Beating the Winter Blues

Beating the Winter Blues

I’ll admit, winter has never been my favorite season. I would gladly trade cold weather, less sunlight and getting sick more often for sunny days at the beach. The “winter blues” is a common term used to describe the increased sadness, lower energy and reduced interest in enjoyable activities many people feel during the winter months. For many people, these symptoms are minor and manageable with a few lifestyle changes, but for others, they become more intense and may develop into seasonal affective disorder (SAD).

What Is Seasonal Affective Disorder (SAD)?

Seasonal affective disorder (SAD) is a type of depression that follows a seasonal pattern. Most often, symptoms are prominent in winter months but can follow other patterns as well. Symptoms of SAD include:

  • Depressed mood
  • Less interest in activities
  • Difficulty sleeping or oversleeping
  • Being more fidgety and restless or more slowed down than usual
  • Fatigue
  • Reduced ability to think or concentrate
  • Recurrent thoughts of death or suicidal ideation

One or several of these symptoms may occur for short periods of time. If you notice these symptoms becoming more persistent and affecting your relationships, work or school activities, you will want to actively take steps to manage them.

Ways to Manage Seasonal Affective Disorder

The cold weather and shorter days of winter are inevitable. The effects of seasonal affective disorder do not have to be. Take steps today to manage symptoms and allow yourself to thrive during all seasons of the year.

Get Moving

Physical exercise is one of the best ways to tackle depressive symptoms. It releases endorphins, improves physical health and can provide a sense of accomplishment.

Reach for Healthy Foods

Foods that are high in whole grains, protein and healthy fats provide energy and boost your mood. Sometimes this can be challenging. Some indulgence is okay (maybe even needed), but allowing large portions or high-sugar foods to become the basis of your diet will only worsen symptoms of SAD.

Stay Connected

When depression sets in, reaching out to friends and family can be daunting. Ironically, it is also one of the best ways to improve your symptoms. Having lunch with a friend, texting a family member or joining a book club are all ways to stay connected when sunlight and outdoor activities may be limited.

Try Bright Light Therapy (BLT)

BLT involves sitting in front of a light box for 30-60 minutes a day to mimic exposure to sunlight. Light boxes can be found for as little as $70 and do not require any special training to use.

Consider Professional Help

Both medication and mental health therapy have been shown to be effective at reducing the intensity of SAD symptoms.

Be Proactive

Because SAD follows a regular pattern, it is easier to anticipate the onset of symptoms than it is for other types of depression. While this pattern may not be exact, beginning these management strategies during the months leading up to the typical onset of symptoms will reduce the intensity and distress caused by symptoms.

Take an Online Screening

If you or someone you care about are concerned about Seasonal Affective Disorder or other mental health conditions, take our online screening now. Many screenings are available. All screenings are confidential and provide information to help you determine your next steps.

Nate Christensen, MS, LIMHP

Nate Christensen, MS, LIMHP

Mental Health Therapist, Bryan Counseling Center

Nate Christensen (he/him) provides therapy to adults with a wide variety of presenting concerns. He has experience working with individuals diagnosed with schizoaffective disorder, schizophrenia, bipolar disorder, depression, anxiety, and personality disorders utilizing Dialectical Behavioral Therapy (DBT), cognitive behavioral therapy, and solution-focused techniques. Nate earned his master’s of counseling degree from the University of Nebraska at Omaha.

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Grieving During the Holidays

Grieving During the Holidays

The grief bubbles up unbidden. I never know when or where it will surface, but inevitably it comes when I least want it. My mom contracted COVID-19 six months ago. She nearly died of complications from the virus. The anticipatory grief I experienced was different from the residual grief I feel now — grief over the many losses that came as a result of Mom’s sudden change in health.

As a hospital chaplain, I regularly interact with patients, family members, and staff who are experiencing dying, death, and grief. The process of grieving often strips away the surface layers of a person’s life, revealing new depth and meaning, as well as flaws. And most people don’t like that last bit.

Giving Ourselves Grace

We struggle with imperfection, just like we struggle with loss and injustice and the profound sense of “missing” that grief brings. I think the holidays often highlight those feelings. We want to feel a thrill of hope and joyful anticipation of good to come. Instead, we might be wondering if we are biologically related to the Grinch. The simple answer? No, we are just grieving.

I have found it helpful to be honest with myself about loss this year. Instead of “shoulding” on myself — thinking I should feel this or that emotion, then working to replace what I really feel with said emotion — I take a step back from the emotion. I name it for what it is and then ask myself, “What is this connected to in your life?” Often, the source was a memory that needed to be acknowledged before I could accept the loss and let go of the grief.

Experiencing New Joy

Letting go of grief doesn’t mean getting over the loss. Rather, thinking about the loss no longer causes pain. There is now room for new experiences and the making of happy memories even while remembering the past. Through the years, people have shared the following strategies that have helped them balance the two:

  • Remember and acknowledge your loved one in meaningful ways.
  • Take good care of yourself by eating healthy, drinking plenty of water, getting moderate exercise and choosing activities that nourish your soul.
  • Limit social gatherings to what brings you joy and helps lift your spirits.
  • Limit the extraneous stuff — decorations, cards, gifts, shopping — and delegate tasks that seem overwhelming or too emotional. Family and friends are often eager to help with these things.
  • Start a new tradition or new variation on an old tradition. For instance, if you always opened presents after church on Christmas Eve, try having a family brunch and opening presents on Christmas morning.

Connecting with Others

Every person’s experience of grief is different. Sometimes, it can feel as though grief has isolated us from the support of our family, friends or faith community. If you or someone you care about is struggling with grief and loss, resources are available to help you reconnect. Please reach out.

Grief and Loss Resources

Here are a few resources you may want to consider:

Trisha Wiscombe

Trisha Wiscombe

Chaplain, Bryan Pastoral Care

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Foolish Mistakes, Calculated Risks and Taking a Leap of Faith

Foolish Mistakes, Calculated Risks and Taking a Leap of Faith

Growing up, I made my share of foolish mistakes.

As a kid, I remember being on a skateboard and holding on to a rope tied to a bike that a friend was riding. We got going pretty fast, and then I fell face forward on the pavement. My face was OK, but I skinned up my right wrist pretty badly, and still have the noticeable scar to prove it.

Another time, I climbed a backyard tree and jumped from one branch to another, planning to grab it with both hands. I grabbed it, lost my grip and landed flat on my back – falling about 10 feet. It knocked the wind out of me enough that my mom took me to the ER. A few months later, I did it again – the same stunt – causing a second trip to the hospital.

I could go on; as I’m sure we all can when we look back on our life. These are just a few lighter examples of foolish behavior to illustrate how sometimes we get lucky (or not) in situations where the outcome could have been much worse.

Calculated Risks

Calculated risks are different. They involve decisions we make to try something new or novel. It is putting concerted energy towards something that will improve our life satisfaction – a conscious decision to improve ourselves through self-exploration, learning, or perfecting a skill or craft, etc.

Calculated risks aren’t foolish but the hoped-for outcomes aren’t guaranteed. My favorite example is going back to school. I once worked at a community college where one of my roles was to help displaced workers find new jobs or careers. It was scary and challenging for them; often they were middle-aged and had only known one job.

With encouragement, some went back to school and pursued a completely new and often quite challenging career. By taking a calculated risk, they discovered meaningful work that was satisfying personally, professionally and financially. Some commented that in retrospect they had never been happier. Losing their employment led them to pursue more meaningful work for perhaps the first time in their lives.

Taking a Leap of Faith

Perhaps it’s time for you to take a calculated risk. Maybe your life could be enriched by learning a second language, trying out for a community theater production, ending a dismal relationship, or having the courage to be vulnerable and start a new relationship.

It can be scary to think about doing something new, but it can also be rewarding. If you’re thinking about it, take the next step. Talk to a friend, do some research or consider visiting with a counselor to help sort things out. Taking that leap of faith just might be the best thing you do in life.

How are you feeling?

If you’re feeling anxious, concerned or stressed about your current life situation, take this confidential online screening to help determine the next steps.

Take Online Screening Now

Tom Cardwell, PhD

Tom Cardwell, PhD

Licensed Psychologist, Bryan Counseling Center

Dr. Tom Cardwell provides treatment for people of all ages. He offers individual and family therapy to help with stress, anxiety, mood and adjustment disorders. Dr. Cardwell has expertise in gerontology and the assessment and treatment of substance abuse and addictions. He enjoys helping people work through life transitions of all kinds. He is interested in helping people improve their lives by learning to be as mentally and physically healthy as possible at every age.

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Mindful Eating vs. Emotional Eating: 6 Steps for Success

Mindful Eating vs. Emotional Eating: 6 Steps for Success

What is emotional eating? Emotional eating is generally when we eat as a way to suppress or soothe negative emotions such as stress, anger, fear, boredom, sadness and loneliness. When we work to reduce emotional eating, it is important to be aware of behaviors we can change to allow our food to be more useful to our bodies and to gain emotional control over food.

Here are six pointers that I have found effective in my practice as a clinical psychologist at Bryan Counseling Center.

1. Slow Down so Your Body and Brain can Communicate

Eating more slowly is one of the best ways you can get your mind and body to communicate what is really needed for nutrition. The amount of time it takes your brain to register that your stomach is full is about 20 minutes. This is why we often unconsciously overeat. Eating more slowly allows enough time to receive the signal from your brain that you are full. This in turn helps us eat the right amount of food. Simple ways to slow down might include many of your grandmother’s manners like sitting down to eat, chewing each bite 25 times (or more) and setting down your fork between bites.

2. Know Your Body’s Personal Hunger Signals

Are you responding to an emotional want or responding to your body’s needs? Often we listen first to our minds, but like many mindfulness practices, we might discover more wisdom by tuning into our bodies first. Rather than just eating when we get emotional signals, which may be different for each of us – stress, sadness, frustration, loneliness, boredom – try to listen to your body. Is your stomach growling, your energy low or are you feeling lightheaded? Too often, we eat when our mind tells us to, rather than our bodies. True mindful eating is listening deeply to our body’s signals for hunger. Ask yourself: What are your body’s hunger signals, and what are your emotional hunger triggers?

3. Cultivate a Mindful Kitchen

Do you eat alone and randomly or do you eat with others or at set times? Another way that we eat mindlessly is by wandering around looking through cabinets and eating at random times and places rather than thinking proactively about our meals and snacks. This prevents us from developing healthy environmental cues about what and how much to eat, and wires our brains with new cues for eating that are not always ideal. (For example, do you really want to create a habit of eating every time you get in the car?)

Sure, we all snack from time to time, but eating at consistent times and places can boost both your mind and body’s health, not to mention greatly helping your mood and sleep schedule. Yes, that means sitting down (at a table!), putting food on a plate or bowl, not eating it out of the container and using actual utensils. It also helps to eat with others if that is possible – not only are you sharing and getting some healthy connection, but you will also slow down and enjoy the food and conversation more.

Having a mindful kitchen means organizing and caring for your kitchen space so it encourages healthy eating and nourishing gatherings. Consider what you bring into your kitchen and where you put things away. Are healthy foods handy? What kinds of foods are in sight? When food is around, we eat it.

You don’t have to plan your food down to each bite, and it’s important to be flexible, especially on special occasions, but just be aware of the fact that you might be changing your eating habits at different times of the year or for different occasions. And when you do plan ahead, you are more likely to eat the amount your body needs at that moment rather than undereating and indulging later, or overeating and regretting it later.

4. Understand Your Motivations

Eating foods that are emotionally comforting vs. eating foods that are nutritionally healthy is a tricky balance. Ideally, we can find nourishing foods that are also satisfying and comforting. When we slow down and think about the healthy foods in our mouths we often enjoy them more than the story we want to tell ourselves about healthy food.

As we practice eating healthier and a greater variety of foods, we are less inclined to binge on our comfort foods, and more inclined to actually enjoy healthy foods. Ultimately we can find many foods mentally and physically satisfying as opposed to just a few.

5. Connect More Deeply with Your Food

Outside of hunter-gatherers or sustenance farmers, most of us have become disconnected from our food in recent years. Many of us don’t even consider where a meal comes from beyond the supermarket packaging. This is a loss because eating offers an incredible opportunity to connect us more deeply to the natural world, the elements and to each other.

When you pause to consider all of the people involved in the meal on your plate: from the loved ones (and yourself) who prepared it, to those who stocked the shelves, to those who planted and harvested the raw ingredients, to those who supported them, it is hard to not feel both grateful and interconnected. Be mindful of the water, soil and other elements that were part of its creation as you sit down to eat whatever you are eating. You can reflect on the cultural traditions that brought you this food and the recipes generously shared by friends or brought from a distant place and time to be handed down in the family.

As you consider everything that went into the meal, it becomes effortless to experience and express gratitude to all of the people who gave their time and effort, the elements of the universe that contributed their share, our friends or ancestors who shared recipes, and even the beings who may have given their lives to a part of creating this meal. With just a little more mindfulness like this, we may begin to make wiser choices about sustainability and health in our food, not just for us but for the whole planet.

6. Attend to your Plate

Multitasking and eating is a recipe for not being able to listen deeply to our body’s needs and wants. We’ve all had the experience of going to the movies with our bag full of popcorn, and before the coming attractions are over, we are asking who ate all of our popcorn. When we are distracted, it becomes harder to listen to our body’s signals about food and other needs. With your next meal, try single-tasking and just eating, with no screens or distractions besides enjoying the company you are sharing a meal and conversation with, even if it’s just your own.

While formal mindful eating practices may be what we think of when we look back on a mindfulness course or retreat we attended, the reality is that we do live – and eat – in the real world, which is a busy place. But we can take the insights gained from our formal practice – slowing down, listening to our bodies, doing one thing at a time, making even small rituals, and considering all that went into our meal on a more regular basis – and bring more informal mindfulness to our daily meals.

Finally, remind yourself each day that food is fuel for your body, not for comfort. By using mindful eating practices, you just may find the food you eat more enjoyable and nutritious.

Stacy Waldron, PhD

Stacy Waldron, PhD

Licensed Clinical Psychologist, Bryan Counseling Center

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.

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8 Great Reasons to Try Acupuncture

8 Great Reasons to Try Acupuncture

Over my 19 years of practicing complementary medicine, since earning a master’s degree in Oriental Medicine, the most common question I hear from people is:

“Will acupuncture treat my _________?” Fill in the blank.

About 90% of the time the answer is YES! Acupuncture is a 3,500+-year-old body of knowledge that has treated over a quarter of the world’s population as the main form of medicine. It is part of the ancient practice of Traditional Chinese medicine.

I’ve seen many people benefit from acupuncture for a vast array of conditions, too many to list in a short blog. So, I will give you the eight most common reasons people use acupuncture.

8 Most Common Reasons People Use Acupuncture

  1. Chronic Musculoskeletal Pain: The research continues to increase on using acupuncture to treat chronic pain. In many cases, acupuncture can reduce the need for medications. NSAIDs and over-the-counter pain medications such as Tylenol, Advil, Motrin or Excedrin can be hard on your kidneys and liver. Opioids can cause unwanted side effects and dependence. Acupuncture can greatly reduce your need to use these pain medications.
  2. Migraine and Chronic Headaches: Surveys show that 1 in 6 Americans (1 in 5 women) suffer from migraine and chronic headaches. Western medicine relies almost exclusively on medications, either oral or injectable, to tackle this common problem. Chinese medicine has been used to treat headaches for thousands of years. The reason it works so well for headaches is because Chinese medicine or acupuncture is designed to treat the individual, not the symptoms. For example, two people with a migraine may be treated in two different ways depending on the person.
  3. Autoimmune and Chronic Illness: One of the best reasons to try acupuncture is for illnesses that may be chronic and persistent, such as Rheumatoid Arthritis, Lupus, Crohn’s disease and other autoimmune illnesses. It’s also very effective for neurological diseases like Multiple sclerosis, Parkinson’s disease, ALS, etc. Acupuncture has been shown to relieve symptoms, decrease the need for medications and slow the progression of the disease.
  4. Women’s Health: There is a huge body of knowledge in Chinese medicine related to women’s health issues. Many ancient texts are written specifically for this branch of medicine. Acupuncture is wonderful for regulating menstruation, helping menstrual pain, assisting with fertility and ovulation, treating menopausal symptoms, PMS, endometriosis and more.
  5. Anxiety and Stress: It may seem counterintuitive that inserting needles in the body would bring about deep relaxation, but it does! In fact, it is common to fall into a peaceful sleep while the needles are inserted into your body. The scientific reason for this is that acupuncture releases brain chemicals called “endorphins” – the feel-good hormones that we get from meditation, exercise and falling in love. Chinese medicine takes into account that emotions can cause illness just as much as the environment. By balancing the body with acupuncture, the mood becomes level and the mind becomes at ease.
  6. Addiction, Smoking Cessation and Weight Loss: Much like anxiety and stress-related problems, our entire society struggles with addictive behaviors of one kind or another. Acupuncture has a sub-category called auricular acupuncture, which is done by stimulating specific points on the ear. In New York City in 1978, a physician named Michael Smith discovered what is now called the NADA protocol, or sometimes called “battlefield acupuncture”. He used five points on the ear to effectively treat heroin and cocaine addictions. This method is now being used for PTSD, depression, addiction and more.
  7. Boosting Your Immune System: If you are susceptible to illness and seem to catch whatever bug is going around, consider boosting your immune system with ongoing acupuncture. Acupuncture is most effective when it is used to prevent illness. Unfortunately, many people only try acupuncture after everything else has failed. Although acupuncture can help in those instances, it can have a powerful effect on keeping you healthy!
  8. Cancer Care: Acupuncture can be beneficial to people living with cancer in many ways. It reduces nausea related to chemotherapy, aids in post-surgical pain and speeds up the healing process. It jump-starts the immune system, which is much needed after chemotherapy. It has been helpful in neuropathy, which can occur after chemotherapy. It is wonderful to aid to increase energy levels as well as sleep and digestion.

I hope this blog gives you an understanding of just some of the ways acupuncture can benefit you or those you love to improve your health and how you feel.

You can learn more about acupuncture, including what to expect at an appointment, how it feels, and more.

Vicki Black

Vicki Black

Massage Therapist, Bryan LifePointe Spa & MedSpa

Vicki has been in the people professions since her early 20s. After obtaining a BA in psychology and working in the mental health/social services field, Vicki changed paths and began studying complementary medicine. She obtained her massage therapy license at the Minnesota Center for Shiatsu and Massage in Minneapolis in 1997, and her master’s degree in Oriental Medicine at Southwest Acupuncture College in Boulder, Colorado in 2003. Vicki specializes in combining massage and acupuncture for powerful, result-oriented treatments. She provides thorough, individualized treatments for a variety of health issues and preventative care.

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How to Break a Sugar Habit

How to Break a Sugar Habit

Have you ever wondered why once you eat something sweet, you keep craving more sugar? It’s not a coincidence; sugar addiction is real! If sweets are getting in your way of achieving your health goals, you CAN break the habit!

In today’s society, we eat ‘dessert’ several times a day and don’t even bat an eye. What’s now considered normal, shouldn’t be. Think about it – sugary cereal for breakfast, donuts at the office, chocolate from the candy dish and ice cream after dinner. Has your day ever looked like that?

Treats can have their place in a healthy diet; that’s called balance. But treats need to be truly considered treats, meaning you only have them on rare occasions. It’s no secret that sugar is detrimental to our health in many ways, but it’s hard to say no!

Why is it so Hard to Avoid Sugar?

Humans are hardwired to enjoy sugar. It tastes good, sometimes makes us feel good, and it’s addictive. When we eat sugar, the pleasure centers in our brains release feel-good chemicals. This is the same effect that drugs, like cocaine, have on our brains. The brain likes that feeling, and wants more – which is why we crave more sugar.

How Can You Stop that Vicious Cycle?

  • Try totally eliminating all forms of sugar for two weeks. It will be difficult for the first few days, but once you’ve broken the cycle, the cravings should decrease.
  • Change your environment. If you’re constantly surrounded by sugary treats, how long can you really avoid them? If they’re not easily accessible, you’re less likely to eat them. That may mean throwing away the leftover Halloween candy. But honestly, do you really need it?
  • Limit the artificial sweeteners. Even though a sugar-free cookie might be a lighter alternative, it’s still a treat. Artificial sweeteners, such as Splenda, are many times sweeter than sugar; so sometimes they only perpetuate the craving for sweets.
  • Find other ways to cope with stress. Many times on a stressful day, nothing sounds better than getting lost in a pint of ice cream. Finding other ways to manage stress will serve your emotional health and your waistline. Jot down some ideas of activities you could do instead such as going for a walk, playing with your pet, calling a friend or listening to music.

You CAN do it, and You’ll Feel Better

I encourage you to look for ways to reduce the amount of sugar you eat to improve your health and how you feel. As someone who loves sweets, I know it can seem daunting. If this is the case, have a friend or family member join you for support and encouragement.

Kinzy Krafka

Kinzy Krafka

Bryan Registered Dietitian

Bryan Registered Dietitian

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What Can I Do to Improve My Sleep?

What Can I Do to Improve My Sleep?

Do any of these scenarios sound familiar?

  • It’s Sunday afternoon and while sitting in my recliner watching television, I end up taking a nap over two hours. Why am I not able to fall asleep at my normal bedtime hour?
  • I had to work late and ended up eating later than normal, then watched TV and browsed on my iPhone. Why am I not able to fall asleep?
  • I had a cup of coffee or a caffeinated product during an evening meeting. Why am I not able to sleep?

It can be very frustrating when you can’t get sleep. And often, the more you worry about not being able to get to sleep the worse it is! Most people don’t realize that simple changes in your daily habits can have a big impact on your sleep.

3 Ways to Improve Your Sleep

Sleep is a vital human function just as important as the oxygen we breathe, the water we drink, and the food we eat. Here are some helpful hints on how to improve your sleep:

Keep a Consistent Sleep Schedule and Make Sleep a Priority

    • Find the amount of sleep you need to help you feel refreshed and energized during the day. Sleep needs vary for each person; there is no magic number.
    • Get up at the same time each day.
    • Avoid naps if possible. If you need a nap, limit the nap to less than an hour and no napping after 3 p.m. A nap longer than an hour or after 3 p.m. will alter your sleep-wake schedule and make it more difficult to fall asleep at night.

Develop Healthy Habits

    • Exercising regularly will help you sleep more soundly.
    • Eat regular meals and do not go to bed hungry. If you are hungry before you go to bed, eat something that is easily digestible, such as a piece of toast (carbohydrate).
    • Avoid excessive liquids before bedtime. This will reduce the number of times you wake up to go the bathroom at night.
    • Decrease caffeine products. Caffeinated beverages and foods (such as coffee, tea, cola, and chocolate) can make it difficult to fall asleep. Caffeine will affect your sleep for up to eight hours after consumption.
    • Avoid alcohol, especially before bedtime. Alcohol may help you fall asleep more easily but will wear off, causing you to wake up more.
    • Smoking may disturb sleep. Nicotine is a stimulant that could interfere with falling asleep.

Create the Right Sleep Environment

    • Make your bedroom comfortable and free from light and noise. Room-darkening shades, earplugs, and/or white noise may help.
    • Have a comfortable mattress and pillow.
    • Find a bedroom temperature that works for you. Cooler rooms often promote better sleep.
    • Stop using your electronic devices 30-60 minutes before your bedtime. The screens on the devices emit a blue light that suppresses the production of melatonin. Melatonin is a natural hormone produced to regulate our 24-hour sleep-wake cycle. Think of it this way: lights off=melatonin on, lights on=melatonin off
    • Do not take your problems to bed. Plan time earlier in the day to work on problems or plan your next day activities.

Take Steps for a Good Night’s Sleep – ZZZs, please!

When you get a good night’s sleep, it’s amazing how much better you feel the next day. It also improves your overall health.

In some cases, there are health conditions that can prevent you from getting the sleep you need, even when you adjust your daily habits to improve your sleep. If this is the case for you, it’s important to talk to your doctor to determine what might be impacting your sleep.

Cindy Dahl

Cindy Dahl

Registered Sleep Technologist

Registered Sleep Technologist, Bryan Center for Sleep Medicine

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When Should You Start Screening for Colon Cancer? 50? 45? Never?!

When Should You Start Screening for Colon Cancer? 50? 45? Never?!

When Should You Start Screening for Colon Cancer? 50? 45? Never?!

If you answered 45 – good for you! Most people don’t realize that the recommended age by the American Cancer Society (ACS) to begin these screenings has been lowered from 50 to 45—and sooner if you have an increased risk or family history.

Here are some other questions you may have:

  • Why was the age to start screening changed from 50 to 45? Studies show colorectal cancer among people younger than 50 is on the rise. The ACS determined that screening starting at age 45 could help save more lives.
  • Why is screening important? The earlier cancer is found, the more treatable it is. A significant number of people with colon cancer, especially early in their disease, don’t have symptoms. One screening method, a colonoscopy, not only detects cancer, but can prevent it by removing precancerous growths before they become cancer.
  • How could this benefit me? If found early, colon cancer can be easier to treat. But colon cancer can also be prevented through screening. That means you don’t have to undergo treatment to beat it; you can prevent it from happening and go on living your life.

If you answered never – you’re probably in good company because many people don’t want to think about this or take the time to do it. But I refer you to the above facts and hope you’ll reconsider your answer.

As an oncology (cancer) nurse navigator and mother of two, I understand that life gets busy and our own wellness is easy to put off for a later time—especially during a pandemic! With our lives being different this past year whether it be working from home, children remotely learning at home, dealing with the stress of not seeing family and friends, and of course, our ongoing daily to-do lists, we have all experienced many changes.

The one thing that remains the same is the need to keep ourselves and our families healthy and safe. This can start with regular checkups with our doctors, which should include screening for colorectal cancer if you are 45 or older, and sooner if you have a family history of colon cancer.

Answers to Common Colon Cancer/Colonoscopy Questions & Misperceptions

The following information is provided by David Newton, MD, a gastroenterologist with Gastroenterology Specialties, through a recent podcast. We encourage you to listen to the entire 10-minute podcast to get more detailed information.

How can you screen for colon cancer?
There are two ways to do this:

  • A sensitive test that looks for signs of cancer in a person’s stool (a stool-based test)
  • An exam that looks at the colon and rectum (a visual exam)

What is the benefit of a colonoscopy (a type of visual exam)?
A colonoscopy is the single most important tool we have for the detection of polyps or tumors. During a colonoscopy, a gastroenterologist screens your colon looking for any growths or polyps. If a polyp is found early, it can be removed before it has a chance to become cancerous.

What about the home-based stool kits; how do they work and are they effective at detecting cancer?
These tests can detect if cancer is present. FIT DNA testing is widely available now, and studies show they will catch 93% of cancers, which is a good number. But when looking at it closer, the test missed one in 13 colon cancers, and about 60% of larger precancerous polyps in the right colon, which we know through studies contributes to 20-30% of overall cancers diagnosed in the U.S.

One of the big differences between these tests and a colonoscopy is that with a colonoscopy, you can not only detect cancer but prevent it by removing precancerous growths.

Many people consider a home test (FIT or FIT DNA test) to avoid a colonoscopy. However, if the home test is positive, the next step is a colonoscopy.

Does insurance cover colon cancer screening?
Colon cancer screening is covered at 100% in Affordable Care Act compliant health plans.

  • If you choose a colonoscopy for screening, it is covered at 100%.
  • If you first choose a FIT or FIT DNA test, that test is covered under your screening benefit. But, if the home test is positive, you will then need a colonoscopy and that colonoscopy would be considered diagnostic and would not be covered 100% by the insurance carrier. This would be subject to both co-pay and deductibles toward the maximum out-of-pocket amount.

Note: At this time insurers are not required to (and some might not) cover the cost of colorectal cancer screening before age 50.

What about the ‘prep’ you have to do for a colonoscopy?
Times have changed! You no longer have to drink a gallon of salty water. There are many small volume prep products on the market. The one we use is only about 25 ounces of a solution that you mix with the clear liquid of your choice. In fact, many of our patients are amazed at how easy it is. So, don’t let misconceptions about what the prep was like in the past affect your future. The preps now are much easier and shouldn’t discourage you from getting a colonoscopy.

You Have the Power to Prevent Colon Cancer

Screening is a way to help find colorectal cancer early or help prevent it altogether. Being an oncology nurse navigator, I have walked alongside many patients during their journeys with colorectal cancer and feel passionate about this topic.

I hope you will go home, talk with your family and add regular screenings to your calendar—so we can stay strong and healthy for ourselves and families.

To learn more, visit the American Cancer Society.

Breanna Nedved, RN

Breanna Nedved, RN

Breanna Nedved, RN, is an oncology nurse navigator at Bryan Medical Center. This is a specially trained nurse who helps patients and their families through each step of cancer treatment.

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Should I Take Aspirin to Prevent a Heart Attack?

Should I Take Aspirin to Prevent a Heart Attack?

There’s been a hot and cold romance with the daily use of aspirin to prevent heart attacks and other conditions for years. On one hand, it’s been shown to reduce the risk of a stroke or heart attack. On the other hand, it’s been shown to increase the risk of bleeding, especially in the brain and gastrointestinal tract. And, of course, all of this leads to confusion. How do you know what’s best for you?

Follow the Research

The answer is, there is no one right answer for everyone. Many factors can play into what’s best for you – your age, current health condition, past health history and more.

Your Age

New research found that the risks of daily aspirin begin to outweigh the benefits starting at age 60. This research released in October 2021 by the United States Preventative Task Force showed the risk of aspirin causing potentially life-threatening bleeding in the brain or gastrointestinal tract increases with age. So this is definitely something for you and your doctor to consider, especially if you have a history of bleeding.

Your Health History

What if you’ve had a heart attack or stroke in the past, or you have heart disease? Does this change what you should do? Yes. If you’ve had a heart attack or stroke, taking low-dose aspirin has been found to be beneficial.

In medicine, randomized controlled trials provide the best information in terms of providing scientific data to guide decision making. Multiple trials have shown two things:

  • Aspirin is not beneficial for primary prevention. Primary prevention means preventing a first-time stroke, heart attack or other cardiovascular condition. If you don’t have a heart condition, most people would not benefit from taking aspirin daily.
  • On the other hand, if you’ve had a heart attack, stroke or heart disease, aspirin is used for secondary prevention. This means to prevent a second heart attack, stroke or other condition. Why? Because once you have these conditions, you are at a higher risk for them to occur again.

To Use or Not Use Aspirin

This can be a complex decision. The best way to decide this is to talk to your doctor to assess your risk level. Each person is slightly different. Some people have higher risks of stroke and heart attacks, while others have higher risks of bleeding.

Your doctor can provide information on the risks and benefits for your specific situation to determine if taking aspirin is right for you.

Dr. Zach Singsank

Dr. Zach Singsank

Interventional Cardiologist

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Women Don’t Talk About it but They Should Know About it: Gynecological Cancer

Women Don’t Talk About it but They Should Know About it: Gynecological Cancer

Compared to other cancers gynecologic cancer is relatively rare, but it is still important for women to know about it and take action for prevention and treatment. Some forms of it can be prevented by taking simple steps. Others have no preventative measures and require awareness of symptoms to seek treatment.

As a gynecologic oncology surgeon, I want women to know the facts, be aware of the role they can play, and be able to have access to the best treatment when needed.

Gynecologic Cancers in Nebraska

  1. Endometrial cancer – This is a type of uterine cancer and is cancer of the lining of the uterus. This is the most common gynecological cancer treated in Nebraska.
  2. Ovarian and fallopian tube cancers – These are the most lethal gynecological cancers we treat.
  3. Cervical cancer – This is actually the most common gynecological cancer worldwide, but it’s the third most treated in Nebraska.
  4. Vulvar cancer – This is a rare skin cancer.
  5. Vaginal cancer – This cancer is also rare.

What You Should Know about these Gynecologic Cancers

Endometrial (Uterine) Cancer

Prevention: There is no specific prevention for this type of cancer. However, it is seen more frequently in women who are obese and have diabetes or other medical conditions that go along with obesity. This is likely due to prolonged estrogen stimulation from fatty tissue.

Warning signs: Post-menopausal bleeding is the most common warning sign. If you experience any bleeding, even minor spotting or a discharge after menopause, this needs to be evaluated to rule out uterine cancer. When following up on this symptom, about 75% of the time uterine cancer can be diagnosed at an early stage.

Ovarian Cancer

Prevention: If you carry the BRCA (BReast CAncer gene) one and two or BRCA genes, you should talk to your doctor about risk-reducing surgery because for certain groups of patients this may be something to seriously consider. It is clear that removing the ovaries and fallopian tubes reduces the risk of ovarian cancer significantly.

Warning signs: Unfortunately, there are no early warning signs. Ovarian cancer grows silently and spreads extensively before it causes much in the way of symptoms. And when symptoms occur, they are very common such as constipation, bloating and pelvic pressure. It’s normal for these symptoms on their own to come and go. But if you experience these symptoms and they persist, and continue to progress – for example, first you have constipation, and then you also have bloating and then you have nausea or vomiting, that is a reason to see your doctor.

Cervical Cancer

Prevention: There is actually a vaccine that is very effective against the human papillomavirus (HPV), which causes cervical cancer. This is an amazing step forward. A recent report shows cervical cancer is declining and this is likely due to the vaccination.

Screenings/Early Detection: A Pap smear or test is a very effective screening test for cervical cancer. While this test doesn’t diagnose cancer, it alerts your doctor to take a closer look. It’s also important to know that the vast majority of women who have an abnormal Pap smear do not have nor do they ever get cervical cancer. Even after the age where Pap smears are recommended, women should continue to have yearly exams with their doctor so that symptoms they may or may not be aware of can be evaluated.

Warning signs: Abnormal bleeding at any time (before or after menopause).

What Can You Do

The 3 most important things women can do are:

  • Get your regular Pap screenings for cervical cancer; continue yearly exams after Pap tests are no longer recommended.
  • Be aware of warning signs and if you experience them, talk to your doctor – don’t put it off.
  • Know your family history.

You know your body and are the best one to be aware, take steps where you can and seek medical advice for early detection.

Dr. Peter Morris

Dr. Peter Morris

Gynecologic Oncology Surgeon

Dr. Peter Morris is a gynecologic oncology surgeon with Cancer Partners of Nebraska. He is specifically trained in the surgical and medical treatment of gynecologic cancers, which include the uterus, cervix, fallopian tubes, ovary, vagina and vulvar area.

This is a very narrow field of specialty with extensive training. After medical school, there is a four-year residency in general obstetrics and gynecology followed by a three-year fellowship in gynecologic oncology.

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Is It Heartburn or Am I Having a Heart Attack?

Is It Heartburn or Am I Having a Heart Attack?

It’s 9 p.m. on a Thursday night and my phone rings. I am on call for the hospital, but this time, the caller is actually a family friend. She says, “I keep having issues with indigestion and what feels like really bad heartburn. I’ve tried taking TUMS but it doesn’t seem to help. Do you think that I should get this checked out?”

As we talked more, we determined it would be best for her to seek medical attention. Thankfully she did, as she was found to have coronary artery disease. This is a condition that develops when the major blood vessels that supply blood to your heart become hardened or narrowed. In this case, my family friend needed a stent to help open the narrowed artery and regain blood flow in that area of her heart. After receiving the stent, her symptoms were resolved.

Heartburn vs. Heart Attack – How do I know what it is?

It can be hard to tell the difference between heartburn and a heart attack because the symptoms can overlap. Heartburn is discomfort from stomach acid backing up into the esophagus (the tube that carries food from your mouth to your stomach). A heart attack is when the flow of blood to the heart is blocked.

Here are some symptoms that can help you determine the difference between heartburn and a heart attack.

Symptoms of Heartburn:

  • Upper abdominal burning sensation that you also feel in your chest
  • Happens after eating or when you lay down or bend over
  • Can awaken you from sleep, especially if you ate within two hours before going to bed
  • Antacids usually provide relief
  • You may notice a sour taste in your mouth
  • May have a small amount of stomach contents rise up into the back of your throat

Symptoms of a Heart Attack:

  • Pain, pressure or tightness in the middle of your chest that you may also feel in your neck, jaw, shoulder, arms or back
  • Shortness of breath, especially with exertion
  • Cold sweat
  • Fatigue
  • Lightheadedness
  • Nausea, indigestion, heartburn or abdominal pain

Warning signs of a heart attack can vary from person to person. The most common symptom of a heart attack for both men and women is chest pain or pressure. Women are more likely to experience more “non-traditional” symptoms such as shortness of breath, nausea or jaw pain. Heart problems are more common as we get older and in people who have high blood pressure, diabetes, high cholesterol, tobacco use or a strong family history of coronary artery disease.

Don’t Ignore What You Think is “Just” Indigestion

It may be indigestion, but it may be something more serious. This is especially true if you have what you think is heartburn frequently and antacids don’t help.

Other conditions, such as esophageal spasms and gallstones, can mimic signs of a heart attack.

The best rule of thumb is, “if in doubt, check it out.”

One final note: If you are experiencing unexplained chest pain, call 9-1-1 or have someone drive you to the nearest ER.

Chris Balwanz, MD, is a cardiologist with Bryan Heart.

Chris Balwanz, MD

Chris Balwanz, MD

I am from Omaha, Neb., and specialize in cardiac imaging. I believe that a team approach in which the patient is comfortable and confident in their care leads to the best outcomes. This involves high-tech procedures and imaging as well as listening to the patient’s concerns and giving them all our attention to provide them the best quality care possible.

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How to Survive the Holidays with Diabetes

How to Survive the Holidays with Diabetes

It’s that time of year when the leaves are falling, days are getting shorter and finally it’s jacket weather. For those living with diabetes this can be a tough stretch ahead…the dreaded Holidays.

Does this sound familiar? It’s much tougher to get that evening walk in after work when it is dark by 6 p.m. School and family activities are in full swing and there’s not a minute to spare for stress relief, let alone meal planning. Your workplace office starts piling up with not so healthy snacks. You get a call from the in-laws telling you they are going to park their RV in front of your house for the month of December. Wait…wasn’t that a movie from the 90s?

What You Already Know

You probably expect this article to focus on food and exercise. You are right, as both are necessary to control blood sugars, but just for a moment. Food choices are extremely important. I rely on our diabetes educators to teach patients the finer points of diet and carbohydrate counting, whereas I like to keep things as simple as possible.

Advice I Often Give to Patients Includes:

  • “Try to avoid the unhealthy carbs.”
  • “Drink more water.”
  • “Try eating your veggies and protein on your plate before you eat your mashed potatoes.”
  • “Move more.”
  • “Be less efficient.” As in park farther from the entrance, take the stairs instead of the elevator.
  • “Try walking for 5-10 minutes after each major meal to lower your post meal blood sugars.”

These can all be helpful, but frustratingly managing your blood sugars is more complex than this.

What May Surprise You

When I sit and talk with patients our conversations often drift towards personal stressors and how these affect blood sugars. The holidays can be overwhelming for everyone. For those living with diabetes, it’s extra challenging. Checking blood sugars and taking medications on time is often easier said than done. I’ve heard many patients describe having diabetes as another full-time job they don’t get paid for.

So How Does “Stress” Raise Blood Sugars?

What exactly does that mean? I often use a grizzly bear analogy, however, you can fill in the blank with your dreaded reptile/insect/animal. A person encounters a bear in the woods and a “fight or flight” mechanism is triggered. A series of neurological and chemical changes occur in our bodies. Our body wants to make sure that our muscles, brain, and heart all have the fuel (glucose) they need to run away.

  • Cortisol and adrenaline are released from adrenal glands into the bloodstream – raising blood sugars
  • Glucagon is released from the pancreas, freeing stored glucose from the liver – also raising blood sugars

Fortunately, most of us won’t run into bears this holiday season, but on a smaller scale, daily stressors (whether emotional or physical) can cause dramatic swings in blood sugar for those living with diabetes. This is very apparent to those who use continuous glucose monitors (CGM). One can often find dramatic differences in glucose readings on workdays versus non-workdays and days with family conflict versus those without. It’s very eye-opening.

Tips to Get Through this Stressful Time of Year

So what are a few tips to get through this stressful time of year?

  • Have a game plan – anticipate stressors, and pick your battles
  • Be prepared – don’t leave home without medications, spare testing supplies, etc.
  • Don’t beat yourself up – if you have some bad numbers it’s not a math test result, just a number. Keep testing!
  • You are not alone – you shouldn’t feel like you are on an island. Diabetes affects the whole family. Enlist their help in your preparation. Educate family members on your signs and symptoms of both low and high blood sugars
  • Go easy on the alcohol – it can mask symptoms of lows and highs, not to mention leading to poor food choices. Alcohol is known to worsen other health conditions common to diabetes such as high blood pressure, high triglycerides, depression, anxiety, and poor sleep quality.

Take It One Day at a Time

Knowing what can affect your blood sugar levels and focusing on this – even with little steps and small changes – can make a big difference in how you feel. Try to work in ways to get exercise, make good food choices and keep your stress at bay. Serenity now! Wait, wasn’t that another 90s show.

Happy Holidays!

Aaron Ward, MD, Internal Medicine

Aaron Ward, MD, Internal Medicine

Dr. Aaron Ward is an internal medicine doctor. He has a special interest in diabetes prevention and management. For those living with diabetes, he is dedicated to working with patients and using emerging diabetes technologies to improve health.

“I get so excited when my patients have breakthroughs with new technologies, or are able to prevent or cut back on medication use through lifestyle changes or new therapies.”

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