 diabetes need to take in-

sulin injections. Many people with type 2 diabe-

tes -- those whose blood sugar can't be controlled

with oral medication, diet, and exercise -- take

insulin injections.

There are several ways you can get too much

insulin in your system and have a drop in your

blood sugar:

You inject too much insulin because you

have difficulty reading the syringes or vials or

are unfamiliar with a new product.

You inject the right amount of insulin but the

wrong type. For instance, you normally take 30

units of long-acting and 10 units of short-acting

insulin. Injecting 30 units of short-acting insulin

is an easy mistake

to make.

You inject in-

sulin, but then

didn't eat. Short-

acting insulin in-

jections should be

timed with meals.

Blood sugar rises

after meals, but

without eating,

insulin lowers

blood sugar levels

to a potentially

dangerous level. You inject the right amount of insulin but inject

it into an arm or leg just before exercise. Physi-

cal activity can lower blood sugar levels and also

affect insulin absorption:

Don't Symptoms of an Insulin Overdose It doesn't matter how it happens. An insulin

overdose always has the same effect: low blood

sugar levels, or hypoglycemia. Symptoms of hy-

poglycemia include:

Anxiety

Confusion

Extreme hunger

Fatigue

Irritability

Sweating or clammy skin Trembling hands If sugar levels continue to fall during an insulin

overdose, serious complications --

seizures and unconsciousness -- can

occur.

Low blood sugar is defined as less

than 70 mg/dL. Hypoglycemia is

defined as a low blood sugar that

leads to symptoms. Some people

with poorly controlled diabetes can

experience the symptoms of "low"

blood sugar at normal blood sugar

levels (70 to 120 mg/dL).

On the other hand, some people

with diabetes won't experience

these symptoms even at low sugar

levels. For unclear reasons, some

people have few warning signs

when their blood sugars drop. This unawareness

of low sugar is more common in people with

type 1 diabetes.

Being unaware of low sugar levels means you're

at higher risk for insulin problems. You may not

have a warning that your sugar is low until you

become too confused to correct the situation or

become unconscious. Family and friends need to

know what to do if the situation becomes seri-

ous.


UNMC on a Mission of

Sharing SHARING Clinic Mission

It began as a medical

student's vision of providing

quality care to Omaha's

underserved. With the help of a

small group of medical and

nursing students, and under the

guidance of Jim Medder, M.D., a

family physician, and Kathryn

Fiandt, a nurse practitioner, the

SHARING clinics were born.

The UNMC SHARING

clinics strive to enhance the well-

being of the greater Omaha

community by providing high-

quality, low-cost health care and

human services to those in need. In

a multidisciplinary educational

setting, the SHARING clinics

empower patients and instill the

values of service and compassion

in UNMC students.

The SHARING

organization oversees four clinics:

SHARING,

RESPECT,

GOODLIFE

and VISION.

Spanish

interpreters are

available at all

clinics. The

UNMC

SHARING clinic is also

partnered with a dental clinic

operated by the College of

Dentistry in Lincoln, Neb. More

information about SHARING

Dental can be found online at:

http://www.unmc.edu/sharing/

VISION Clinic The VISION Clinic was founded in

March 2011. It provides ophthalmology

services upon referral from the SHARING

and GOODLIFE clinics.

SERVICES: Ophthalmology, diabetic eye

screenings

HOURS: 1 p.m. to 3:30

p.m. on the first

Wednesday of each

month.

ADDRESS:

UNMC Truhlsen Eye

Institute

3902 Leavenworth St

Omaha, NE 68105

PHONE: 402-559-2020

GOOD Life Clinic The GOODLIFE

Clinic opened in

October 2002 to

address the primary

care needs of those

living with type 2

diabetes in the

Omaha community.

Patients must

demonstrate

financial need to be

seen at the GOODLIFE clinic. Those

who attend the clinic receive

comprehensive type 2 diabetes

examinations, laboratory evaluations,

and medications.

SERVICES: Treatment of type 2

diabetes mellitus

HOURS: 5:30 p.m. to 7 p.m. on the

second Wednesday of each month.

ADDRESS: Baker Place

5050 Ames Ave.

Omaha, NE 68104

PHONE: 402-595-2280

RESPECT Clinic The RESPECT Clinic opened in

October of 2001. The clinic provides

confidential testing, treatment, and

counseling for sexually transmitted

diseases. RESPECT is proud to

partner with the Nebraska AIDS

Project. The RESPECT Clinic is open

each Monday of the month from 5:30

p.m. to 7 p.m.

SERVICES: Sexually

transmitted disease

testing and treatment,

HIV testing and

counseling

HOURS: 5:30 p.m. to 7

p.m. Mondays

ADDRESS: Baker Place

5050 Ames Ave.

Omaha, NE 68104

PHONE: 402-595-2280

http://www.unmc.edu/sharing/


Health Spirituality staying healthy with Spirituality

What can you do, today, to make yourself healthier?

This can be more difficult to answer than it sounds. There is a lot of pho-

ny advice on the internet that only creates confusion. Sometimes there is

just enough time to get the kids to school safely let alone time to make any

decision. The bottom line, however, is that in order to be healthy you have

to make healthy decisions. If you never decide to eat right or exercise

more, you will end up as an overweight coach potato.

A Health Spirituality helps us to make and carry out healthy decisions.

Over 2500 years ago, Isaiah said that when you have spirituality you

have”the Spirit of wisdom and of understanding, the Spirit of counsel and

of might, the Spirit of knowledge.” This Spirit of Wisdom helps you de-

cide what you need to do and gives you the strength to carry out these de-

cisions.

If you look at all the futile New Year’s resolutions to get more exercise or

quit smoking you may wonder why so many decisions to get healthy fail.

Failure or success is a battle between short term and long term thinking

and short term usually wins.

You have a big role in deciding how healthy you are. Smoking, drinking

too much, and eating the wrong foods all must be initiated by your deci-

sions. All these health decision have short term benefits. Eating a Twinkie

makes you feel good now. Deciding that you won’t eat a Twinkie does not.

You only have to over eat once in a day to gain weight. You have to not

over eat all day to lose weight. Unhealthy decisions give quick results,

healthy decisions take longer.

Spirituality, or the belief in something greater than yourself, makes you less

frightened and less likely to make impulsive decisions. This is the Spirit of

Wisdom that is spoken about in Isaiah. Studies have shown that prayer,

meditation, scripture and church based interventions are effective ways to

improve health by providing a deeper meaning to the effort.

Suppose two people are trying to lose weight. One person is trying to lose

weight to fit into a smaller dress size and the second sees losing weight as a

decision they have made after prayer and meditation. Who will be more

likely to be successful?

Before you answer imagine that both people are driving on Ames St from

72nd to 30th street. How many fast food joints, restaurant, convenience

stores and billboards selling quick and tasty food are there? At each and

every one both people will have to make a decision to follow their diet. It

is a fact that people eat more when they see more fast food signs. To lose

weight a person will have to say No to each and every fast food joint, res-

taurant or convenience store.

In the face of such temptation, it is more likely that the dress size motivat-

ed person will fail. People who have a deeply held belief about what they

are doing will tend to do better.

Now I am not saying that it is wrong to go to Burger King or get some re-

ally good ribs. Far from it, no food is bad. Nor am I saying that all over-

weight people are not good folk who go to Church. However, when a per-

son decides to lose weight they are more likely to carry out that decision

successfully when Health Spirituality is used.

Of course there is more to Health Spirituality than prayers and meditation.

As a preacher friend of mine says, “You have to put the feet to your pray-

ers.” Health Spirituality has to be combined with effective interventions

and behaviors. For example when I use Health Spirituality and weight loss

I recommend people do the following:

Every day decide what you want to eat for the following 24 hours

Keep a written record of what you eat even if it exceeds what you

planned to eat

At the end of the day, review what you ate. Look for feelings of stress,

fear or impulse. Complete this review without shame or remorse.

Weight yourself weekly, again without shame or remorse

Number 1-4 are the most essential to start with. Try and implement these

all at one time. If you feel like you are able, then add the next two. If you

can’t add them immediately then add them when you feel able. The last

two steps are:

Do some physical activity three times a week. Try to increase the

amount slowly with the goal of some physical activity for 30 minutes

three times per week.

Learning something new about healthy eating weekly

These interventions take the focus away from following a diet with it

shame of failure and increasing your awareness of what you eat. They

seem to help the person follow their body’s natural hunger signals.

At the NOAH clinic we are going to run a 6 week weight loss program

using Health Spirituality and these steps. We hope to start

this in April when the weather is nicer. If you would like to be a

part or this call 933-0737 or you can find out more information on

Health Spirituality on my website www.healthspirituality.com

NOAH paper is compiled and distributed by North Omaha Area Health Inc. Black Family

Health and Wellness Association/The University of Nebraska Medical Center and the

Methodist Foundation are one of the many sponsors that support the publication of this

paper. Questions or comments please write the Editor Ira Combs at 5050 Ames Ave Omaha

Nebraska 68104, or email [email protected] or call 402-250-2370.

A Spiritually Based Approach to Weight

Loss/Diet in an African American

Community-The North Omaha Area Health (NOAH) Clinic provides

holistic health screenings in a medically underserved area of Omaha. The clinic

has noted a need for weight loss and dietary

counseling in the client it serves this new

programs pilot project will address weight

loss and diet needs using a holistic approach

including Spirituality. The approach will

focus on the use of Spirituality to make and

carry out healthy decisions. If you are

interested participating in this program

please call us at 402-933-0737 to sign up,

classes will start in May.

http://www.healthspirituality.com


16th Annual


By Nick Schinker

Reprinted from New Horizon Newspaper a publication of Eastern Nebraska Office on Aging

If you

Google the word “clinics” in Omaha on the Internet, a map appears covered by colorful dots and markers

that signify health clinics, counseling services, physical therapists

and doctors’ offices. But if you look more closely, the dots aren’t

spread very evenly. Some neighborhoods have fewer dots than oth-

ers.

North Omaha doesn’t have many at all.

“There are more veterinary clinics in north Omaha than peo-

ple clinics,” says Ira Combs, RN, community nurse liaison in the

Center for Reducing Health Disparities at the University of Nebraska

Medical Center (UNMC) College of Public Health. “Pets have better

access to health care than people.”

For many people, when we see something we consider to be

wrong or an injustice to ourselves or others, we complain.

Not Ira Combs. For him, another word comes immediately to

mind: Change.

As one man, he can’t cure all the sickness and disease in

north Omaha. But he can save lives. His medical specialty? Preven-

tion.

“Most hospitals originally were missions run by nuns and

clergy,” says Combs, 62. “Today, a hospital is a business, and the

bottom line of any business is to make

money.”

Combs is concerned by recent

developments in the medical communi-

ty, such as the news that Alegent

Creighton Health System is moving its

trauma center from 30th and California

Streets to Bergan Mercy Hospital at 78th

and Mercy Road.

“I’m a realist,” he says. “It’s my

fear that medical services are moving to

where the money is. So how do we take

care of that? We use prevention and ed-

ucation to keep people healthy.”

Combs’ efforts to educate the

public in healthy habits have earned

him recognition as a Public Health Prevention Champion of Change

by the White House and President Obama. He was one of eight peo-

ple cited this year for “helping communities focus on prevention . . .

to move us towards a healthier America.”

On Sept. 10, Combs was honored at a White House reception

and participated in a panel discussion describing his work.

In the ceremony and on the Champions of Change website,

the White House noted Combs’ many prevention activities:

“Mr. Combs’ work emphasizes inspiring young African-

Americans to become involved in public health. He created a youth

organization, Youth Expressions of Health, which includes an annu-

al Youth Summer Internship Program in partnership with UNMC. It

has helped more than 45 young people prepare for and start college

with a focus on entering the field of health care.

“Mr. Combs also coordinates health screenings and interven-

tions for minority and underserved populations. He is the founding

director of North Omaha Area Health Inc. (NOAH), an agency that

addresses the needs of the underserved in Omaha.

“Working with a handful of dedicated community volunteers,

he is helping to meet the needs of the community including produc-

ing health-oriented materials for kids and sponsoring and maintain-

ing websites and social media networks that link the community

with information about healthy living and health screenings.”

Combs tries to shrug off the accolades. “I’m just doing my

job,” he says. And he has much more work to do.

Ira Combs is one of four children born to the late Virgil

Combs and his wife, Willietter (Ware) Combs, now 94. Originally a

farmer in Missouri, Virgil Combs and his brothers moved to Omaha

to work in the packing houses.

After attending Howard Kennedy Elementary School, Ira

Combs went on to Horace Mann Junior High and Central High

School, where he graduated in 1969.

He was a member of Boy Scouts’ Troop 23 and worked to

become an Eagle Scout. “Our troop master put out seven black Eagle

Scouts,” he says.

It was a turbulent time for the city and the nation as people of

all races demonstrated peacefully and sometimes violently in the ef-

fort to gain civil rights for African

Americans.

“We threw rocks at George Wallace’s

motorcade in 1968 when he spoke at the

Civic Auditorium,” Combs says. “And I

remember people throwing rocks at us.

“I lived at 32nd and Miami Streets, and I

remember going with my friends to 32nd

and Ohio sitting on the hill looking

down at 24th and Lake and seeing the

fires burning during the riots.”

Combs says it was difficult to under-

stand why violence had come to his

peaceful neighborhood.

“Part of me was really rebellious and

resentful,” he says. “But part of me

thinks the community did really well on its own.

“When I was a kid, we had four black doctors in the commu-

nity. Dr. Johnson even made house calls. We had the Ritz Theater

and we had grocery stores and our own churches. Because of segre-

gation, we had our own places. During the time of integration, that’s

when we started having problems.”

He says that when it comes to securing better healthcare, the

black community needs to rekindle a bit of the independent spirit

that fueled the civil rights movement.


“We need to make some changes,” he says. “We need to

change the way our community thinks. We need to be able to look at

our street corners and see stores that don’t just sell liquor and cup-

cakes and cigarettes.

“We have to get that feeling back again, that we are masters

of our own destiny, “ he says, “and not sit back and wait for some-

one to do it for us.”

Education has been a lifelong expe-

rience for Combs.

He earned a bachelor of arts degree

from Grace College of the Bible in 1974

and a Child Development Associate certi-

fication from Iowa Western Community

College.

“After that, I opened a children’s

home,” he says. “That’s where I met my

wife.”

He and Victoria have been married

34 years. They have two daughters, Antoi-

nette and Jimeta, and a son, Caleb.

Ten years after opening the chil-

dren’s home, Combs went back to school.

He received an EMT-Paramedic certificate

from Creighton University and went to

work for an ambulance service.

He continued to explore his options as a health care provider,

earning a bachelor of science degree in health care management

from Trinity University and an Associate Degree in Nursing (AND)

from Metropolitan Community College in 1991.

Combs received advance nurses training in the intensive care

unit at St. Joseph Hospital, where he also received his peritoneal di-

alysis nurse certification in 1993. He is Basic Life Support (BLS)

certified, as well as certified in chemotherapy administration/

oncology nursing and Advanced Cardiac Life Support (ACLS) , and

was an ACLS instructor from 1992 to 1995.

Two days each week, Combs assumes the title of Health Pro-

motion Coordinator and hosts a wellness and medical screening clin-

ic at the Lighthouse Wellness & Community Center, operated at

5404 Ames Avenue by Lighthouse founders and directors Haskell

and Shirley Lee.

In the year that he has been at the Lighthouse, Combs has

screened 280 people for everything from high blood pressure and

diabetes to prostate cancer, sexually transmitted diseases and HIV.

“We are trying to do these screenings in a comprehensive way

and document everything we do, especially when it comes to preven-

tion, “ he says, “because if you do it right, you never know about it.”

As founder and volunteer director of the all-volunteer health

organization, Omahealth, Inc., which also offers free health screen-

ings and education programs, his responsibilities include coordinat-

ing operations; editing the NOAH newsletter; designing the web

page; and producing a monthly cable health program, “Dr. Jesse &

the Prevention Gang” based on one of his puppet characters.

Besides Dr. Jesse, Combs’ puppets include Dr. Healthy (a

woman doctor) and Mr. Jones, who never does anything right. He

also has created a variety of African-American superheroes such as

Prevention Man, Medical Dude and Vernon the Vegetarian Veggie

Bird, and has produced comic books and coloring books with the

characters to make it fun to learn about health.

“To get people to listen, you have to have a marketing plan,”

he says. “You have to be able to get people’s attention. There is

nothing more boring than standing in front of a room full of people

and reading a list of numbers and statistics.

But everybody listens to puppets.”

The puppets are especially helpful

teaching children.

“The best time to talk to a person about

their health is when they are young,”

Combs says. “Habits are easier to make

than to break.”

He tells children about the dangers of obe-

sity and the advantages of eating lots of

fresh fruit and vegetables – and is an exam-

ple of practicing what he preaches.

“I’ve lost 30 pounds in eight months,’ he

says, “all through diet, a better regimen and

cardio-training to burn off the calories.”

It isn’t just to look better. This time, the

nurse is trying to save his own life.

Ira Combs has kidney disease and has been on dialysis for

two years. “There are five stages of renal disease and I am stage

four,” he says. “My kidneys still function, but I need a transplant.”

In order to get on the transplant list, he must lose weight and

prove to be a viable candidate.

As an oncology nurse, Combs saw how devastating it can be

to combine disease and desperation. The battlefield isn’t just in the

body but also the mind.

“I have a lot of friends I have met who are on dialysis, and it

does get depressing,” he says. “To sit in that dialysis chair three

times a week, three or four hours at a time, that’s probably the most

torture for me.”

His work helps by providing purpose, he says.

“I try to prepare everyone to be part of the solution,” he says.

“I tell the kids I teach that I may not always be around but it’s a joy

to me knowing they will be able to pick up where I left off.

“When I teach a young person how to take someone’s blood

pressure, I tell them to go out and not only use that skill but also

teach it to someone else. It’s like Scouts. I learned a lot of leadership

skills teaching others to help others.”

It also goes back to working on his grandfather’s farm in Mis-

souri.

“As a family, we’d go down and help out,” he says, “because

he couldn’t do it alone. And if there was a storm coming, the neigh-

bors would all come over and help, too.

“We need to do a better job of spreading that idea,” he says,

“that we are all neighbors and friends.”

Good advice. Good health. Ira Combs is doing his part to

make certain the Omaha community gets plenty of both.


THE

CRITICAL lack of quality and affordable health

care is devastating for African

Americans. Twice as likely as whites to

go without insurance, African

Americans suffer chronic illnesses such

as high blood pressure and diabetes at

an escalating rate. The root of the

problem is not inferior Black — or

better white — health care. It’s

because only the wealthy can afford

“the best medical care in America.”

Everyone else’s care is rationed by the

employer or private plan that

each can afford to buy, or if

uninsured, by the use of “free”

clinics and emergency rooms.

The debate over the broken

health care system and what to

do about it is one of life and

death. Following many from

the cradle to the grave literally.

The facts don’t lie. The

United States is the only

industrialized country that

refuses to provide health care

for all its citizens on principle.

Health care is considered a privilege,

not a right. The words “preventive

care” and “cradle to grave” are

demonized as “socialistic” and anti-

capitalist — against the American way

of life.

Unlike hundreds of billions spent

on U.S. wars of occupation in Iraq and

Afghanistan, the cost to provide quality

health coverage for all Americans is

considered “too expensive.” The

“right” of the medical groups that make

profits off the backs of sick people is a

foundation principle of the free market

health care system.

It’s not new. In the 1940s the

same forces fought President Truman’s

call for national health care. In the

1960s Ronald Reagan, led the charge

against “socialized medicine.” Reagan

attacked a government-run health care

system for the elderly (Medicare) as

being the sure-fired road to socialism.

He aggressively opposed the

establishment of Medicare.

Thanks to Medicare most retirees

have better health care than younger

citizens who can’t afford high

insurance premiums. In fact, fewer than

10% of Americans with Medicare

coverage say they don’t like it. Not

surprisingly, the right refuses to openly

call for its elimination even as they

attack the Affordable Care Act. The

Veterans Administration is another

successful government-run health

program. It provides a program that is

superior to most private for-profit

plans. Yet it came under attack by

President Bush who sought to gut the

VA and shut hospitals. This was only

stopped by scandal when the public

learned how our veterans were not

getting the treatment they expected.

The problems with Medicare and

veterans care are mainly about money,

as privatization hawks seek to starve

the programs to get the private sector

back. Both Medicare and the VA

programs provide better health care

than the private sector — and,

significantly, equal care to all racial and

social groups.

With the profit motive taken out

by the government, the service is more

“socialized.” The limitations of these

programs are primarily due to

Congressional attempts to underfund

them, not administrative inefficiencies

that are comparable to the private

sector and much cheaper to taxpayers.

These two government programs could

be the basis to build fair medical

coverage and provide universal

care. Most importantly, they show how

a government solution could begin to

close the racial gap in the type of care

provided to Blacks and Latinos. By

closing the gap we would

then reduce the broad

health disparity margins

between minorities and the

rest of the American

population and increase the

years that minorities live

between the “cradle-to-the-

grave”. The Affordable

Care Act , as wounded and

beat up as it is by

politicians, is still by far the

best news the uninsured

and underinsured have

received in a long time.

From the

cradle to the

grave black youth

in North Omaha experience a set

of circumstances that are rooted in

a segregated set of circumstances.

Not that kind of "for whites only

restroom" type of segregation, but

a set of conditions that make it

clear that North Omaha's social,

economic and political context has

an impact on their lives that they (Continued on page 11)

Ira Combs-RN

Editor NOAH

Matthew Stelly

Triple-one

Neighborhood

Association


have to deal with on some level.

But whatever the situation, one

thing is clear: the negatives cannot

be avoided and the positives have

to be pursued. There is little

ascribed status (that which they

inherit), only that which is

achieved (and that is controlled by

outside forces and sources).

There are groups that are

working for empowerment in the

North Omaha community. They

are doing it in a holistic manner by

bringing in all the groups, and all

the stakeholders. But linked to an

empowerment effort has to be a

survival part because the latter is

much more important than the

former. Without a need to survive,

empowerment efforts won't and

can't be appreciated.

Empowerment is a luxury for

those who can appreciate it;

survival is a concrete need. The

Empowerment Network has done a

great job in addressing both .

From the cradle we have an

infant mortality rate that is almost

triple that of the rest of the city.

That means that black babies have

a higher rate of death - before they

even get to the cradle - than other

kids do. The lack of transportation

oftentimes makes prenatal health

care difficult, and even when it is

accessible, the funding to afford

what is needed means that the

mother is going to be a ward of the

state in some capacity. And in

Nebraska, being a ward of the state

does not protect that child from

being abused: the foster care, day

care and social service programs,

as recognized by the Federal

government on a number of levels,

has a long way to go before it

practices the kind of cultural

competence that can have a direct

and positive impact on that family

and as a result, that child. Older

Black men are twice as likely to

die from prostate cancer as their

white counterparts, but do you see

any local medical institutions

putting together a comprehensive

programs to address this

disparity?

(Continued from page 10)

NOAH 2014 North Omaha Area Health

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