Navigating Life with Migraines: My Journey and Insights

Navigating Life with Migraines: My Journey and Insights

by | Jan 21, 2025 | Expert Health Tips

Have you ever felt a headache so overwhelming that it seemed to take over your entire day, leaving you desperate for relief? For me, migraines became an unwelcome companion during high school. Back then, I didn’t even know what to call them; I just knew that the pounding pain, nausea and sensitivity to light made it impossible to focus, let alone enjoy life.

Over the years and through my medical training, I’ve learned a lot about migraines, other types of headaches and how to manage them. My journey hasn’t been easy. I’ve been through multiple medications (some with not-so-great side effects) which has taught me resilience and made me an expert on my own health, along with other unique insights – sometimes I even joke that I’m my own personal meteorologist! (More on that later.) It’s also provided the opportunity to help my patients.

In this post, I’ll share my story, outline different types of headaches (because not all headaches are created equal) and dive into exciting treatment options that have changed my life. According to the World Health Organization, headache disorders globally affected approximately 40% of the population or 3.1 billion people in 2021.

Whether you’re a fellow headache sufferer or just curious, I hope this helps shed some light on a condition that affects so many people.

Types of Headaches

Headaches come in many forms, and each type has unique triggers, symptoms and treatments. Knowing the difference is crucial for effective management.

Here’s a breakdown of the most common types:

  • Migraines are characterized by throbbing pain on one or both sides of the head, nausea and sensitivity to light or sound. They may include visual auras (seeing spots or stripes of light) or other neurological symptoms.
  • Tension headaches are the most common. They feel like a band of pressure or tightness around your head, often caused by stress or muscle strain.
  • Sinus headaches are caused by inflammation in the sinuses and are accompanied by facial pressure and nasal congestion.
  • Rebound headaches result from overuse of over-the-counter pain medications to treat headaches, creating a vicious cycle of pain and relief.
  • Caffeine headaches can result from a sudden withdrawal from caffeine and can lead to a dull, throbbing headache – not a good New Year’s resolution if you’re addicted to coffee like me!
  • Exertion headaches are triggered by intense physical activity. They are often short-lived but can be severe.
  • Hormonal headaches are linked to fluctuations in estrogen, and are common in women during menstruation, pregnancy or menopause.
  • Hypertension headaches are caused by very high blood pressure and feel like a pulsing sensation. These headaches require immediate medical attention.
  • Cluster headaches are rare but extremely painful. They occur in cyclical patterns or “clusters” and are often localized around one eye.

I personally deal with migraines, tension headaches and sinus headaches. Understanding the differences in these headaches has been a game-changer for me. Treating a sinus headache with a migraine medication, for instance, wouldn’t get me anywhere.

The Power of Journaling to Find Your Triggers

For years, I couldn’t figure out what triggered my migraines. I tried eliminating foods, tweaking my sleep schedule and even cutting out caffeine entirely. Nothing clicked until I started keeping a headache journal.

In that journal, I noted everything: what I ate, how much I slept, my stress levels, the weather and any new medications or supplements I tried. Slowly but surely, a pattern emerged – barometric pressure changes. If a storm was brewing, I could almost guarantee I’d be sidelined with a migraine. Now, I check the weather as religiously as I check my calendar, and I’ve embraced the title of “personal meteorologist.” Journaling isn’t just about finding triggers; it’s about taking control and learning to listen to your body.

Treatments That Changed My Life

The journey to effective migraine management is rarely straightforward, and it took me years to find treatments that worked. Over-the-counter medications, rest and hydration helped to some extent, but they weren’t enough.

Enter CGRP inhibitors – a class of medications that specifically target the proteins involved in migraine attacks. For me, these treatments have been life-changing. They don’t just reduce the severity of my migraines; they allow me to stay functional even when one hits. For anyone feeling stuck in a cycle of pain and frustration, these newer treatments offer hope.

Of course, treatment is never one-size-fits-all. Some people find relief with lifestyle changes like regular exercise, stress management or dietary adjustments. Others benefit from alternative therapies like acupuncture or biofeedback. Other prescription options such as triptans and preventative medications are highly successful as well. The key is finding what works for you.

Living With Migraines: You Are Not Alone

Living with migraines or any chronic headache condition can feel frustrating, but you’re not alone. Whether you’re just beginning to explore your triggers or considering new treatment options, know that progress is possible. It took me years to connect the dots and find a solution that worked, but every small step brought me closer to where I am today – an empowered, informed and hopeful physician assistant with a toolbox full of treatment options to improve patients’ quality of life.

If you’re struggling, start with the basics:

  • Learn about the type of headaches you have.
  • Track your symptoms.
  • Talk to a healthcare provider about your options.

The road may be long, but it’s worth it. And who knows? Maybe one day, you’ll be your own personal meteorologist, too. If you’re looking for guidance, I’m here to help.

Molly Babl

Molly Babl

PA-C - Bryan Plaza Family Medicine

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Get the Protein You Need: How Much & What Kind Is Best for You

Get the Protein You Need: How Much & What Kind Is Best for You

by | Jan 7, 2025 | Expert Health Tips

As a doctor, I get a lot of questions about how much protein we actually need. There is so much information available to us that finding the “right” answer can be hard. Protein is an important part of a well-balanced diet. However, getting the correct amount is just as essential as getting the correct kind of protein.

Why Is Protein Important?

Protein is basically a building block for almost every process in our bodies. When we talk about diet, protein helps us feel satisfied (full) after a meal or snack. It burns slower than fats or carbohydrates, and this keeps us satisfied until our next meal. Not getting enough protein can lead to conditions like malnutrition or kwashiorkor (protein deficiency). However, too much protein can cause problems like acidosis or kidney disease. This is because protein is harder for our bodies to process.

How Much Protein Do We Need?

The standard recommendation for protein intake is 0.8 grams of protein per kilogram (kg) of body weight per day.

A person who weighs 70 kg (150 pounds) would calculate their protein intake as follows:

70 x 0.8 = 56 grams of protein per day

There are a few situations when you would need more than this, but not many. Additional protein is recommended for women who are pregnant or breastfeeding, burn victims or patients who have had bariatric surgery. But even in those situations we only boost protein intake to about 1.2 grams of protein per kg of body weight per day.

We do try to calculate protein intake based on a more ideal body weight. If you are overweight or obese and your calculation comes back much higher than 100 grams per day, be sure to talk to your doctor before you adjust your intake.

Where Should We Get Protein From?

Plants! Did you know that one-half cup of lentils has more protein than an egg? Plus, they are packed with fiber and there is no cholesterol in them! When you think about food, you want to eat nutritionally dense foods. Getting the biggest nutrient burst from what you eat should be the goal.

Unprocessed whole plant proteins have plenty of protein, and also come with fiber as well as vitamins and minerals while not having a lot of saturated fat or cholesterol in them. For example, one-half cup of lentils has protein, fiber, iron, calcium and unsaturated fat. Compare that to an egg which has a lesser amount of protein, no fiber, and contains both saturated fat and high amounts of cholesterol. This is a common theme when comparing animal protein to plant protein. As you are picking foods to nourish yourself, remember to pick foods that are going to give you the most benefit. You want foods that are high in protein, high in fiber and low in sugar.

Studies also show that high amounts of animal protein intake make the kidneys work harder to filter the blood. Over time this causes damage to the kidneys. Interestingly, plant proteins don’t have the same effect. It appears the stress on the kidney is related to the high amounts of inflammatory mediators in animal protein and how animal protein triggers increased inflammation in the body. When the same amount of protein is given from unprocessed plant sources, you don’t see the increased strain on the kidney.

Another question often asked is if meat alternative foods are okay. While these are highly processed and sometimes have added oils and salt, the studies don’t show as much strain on the kidney when compared to animal products. That being said, our dietary goal should be to eat WHOLE food and keep the processed foods to a minimum. While meat alternatives are great transition foods, please think of them as exactly that – a transition from a meat-heavy diet to a plant-based diet. As eating more plant-based, whole foods becomes easier, you can reduce more processed foods from your diet.

What Foods Are High in Protein?

Here are examples of plant foods that contain the highest protein:

  Protein Content (grams) Serving Size
Pumpkin seeds 8 One-third (1/3) cup
Lentils 18 1 cup cooked
Edamame 9 One-half (1/2) cup
Tofu 12 4 oz
Seitan 21 One-fourth (1/4) cup
Pinto beans 12 1 cup cooked
Kidney beans 14 1 cup cooked
Peas 8 1 cup
Chickpeas/garbanzo beans 12 1 cup
Peanuts 8 1 oz
Hemp seeds 10 3 Tbsp
Nutritional yeast 6 1 Tbsp
Quinoa 8 1 cup cooked
Oat groats 10 1 cup cooked
Wheat berries 9 One-half (1/2) cup cooked

The take home message is make sure you eat enough protein for you, but be careful to not overdo it. And eat more plants!

Dr. Crista Few

Dr. Crista Few

Family Physician, Bryan Primary Care

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“Good Enough” Parenting: Perfection Not Required

“Good Enough” Parenting: Perfection Not Required

by | Dec 16, 2024 | Expert Health Tips

Parenting is one of the most fulfilling yet demanding roles you can take on. Over the years, through my professional experience and my own journey as a parent, I’ve realized that perfection isn’t just unattainable—it can actually get in the way. Let me share a few suggestions that might help you embrace the concept of “good enough” parenting, a mindset that prioritizes love, structure and flexibility over unattainable ideals.

1. Lead with Love and Authority

Above all, your children need to feel loved. This doesn’t mean there aren’t rules—far from it. Love and structure go hand in hand. Be clear about your expectations and consistent in enforcing them, but ensure the consequences match the situation. For instance, don’t ground your child for a week over a small mistake. If you find yourself angry, it’s okay to delay imposing consequences. You can say, “We’ll discuss this later.” This gives you time to cool off.

2. Pick Your Battles

Not everything is worth an argument. Parenting isn’t about reacting to every little thing—it’s about guiding your child’s growth into a responsible, independent adult. Some lessons are best taught through your example. Sometimes, simply modeling the behavior you want to see is enough.

3. Get to Know Your Child

Every child is unique. Take time to understand your son or daughter’s personality and what drives them. Do you naturally warm to their temperament or does it sometimes challenge you? Factors like birth order, peers and personality all shape who they are and who they are becoming. Understanding these influences will help you connect with them as they grow.

4. Remember Perfection Isn’t the Goal

The notion of perfect parenting is not only unrealistic but counterproductive. Trying too hard can stifle your child’s development. Over-involvement, like helicopter parenting, can prevent them from becoming independent. Aim to be “good enough”—someone who provides love, structure and support without smothering them.

5. Provide a Moral Framework

As parents, we serve as scaffolding for our children’s moral and ethical development. They’ll rebel at times—that’s normal. But over time, they internalize the values we instill. This framework helps them navigate life long after they’ve left our care.

6. Set Rules, Rituals and Routines

Consistency provides stability for children.

  • Rules give clear expectations, such as completing homework or contributing to household chores.
  • Rituals like sharing gratitude at dinner or celebrating family milestones strengthen bonds.
  • Routines establish a sense of reliability, whether it’s grocery shopping on Saturdays or writing thank-you notes together.

7. Keep Communication Open

Kids can be surprisingly perceptive. They may not always come to you when they’re upset, so make an effort to regularly check in. Be a good listener. Sometimes, they need your guidance, but sometimes, they just need you to hear them out.

8. Know What to Share

While openness is important, there’s a fine line between honesty and oversharing. Your children don’t need the full details of your financial struggles or marital issues. Be mindful of their age and emotional capacity. It’s okay to let them know you’re having a tough day, but your job is to provide a sense of safety and stability.

9. Take Care of Yourself

Parenting is hard work, and if you’re not in a good place yourself, it’s tough to be there for your kids. If you’ve developed unhealthy habits, work to replace them with better ones. Taking care of your physical and mental health models the importance of self-care for your children.

10. Always Show You Care

Above all, make sure your children know how deeply you care. Even when you stumble—and we all do—your love and effort will shine through.

A Closing Thought

I’ve made plenty of mistakes as a parent. But what I’ve learned is this: your children don’t need you to be perfect. They need to know you love them, believe in them and are there for them no matter what. Remember, it’s not about never making mistakes; it’s about showing up, learning and growing alongside them.

Tom Cardwell, PhD

Tom Cardwell, PhD

Counselor, Bryan Health

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How to Lower Your Cholesterol

How to Lower Your Cholesterol

by | Nov 18, 2024 | Expert Health Tips

Do you have high cholesterol? Or have you been told to watch your cholesterol level? You might wonder what steps to take. Eat healthier, maybe more veggies? Exercise more? Limit calories? So many questions!

I hope to help provide a little direction to help you.

What Is Cholesterol?

Let’s start with a little bit about cholesterol first. Cholesterol is a molecule made by the liver. It is a part of the lining of each of our cells and helps with hormone and vitamin D metabolism.

Our liver makes all the cholesterol we need so we don’t need to get cholesterol from our diet or the environment. We refer to it as a non-essential dietary nutrient. For this reason, our intake amount is a recommended daily allowance.

What Are Cholesterol Intake Recommendations?

The American Heart Association recommends less than 100 mg of cholesterol per day if your cholesterol levels are normal. If your cholesterol levels are abnormal, the American Heart Association refers you to your doctor. In that situation, our quickest answer is usually to try a medication or to tell you to eat healthier. While there are certain conditions where cholesterol medications are necessary, there are just as many times where modifying your diet is the first recommendation.

Often addressing dietary intake can be a long-term solution to lowering cholesterol. It can also help avoid medications. Even if you and your doctor decide that a medication would be helpful, diet changes to lower your cholesterol intake will also help your condition.

What Are Safe or Normal Cholesterol Levels?

When we talk about cholesterol levels, we measure several different components. The low-density lipoproteins (LDL) are usually what are directly related to cardiovascular risk. For this reason, LDL is sometimes called the ‘bad’ cholesterol. Sometimes we will look at other components of the lipid panel, but overall, getting LDL to the goal level is the focus. This also helps determine dietary recommendations and medication management.

The American Heart Association and the American College of Cardiology help set lipid panel guidelines. A lipid panel is a blood test that measures your cholesterol and triglyceride levels.

Here are the recommended levels for optimal health:

  • Total cholesterol: Less than 200 mg/dL
  • LDL: Less than 70 mg/dL
  • HDL: Greater than 45 mg/dL in women and greater than 50 mg/dL in men
  • Triglycerides: Less than 150 mg/dL

There are a lot of factors that go into your cholesterol levels, but one of the biggest is diet. Cholesterol levels are directly related to how much cholesterol you eat, even if high cholesterol runs in your family genetics.

How Can You Use Your Diet to Lower Cholesterol?

My first recommendation is to pay attention to how much cholesterol you are actually eating. Thankfully, a food’s cholesterol content is listed on the nutrition panel. Simply flip the package over, find the nutrition panel and the cholesterol content is listed there. We care about the milligrams of cholesterol as opposed to the percentage. Please also pay attention to the portion size as this will be how much cholesterol is in a specific portion size of that food. Your cholesterol intake throughout the day should be less than 100 mg.

Which Foods Contain Cholesterol?

Anything that has a liver to produce cholesterol will have cholesterol in it or its products. So, any kind of meat or animal product will have cholesterol in it; how much is entirely dependent on the product. That’s why it is important for you to look at the nutrition panel. Some foods are very high in cholesterol, such as eggs. One egg has anywhere from 220 to 250 mg of cholesterol. That’s over two days’ worth of cholesterol intake! However, other animal products such as skim milk won’t have as much cholesterol.

So, to reduce your cholesterol intake, it is going to mean eating a more plant-based diet. Foods that come from plants do not contain cholesterol because there’s no liver to create the cholesterol. However, it is important to note that we don’t want a highly processed plant-based diet. (Oreos are technically vegan.)

What About Protein in a Plant-Based Diet?

The next question my patients normally ask is, “What am I going to eat for protein?” A well planned, well balanced plant-based diet will get you enough protein. I will talk about protein requirements in a future blog, but just know that you can get plenty of protein through a plant-based diet.

There are a lot of plant-based protein alternatives. The key is to try to make it as unprocessed as possible. That is where your whole grains, legumes, beans, nuts and seeds come in. Meat alternatives (veggie meats) are a good option for those special occasions where we typically eat meat.

Some of the most common and highest protein containing plant products are:

  • Edamame
  • Tofu
  • Lentils (Did you know there are 5 different colors of them?!)
  • Beans
  • Peas
  • Tempeh
  • Seitan
  • Quinoa
  • Millet
  • Hemp

With a little bit of research, these are easy foods to learn how to cook and make tasty. There are tons of recipes online that can help with this.

7 Tips to Lower Your Cholesterol

  1. Pay attention to how much cholesterol you eat each day.
  2. Work on limiting cholesterol intake to less than 100 mg per day; if your cholesterol level is already high, make your intake even lower or eliminate cholesterol.
  3. Follow a more whole food (unprocessed), plant-based diet.
    • Try a meatless Monday. Or a meatless Monday, Wednesday and Friday! Or a meatless week!
  4. Remember, it is not just meat that contains cholesterol, but also animal products like eggs.
  5. Work with your doctor to monitor your cholesterol levels as you make some of these changes so you know how much cholesterol your body can actually handle.
  6. Remember that cholesterol is made by our body and therefore it is not something we are required to eat.
  7. Remember that sometimes cholesterol medications are still recommended for certain conditions even if your cholesterol levels are normal. If your doctor is recommending this, make sure you understand why they want you on a cholesterol medication.
Dr. Crista Few

Dr. Crista Few

Family Physician, Bryan Primary Care

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Breast Cancer & Lymphedema

Breast Cancer & Lymphedema

by | Oct 21, 2024 | Expert Health Tips

Lymphedema is a condition that occurs in one in five breast cancer patients. It might occur right after surgery or radiation therapy, or it might happen months or years later or not at all. If lymphedema is not treated, it can become debilitating and cause an infection known as cellulitis. While there is no cure for lymphedema, there are things you can do to help reduce or relieve the symptoms.

What Is Lymphedema?

Lymphedema is an abnormal swelling that can occur after damage of the lymphatic system or lymph node removal. This might be the result of treatment options such as surgery or radiation therapy. When damage occurs to the lymphatic system, lymphatic fluid can build up. This causes uncomfortable swelling. When identified early, lymphedema symptoms can be treated and relieved.

What Are the Symptoms of Lymphedema?

Symptoms of lymphedema include a feeling of fullness, heaviness or tightness of the affected area. Lymphedema typically begins slowly. You may notice jewelry or clothing begins to leave an indentation on your skin. Comparing the affected areas (such as an arm, leg, foot or hand) may show differences where one is more swollen than the other.

What Can Be Done to Treat Lymphedema Symptoms?

A trained therapist can provide complete decongestive therapy (CDT) to treat lymphedema. This treatment helps reduce swelling caused by excess fluid in the body.

What Does Complete Decongestive Therapy Include?

CDT includes manual lymph drainage massage, skin care, exercise, use of compression when appropriate and education about how to manage lymphedema symptoms yourself at home.

Manual Lymph Drainage Massage

Manual lymph drainage is a type of massage with specific techniques that can effectively help rid the body of excess fluid and symptoms of swelling. Manual lymph drainage massage uses very light pressure because the lymphatic system is close to the surface of the skin.

Skin Care

Lymphedema can increase the risk of skin infections. For this reason, skin care education is very important. Using products without fragrances or perfumes is recommended as they can irritate the skin. Wound and nail care may also be recommended.

Exercise

Special exercises are used with lymphedema treatment to promote circulation towards the center of the body. Cardiovascular exercise such as walking, jogging, swimming or rebounding promote increased lymphatic circulation in the body. Avoid excessive strain or heavy weightlifting.

Compression Garments

These are usually elastic-type sleeves or stockings that fit closely to the skin. They compress the affected area (usually the arm for breast cancer patients) to promote drainage of lymph fluid. A skilled rehabilitation therapist can recommend various products tailored for each person’s needs. This might include compression wraps, garments, pads and pneumatic compression pumps. At the April Sampson Cancer Center, a team of certified fitters provides measurements to ensure the proper compression and fit for each person.

Additional Services for Breast Cancer Patients

Also at April Sampson Cancer Center are certified mastectomy fitters can help patients with breast prosthetics—whether partial, full, custom or nipple prosthetics—as well as bras.

Tracy Bender

Tracy Bender

Occupational Therapist, Cancer Partners of Nebraska – April Sampson Cancer Center

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Knee Pain & Surgery: How to Avoid It & When to Know It’s Time

Knee Pain & Surgery: How to Avoid It & When to Know It’s Time

by | Sep 16, 2024 | Expert Health Tips

If you’re experiencing knee pain, you might be wondering what you can do to avoid surgery and when surgery might be your best option. Here are answers to these common questions and information to help you determine next steps to resolve your knee pain.

Knee Pain, Why?

There are many reasons why you might develop knee pain. Many patients are happy to hear that often knee pain can be treated and resolved without surgery. However, there are times when surgery is the most reliable solution.

Common Reasons for Knee Pain

Two of the most common causes for knee pain are musculoskeletal strains or an exacerbation of arthritis.

  • A musculoskeletal strain is simply a case of overworking the muscles around your knee joint. Think of this as feeling tired at the end of a long day but specifically related to your knee.
  • Arthritis is a lack of cartilage, which is the shiny, smooth substance that facilitates movement of your joints. When this cartilage wears away, the bone underneath is exposed, which can cause pain. You may have heard of this referred to as “bone on bone.” Your bones are rubbing together without the cartilage between them that makes movement smooth and painless.

Additional Causes of Knee Pain

There are many other conditions that can cause knee pain, such as tendinitis, fractures, or injuries to the meniscus, collateral ligaments or the ACL or PCL. These injuries can be strains of varying severity or complete tears.

Let’s focus more on knee arthritis, which is typically a condition that progresses as you age.

Treatments for Knee Pain due to Arthritis

Conservative treatment (meaning no surgery) offers many different approaches. Treatment options include:

  • Physical therapy
  • Anti-inflammatory pain medications such as ibuprofen
  • Activity modification to avoid activities that have caused knee pain in the past
  • Weight loss
  • Knee injections
  • Bracing

These options might be used on their own at various times or in combination with each other to relieve pain.

Time for Surgery?

Eventually, knee arthritis progresses to a point where it is time to consider surgery. You’ll know you are at this point when your ability to do what you want to do is no longer acceptable to you. You will start to “live your life around your knee,” meaning your knee pain is dictating what activities you are able to do, and negatively impacting your life.

This is when you’ll want to discuss surgery with your orthopedic surgeon. The mainstay of treatment for end-stage arthritis is a total knee replacement. Knee replacement surgery is an elective procedure, and the decision to undergo surgery is a personal one.

Getting the Most out of Life

There are many advances in treatment that can help resolve knee pain, and even delay the need for surgery. When you have persisting knee pain, a referral to an orthopedic surgeon can give you more clarity on the causes, natural history and treatment options for your specific diagnosis.

Nick L. Van Roekel, M.D.

Nick L. Van Roekel, M.D.

Orthopedic Surgeon, Nebraska Orthopaedic Center, PC, South

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Acupuncture: Ancient Medicine with Modern Applications

Acupuncture: Ancient Medicine with Modern Applications

by | Aug 13, 2024 | Expert Health Tips

My interest in acupuncture started while working alongside an acupuncturist in Anchorage, Alaska, at a large medical clinic. I was working as an X-ray technician, massage therapist and laboratory technician. I was also experiencing chronic neck pain due to a waterskiing accident.

After seeing acupuncture treat many patient symptoms and conditions, I decided to give it a try. My pain relief started immediately with my first treatment, and after a series of treatments I was pain free. I thought to myself, “there must be something to this” and started researching the science behind it. This led to acupuncture school in San Diego and a three-year master’s degree.

I’ve been practicing acupuncture for 25 years. During this time, I’ve been fortunate to help people feel better, decrease pain and heal from mental health struggles. I’ve enjoyed seeing acupuncture become more mainstream as more hospitals and the Veterans Administration see the benefits of this type of therapy. I like the diversity of treating patients of all ages with a variety of conditions.

What Is Acupuncture?

Acupuncture is an all-natural therapy that uses very fine needles at strategic points in the body to relieve pain and promote healing. Inserting needles in specific points leads to physiological and/or hormonal changes and helps the body re-balance and stimulate its own natural healing abilities.

How Does Acupuncture Work?

Here are five ways acupuncture works to improve overall health and wellbeing. Acupuncture:

  1. Relaxes muscles
  2. Decreases inflammation
  3. Blocks nerve pain
  4. Increases endorphins
  5. Balances hormones

Acupuncture can be a stand-alone treatment or used alongside conventional medicine.

What Can Acupuncture Treat?

There are a range of conditions acupuncture can improve for people of all ages and all stages of life.

Women’s Health

Women experience many changes from their teenage years to pregnancy, middle age, menopause and beyond. Each woman has a unique journey and different needs at different stages of their lives. Acupuncture can help at each stage. Certain medications, procedures and cancer treatments can cause symptoms resembling menopause, which is also treatable with acupuncture.

Since acupuncture helps balance hormones, it can treat these conditions for women:

  1. Menopause/perimenopause symptoms (including hot flashes)
  2. Endometriosis pain
  3. Menstrual symptoms (irregular or painful periods)
  4. Morning sickness, discomfort with pregnancy and induction of labor
  5. Fertility
  6. Urinary tract infections
  7. Pelvic pain

Men’s Health

Acupuncture can also treat these common issues for men:

  1. Prostate symptoms (pain, frequent urination, hot flashes)
  2. Fertility
  3. Urinary tract infections
  4. Pelvic pain

Cancer Treatment Symptoms

Acupuncture can help with many treatment-related issues for cancer patients:

  1. Chemotherapy-induced nausea/vomiting
  2. Chemotherapy-induced neuropathy
  3. Appetite suppression
  4. Low energy
  5. Pain

General Conditions

Acupuncture can help anyone dealing with these types of conditions:

  1. Pain
  2. Auto-immune disorders
  3. Headaches/migraines
  4. Insomnia
  5. Allergies
  6. Mental health – anxiety, depression and post-traumatic stress disorder (PTSD)
  7. Gastric conditions – irritable bowel syndrome (IBS), reflux (GERD)
  8. Substance abuse (tobacco, drugs and alcohol)

Frequently Asked Questions About Acupuncture

Does Acupuncture Hurt?

No, the needles are not needles in the true sense. They’re thin, sterile wire. Most of my patients don’t feel any of them. It’s a sensation, but it’s definitely not painful. It’s very relaxing and many of my patients actually fall asleep.

Does Insurance Cover Acupuncture?

Many insurance companies cover acupuncture. Definitely check with your insurance company first.

Is Acupuncture Right for Me? How Do I Get an Appointment?

I’m happy to visit with you about any issues you’re facing and see if you may benefit from acupuncture therapy. You can book an appointment now or call 402-481-7973.

Betsy DeGrandi

Betsy DeGrandi

Acupuncturist, Bryan Medical Center – The Spa

DeGrandi has been practicing acupuncture for 25 years and has worked in hospitals, private practice and with veterans. Her passion is empowering her patients and meeting them where they are in their healing journey.

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Preparing for a New Family Member

Preparing for a New Family Member

by | May 20, 2024 | Expert Health Tips

3,591,328—the number of babies born in the U.S. in 2023. Wow! That’s a lot of homes adding a new family member. And what about the 1 in 25 U.S. families who have at least one adopted child? Or the six million U.S. households that have more than three generations living under one roof? How about the 203,770 children that entered foster care in 2021?

Adding a new member to your family can be challenging for everyone. A smooth transition begins with open and honest communication. If you or someone you know is preparing to add a child to their family, here are a few tips to prepare the whole family for the changes.

Tips for Parents & Caregivers

  • Start the conversation early. Be open and honest while being age-appropriate.
  • Spend individual time with each child and try to continue things you did with them before the addition, i.e. watching movies, reading, etc.
    • For older children, consider writing encouraging notes, or getting them a card or a little gift.
  • Model healthy expression of feelings such as, “I’m feeling overwhelmed right now. Let’s take a break.” This normalizes a healthy response and feeling big emotions.
  • Communicate the need for safety (physical and emotional) of the new family member.
  • Teach children that crying is one way babies communicate.
    • Normalize that it may be “annoying” or “loud”, but remind them that we all cried when we were babies too! Or give an example, “Remember when you fell and scraped your knee and cried? What happened? You cried and I came to see if you were okay, and we put a band-aid on it. Your crying got you the help and comfort you needed.”
  • Build on each family member’s strengths. For example, if your youngest daughter is great at organizing, have her help organize things in the home ahead of her sibling’s arrival.
  • Encourage family and friends to give all children equal attention. This will avoid current family members feeling forgotten when the new family member is in the home.

Preparing Young Children

Infancy to Age Two

Young children, infancy to around age two, don’t fully comprehend the addition of a new family member, so simple things may help them adjust.

  • Be positive and talk about the baby or new family member in a positive way.
    • Kids are very smart and will seek to emulate your behavior and attitude. If you’re positive, they will feel positive.
  • Look at and read books about babies or changing family dynamics.
  • Do something special when the baby arrives. I still remember getting a “Big Sister” pin at Bryan when my little brother was born.

Toddlers

The toddler age can be a territorial age for children as they feel strongly connected with caregivers.

  • Relate things to a TV show, movie or book they love.
  • “Practice” for a new baby by getting a doll and showing them how to handle it as if it were a real baby.
  • Involve them in preparing.
    • Work on routines that will help everyone. For example, toilet training, moving from a crib to a bed, reinforcing or making adjustments to sleep schedules.
  • Let them spend “special time” with someone important to them ahead of the new member’s arrival.

School-Age Children

School-age children tend to be a bit easier in preparing for a new family member but still need reassurance and help adjusting. Remember to keep open communication and encourage questions and curiosity.

  • Explain what’s going to happen in a way they understand, including the “good” and “bad”.
  • Let them help prepare for the arrival.
  • Practice with a baby doll, or if you have a close family member/friend with an actual baby.
    • Provide positive reinforcement for them by saying things such as “You’re such a great big brother/sister.” or “I can tell you really care about ______.” or “You’re such a great helper!”
  • Let them come to the hospital as soon as possible after the baby is born so they continue to feel like a part of the growing family.

Managing Regression

Children may experience regression, “childish” behaviors, from time to time during this process of adding a new family member. For example, wanting to drink out of a bottle again, bed wetting or having accidents, or using a “baby” voice. When children regress, remember it’s normal and there’s nothing wrong with your child.

Here are a few facts and helpful tips to manage regression:

  • Children’s brains aren’t fully developed yet, so regression is a way they feel loved and cared for.
    • Attention is ATTENTION to a child’s brain. Even when a child “acts up,” they are getting attention which reinforces the idea that someone cares. They don’t understand the depth of what or why they are acting this way, but this is how they are communicating their need for love, affection and reassurance.
  • Regression typically resolves on its own, but if not, use resources to help.
    • Use books, friends, family, religious or cultural support, medical professionals and counselors.
  • Reinforce the positives. Even the smallest positives help build reassurance that they are loved and their needs will be taken care of.
  • Try to increase individual time with the child that’s struggling or be creative in finding ways to include them.

Support Each Other

There are no perfect ways to handle changing family dynamics, but these tips and tricks may make the transition smoother for everyone. Children are innately curious and thrive off love and affection. There is no right or wrong way to adjust your family dynamics as long as supporting each other with open communication and honesty is at the root.

There will be tough times, so give yourself grace. As your family grows, you all may experience some “growing pains”. When you seek to understand and support each other, you’ll all grow together.

Cassie Finkner, MA, LIMHP

Cassie Finkner, MA, LIMHP

Mental Health and Substance Abuse Counselor, Bryan Counseling Center

Cassie provides individual therapy to adolescents and adults. She specializes in trauma, including PTSD, major mental illness, suicidality, substance use, depression and anxiety. Cassie has been specifically trained in Eye Movement Desensitization Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT) and Motivational Interviewing (MI), however, utilizes a variety of different treatment modalities based upon the individuals needs to meet their treatment goals. Additional experience includes working with people encountering housing instability, poverty and trauma related to military experiences, including deployments and crisis intervention.

Cassie earned her Master of Arts in Counseling at Doane University (CACREP accredited).

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8 Tips to Avoid Injury: Insights from Sports Medicine Trainers

8 Tips to Avoid Injury: Insights from Sports Medicine Trainers

by | Apr 16, 2024 | Expert Health Tips

Whether you’re a weekend warrior, a recreational sports enthusiast or professional athlete, we can all use tips to avoid injury and stay healthy. We asked our athletic trainers to share some of their best tips.

1. Listen to Your Body & Address Pain or Discomfort Early

Grant Rider, athletic trainer at Seward High School

Pain is a message from your body that something is wrong and you should take a break before it worsens. Listening to your body and addressing pain or discomfort early will prevent minor issues from becoming major issues. It’s better to take a short break and avoid a more serious injury than to play through pain and cause a bigger problem later.

2. Stretch Before & After Activities

Terry Adair, athletic trainer at David City Aquinas and David City Public Schools

Stretching is essential to improve your flexibility and reduce your risk of injury. It also helps you warm up before exercise and cool down afterwards. Stretching improves blood flow and reduces muscle stiffness that can lead to injuries. Here are a few tips to get the most benefit from stretching:

  • Relax into your stretches
  • Don’t bounce while stretching
  • Hold each stretch for 30 seconds

3. Add Foam Rolling into Your Daily Routine

Ashley Elwell, athletic trainer at Crete High School

Foam rolling is a self-massage release technique. By using a lightweight cylindrical tube made of dense foam, you can roll over tight spots to help reduce muscle tightness, soreness and inflammation. Foam rolling is an effective tool to add to your warm-up and cool-down routines.

4. Drink Half of Your Body Weight in Water Each Day

Stacy Dahlkoetter, athletic trainer at Lincoln Christian and Parkview Christian Schools

If you participate in exercise or activities where you sweat a lot, your hydration need may be higher, and you will also need to replace electrolytes. Energy drinks do not count as a hydration drink. They actually dehydrate you and you will need to drink more water. To make sure you get enough water, drink half your body weight in water each day. So, if you weigh 120 pounds, you should drink 60 ounces of water a day.

5. What You Put into Your Body Matters

Kyle Younkin, athletic trainer at Lincoln Lutheran and Parkview Christian Schools

Maintaining a healthy diet with a good balance of carbs, proteins, fats, vitamins and minerals will keep you in your best shape. Complex carbohydrates from pasta, whole-grain breads and rice provide energy, fiber, vitamins and minerals without a lot of fat. Choosing lean meats will give you protein without contributing to issues like weight gain or high cholesterol.

6. Sleep Is Important

Choc Bowen, athletic trainer at York High School

Lack of sleep and/or poor sleep quality can impair muscle strength, speed and other aspects of physical performance. Sleep issues can also impair recovery following injury. Aim for 8-10 hours of sleep each night to ensure the proper amount of rest and to allow your muscles to recover.

7. Allow Time for Rest & Recovery

Bethany Dolezal, athletic trainer at Kinetic Sports Complex

Give your body what it needs to recover between training/exercise. Eat well, sleep well, stretch well and take rest days to avoid overdoing it. Don’t feel guilty if you take a day off. It is good for your mental and physical health to take time when you need it. Athletes should also take time between seasons to recover and prevent injuries.

8. Share Any Pain, Discomfort or Injuries with a Health Expert

Cassie Metzner, athletic trainer at Waverly High School

Everyone wants to get back to sports or activities. If injured, seek help from a professional—an athletic trainer, physical therapist or other health expert. Be honest with them about your injury and how you are feeling so that they can best help you recover and return to the activities you love.

Bryan Health/Nebraska Orthopaedic Center

Athletic Trainers

The Bryan Health Center and Nebraska Orthopaedic Center team of certified athletic trainers brings to our region’s youth extensive knowledge, experience and passion for working with young athletes. Learn more about Ashley Elwell, Bethany Dolezal, Cassie Metzner, Choc Bowen, Grant Rider, Kyle Younkin and Terry Adair.

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New Advances in Care: What Do I Need to Know If Someone I Love Is a Past or Current Smoker?

New Advances in Care: What Do I Need to Know If Someone I Love Is a Past or Current Smoker?

by | Mar 18, 2024 | Expert Health Tips

We all know it — smoking is not good for you. Yet for many, it is a reality of our daily lives. Let’s face it, it’s addictive and it’s often not easy to stop. And some people don’t want to quit. Given all of this, what’s a person to do? What steps can you take to make a difference in your life?

Screening & Follow-Up Are Key

There are several ways testing or a screening can help provide early detection. One of the most common is one you may not know about — an incidental finding. A low-dose CT scan is another important screening.

Incidental Findings

An incidental finding happens when you are being treated for one condition and receive an x-ray or CT scan and the doctor notices an abnormal growth in your lung. At Bryan Health, we have a team that follows up on these findings with our patients.

This can be life-changing and life-saving. Here’s a perfect example of the power this has on a life. ‘Suzie’ is a smoker, but she doesn’t have any symptoms of lung cancer. While being seen in the ER, a chest x-ray is done and an abnormal growth is found. She does the follow-up testing and finds out she has very early-stage lung cancer. Because the follow-up testing is done with an advanced robotic procedure and it’s found so early, we can move quickly through staging and resect (remove) the tumor early. The cancer doesn’t grow or metastasize (spread), and further treatment is not needed.

Low-Dose CT Scan

This is a test specifically designed for early detection of lung cancer. Current guidelines for who should receive this screening are:

  1. A daily smoker within the last 15 years
  2. Age 50-80
  3. Smokes at least one pack a day for 20 years or two packs a day for 10 years

A low-dose CT scan is recommended yearly unless it has been more than 15 years since the person has used tobacco. If you qualify for this screening, talk to your doctor about ordering this test.

3 Reasons People Avoid Screening & 6 Reasons to Get Screened

If you or a loved one have any of these thoughts, consider the following.

Reason One: I Know Smoking is Bad For Me. I’m Not Going to Quit/I Already Quit So Why Get Screened?

  1. Getting screened for lung cancer is about life — your life. And, using the latest technology can catch cancer early, so you can go on enjoying life.
  2. If you no longer smoke, that’s great. But you are still at risk and should be screened. Think of it as an extension of your healthy habits.

Reason Two: I Don’t Have Any Symptoms

That’s exactly when you should be screened for two reasons:

  1. You could find out you don’t have cancer and your lungs are fine.
  2. You could find cancer before any symptoms occur, when it can be treated quickly and easily.

Reason Three: I Don’t Want to Know. What If They Find Something?

  1. If something is found that requires a biopsy (further testing), 95% of the time it is not cancer.
  2. If it is cancer and it’s found early, the five-year survival rate is 92%.

New Advances in Diagnosing & Treating Lung Cancer

When it comes to diagnostics (biopsy) to determine if a nodule (growth) is cancer, there are three options.

  1. A biopsy with Interventional Radiology (IR) — This is the most common and is usually a same-day procedure.
  2. Surgical resection is also an option, though it is much more invasive and requires a hospital stay.
  3. A new advancement in bronchoscopy (a way to look at the lungs with a small camera) — This has been a significant enhancement in care and is generally a same-day procedure.

IR Biopsy

A typical IR biopsy identifies just the lesion (growth) in question. Then a separate procedure is needed to determine the stage of cancer (i.e., no cancer or how much cancer there is and if it has spread) followed by surgery, if needed.

Bronchoscopy Advancement

This advancement is robotics, and the platform we use at Bryan Medical Center is Ion. The benefit of this type of procedure is in its completeness. With robotic-assisted bronchoscopy and the Ion platform, we are able to reach nearly anywhere in the lung for the nodule, although there are some limitations.

Where Ion and bronchoscopy really shine is not just in the identification of the nodule, or spot, on the lung. In the same procedure, we do a staging — determining if the cancer has spread — for all patients with biopsy of the lymph nodes in the chest. This reduces the need for staging after the initial diagnosis. As a combined procedure with Ion, we can reduce the time from nodule-to-knife (diagnosis of the lesion to when it can be surgically removed).

Take Advantage of Advances in Care

There are exciting advances in medicine that allow us to diagnose and treat lung cancer to make a significant difference in a patient’s life. The key is early diagnosis.

Ryan Martin, MD

Ryan Martin, MD

Pulmonologist

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How to Avoid Burnout in Work & Life

How to Avoid Burnout in Work & Life

by | Feb 1, 2024 | Expert Health Tips

Do you feel sluggish and exhausted? Can simple tasks seem overwhelming to complete? Have you found yourself so stressed out that you quickly become angry or frustrated? If you’ve noticed feeling this way, you might be experiencing burnout.

Burnout can be difficult to describe to others. According to the American Psychological Association, burnout is defined as “physical, emotional, or mental exhaustion, accompanied by decreased motivation, lowered performance and negative attitudes towards oneself and others.”

Burnout Can Be Caused by More Than Your Work

Most people associate burnout with a stressful job. However, burnout can affect many aspects of your life, from being a parent to your relationship with your significant other or even being a caregiver for an elderly parent. Understanding the symptoms of burnout and what you can do about it can improve your mental health and quality of life.

Over the last few years, burnout has been developing more and more as work-life balance gets out of sync. This is because of the increase in remote work and technology that does not let us “turn off” and reset from our workday or slow down and manage our personal lives along with our work demands.

Signs You May Be Experiencing Burnout

There are many physical, emotional and behavioral signs that could mean you are experiencing burnout.

Physical Signs:

  • Feeling tired all the time
  • Frequent headaches
  • Changes in appetite or sleep habits

Emotional Signs:

  • A sense of failure and self-doubt
  • Detachment and feeling alone
  • Feeling trapped or defeated
  • Loss of motivation
  • Decrease of satisfaction and sense of accomplishment

Behavioral Signs:

  • Withdrawing from responsibilities
  • Isolating from others
  • Procrastinating to get things done
  • Taking frustrations out on others
  • Skipping work or coming in late and leaving early

Although many of these symptoms may line up with depression, causes of depression tend to be broader whereas burnout symptoms can be pinpointed to specific reasons or triggers in a person’s life.

Burnout Happens When Work-Life Balance Is Out of Sync

This may be due to:

  • Working too much without enough time to socialize or relax
  • Lack of close, supportive relationships and not reaching out to others for help
  • Not getting enough rest to recharge
  • Taking on too many responsibilities at work and home

Ways You Can Manage Burnout

Here are ways you can deal with burnout and perhaps prevent it in the future.

Recognize the Warning Signs

If you are feeling that there are no boundaries between your personal and work life or if you sense that you have been going 100 miles per hour and it would be impossible to slow down to even 85 miles per hour, this might be a sign that you are depleting your physical and emotional reserves and need to reach out for some support.

Reach Out for Support

Focusing on day-to-day activities might give you clues on what you need to work on to make substantial changes in your life. Sometimes talking to a friend about how you are feeling can really improve your outlook. There are other times when it is important to reach out for professional help from a therapist. The nice thing about therapy is that you have a safe place to talk with someone who is not a family member, friend or coworker.

Improve Your Self-Care

One of the best starting points is building personal check-ins into your schedule. Taking a step away from the computer or whatever your source of stress is and asking yourself daily, “How am I doing emotionally? How am I doing physically?” is a perfect first step.

Adding some physical exercise into your routine can definitely improve your outlook. “Regular exercise can reduce stress, anxiety, and depression” according to the American Psychological Association. Exercise is also an essential part of a wellness journey. There are many ways to be physically active—from walking your dog to walking with a work friend at lunch to release some excess stress.

Establishing a healthy daily routine for sleep, diet, movement and non-work time is crucial for your well-being. It is critical to tell yourself, “I have worked hard today, now I need to stop, change gears and attend to the social and personal aspects of my life. I need to do things that are fun and relaxing.”

We’re Here for You

If you think you might be experiencing burnout or would like to explore talking to a therapist about symptoms you are having, please reach out to Bryan Counseling Center at 402-481-5991. You can also take a free mental health screening on our website.

Stacy Waldron, PhD

Stacy Waldron, PhD

Dr. Stacy Waldron provides treatment for individuals of all ages across the lifespan and specializes with adolescents and adults. She offers individual and family therapy to help clients with stress , anxiety, mood disorders, life transitions and chronic pain. This includes helping individuals with stress management, assertiveness training, communication and problem solving skills as well as relaxation training. She also provides psychological assessments that include bariatric surgery evaluations, spine surgery, and spinal cord stimulator evaluations.

Waldron earned a doctorate in counseling psychology from the University of Southern California in Los Angeles. She serves on the Board of Psychology for the State of Nebraska, the Board of Directors for the Midwest Pain Society, and the Association of State and Provincial Psychology Boards.

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Let’s Talk Osteoporosis: How to Keep Your Bones Strong

Let’s Talk Osteoporosis: How to Keep Your Bones Strong

by | Jan 22, 2024 | Expert Health Tips

It might seem hard to believe but we reach our peak bone mass in our late 20s or early 30s. From there, men and women start to lose some amount of bone density throughout their lifetime. The loss in bone density causes an abnormal structure and ultimately weakens our bones, increasing the chance of osteoporosis and a bone fracture.

What Is Osteoporosis?

Osteoporosis is the loss of density or mass within our bones.

To illustrate, picture a healthy bone as a honeycomb and then put a bone with osteoporosis next to it. The bone with osteoporosis will have much larger holes than the healthy bone.

Osteoporosis affects all of our bones. But the ones most likely to fracture due to osteoporosis are in your spine, wrist, shoulder and hips.

Most Common Osteoporosis Risk Factors

There are many risk factors that can lead to osteoporosis.

  • More common in women
  • 50+ years old
  • Post-menopausal
  • Caucasian
  • Low body weight
  • Undergoing chemotherapy for cancer treatment
  • Certain diabetes and seizure medications, and some medications that cause immunosuppression
  • Current or previous use of tobacco/nicotine products

Ways You Can Slow Bone Density Loss

Here are some ways you can help your bones stay strong and slow bone loss.

  • Avoid drinking alcohol/drink alcohol in moderation
    • Alcohol affects your nutrition level, which can mean your bones don’t get the adequate nutrients to stay strong
  • Avoid smoking
  • Make sure you get the right amount of vitamin D and calcium
  • Stay active
    • Weight-bearing and strengthening exercises at least three to four times a week

Screenings to Diagnose Osteoporosis

Screenings for osteoporosis risks include a FRAX score and DEXA scan.

FRAX Score

This screening should be done when you reach menopause. It involves reviewing risk factors and answering a series of questions with your provider. With this information, your provider can determine your FRAX score. This will help to understand your chance of having a fracture within the next 10 years.

DEXA Scan

This screening typically begins at age 65, unless your FRAX score is higher than the recommended level. A DEXA scan tells us the quantity or amount of bone. It’s a bone mineral density test. The DEXA scan looks at the bone density of your lumbar spine, and then usually at a hip or wrist or forearm. It’s noninvasive, similar to having an x-ray.

Possible DEXA scan results:

  • Normal, meaning you don’t have osteoporosis.
  • Osteopenia, meaning your bone density is in between normal and osteoporosis.
  • Osteoporosis, meaning your bone density has reached the level to be diagnosed with osteoporosis.

Based on the results, DEXA scans may be repeated every couple of years to monitor your bone density.

Treatment & Prevention of Osteoporosis

Medication to Treat

Medications typically are not started until you are diagnosed with osteoporosis. The exception to this would be if you have osteopenia and have a fragility fracture. A fragility fracture is a fracture from a fall at standing height or less. It can be both a sign and a symptom of osteoporosis.

Diet & Exercise to Prevent & Treat

It’s really important to make sure you have a well-balanced healthy diet and are getting enough protein, calcium and vitamin D. Most of our vitamin D comes from the sun, so in the fall and winter months, a vitamin D supplement may be beneficial. It is possible to get too much of these vitamins, so it is important to talk to your health care provider to make sure you’re taking the correct amount.

Staying active is also important. Exercise, walking and generally taking care of our bodies helps not only to slow our bone loss down, but also helps us to prevent falls.

Megan Simpson, APRN-NP

Megan Simpson, APRN-NP

Bryan Primary Care

I believe in a collaborative approach to care, and want to create a partnership with my patients. It’s important to me to provide each patient with the knowledge they need to make decisions that are best for them and their health.

I’m here for my patients – to listen to you and your concerns and answer questions you have at the office or after you go home.

Care for:

  • Toddlers age 2 and older
  • Children, teens and adults of all ages
  • Preventative care, wellness checks and screenings
  • Chronic conditions like high blood pressure and diabetes

It’s a privilege for me to help people of all ages live their best lives.

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