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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Breast Cancer Awareness and Prevention: Be Your Best Advocate

Breast Cancer Awareness and Prevention: Be Your Best Advocate

As a doctor, my training and focus is entirely on breast health. I love my patients and love what I do. One thing that is extremely important to me is empowering women to take control of their health – especially their breast health.

Did you know breast cancer affects 1 in 8 women? This means that the average woman has a 12% risk of developing breast cancer in her lifetime. But, the risk can increase with certain factors such as a family history of breast cancer or lifestyle habits.

While there are some things you can’t change, there are many you can. Being informed and actively engaged is the best way to take care of yourself. You have to know your history and your body. No one will take care of you like you will. Be your best advocate!

Here are a few breast cancer facts to help you.

9 Factors that Increase Your Risk for Developing Breast Cancer

  • Family history of breast cancer
  • Alcohol intake
  • Smoking tobacco
  • Not having children
  • Starting your menstrual cycle before age 12
  • Starting menopause after age 55 (longer exposure to estrogen in your life)
  • Taking hormone replacement therapy
  • An inactive lifestyle
  • Having a breast cancer gene mutation such as BRCA – this is determined through genetic testing

6 Factors that Decrease Your Risk for Developing Breast Cancer

  • No tobacco
  • Minimal alcohol intake
  • Routine exercise
  • Not taking hormone replacement
  • Being at your ideal body weight
  • Breastfeeding

What Does the Research Show, and What Do I Need to Know

Alcohol Consumption: Compared to women who don’t drink at all, women who have 3 alcoholic drinks per week have a 15% higher risk of breast cancer. Experts estimate that the risk of breast cancer goes up another 10% for each additional drink women regularly have each day.

Exercise: Research shows a link between exercising regularly at a moderate or intense level for 4 to 7 hours per week and a lower risk of breast cancer. Exercise consumes and controls blood sugar. It also limits blood levels of insulin growth factor, a hormone that can affect how breast cells grow and behave. People who exercise regularly tend to be healthier. They are more likely to maintain a healthy weight and have little or no excess fat compared to people who don’t exercise.

Fat cells make estrogen and extra fat cells make extra estrogen. When breast cells are exposed to extra estrogen over time, the risk of developing breast cancer is higher.

Ideal Body Weight: Overweight and obese women — defined as having a BMI (body mass index) over 25 — have a higher risk of being diagnosed with breast cancer compared to women who maintain a healthy weight, especially after menopause. Being overweight also can increase the risk of the breast cancer coming back (recurrence) in women who have had the disease. This higher risk is because fat cells make estrogen; extra fat cells mean more estrogen in the body, and estrogen can make hormone-receptor-positive breast cancers develop and grow.

Breastfeeding: Breastfeeding can lower your breast cancer risk, especially if you breastfeed for longer than one year. There is less benefit for women who breastfeed for less than a year, which is more typical for women living in countries such as the United States.

Signs and Symptoms of Breast Cancer

  • Breast mass (or a lump in your breast)
  • Breast redness
  • Breast skin dimpling
  • Nipple inversion
  • Nipple discharge
  • Nipple and areolar scaling, thickening or redness
  • A mass (lump) in the underarm area

Breast Cancer Screening

Early detection is your best defense. Take these steps for peace of mind.

  • Start your self breast exams in your 20s
  • Start your mammograms at age 40
  • Start your mammograms earlier if a family member had breast cancer at a young age
  • Always get a 3D mammogram
  • If you have dense breast tissue:
    • Get an MRI six months after your mammogram
    • Whole breast ultrasound can be used in addition to a mammogram

Follow up for the Care You Need

If you notice a concerning change in your breasts, schedule an appointment with your doctor. Make sure you share your concerns and the issue is investigated. Any change in your breasts should prompt an exam and diagnostic imaging.

Take care of yourself and be your best advocate!

Get More Information & Tips with our Podcast: 3 Ways to Beat Breast Cancer

Dr. Jendro shares ways to prevent breast cancer, detect it and treat it with personalized care.

Rachel N. Jendro, DO, FACOS, fellowship trained breast surgical oncologist

Rachel N. Jendro, DO, FACOS, fellowship trained breast surgical oncologist

Dr. Rachel Jendro completed medical school in Kentucky, followed by a five-year general surgery residency in Ohio. She continued her training at Moffitt Cancer Center in Florida, completing a breast surgical oncology fellowship. Her focus is exclusively on breast care, treatment and surgery.

Learn more about Dr. Jendro!

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The Truth About Knee Pain

The Truth About Knee Pain

If you’re experiencing knee pain, you’re not alone. Knee pain is quite common and the reasons behind why we experience it can vary. Here’s what you need to know about knee pain and some ways to treat it.

What Are the Causes of Knee Pain?

As an orthopedic surgeon, I see many people with knee pain. This pain can be caused by many things: age, sports injury, or overuse—even genetics. Most commonly, we see knee osteoarthritis, which is essentially the breaking down, wear and tear, of your knee joint. Our knees are covered in cartilage, which allows them to move and glide smoothly. When that cartilage surface starts to wear and break down (as most things do over time), the knee starts to hurt. We call that break down of the cartilage osteoarthritis. It’s a basic part of aging, and almost no one can escape it!

Why is Osteoarthritis So Painful?

It’s painful for many reasons. As already noted, osteoarthritis is the wear and tear of your joints. This causes inflammation, and in turn, inflammation causes pain. The pain also comes from losing the cushioning in our knees; we start to see more “bone on bone” wear. This simply means that the bones rub against one another because that natural cushioning cartilage is worn away. This creates friction and more swelling, and it leads to more pain.

What are the Signs and Symptoms of Knee Arthritis?

Symptoms vary from person to person, but the most telling sign is pain – especially with activity such as bending or flexing your knee. Consider these symptoms that you may experience with knee arthritis:

  • Is it hard to get from a sitting to a standing position?
  • Do you have trouble kneeling down, does your knee become more painful, or is it downright difficult to get off the ground once you’re kneeling?
  • Is your knee swollen – even if you didn’t have any injuries or falls?
  • Do you have pain at night? Do you have trouble falling asleep due to knee pain?

Who Is Most Likely to Get Knee Arthritis?

Knee pain and arthritis are rather universal, especially as we get older. Our knees do a lot of the heavy lifting in life. Those with knee pain might have very physical jobs, or could be athletes or just very active. They may be seeing pain from a previous injury when they were younger. Traumatic injuries are another cause of ongoing knee pain. Really, everyone is at risk of developing osteoarthritis of the knee at some point in their lives.

Is My Knee Pain Due to Arthritis, and What Can I Do About It?

How we treat knee pain and arthritis depends largely on the extent of the damage to your knee and how the pain is affecting your overall quality of life. Of course, we try to take care of it through less aggressive, non-surgical approaches. There are various treatment options to consider before moving to something like joint replacement.

Treatment options include:

  • Non-steroidal anti-inflammatory drugs – These include aspirin, Ibuprofen, Aleve, or prescription anti-inflammatories.
  • Activity modification – Your doctor and/or physical therapist can work with you to ensure you aren’t doing things to aggravate the pain and inflammation.
  • Weight loss – Carrying extra weight is bad for your knees, so there will be some people for whom weight loss can be very effective in easing pain.
  • Steroid injections in the knee – These also help with inflammation and pain.
  • Viscosupplementation (or hyaluronate acid injection) – Another type of injection that eases inflammation by adding a sort of “fluid film” and padding into the joint, decreasing friction between the bones.

Next steps: What Can I Do About My Knee Pain?

If you’re experiencing knee pain, there are steps you can take to relieve your pain. The first step would be to talk to your health care provider and get an evaluation of your knee to determine the cause of the pain and possible treatment options.

The bottom line is you don’t have to live with knee pain. I encourage you to get an evaluation, find out your treatment options, and get back to enjoying life!

Brad Webb, DO

Brad Webb, DO

Brad Webb, DO, is a board-certified orthopedic surgeon, fellowship-trained in adult reconstruction and total joints.

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Setting Expectations for Your Children

Setting Expectations for Your Children

It’s important to have clear expectations for your children starting at a young age. Having specific rules about chores, curfew and other expectations can make life easier for you and your child. It can also help your child gain confidence, grow and learn to be responsible. As your child gets older and learns to uphold expectations, some of these expectations may decrease—and others may be added.

It’s also crucial to have set rewards and consequences when expectations are met or not met. The best way to do this is to sit down with your child and come up with reasonable expectations, as well as reasonable rewards and consequences.

What does a Plan for Expectations, Rewards and Consequences Look Like?

Here are a couple examples of how this might look for you and your child, how to put the plan in place, and how having a plan in advance can help both you and your child.

Example A – Consequences

You and your child create a plan related to curfew. You both agree:

· Curfew is 10 p.m. on weeknights

· If they are late getting home, they will lose their phone for three days

A few weeks after establishing these rules and expectations, your child doesn’t get home until after 11 p.m. In the moment, it can be easy to become upset, but having a set plan beforehand helps immensely.

Instead of saying “you’re grounded, give me your phone,” you will be able to say “because you didn’t get home by curfew, you will lose your phone for three days.” Since this was agreed to in advance, you and your child will already be aware of the consequence of staying out later. This way you’re not put on the spot trying to determine a consequence in the heat of the moment, and your child is not caught off guard by the consequence since they participated in creating it.

Example B – Rewards

Setting expectations can also work to reward your child. If you have younger kids, you could have a list of chores and expectations that they can do to gain rewards. When they meet a certain number of chores/expectations a day, they might be able to earn one hour of screen time. Another option might be that they aren’t allowed to have screen time until they complete a certain number of tasks.

Tips for Setting Expectations & Consequences/Rewards

Here’s a list of tips to follow when setting expectations and consequences/rewards.

  • Be clear and concise
  • Be reasonable
  • Don’t take away things for an undetermined amount of time
  • Don’t say “you won’t get your phone back until you learn to respect me” as that is a very subjective measure and difficult to quantify for both you and your child
  • Having a set amount of days is the easiest way to have a consistent and clear expectation
  • What works for one child may not work for another; plans should be individualized for each child
  • Write down or print the list of expectations and consequences/rewards, and keep them somewhere visible for the family
    • This will help your child remember what is expected, as well as know what will happen if they decide to stay out later than curfew or fail to do chores
  • Make sure the list is manageable for you and your child; having too many expectations will be overwhelming
  • Be consistent – if you sometimes give the reward or consequence and sometimes don’t, this will create confusion for your child

Want Ideas for Reasonable Expectations?

There are several online resources available to help! You can search reasonable expectations by age and developmental level, as well as advice from other parents. Just remember each child is unique, and what works for others may not work for your child.

Here’s one resource you may want to check out: The Ultimate List of Age-Appropriate Chores.

If your child sees a therapist, they will also be able to help you and your child come up with a plan.

Set Expectations & Help Your Child Grow

It’s never too soon or too late to set expectations to help your child grow and become responsible, and to celebrate your child’s achievements as they take on responsibilities. The key is to work together, set reasonable expectations and consistently follow through.

Also, remember life’s a work in progress! There may be times when you need to adjust expectations or set new expectations, and this is perfectly fine.

Arianna Shay, PA-C

Arianna Shay, PA-C

Arianna Shay, PA-C is a physician assistant with Bryan Heartland Psychiatry. She graduated from Union College with a masters degree of physician assistant studies in 2019. She has worked in child and adolescent psychiatry for over two years, and is part of a wonderful inpatient team of providers, therapists, social workers, nurses and mental health technicians. Arianna works with children, teens, parents and families.

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