I started writing this quarterly column for 10-4 Magazine in February 2003, twenty years ago. At the time, I was working as a Nurse Practitioner on the Texas-Mexico border where there was and continues to be an enormous number of truckers who need their DOT health clearances. I spent a good part of every day listening to truckers’ stories of the road, missing family and, of course, their health concerns. The conversations didn’t vary much – most of my truck-driving patients complained about their backs hurting, trouble sleeping, gaining weight, and having a hard time finding nutritious food to eat. Many of these drivers were at risk for or were already taking medicines for diabetes and high blood pressure.
At first, I thought about creating a pamphlet addressing these concerns, that I would leave in the waiting room of the clinic where I worked in Laredo, TX. Patients could read it while they waited or take it with them for a little nighttime reading later on. The pamphlets seemed like a good idea until I realized that little kids would try to eat them or shred them and put them up their noses! It then occurred to me that there might be a magazine for truckers where I could publish my ideas for better health. And there it was – 10-4 Magazine!
This seemed like a good place to start, so I sent an email that morning with my proposal about writing articles on truckers’ health issues. I quickly received a response, and by that very afternoon, I was the new “Health and Happiness” columnist. When I started writing, there was very little available on the internet regarding trucker health. Now, there is so much it’s difficult to have enough time to read through it all. What a great advance, that this industry is finally taking trucker health seriously, and that there are several health professionals researching how to improve it even more.
Amazing things have happened in health care over the past few decades. The HIV/AIDS epidemic started in the early 1980s and such a diagnosis was initially a death sentence. There was a huge amount of stigma around having HIV/AIDS, so people were hesitant to be diagnosed (and there wasn’t much in the way of treatment anyway). Over the years, so many medicines for HIV prevention and treatment were developed that people are no longer immediately considered “terminally ill” and can carry on with their lives for a long time if they take these medicines routinely.
It is largely because of this epidemic that changes were made to health care laws around privacy. It used to be you could just call an office and ask about your friend’s/partner’s/kid’s lab reports or other health information, and it would be given to you over the phone. And vice-versa – they could call and ask about yours, too. No more, thanks to HIPAA (the Health Insurance Portability and Accountability Act of 1996). As much of a pain as it can be to fill out all those forms every time you go to a health care provider, at least you know that no family member or random stranger can just pick up the phone and get delicate information about you. Your employer can’t fire you based on your health history if they can’t get that information without your permission and, thanks to the Affordable Care Act, insurers cannot refuse you because of a pre-existing condition.
I remember a patient I had that was a trucker who had contracted Hepatitis C, a liver disease that can, over time, be fatal. Some people will get the infection (usually from sharing needles or shaving equipment or sexual contact) and clear it on their own – poof! The body takes care of itself, and it goes away. But that’s infrequent. About 75% of people with Hepatitis C will not clear it. It was amazing that my patient had cleared it on his own without any treatment. In 2010, a medication was formulated which has now been shown to actually cure Hepatitis C. I didn’t think that miracle would ever happen in my lifetime, but it did.
In the 1980s, nicotine gum became widely available. There are several medications available now to help smokers quit, many of which are covered by insurance or are available over the counter. Tobacco addiction is the primary cause of premature death around the world. There isn’t an organ in the body that isn’t affected by it. What a wonder for the people who take advantage of these medicines to help keep them from smoking including nicotine patches, bupropion and varenicline, as well as some others still being researched. If interested, ask for these prescriptions by these generic names rather than their brand names (it is the same drug at a cheaper price). Every state has a health agency to help people quit smoking that is just a phone call away. Going “cold turkey” is a thing of the past, but it certainly is still an option, if you can do it.
In 2002, Al Roker, the famous TV weatherman, had bariatric surgery for weight loss. Even though this procedure had been done since 1954, the procedure as one that the average citizen dealing with obesity could have was not really common until Al took the leap. Everywhere you look now people are having this surgery to improve their health. Statistics show that most people maintain most of their weight loss 10-14 years after their surgery. One must still be cautious with eating habits, but there have been some outstanding results, including people no longer needing to take medicines for high blood pressure and diabetes. Obesity is much higher in the trucking community, so this procedure may be a true life saver for many.
Truckers are less likely to have health insurance than many others. Centers for Disease Control (CDC) statistics from 2014 show that over twice as many truck drivers are not covered by health insurance or a health care plan (38% vs. 17%). There are now insurance companies serving truckers specifically, and the health exchanges in each state set up by the Affordable Care Act can offer health insurance to truckers, as well. While there have been many miracles, there are still challenges for all of us. The mundane is still the most important – quit smoking, drink a minimal amount of alcohol, eat fruits and vegetables, avoid risky behavior, and exercise. Not so easy, I know, but if you can do it, you probably won’t need a medical miracle!
~ Norma Stephens Hannigan is a Doctor of Nursing Practice who recently retired after a 43 year career providing direct care and teaching future nurses and nurse practitioners. Dr. Norma has treated many truck drivers at the various clinics she has worked. She currently writes for 10-4 from her home in New York.
