Quotes to Live By This Christmas

Article by: Jennifer Clark, PA-C, MPAS

What greater thing is there for human souls than to feel that they are joined for life - to be with each other in silent unspeakable memories. ~George Eliot

            

The holiday season is here, and as Christmas draws closer the news is saturated with stories of frantic shoppers using pepper spray to gain an advantage, people dying in wars and conflicts that may not make any sense, families that are divided by distance or pride, and people across the world who are suffering. Knowing all of this can certainly be depressing, which is why I feel like it is important to take a moment this Christmas and talk about love and family. All too often we take our relationships with others for granted; letting life and our careers get the best of us. Thankfully certain reminders surface along the way that bring our hearts back to where they should be.

Families are the compass that guide us. They are the inspiration to reach great heights, and our comfort when we occasionally falter. ~ Brad Henry

          

I have personally been guilty of taking family for granted very recently. I had been so busy with “life”, that I unknowingly seemed to put my relationship with my husband and my family on the back burner. It finally took one night of my husband confronting the issue for me to realize it was even happening. I had lost sight of the little things that make our family so special.  We promptly went out on a mandatory date night and spent several hours talking and nurturing our relationship. Since that night I have felt my” blinders” have been removed and I am seeing again how vital our time with family is. The joy in our children’s eyes as they anticipate the gifts they will receive, the heartwarming feeling as you watch loved ones open a gift, the traditions passed down for generations in families every Christmas, random acts of kindness and humanity, to the priceless moments we share with each other every day.

The happiest moments of my life have been the few which I have passed at home in the bosom of my family. ~Thomas Jefferson

Christmas literally means mass (or celebration) of Christ (the anointed or one set apart by God for a special purpose). Whatever your religious belief may be, Christmas is a holiday that has been treasured by people across the world for centuries. Sadly, for many people it may mean sadness, due to loss of a loved one, difficult economic times, separation from friends and family, hunger, or loneliness.  My hopes in writing this is that it serves as one of those special reminders to each of you that while these are certainly hard times, it is important to remember the power of love.

We can cure physical diseases with medicine, but the only cure for loneliness, despair, and hopelessness is love. There are many in the world who are dying for a piece of bread, but there are many more dying for a little love. ~Mother Theresa

As you prepare for the holiday remember what it is truly about and how important loving one another is. Go out of your way with gestures of love and humanity.  Love your families with every ounce of your soul, embrace the moments you have together. God Bless you all and Merry Christmas.

Understanding DVTs this Holiday Season

Article by: Jennifer Clark, PA-C, MPAS

Over the river and through the woods to Grandmother’s house we go! The holiday season is here and for most everyone that means some sort of travel; whether you yourself will be making a trip, or loved ones are coming to visit you. Knowing this, it is very important to get the word out about DVTs and how to prevent them. As you read this you may be wondering, what is a DVT? A DVT is a blood clot that forms in the deep veins in the body, most commonly in the legs. DVTs affect over 2 million Americans a year, and of that 2 million, over 600,000 suffer a life threatening complication called a pulmonary embolism (PE).  A pulmonary embolism occurs when a piece of the blood clot breaks loose and travels to the lungs. This can be a life-threatening condition with approximately 300,000 related deaths a year which is more than both breast cancer and AIDS combined.

DVTs can happen to anyone, but certain things can make people more prone to developing blood clots. The following is a list of some of the most common risk factors for developing a DVT:

·         Immobility

·         Recent surgery

·         Obesity

·         Dehydration

·         Bleeding disorder/Family history of blood clots

·         Cancer

·         Pregnancy

·         Hormone replacement therapy/birth control pills

·         Recent traumatic injury

By understanding these risk factors you can be more proactive in preventing the development of a DVT. If you are traveling over the holidays make sure you make frequent stops if you are driving or get up and walk the aisle if you are flying for several hours. If possible elevate your legs. Stay hydrated with water and/or liquids with electrolytes. When traveling invest in a pair of knee high compression hose to wear during your trip, this will help improve the circulation in your legs which can help prevent a DVT.

 Recognizing the signs and symptoms of a DVT can be difficult at times, sometimes people can be relatively asymptomatic, or perhaps even attribute the symptoms they do experience to something else such as a skin infection or muscle strain. Most commonly we see that DVTs cause pain, swelling, redness and warmth the affected limb.  If you experience any of these symptoms it is important to have further evaluation. For more information on DVTs you can go to www.preventdvt.org. This is a very useful website that has a tool you can use to assess your risk for developing a DVT. I hope you share this useful information with your family and friends and I wish you the very best holiday season filled with many blessings, love, and laughter.

Thanksgiving is Upon us Again

Article by: Bud Shuler, MD, FACS

Thanksgiving is again upon us, which to many, means good food, football, and some well-deserved time off from work.  To others it is the lead in to the holiday shopping season with Black Friday’s mad rush for the best deals of the year.  Originally, according to Wikipedia, Thanksgiving began across Europe as festivals to celebrate a bountiful harvest.  Thereafter, from a traditional standpoint, we in the United States, have tied it to the Plymouth settlement and their appreciation to the Wampanoag Native Americans for help in surviving in the New World.  President Lincoln, in 1863, established Thanksgiving as a nation-wide holiday on the final Thursday in November in an attempt to bring together a warring country. Later, in 1941, President Roosevelt established the holiday earlier, on the forth Thursday, in an attempt to stimulate the economy.  Surprisingly, I have never tied Black Friday to FDR.  Thanksgiving, however, should be a time to reflect on what God has provided and a opportunity to give thanks for our many blessings. 

But what of these blessings?  Many of us in this country are on hard times.  Many of our family members, or ourselves, are without work or struggling to make ends meet.  Times seem tougher now than ever before.  But we are blessed with the ability to choose how we accept these challenges.  We should still thank our God for what we do have.  Father Steve added perspective to the elementary students at Holy Nativity’s weekly chapel service on Wednesday, and reminded them of some of the basics of why we should be thankful.  70% of the world’s population cannot read because they are unable to go to school.  80% of homes in the world don’t have running water, electricity, and indoor plumbing.  And at least 50% of the world goes to bed hungry and has no clean water source to drink.  If you have money in the bank, in your pocket, or in a jar on your dresser, you are in the wealthiest 8% of the world.  92% of the world is poorer financially.  However, to many of them wealth is not measured in homes, food, or dollars but in relationships.  Families are closer and relationships are more meaningful. 

So as we gather together during the upcoming holidays, let us each take the time to remember from where we came and who brought us to where we are now.  Let our family and friends know how much we appreciate them.   We have a short time on this earth to live and love and be thankful for what we do have.  Let’s all commit to being more thankful over this next year and focus on what we do have rather than what we don’t.  I know we will be happier.  Happy Thanksgiving.

Life is short, and we haven’t much time to gladden the hearts of those who travel with us. So let us be swift to love, and make haste to be kind, and the blessing of God almighty, be with you now and forever, Amen.   [based on the words of Henri Frederic Amiel (1821-1881)]

Gensundheit

Article by: Clark Stream, PA-C

Gensundheit is the German work for health.  When a person sneezes, Germans typically say gensundheit to wish them good health.  Another common response to an audible sneeze is “God Bless You”.  The custom to bless a sneeze reportedly began on 16 February 590 A.D., when Pope Gregory decreed that whenever someone sneezed, others should say “God bless you” in response.  During this time Rome was dealing with an outbreak of the bubonic plague.  The blessing was given in belief that the one who sneezed wouldn’t then develop the plague.  Regardless of what we say when someone sneezes, we know that the sneeze can be the start of an illness such as a cold.

According to the Guinness World Record, a 12-year-old in England named Donna Griffiths holds the longest attack of sneezing on record.  Apparently, she sneezed for over 978 days between January 1981 and September 1983.  At first she sneezed every minute, but as the days moved into weeks and years her sneezes occurred every five minutes.

The world speed record for a sneeze is over 115 mph.  A sneeze is an irritation to the nasal mucosa that can send up to 40,000 droplets from the nose to a distance of up to 10 feet.  With the holiday season in full swing comes an increased opportunity to contract illnesses avoided so far this year.  As the temperature outside drops your chances of catching a cold increase.  You can reduce your chances by following these 6 simple steps:

1.       Cover your nose and mouth with a tissue when you cough or sneeze.
2.       Avoid touching your face with your hands as cold viruses can easily enter your body through the eyes and nose.
3.       Wash your hands with soap and water.  Alcohol based hand sanitizers are a great alternative to carry with you during this busy time since cold viruses can live up to three hours on surfaces. 
4.       Get plenty of rest.  Exhaustion can make you more susceptible to the airborne germs that multiply during the colder months.  Studies show that 6-8 hours of sleep help fend off germs that can bring down your immunity.
5.       Eat as healthy as possible while on the run this holiday season.  A balanced diet of carbohydrates, healthy fats, protein and limited processed foods are a great start.  Like always, fruits and veggies are best.  Also, plenty of vitamin C can help prevent cold
6.       Finally, if you’re the one with the cold…be polite…cover your mouth when you sneeze and wash your hands often to prevent spreading the cold virus. 

A cold is the one thing you don’t want to share this holiday season.  Gensundheit and God bless you.

Trick or Treat and Mom and Dad's Achy Feet

Article by: Jennifer Clark, PA-C, MPAS

Alright parents! October has arrived, and with it comes the joys of Halloween!  It is guaranteed to be filled with festivities from picking out costumes to stocking up on candy to parties and events and finally the big night filled with trick or treating! The average child will spend 1-3 hours walking from house to house to collect their goodies, and for most of us parents, that means we are walking with them! By the end of the night your dogs certainly may be barking! What if I told you there was a way to end the busy night with legs and feet that feel great? The answer is simple…compression hose!

                Compression hose help the calf muscles to squeeze those veins in our legs a little tighter which helps them work more efficiently, therefore improving how our legs feel.  Compression hose help reduce pain and swelling while improving our circulation. I know what many of you may be thinking; you don’t want to wear something that looks like you just walked out of the hospital….unless of course that is the look you are going for with your costume! Take relief in knowing that compression hose are much more stylish than they were in the past.  Many look like trouser socks, athletic socks or knee high panty hose, so that often times you cannot tell the difference. Some even come in fun colors. I wear knee high compression hose almost every single day and my only complaint is that I wish I would have started wearing them sooner. My legs don’t feel nearly as heavy, tired, and achy as they did before I began wearing them.

You may be wondering where to get compression hose.  They are available over the counter as well as by prescription by a provider. Often times you can find them in the pharmacy section or the sock aisle at your local store. Compression hose are also used for more serious conditions such as venous stasis ulcers, lymphedema, congestive heart failure, etc. If you have any of those conditions, I recommend you discuss compression hose with your primary care provider to ensure you purchase the correct size and graduation of compression. Typically you will find 8-15 mmHg compression hose over the counter which is fine for leg discomfort.  

So this Halloween, I hope you and your family have a safe and fun night trick or treating. Grab your compression hose on your way out! Who knows… you may even be able to incorporate them into a fun and comfortable costume!

Prediabetes, A Scary Diagnosis

Article by: Clark Stream, PA-C

Prediabetes, formerly known as boarder line diabetes, is a condition where blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. There are almost 80 million people in the United States who have prediabetes. Research has shown that long-term damage to the body, especially the heart and circulatory system, may already be occurring during prediabetes.

How to Tell if You Have Prediabetes.

There are three tests your doctor can use to determine whether you have prediabetes:

• The A1C test
• The fasting plasma glucose test (FPG)
• or the oral glucose tolerance test (OGTT).

The blood glucose levels measured after these tests determine whether you have a normal metabolism, prediabetes or diabetes.

If your blood glucose level is abnormal following the FPG, you have impaired fasting glucose (IFG); if your blood glucose level is abnormal following the OGTT, you have impaired glucose tolerance (IGT). Both are also known as prediabetes

Prediabetes is a serious medical condition that can be treated. The good news is that the recently completed Diabetes Prevention Program (DPP) study conclusively showed that people with prediabetes can prevent the development of type 2 diabetes by making changes in their diet and increasing their level of physical activity.  
Who should get tested for prediabetes?
If you are overweight and over age 45, you should be checked for prediabetes during your next routine medical office visit.  For adults younger than 45 and overweight, your doctor may recommend testing if you have any other risk factors for diabetes or prediabetes. These include high blood pressure, low HDL cholesterol and high triglycerides, a family history of diabetes, a history of gestational diabetes or giving birth to a baby weighing more than 9 pounds, or belonging to an ethnic or minority group at high risk for diabetes.

What is the treatment for prediabetes?
 Treatment consists of losing weight (5-10 percent of total body weight) through diet and moderate exercise, such as walking, 30 minutes a day, 5 days a week. Don't worry if you can't get to your ideal body weight.  A loss of just 10 to 15 pounds can make a huge difference.  If you have prediabetes, you are at a 50% increased risk for heart disease or stroke.  Your doctor may wish to treat or counsel you about cardiovascular risk factors, such as tobacco use, high blood pressure, and high cholesterol.


What is the diet for prediabetes?

The American Diabetes Association recommends plenty of fruits and vegetables, nuts, and eat more fish.  Avoiding both saturated and trans fats are a heart healthy choice.  Together, these fats can increase your total and bad (LDL) cholesterol levels while the trans fats can lower your good, (HDL) cholesterol. 

With Halloween just around the corner, can your eat candy?

Yes, if you follow some simple rules.  Beware of chocolate with trans-fat from partially hydrogenated oil.  Be warned!!  Sugar free candy is not always the best choice.  Look for artificial sweeteners and read the nutrition labels.  Candy with low fat and carbs, enjoyed in reasonable portions are your best choice.  For the prediabetic, candy does not have to be scary.

Restless Legs Syndrome: Everything you need to know from symptoms to soap

Article by: Jennifer Clark, PA-C, MPAS

Do you ever complain of an uncontrollable urge to move your legs? Or perhaps you feel what may be described as a gnawing, or pulling, maybe even a creepy, crawly sensation in your legs that seems to happen when you rest? Does it seem to improve with movement?  If so, you may be suffering from Restless Legs Syndrome (RLS), a condition affecting 1 in 10 Americans. Many people suffer from these symptoms but don’t realize that it is in fact a known medical condition.

There is a significant amount of research out there looking for the cause of this condition, and it has not been nailed down to one particular cause. It has been found to run in families, and seems to affect women more than men, especially during pregnancy. There is thought that it is also due to an imbalance of a substance called dopamine, which is a chemical that is responsible for transmitting signals between the nerve cells in the brain. Anemia and low iron levels can also make these symptoms worse. Certain medications such as antihistamines, calcium channel blockers (used to treat high blood pressure and heart disease), and antidepressants can also provoke the symptoms.  Interestingly, research has also found that a large number of patients who suffer from RLS have an underlying venous disease such as venous insufficiency where the valves in the veins are not working correctly. The patients that seem to be impacted the most by both conditions are very similar: women, individuals over 50 years old, people who have standing professions, obese individuals, and those with a family history of the condition. In our practice we have found that 80-85% of the patients that complained of symptoms of RLS improved significantly after treatment of their venous disease.  By meeting with your primary care provider and discussing your symptoms he or she can review your symptoms, medications and lifestyle habits to help make the diagnosis and search for a possible underlying cause.   Simple blood work can determine if you have conditions such as anemia or iron deficiency.

Treatment for RLS ranges from treating the underlying cause, lifestyle changes, to medications and even surgical intervention to correct venous insufficiency. Here are some lifestyle changes you can try to help alleviate your symptoms:

·         Keep a regular sleep schedule.

o   Fatigue often makes symptoms of RLS worse. Try to go to bed and wake up the same times during the day to help your body get into a routine. Also avoid falling asleep with the television or lights on.

·         Compression hose

o   Wearing during the day when you are on your feet can help improve your symptoms, especially if you have underlying venous disease

·         Exercise in moderation

o   By maintaining aerobic fitness symptoms often improve, however intense or extensive training such as running a marathon can sometimes provoke symptoms

·         Stop smoking and drinking alcohol

·         Cut back on caffeine

·         Take a multivitamin

o   Often deficiencies in magnesium, iron, folic acid, and vitamin B can cause symptoms of RLS

·         Weight loss

·         Yoga

Lastly, I would like to leave with you with an anecdotal remedy. I will forewarn you, as I do with all of my patients I tell this to in clinic, that it may sound ridiculous! Are you ready? Place a bar of colored soap at the foot of your bed underneath your fitted sheet. Some people have even placed a small bar of soap, similar to the size you find in hotel rooms, in each sock when they sleep. It is not known how or why this works, but we have found that 70-80% of our patients that try it notice significant improvement of their symptoms. I always say, as silly as it sounds, it is certainly worth the cost of a bar of soap to try!