Harford County's Call to Action: Beating Colorectal Cancer with Early Detection

Rich Bennett 0:00
So I'm sitting here today at the hard for County Health Department. Well, goodness, I can't believe it's been two years since we've talked about this, but March is coming correct. Awareness Month, is that right? Taking it. 

Megan Casem 0:13
Regular. 

Rich Bennett 0:14
Colorectal cancer and we're it right here. Colorectal cancer awareness Month may. 

Karrie Schnaufer 0:25
And it's so. 

Megan Casem 0:27
Called CRC. 

Karrie Schnaufer 0:29
The warning just told me that there's just. 

Megan Casem 0:31
No one. 

Rich Bennett 0:32
Else with anybody listening to no one I was talking. 

Megan Casem 0:35
To say colonoscopy. Now you can't say colonoscopy. 

Karrie Schnaufer 0:38
That's going. 

Megan Casem 0:38
To say. 

Rich Bennett 0:39
Call it ask. You're going. 

Megan Casem 0:40
To ask if you. 

Rich Bennett 0:41
Can't. Yes. 

Karrie Schnaufer 0:42
Can't say that. 

Rich Bennett 0:44
You don't want to go around the table starting in my immediate left and let everybody introduce themselves. 

Megan Casem 0:50
All right. I'm Sarah. Well, I am the communications specialist here at the Harper County Health Department. And hi, I'm Kari Schnapper, and I am the office supervisor for the cancer Prevention Program in Hartford County. Hi, I'm Megan Kasem and I'm the nurse case manager for the Hartford County Health Department Cancer Prevention Program. 

Rich Bennett 1:09
I want to just start off right away. Why March? I mean, being Colorectal Cancer Awareness Month, Why not? 

Megan Casem 1:17
They just chose. 

Rich Bennett 1:18
See, that was the perfect answer. Well, doing good. At least it's not an October when everything else is, because it was just. 

Megan Casem 1:27
It's just awful. So. 

Rich Bennett 1:28
Yeah. Where are you going from? You know. 

Megan Casem 1:29
The mission that's important to. I mean, colon cancer is. 

Rich Bennett 1:35
No, you. 

Megan Casem 1:36
Know, it's not a no brainer. Yeah, It's the third leading cause of death for males and the fourth leading cause of death for females in the. 

Rich Bennett 1:44
Yeah, I didn't realize it was fourth for females. 

Megan Casem 1:47
Yeah, totally. I mean, and it's it's treatable and preventable by getting your screenings now. 

Rich Bennett 1:54
It's hereditary too, isn't it? 

Megan Casem 1:56
There are hereditary risk factors, but there's also risk factors for that you can control. 

Rich Bennett 2:03
Okay, So why. No, these are what 50 is. When you started. 

Megan Casem 2:07
45. 

Rich Bennett 2:08
Oh 45. 

Megan Casem 2:09
They moved it down because they found that a pilot takes about ten years to develop into cancer. And so they decided that the earlier the better. So screening should start at age 45. 

Rich Bennett 2:21
But what if it's it runs in your family should start earlier. 

Megan Casem 2:24
Yes. 

Rich Bennett 2:25
Okay. 

Megan Casem 2:25
They if you have Crohn's disease colitis or there's a list of hereditary diseases as well that you do start early as well as if you're having symptoms, you should have a colonoscopy. So, well, we'll screen people who are in their twenties and I'm sure they do pediatric screenings at pediatric hospitals if they're having. 

Rich Bennett 2:47
Yeah, well. 

Megan Casem 2:48
It's very uncommon for kids to have colon cancer, but. 

Rich Bennett 2:53
It has happened. I'm sure I'm. 

Megan Casem 2:55
I'm sure I don't know the statistics for it, but. Yeah. 

Rich Bennett 2:58
So what are the symptoms? 

Megan Casem 3:00
And so the symptoms that you can have for colon cancer, you want to see if you have unexpected weight loss, tiredness, unexplained Zionism, fatigue, change in bowel habits, rectal bleeding, ongoing stomach discomfort or cramps, gas pain that is doesn't get resolved in a few days. If you feel like your bowels aren't emptying after you go to the bathroom, like you still have to go, right? Yeah. 

Rich Bennett 3:27
All right. And with that, because and a lot of people don't agree about this, but when it comes to bowel movements, there should be at least once a day, right? I would think. 

Megan Casem 3:37
Yeah. So, I mean, what happens is if you don't go, then it just keeps building on up and then it's harder to go because the amount that needs to come out doesn't really fit very well. 

Karrie Schnaufer 3:47
So. 

Megan Casem 3:48
Okay, so you want to make sure that you have a healthy diet that has fiber, lots of fruits and vegetables and that's going to keep things regular. If you have a staying constipated and not going can cause toxins to build up and that is also can be a risk factor for people who, you know, going high early is really important for your health to get rid of the I mean, that's what happens when you go to the bathroom. You're getting rid of what your body doesn't need. Yeah. So you're correct at least, I mean, once a day. Right. Some people twice a day. 

Rich Bennett 4:20
And look at it, because that's going to determine a lot. I know it sounds gross, but it's true. Actually determine a lot. 

Megan Casem 4:27
Well, it's going to determine I mean, if there's blood in your stool, you're right. I mean, other I mean, there could be you should know when you're wiping. But yeah, I mean, you should look I mean, if it's rainy, if it's black, if it's tarry looking, if that's there's there's a couple of different. 

Rich Bennett 4:44
Way of. 

Megan Casem 4:44
Going. Yeah. Like you want I mean, but all those symptoms can also be attributed to a lot of other things say. 

Rich Bennett 4:51
But it's still important to know to what you should. 

Megan Casem 4:53
Change about that and you should definitely see a gastroenterologist. Right. And even with being constipated, you should see and we have a fabulous Harvard gastroenterologist and Harvard Company there near Abingdon there. That's who our program uses. And oh. 

Rich Bennett 5:09
I didn't do. 

Megan Casem 5:10
That. Yeah, and they are fabulous. I've never had a patient complain. They're so amazing. 

Rich Bennett 5:15
I think I know who you're talking about. And they are all. 

Megan Casem 5:17
Yeah, they are awesome. 

Rich Bennett 5:19
Yeah, very good. Yeah. You said stop, then get gassed. Get gassed. I was a. 

Megan Casem 5:27
Gastroenterologist. 

Rich Bennett 5:28
Yes. Thank you. Because I've gotten into arguments with people about this because they said, Oh, no, that's I and I don't. That's for gas, not for your colon. I said, No, that is for me. My brother argued that this all the time that doctor telling me I should go see against whatever thing I was like, Well, yeah, yeah, he's I don't have gas. I can't go to the bathroom. I say, Well, that's why you need to go. 

Megan Casem 5:54
Yes, correct. 

Rich Bennett 5:56
So there is no other type of thought. 

Megan Casem 5:57
Let's here that doctor. 

Rich Bennett 5:59
Yeah. Okay. 

Megan Casem 6:00
Yeah, that's the there are the people you go to if you're having any stomach issues, bathroom issues, there's stomach. People just think of a gastroenterologist as the stomach. 

Rich Bennett 6:09
People see you laughing at me. Sure. But there are people that think that way. Okay? There are. And people are. I don't know if it's because they're scared or just stubborn or just. 

Megan Casem 6:19
Or don't understand why called a gastroenterologist as opposed to going to see. 

Rich Bennett 6:24
Them. 

Karrie Schnaufer 6:25
Allergist or natural. 

Megan Casem 6:26
Pathologist? 

Rich Bennett 6:28
Yes. Thank you. That was the other one. I think. 

Karrie Schnaufer 6:31
They're. 

Megan Casem 6:31
Not very common. 

Karrie Schnaufer 6:33
Yeah. 

Rich Bennett 6:35
So when it comes to die, cause I know. Yeah, we there's definitely some things you should eat, but isn't there a lot of things you stay away from as well? Yes. 

Megan Casem 6:44
Yes. So the risk factors for your diet are processed meats cooking in high temperature. 

Rich Bennett 6:52
Versus home. 

Megan Casem 6:53
Cooking grill. Yeah, broiling. I mean, everything in moderation. But if you're eating red meat every single day and then you then you might be that might be a problem not just for your cholesterol, but, yes, it's a risk factor for colorectal cancer. Diets low in vitamin D and grilling. So everything in moderation. I know I didn't make these up like kill the messenger. 

Rich Bennett 7:21
Way, but what do you mean? 

Megan Casem 7:22
Grilling the high temperatures, change the food that you're eating and that the. 

Rich Bennett 7:30
Okay, direct grilling, but not not like smoking where it's slow and slow smoking also. Oh, no, no, not smoke. A cigarette smoking. 

Megan Casem 7:39
Yes. Because you're you're changing the the natural composition of the food. 

Rich Bennett 7:45
Maggie, you're killing me here. 

Megan Casem 7:47
Are you that chemistry thing? It's the chemistry that you're changing. Cook food. You can well, you can do that in moderation. How are you supposed to cook food? 

Rich Bennett 7:58
Explain moderation. 

Karrie Schnaufer 8:00
And you think you get it? 

Megan Casem 8:03
It's. It's a grilling for red meat. So it changes the way that the way it's digestible. 

Rich Bennett 8:10
Yeah, I. 

Megan Casem 8:11
Didn't know that. 

Rich Bennett 8:11
No, I didn't. 

Megan Casem 8:12
Know that answer. Well, it causes like. Yeah, carcinogens and. Well, yeah, cause it causes like changes the 

what's like the blackened like the char that. 

Rich Bennett 8:25
Oh yeah. 

Megan Casem 8:26
Cancer is a carcinogen. Yeah, yeah, yeah. So you mean you can still have red mean you can still have red meat. You just sit and grill seven days a week and have a steak. 

Rich Bennett 8:38
Oh okay. So other things It's okay. Grill or now. 

Karrie Schnaufer 8:41
It's. 

Megan Casem 8:43
Because you. 

Rich Bennett 8:44
Like. 

Megan Casem 8:44
Yourself. You want to remember everything in moderation. So if you're cooking your food at high temperatures, every single meal, that's going to be a carcinogen. That is a risk factor for colon cancer. It doesn't mean that if you do that, you're going to have that just like people have been smoking 50, 60 years. That's a risk factor for cancer. But doesn't mean they're going to they're going to get it. So it's the same thing. It's just these are risk factors that if you continue this kind of lifestyle, you have a higher chance of having colon cancer than somebody who eats baked chicken. 

Rich Bennett 9:17
All right. So now you got to be worried here. And I don't know if you can answer this or not. What about like air fryers, because that's still in high heat. 

Megan Casem 9:25
I might do it. So now I don't really show h. C. S and p h is cause cancer cause changes in DNA that may increase the risk of cancer. H ks develop in meat when amino acids react to high heat. But time is your enemy. The amount of H's increases, the longer meat is exposed to heat so high cooking your food at high temperatures. So then someone's going to ask, What about if you have a rare steak that you grill and sear and you might not have colon cancer, but you might have like food poisoning? 

Karrie Schnaufer 10:00
Oh, yeah. 

Megan Casem 10:01
A lot of people eat red meat. A lot of people I mean, there's people like only eat steaks where I mean, it's a sandwich. You cook it. Anyone? Yeah, yeah. 

Rich Bennett 10:11
Yeah. You don't want, like, a hockey puck? 

Karrie Schnaufer 10:13
Yeah. Yeah. 

Megan Casem 10:15
Hey, I eat lots of grilled fruit, so. Oh, yeah, we're not. We're not. I'm not. We're not sitting here saying we don't do any of that. 

Rich Bennett 10:25
That's well in moderation. I mean, yeah, I mean. 

Megan Casem 10:27
I like making processed meat. Like if I could eat hotdogs every day that that's the one that I think people need to be careful of is processed meats, processed meat, hot dogs, lunch meat. So be careful of the foods that you're eating that have been changed in their molecular form because that causes fresh meat. Yeah. Yeah. 

Karrie Schnaufer 10:50
And cook it. 

Megan Casem 10:51
Cook it, make it. 

Karrie Schnaufer 10:53
Think. 

Megan Casem 10:54
It's interesting. I don't know about the air fryer. That's a good question because it's not exposed for a long time, right? Because in your air frying, it's high temp at shorter time. 

Rich Bennett 11:04
But not that much shorter. 

Megan Casem 11:05
Well, it's pretty like my air fryer. It's like 400 degrees for, you know, 12 minutes. 

Rich Bennett 11:10
Well, yeah. 

Megan Casem 11:12
I mean, and if you're going to put wings on the grill, take longer than 12 minutes. 

Rich Bennett 11:16
But I guess the air fryer works the same way as like your convection oven. 

Megan Casem 11:22
Yeah, it's similar, I think. I think it's just the heat. I think it's the high heat cooking. So if you cook something in a crock pot. All right. And you have it cooking slow over a long period of time, then that's not going to change the chemical, the chemistry and chemistry of the main. So what. 

Rich Bennett 11:40
About like on the stove top, like a cast iron skillet or anything that same way, I guess. 

Megan Casem 11:45
It's high tech. 

Rich Bennett 11:46
Still high tech. 

Megan Casem 11:47
Wow. I mean, you could cook stuff in a cast iron pan on low and medium. 

It's not your cookware, it's the temperature. 

Rich Bennett 11:58
Kearsarge got Puyallup. It's got to be. You can't have that smoke coming up. Yeah, you could. 

Megan Casem 12:04
Do it. Everything in moderation. 

Rich Bennett 12:06
Now I'm just going to become a vegetarian, you know, shrimp and salad. Now. Thanks. You just ruined everything I 

know, kid. Yeah. You know, I think we discussed this the last time because. Yeah, I was like your girl on my grilling days, but if you do it in moderation, that's the key. Yeah. 

Megan Casem 12:25
Everything. Yeah. 

Rich Bennett 12:26
I don't know of anybody that grills every day. 

Megan Casem 12:30
I mean, that's just one of the factors, the risk factors. There's other risk factors that you can change. Like your weight in. Overweight is a risk factor, a sedentary lifestyle. So if you are overweight and you have a sedentary lifestyle and you cook every meal, add, you know, fried and high temperatures that low vitamin D and you smoke and you drink alcohol more than two a day, you're you're at very high risk of having. 

Rich Bennett 12:59
Drinking more than two. 

Megan Casem 13:00
Alcohol drinks per day. 

Rich Bennett 13:03
First of all, I think if you're drinking two a day, there may be a problem. 

Megan Casem 13:07
It's because if you do all of them, I don't think colon cancer is your only risk factor. 

Rich Bennett 13:14
Yeah, 

those are really. 

Megan Casem 13:17
A lot of problems and there. 

Rich Bennett 13:18
Are a few listed issues. Then that doesn't mean that if you don't drink for six days, you can have 14 on that last. 

Megan Casem 13:29
Well B 13. 

Rich Bennett 13:31
Because. 

Megan Casem 13:31
If it's two drinks per. 

Karrie Schnaufer 13:32
Year, you have. 

Megan Casem 13:34
13, two. 

Rich Bennett 13:35
Times seven is four. 

Megan Casem 13:36
Under. Yeah. Then you're under, you want to stay under it so that okay, you're good if you have 13, 14, 

you're driving, you're really trying to be you want to try and be as healthy as you can. Yeah. You want to make smart choices, try and have vegetables, protein and a healthy carb at your meals. Include fruit. You want bulk things that are going to bulk up your poop and get it out. So fiber and but you want to have fruits which also make it. 

Rich Bennett 14:12
And stay away from shells. No, like sunflowers because I know a lot of people swallow the shells peanuts when people eat the shell. 

Megan Casem 14:19
Those from that well, those are issues with diverticulitis, which is that those seeds can get stuck. And that's not colon cancer, but it can definitely cause issues. Yeah. In your section of your. Yeah, just. 

Rich Bennett 14:35
So what about the I know if the health department people, you know, people coming in, you get screened get the colonoscopy but now you have the box thing so. 

Megan Casem 14:45
So there are other tests other than just having the colonoscopy. The gold standard is the colonoscopy at every county health department. We only do colonoscopy because when people do the other tests, if they have a positive box test, right, they will end up having a colonoscopy anyway. And Harvard Gastroenterology Associates prefers the colonoscopy. But if people are anxious about having the procedure done and it's whether do the genetic testing or the bomb testing versus not having it at all, there are tests that are done. And like I said, our program doesn't do it, but there are tests where they have you poop in a box, right? Then they check it for there's a one test that tests test it for DNA that is positive for colon cancer. And then there's another one that tests for blood in your stool. So the DNA one is obviously the gold like more practices and the more physicians are using that one. Yeah. And normally that's something that you can get from your general practitioner. 

Rich Bennett 15:53
And you got to do it once every three years, not five. 

Megan Casem 15:55
It depends on what the results show and your risk factors as well. If you're if you're at high risk, they're not going to say they're going to want you to do the colonoscopy. But if you're 45 and healthy and don't have a history of any type of polyps or any type of colon cancer, then they may start out that way as opposed to send any for the colonoscopy. 

Rich Bennett 16:19
Something else with the colonoscopy, because I know a lot of people are scared of it. Get it done. Can you explain to everybody how simple it is? 

Megan Casem 16:29
It takes 6 to 7 minutes. 

Rich Bennett 16:31
Normally, it seems longer because, well, you're sleeping. 

Karrie Schnaufer 16:35
For an hour. You know, it's either. 

Megan Casem 16:36
Yeah, you don't even know it's happening. I there's no pain involved. You have to have anesthesia and you have to just have clear liquids the day before. So the hardest part of having a colonoscopy is generally not being able to eat the day before. But you can drink like you can drink Gatorade and a whole bunch as long as the liquids, you know, are clear. 

Rich Bennett 17:00
Right. 

Megan Casem 17:00
And stuff. That's the hardest part for people. And that the drink a bowel prep. 

Rich Bennett 17:05
Okay. I was gonna say sugar, but they can't. 

Megan Casem 17:07
Eat solid foods. Right? That's the hardest part that I've heard people say. But then every single person says, how easy it was. And one of the things that they don't say anything about pain, they just say that they were hungry. And then the other thing is, once you have the colonoscopy, it's really, really important that you rehydrate because people think because I just drank the day before that, I'll be fine, but it's going right through you. Yeah. So a lot of people kind of can feel crummy after having their colonoscopy because they have to replenish the fluids that they lost that they don't realize they lost. So that's why when you hear celebrities fainted like in and out burger after they got their corn, that's good. Maybe it's because they're hungry and they're not replenishing their fluids so they. 

Rich Bennett 17:49
Don't get a shake afterwards. 

Megan Casem 17:51
Yeah, sure. You drink fluids after you have your colonoscopy. You know, some people have different react differently to anesthesia. So that might make you feel, you know, anesthesia itself. I personally have a hard time with it, so I usually don't feel very good for you know, I don't feel good for about 12 hours. I really yeah, I got a really bad headache and I got I can't rest. I'm tired, but I can't sleep. I just don't feel good. 

Rich Bennett 18:18
So what would they do in your case, then? 

Megan Casem 18:20
I'd still have the anaesthesia. I just wouldn't feel good about it. Like. So you're not feeling if you don't feel well, it's not because of the procedure itself, Meghan said. It's because you're dehydrated. Or perhaps you, you know, don't react Well, the anesthesia. But the best way to get the anesthesia out of your system is to drink fluids and switching anyway. Yeah, but. And you need to have someone drive you home from Skippy. So every time someone calls our program and they want to have a colonoscopy, I say, make sure you have somebody they can drive you home. Our program actually has a it's a Comfort Keepers. They are an organization that we have a contract with and they are available to drive our patients home and stay with them during the colonoscopy while stay in the waiting room while they're going to Skippy and they'll drive them home and make sure that they're feeling well enough. They'll stay. I believe. 2 hours. Yes, 2 hours. Yeah, sure. Yeah. And when. So yeah. So we have that available to you. But for the normal public, that doesn't use us. Yeah, because it's really unfortunate. There are a lot of people which is it makes me sad, but there are a lot of people who don't have anybody right that are able to take them. And you can't take an Uber or a left to the because you cannot I mean, legally, they cannot give you anesthesia without someone being present. So that's another thing, too. You can't just drop someone off and then have them call you when they're done. Doesn't work that way either to be physically there. But Megan worked hard on getting this contract, and now we're able to help more people because there are a lot of people who have had to cancel because they don't have a ride. 

Rich Bennett 20:00
Yeah. 

Megan Casem 20:01
Or they don't have someone who can stay with them. Right. 

Rich Bennett 20:04
And that yeah, that's definitely a big problem and that's sad, but that's good that you talk. Of course. Yeah. I didn't know that. 

Megan Casem 20:09
Yeah. Yeah. That's new. That was. 

Rich Bennett 20:11
Planned. 

Megan Casem 20:12
Yeah. That was actually signed two months ago. 

Rich Bennett 20:16
Was very. 

Megan Casem 20:17
New. Yeah. 

Rich Bennett 20:18
You have been working hard 

now that's comfort keepers with the K, right. C it is with a C. 

Megan Casem 20:26
Yeah. Come with me and K with the keepers. 

Rich Bennett 20:29
Okay. Okay. And they're local. They're here in Norfolk County. Are they. 

Megan Casem 20:34
They're in I believe Baltimore County. 

Rich Bennett 20:37
Okay. 

Megan Casem 20:38
But they serve as Harford County as well. 

Rich Bennett 20:40
That's great. Yeah. That is awesome. How did you find out about them? 

Megan Casem 20:46
And an M.D., a maryland Department of Health nurse case manager, meaning I think Allegheny County was using them. 

Rich Bennett 20:53
So, okay. 

Megan Casem 20:55
They were saying how helpful they were with our program. So we just slipped into it and we found that the contact for Harford County. 

Rich Bennett 21:03
So somebody needs to schedule and they get in contact with you guys for a call on our screen. 

Megan Casem 21:12
So they can call 

4109427930 and we will get their information then. Usually the way it works, as we'll get the information and it'll be forwarded to Megan and then Megan will reach out to the person and go over everything with them. We also offer, if you don't speak English isn't your first language, it'd be very helpful if you know someone or someone wants to call who English is not their first language. If there's a way for them to communicate their name and their phone number so that we can in turn call them back with an interpreter and give them all the information we use the interpreter services quite frequently. And I mean, I even know the interpreters names. 

Rich Bennett 21:55
Like, Wow. 

Megan Casem 21:56
So it's great. And then we also so our program offers no cost colonoscopies for eligible Maryland residents. Well, also, eligibility is financial like, so how much they make per year they and also they have to live in the state of Maryland. Well also help people who have insurance but have high deductibles and co-pays. Right. So it will also us and would do that. And then we'll make the office visit appointments. We'll help them understand the process for the colonoscopy. We'll set it all up for them and then get results letters. And then they're entered into a state database so that they'll be recalled when their next colonoscopy. 

Rich Bennett 22:38
Is cleared with the law. 

Megan Casem 22:39
TODD Yeah, 100%. I mean, I'm calling them to remind them of their office visit appointment. I'm making their appointment for them. They're calling them before their colonoscopy, seeing if they have questions, reminding that they can't eat anything and giving them suggested clear liquids, then calling them and letting them know what the results of the colonoscopy is. And so they have a care team that's here to help them through the process. 

Rich Bennett 23:05
How long have you been with the program now? 

Megan Casem 23:08
Three years. 

Rich Bennett 23:08
Yeah, only three years. Yeah. 

Megan Casem 23:10
Really? Yeah. 

Rich Bennett 23:12
So we did those three years have how have you shaped besides comfort keepers, Have you seen it grown a lot for the better in other words, and helping more people out. 

Megan Casem 23:23
I mean when I came on it was the it was still covered. So it's really hard to forget that. It's actually it's very easy to beat those numbers because they weren't doing. 

Karrie Schnaufer 23:35
Like. 

Megan Casem 23:35
The screenings as much then. So I don't know. But I you know, we've we're helping a lot of people. Yeah. 

Rich Bennett 23:44
Which is a good thing. 

Megan Casem 23:45
Yeah. Yeah. No. And Marge, we're sorry. No, that's okay. Yeah. And we're very helping a lot of people. And before I forget, you also asked about how to contact us or how to call or write, So I gave the phone number. But you can also go to the Hartford County Health Department's website and go under our services. There's a little tab at the top that says our services. And then you click on cancer prevention and that has all of our information. There. And there's also a link that will take you to a little form you fill out and then that gets emailed to us and then we call you. So it's super easy. 

Rich Bennett 24:18
Yeah, you're always online for Yeah. 

Megan Casem 24:22
Yeah. Sarah created that idea. It's wonderful. 

Rich Bennett 24:26
Oh, okay. So four years ago, so it wasn't always higher. 

Megan Casem 24:29
Now it's now that, right? Yeah. Like, right, right before. Okay. Right. Yeah, yeah. And I mean, it's just really helpful. You don't have to worry about calling on swamped or talking to anybody. You don't want to right at that time. You just click on there and put your name and what you want and it's an experience. So yes, there's also on in Spanish for that. So that's important that it's there and it's easy to find. And there's Sarah made a QR code that you might see if you see our posters, we're actually doing a lot of promotional things for the month of March. So there's posters up and we're also doing a giveaway for the month of March. At the end of the month of March, we're going to do a random drawing of the people that filled out their interest forms and and there they can get them. They're going to get a prize at the at the end of March. We're going to pick someone randomly and they'll get a basket of her for county health department cancer prevention goodies. 

Rich Bennett 25:25
Okay. 

Megan Casem 25:26
Lydia T-shirt. No, no. We are socks and a hat and mugs and. Yeah, so. 

Rich Bennett 25:34
Not a grill. 

Megan Casem 25:37
Not any products, no hot dogs, though. 

Karrie Schnaufer 25:42
That was funny. That was funny. 

Rich Bennett 25:45
So is there anything else that people need to know about that we may not have covered? 

Megan Casem 25:49
Oh, yeah, we do cover. We pay for the entire we pay from start to finish. So we pay for the initial doctor's visit that you have because you have to go see the doctor first to meet them. Then you would see cancer cancelling schedule your colonoscopy. We pay for the colon prep so the stuff you drink before you go in, we cover that at the pharmacy and then we cover the entire colonoscopy. So the charge for the facility fee, the anesthesia and the colonoscopy itself, and then any pathology or lab work that needs to be done if there's a polyp. So from start to finish. 

Rich Bennett 26:26
Wow. And even looking for keepers. 

Megan Casem 26:29
Yes, it's all covered. So as long as you qualify, which I will say the state of Maryland is doing much better by increasing that income. Yeah, increasing that number. Right. So that if you are, you know, before it was a very low amount that you had to make, they've been increasing that quite a bit. So more people are also qualifying for the program, which is wonderful because it's expensive, insurance is expensive and we get a lot of people who call and say, can you please help me because my deductible is so high, I can't afford to have this colonoscopy. And that's. 

Rich Bennett 27:03
Good. 

Megan Casem 27:04
And we will help you. Yeah. And the other thing is we work in the same office as the Medicaid providers here in Sanford. Grace Oh, really? Yeah. And they're awesome. So if I have somebody that qualifies for Medicaid, but we need to get them in for a colonoscopy, but they might need follow up for what they found. We worked closely with them because the whole process can be overwhelming to then apply for insurance. They're fabulous here. And I mean, they really help several of our patients get insurance so that if they find some sort of cancer, they're able to have their insurance by the time they get to the oncology appointment. 

Rich Bennett 27:40
Wow. 

Megan Casem 27:40
So we work really well together. And Sarah does a amazing job at like getting the promotional stuff out. So I think that we have a really good thing going. 

Rich Bennett 27:53
Yeah. 

Megan Casem 27:53
Carrie's also I mean, we're I love like we're a great team. It's really fun and great. We enjoy working together. Yeah. Yeah. And we enjoy, you know, it's important that we can help people who need it. 

Rich Bennett 28:04
So how long have you been here now? 

Megan Casem 28:07
This three and a half year. 

Rich Bennett 28:08
Three. Okay. 

Megan Casem 28:10
As with the health department prior to that, with cancer prevention for that. 

Rich Bennett 28:13
Program where you went to for. 

Megan Casem 28:15
Environmental health. 

Rich Bennett 28:16
But how in the world do you come from environmental health to this? 

Megan Casem 28:21
Well, this isn't this is what I mean. 

Rich Bennett 28:23
I want this is what you wanted. 

Megan Casem 28:24
This is what I want. I mean, in all honesty, I think, well, now I come from the medical field, but I wanted to get a job with the state of Maryland. 

Rich Bennett 28:32
Okay. So why public health? 

Megan Casem 28:34
And that's honestly, Yeah, because I kept applying every month to every job I could to get I at the state of Maryland. 

Rich Bennett 28:42
And this is this is what you wanted. 

Megan Casem 28:44
The government to be. This is where you were when I got. 

Rich Bennett 28:47
You to you as well. 

Megan Casem 28:49
Oh, no, my my partner was crazy. I, I. 

Rich Bennett 28:58
Well, go ahead. Now, you got to share. 

Megan Casem 28:59
I was. It's not that exciting. It's just. No, I knew we were on that. We were all in the in the health field prior to that. Right now, you know, we got a job at the state of Maryland and I was in the private sector for. 

Rich Bennett 29:12
Well, that's what amazes me a lot of times, because people come from the private sector and then into public health. 

Megan Casem 29:18
Which it's a it's a lot different. 

Rich Bennett 29:20
A big. 

Megan Casem 29:21
Time. But this is much more rewarding. Yeah, I was a hospital nurse for 20 some years and then I wanted to be a school nurse, so I worked for CPS. But then when COVID hit, all of my kids were home. And so I had a I got a job as a nurse case manager for CPS. And then but I was helping out with COVID. And so when COVID ended, I didn't have a job for a month and I didn't know what I was going to do. And Harford County Health Department called H. CPS to see if there were any nurses interested in taking on a case management position. And so, in fact, yeah, it was just really crazy. And I just worked out. Yeah, it came out of nowhere. 

Rich Bennett 30:07
Wow. 

Megan Casem 30:07
Because I wasn't sure what we were going to do with COVID and my kids home. And so, yeah, it was really weird. 

Rich Bennett 30:15
Interesting. So I don't think three weird. I think it's pretty cool though, because, you know, we've talked about this a lot and a lot of people don't realize everything you get is into the public health field and, you know, a lot of times what people go to school, whether it be for doctor nursing or whatever, they want to get into the private sector. 

Megan Casem 30:34
And the money that. 

Rich Bennett 30:35
Yeah, but then it goes rained out the mansion she went to a lecture on public health and that's what changed her mind. And it seems like a lot of the people I talked to once they learn more about it, it's like this. It pulls them, right? 

Megan Casem 30:51
It yeah. And you get you do learn about it and plus when you when in for I was a supervisor of an amateur surgical center and working there for as long as I did seeing what happens especially when Medicare changed and insurances change and how people are living on fixed incomes and how expensive that can be, it's important that we can help people, whether it's excuse me, young people or the elderly or anyone in between. Yeah, health insurance is expensive and a lot of times if it is affordable, your deductibles and co-pays are so high. I mean, if you have a $5,000 deductible, you may now you might not reach that every year. You may not. I mean, especially if you're if you're healthy, then you're not going to reach that. So if you do need a procedure or something, that's a lot of money out of pocket and unfortunately you can get paid plans, but sometimes you can't afford, you know, maybe you don't have an extra $300, you just may not. 

Rich Bennett 31:51
Yeah. Especially nowadays. 

Megan Casem 31:52
I mean, now that is what almost I mean. 

Rich Bennett 31:55
Almost back up to 40. 

Megan Casem 31:56
$4 a gallon. 

Rich Bennett 31:57
That's expensive. I want to see the other day it was an affair of family size. I should mention it, because I'm going to get yelled. 

Karrie Schnaufer 32:04
At by. 

Rich Bennett 32:06
A family size box of macaroni and cheese was 899. The price of what's. 

Megan Casem 32:12
Been going on with macaroni and cheese. I really. 

Karrie Schnaufer 32:16
It's not that is. 

Megan Casem 32:17
So expensive. 

Rich Bennett 32:19
It is. 

Megan Casem 32:19
It's my gosh, it really is. It's outrageous. And every time you go to the grocery store, it's it's so it's not what it used to be. Yeah. So things are expensive. Things have been hard since COVID. And there are tons of programs that the Harvard County Health Department offers. There's a lot. So, you know, and honestly, the worst case scenario, you make too much money and don't qualify. Right. And if that's the case, we can try and help you figure out something else and you can get in our drawing and get free socks. Yes, you can. 

That are for colorectal cancer awareness. You can advertise for us. They are at half the price. Somebody might see your socks walking around and we can help them. And they need to ask you about colorectal cancer and you might save someone's life. 

Rich Bennett 33:10
I need the socks to wear when I'm grilling, hopefully once a month. 

Karrie Schnaufer 33:13
Now I would lots your socks. 

Megan Casem 33:16
Yeah. Offs and your shorts. That's perfect. You just are walking billboard you are. 

Rich Bennett 33:21
Okay that the what's the website now they said you can. 

Megan Casem 33:27
The website is Harford County health dot com. 

Rich Bennett 33:31
Phone number four here. 

Megan Casem 33:34
For one of 

9427930. 

Rich Bennett 33:37
Thank you Yes thank you I can't get that vision out of my head. Down to socks and flip flops. I'm sorry. 

Karrie Schnaufer 33:45
I.