5 Ways to Keep Cool & Safe When Exercising Outside

5 Ways to Keep Cool & Safe When Exercising Outside

It’s hot out there, but summer weather shouldn’t stop you from exercising, gardening or enjoying other activities outside – in fact, getting out in nature helps with stress levels! But it’s important to be prepared and proactive to avoid heat-related problems.

The more physically fit you are, the better you’ll be able to adapt. If you have medical conditions, please check with your health care provider before you begin exercising in the heat. Then, use these guidelines to help ensure that when you do go out, you’re being smart and safe.

Hot Weather Guidelines

Take It Easy at First

If you’re used to working out at the gym or are not used to hot temps, decrease your usual intensity, frequency and/or duration to allow yourself to acclimate. Monitor your heart rate and your feeling of exertion. For example, if you normally walk for 60 minutes, start with 30 minutes, at a slower pace than you’re used to. It can take up to two weeks of repeated activity in the heat to acclimate.

I know, it’s hard! I have known many athletes over the years and even those who are quite fit are surprised at what heat will do to a workout! Be aware of the “feels like” temperature as opposed to the actual temperature; humidity levels also make a difference.

Drink Plenty of Fluids, Preferably Water

At a minimum, drink 12 ounces before exercise, 12 ounces every 30 minutes during exercise, and 12-16 ounces after exercise. Drink more if you feel that you have lost a lot of fluid due to sweating during your exercise. It’s also helpful to monitor your urine output. If it’s dark yellow and/or low in volume you need to rehydrate.

But Don’t Drink Too Much!

Drinking too much water, called over-hydration, can lead to low blood sodium. To stay hydrated but not overly so, here is a general rule: Drink before, during and after exercise and other physical activities. At other times of the day, drink when thirsty.

Wear Loose, Light Clothing in Fabrics That Evaporate and Wick Sweat Away

Try clothes such as DryMax, CoolMax and others. Avoid dark colors, because they absorb heat (darker colors also attract mosquitoes). Wear a light-colored hat to help limit direct sun exposure.

Use Sunscreen, and Try To Reapply at Two-Hour Intervals Even if the Labels Have Sweatproof and Waterproof Claims

Sunburn increases the risk of premature skin aging and skin cancer. Another good way to decrease sun exposure is to a wear wide-brimmed hat, avoid the midday sun and heat (10 a.m.-2 p.m.), rise early, or make sure your route/trail for exercise is shaded. Or, consider a swim!

What If You Start to Feel Sick?

Pay attention to the heat. Listen to your body. If you start to feel faint and/or sick, stop immediately. Sit down in the shade and drink water. If possible, it’s also a good idea to have a healthy, hydrating snack, such as fruit. Energy bars or crackers are not ideal as they slow hydration.

Here are some of the most common heat-related illnesses and how to handle them:

Cramps

If you get heat cramps, usually occurring in your legs, stop the activity, move to a cool spot, place a chilled cloth around your neck, and sip water or a sports drink – water is usually better. Since sweat helps your body cool itself, if possible sit in a breeze or in front of a fan.

Heat Exhaustion

Signs include heavy sweating, weakness, dizziness, nausea, a fast and weak pulse and possibly fainting. Seek medical help if symptoms are extreme or if they last longer than an hour.

Heat Stroke

This is the most serious, potentially fatal, heat-related condition. Symptoms include high body temperature (104 F or higher), absence of sweating with hot, flushed or red/dry skin, rapid pulse, difficulty breathing, hallucinations, confusion, agitation, seizure, coma, and if untreated, death.

Sometimes these things come on quickly with little warning. If you suspect that you or others are suffering heat stroke, call 911 immediately. If possible, move to a shady area, drink and spray cool water on the person, avoid alcohol or caffeine (in tea and soft drinks), apply ice packs under the armpits and groin, and fan until help arrives.

Any Amount of Exercise You Get Has Health Benefits

Having said all of this, always remember that even a 20-minute workout has positive health benefits! Don’t sweat it (no pun intended!) when the weather is not giving you your best day out. It’s the number of days you exercise that matters most, not the length of time of any given exercise session.

Cindy Kugler, MS, Bryan LifePointe

Cindy Kugler, MS, Bryan LifePointe

Cindy is a certified exercise physiologist and certified strength and conditioning coach.

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ATVs – Before You Ride, Make Sure You Have Safety on Your Side

ATVs – Before You Ride, Make Sure You Have Safety on Your Side

Summer and the sun is finally here. Many are taking this opportunity to get outside and enjoy outdoor activities. One activity that is growing in popularity is the use of All-Terrain Vehicles (ATVs).

It has become very popular with agriculture, farming and recreational activities, and sure can be fun and enjoyable going on a relaxing ride.

However, many do not realize the dangers of this high-risk activity. In my role working to prevent injuries, I am passionate about getting the word out on how important it is take safety into account when you’re out having fun on an ATV. Last year, Bryan Trauma treated nearly 55 people who had life-threatening ATV-related injuries. And, in the first five months of 2020 we’ve already cared for 32 patients with life-threatening injuries due to ATVs.

We want you to have all the fun, and none of the injuries. Here are some tips to keep you and others safe when you’re out on an ATV.

ATV Do’s and Don’ts

Do:

  • Ride an ATV that’s right for your age – this is especially important for youth.
  • Wear a DOT-compliant helmet, goggles, long sleeves, long pants, over-the-ankle boots and gloves.
  • Ride only on designated trails and at a safe speed.
  • Scan the path ahead and identify potential hazards such as rocks, stumps, low or fallen branches, fences, guy wires, and rough or unstable path surfaces.
  • Be careful when driving with added ATV attachments. These affect the machine’s stability, braking and operation.
  • Tell someone where you are going and when you will return.

Don’t:

  • Allow children to operate ATVs without training.
  • Operate the ATV on streets, highways or paved roads, except to cross at safe, designated intersections.
  • Ride under the influence of alcohol or other drugs.
  • Carry passengers.
  • Operate an ATV at excessive speeds. Go at speeds right for the terrain, visibility conditions and your experience level.

UNL Videos to Help You Prepare

To help prepare yourself and those you care about for safe ATV outings, the UNL Nebraska Extension Office offers free educational videos developed for the Bryan Trauma Center. We encourage you to take advantage of this to learn more.

Other ATV Resources for You

Want to learn more? Check out this free ATV online safety course.

The ATV Safety Institute (ASI) offers three e-learning courses to address basic ATV safety for:

  • Adults and teens
  • Youngsters
  • Adults who will be helping youngsters on ATVs

The courses includes videos, pictures and interactive lessons to make them fun and effective learning experiences. After completing a course, you can receive a certificate of completion.

Interested in Nebraska laws for ATVs? Get that information now.

Have Fun and Be Safe!

I hope you’ll take advantage of this information to enjoy outings on ATVs. We all know how much fun this can be, and while the Bryan Trauma Center offers expert treatment, we don’t want you to be sidelined from the fun while you recover from an injury.

Joni Folkerts RN, MSN

Joni Folkerts RN, MSN

Trauma Outreach & Injury Prevention Coordinator

Joni Folkerts, RN, MSN, is the trauma outreach & injury prevention coordinator the Bryan Trauma Center.

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Your Ankle Pain: Could It Be Arthritis?

Your Ankle Pain: Could It Be Arthritis?

How many times have you stepped off the curb or out of your car the wrong way, and twisted your ankle? Probably more than you’d like to admit! Ankle injuries are pretty common. It’s easy to make a misstep and give yourself a strain or sprain. But as an ankle surgeon, many of my patients are surprised when they learn that arthritis can also be the source of their ankle pain.

So What Causes Arthritis in Our Ankles?

The most common form of ankle arthritis is actually caused by a previous trauma or injury. Perhaps you were in a car accident, or had a sports injury and had surgery for it. Then this injury, in a way “re-awakens.” This is different than when you get arthritis in your hip or knee, as these cases are usually caused by overuse or general wear and tear over time. With trauma, we can see deformities of the ankle caused by the injury.

Symptoms of Ankle Arthritis

There are several grades of arthritis, and your symptoms and treatment largely depend on these.

Grade 1

This is a very mild form of arthritis. You may only feel pain when you exercise or perform certain work duties or chores. Your pain might be in a specific area of your ankle joint. Pain will come and go; you’ll have good days and bad days.

Grade 2

This is a more moderate form where a significant portion of your cartilage may be lost. You’ll have more pain, and more limited range of motion and function. You might feel the changes in weather because your ankle might swell and be painful.

Grade 3

This is what we often consider end-stage arthritis, where we see bone-on-bone in the joint. This means the two bones now grind together because there is no cartilage to provide a nice gliding surface and lubricating joint fluid. Think of an engine trying to run without motor oil. This friction causes inflammation, and the ankle further deteriorates and starts to deform. When you reach this stage, ligaments and tendons can become compromised as your ankles are now weakened and unstable. At this stage, your pain is persistent.

Treatments for Aching Ankles

For those with milder symptoms, there are several things we recommend. Anti-inflammatory medications, using a brace or wrap, and shoe modifications such as orthotics are great first steps. As podiatrists we may recommend specific types of rocker bottom shoes or modifying certain activities. We also prescribe physical therapy to strengthen muscles around the ankle. There are also some injections that may help.

Some patients benefit from minor arthroscopic procedures that enable us to go in and clean up scar tissue or remove bone or cartilage fragments that may be the cause of pain. These are the types of treatments we consider for those with both grades 1 and 2. Again, frequency and intensity of these treatments depend on the each person’s case. If you’re at grade 3, surgery may benefit you. Two types of surgery are ankle replacement and ankle fusion.

Who Needs Surgery and What Kind of Surgery?

Ankle fusion

This is the tried and true method of treating end-stage ankle arthritis. It’s been described in the medical literature since the 1850s believe it or not! This is where arthritic bone is removed, the joints are “welded” shut, and held in place at a 90 degree angle with plates and screws. This eliminates grinding and eases inflammation and pain. It does a great job of relieving pain, but the ankle does become quite stiff. This is good for those who perform high-impact activities or whose job entails heavy labor, because it’s sturdier than ankle replacement.

Ankle replacement

With ankle replacement, we take out the arthritic joint and replace it with two metal surfaces with a plastic liner in the middle. This allows patients to have some flexibility and range of motion. The goal is to ease or eliminate pain while preserving range of motion as much as possible. You will have a more normal walk compared to joint fusion, but not as complete as before surgery. This is a great option if you prefer low-impact activities, such as walking, playing golf, swimming, etc. It’s also a very good option if you are in your 50s or older.

What to Expect After Ankle Replacement Surgery

After your ankle replacement surgery, you probably won’t do any weight bearing activities for 2-6 weeks. This timeframe really depends on your surgeon and your situation. When your surgeon thinks it’s appropriate, you’ll ease into exercises for range of motion, strength and balance. After that, you can expect several months of physical therapy. You’ll likely stay in touch with your surgeon periodically for months or even years to ensure your joint is still in its proper place and your pain is still relieved.

In the final analysis, we want to make sure that you get the right treatment for your lifestyle and life stage so that you can live as pain-free as possible.

Dr. Eric So

Dr. Eric So

DPM

Dr. Eric So, DPM, is a fellowship-trained foot and ankle surgeon with Capital Foot and Ankle, in Lincoln, Nebraska.

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COVID-19: Coping with Stress, Social Distancing and the New Normal

COVID-19: Coping with Stress, Social Distancing and the New Normal

We certainly live in stressful, uncertain times right now. Events, schools, jobs, services and life’s milestones, are all coming to a standstill.

As someone who has worked in mental health for 23 years, I want to assure you that some level of anxiety and stress is normal. In fact, some stress is good because it alerts us to threats and motivates us to take care of ourselves.

And, I urge you not to neglect your emotional well-being and self-care during these times. If gatherings, support groups, exercise classes or other outlets you usually rely on are off limits, try phone calls, social media and texting to stay in touch with those you care about.

Here are some other strategies to help while we are safely social distancing:

Strategies for Adults

  1. Practice relaxing and breathing. Take breaks during the day, practice relaxation skills and take deep breaths. As the old Johnny Mercer song goes, accentuate the positive!
  2. Stay positive. Start a journal and write about positive things going on in your life.
  3. Stay Connected. Check in with people through text, phone, email or social media.
  4. Keep in touch, especially with those you trust with your feelings, and share with them your thoughts, concerns and needs.
  5. Have some fun! Watch a movie, go for a walk, play games.
  6. Avoid too much exposure to news and information. You can watch a bit of news each day to stay informed, but don’t get absorbed by it. It can weigh you down.
  7. Take care of yourself physically. Exercise, eat healthy foods and get plenty of sleep.

Strategies to Help Young People in Your Life

  1. Talk and answer questions. Have daily discussions and ask your children if they have questions or concerns. Go over the facts with them.
  2. Reassure children that they are safe. Our community is taking extra care to ensure that we are practicing social distancing and taking other precautions to prevent the spread of this virus.
  3. Be a good role model. Practice good coping skills such as those above. Share the healthy ways you deal with stress.
  4. Limit media exposure.
  5. Keep structure in their lives. Work with your child to set a daily routine.

We’re in this Together

Try to remember: We’re all in this together, and hopefully soon, the “old normal” will return. Perhaps, we will even see our lives with new clarity and hope for a better future.

You can find more information in my podcast “Staying Sane During Social Distancing”.

If you find yourself anxious or if life seems overwhelming and this it’s impactive your daily life, or if you think you are having symptoms of depression, please take our free, online mental health screening.

Additionally, the Bryan Medical Center Bryan West Campus mental health emergency room is available 24/7 to determine if hospitalization is appropriate.

David Miers, PhD, LIPC

David Miers, PhD, LIPC

Health Expert

David Miers, PhD, LIPC, is the Counseling and Program Development Manager for mental health services at Bryan Medical Center in Lincoln, Neb. 

Learn More About Our Counseling and Mental Health Services

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Understanding Kidney Stones: What are They & How do They Form?

Understanding Kidney Stones: What are They & How do They Form?

If you’ve ever suffered from kidney stones, you don’t need to be told how painful they are. They’re also very common, as more than half a million people visit emergency rooms each year for kidney stones. As a nephrologist, I see a lot of kidney stone cases. They are most common in warm, humid times of the year; when people sweat, they get dehydrated, which isn’t good for the kidneys.

We tend to see more men with kidney stones than women; about 1 in 7 men will have a stone in their lifetime. Females experience about half of that. Although interestingly, in the last 10 to 20 years or so, kidney stones in females has been on the rise.

How Do Kidney Stones Form?

Calcium or Uric Acid Build Up

The most common reason is a build up of too much calcium in the urine. About 8 out of 10 types of stones that are formed are calcium stones, and a smaller percentage are what we call uric acid or gout stones.

Chronic Infection

Some kidneys stones are caused by chronic infections, but these are much less common

Other Contributors to Kidney Stones

  • Age: As we get older, we’re more prone to get kidney stones. Caucasians have the highest incidence of kidney stone disease of any ethnicity.
  • Family history: If someone in your family has or had kidney disease or stones, you’re more likely to develop them.
  • Obesity: People who are obese and people who lose weight after bariatric or weight reduction surgery, have a higher incidence of kidney stone disease.
  • High-salt diet: When you have too much calcium in your urine it is usually a result of too much sodium in your diet.

Kidney Stone Symptoms

Pain

The most common symptom of kidney stones is abrupt, severe pain. It’s usually felt in your back, or what we call the flanks, although the pain can be felt in a number of different areas, starting from your back, rotating around to the side, going into your groin, and in some cases it actually goes into your genital area. Note again that this pain would be abrupt, severe and may or may not include some blood in the urine.

What to Do if You Think You Have Kidney Stones

If you’re having severe pain, go to either an urgent care or an emergency room to be checked. Providers will likely need to do an X-ray (there are several types of X-rays or scans to diagnose kidney stones) or ultrasound, as well as a urine analysis. A physical exam also provides clues, because you may have a pelvic or bladder infection; or even appendicitis or gallbladder attack that can mimic kidney stones. It’s important to have a good handle on your medical history.

Treating Kidney Stones

Treatment depends on the size of the stone.

Water and Pain Meds for Smaller Stones

Drinking a lot of water and easing the pain are the best ways to deal with smaller stones. If the stone is less than about 5 mm, which is small, it most likely will pass through with urination, along with pain meds and hydration. Hydration will be either orally or through an IV, depending on the severity of dehydration. Finally, on rare occasions we might need to use other meds, like alpha blockers, to help pass those stones.

Surgery May be Needed for Larger Stones

If the stone is greater than about 10 mm, it likely won’t pass on its own, so surgery is the best option. Surgeries include:

  • Lithotripsy, where sound waves are used to break up the stones
  • Cystoscopy, which goes through the bladder with a small ‘basket’ to break up stones
  • Major surgery, where the kidney stone has to be cut out or directly visualized by the surgeon

Home or Hospitalization?

Whether you are treated at home or in the hospital really depends on your degree of pain. If you can drink water and take your pain meds without nausea or vomiting, you can wait it out at home – again, taking your meds and drinking a lot of water.

But if you are vomiting or having severe nausea, which can be very common with stone disease, then you’ll likely be hospitalized.

Preventing Kidney Stones

Hydrate

I tell my patients to think about it like this: Say you’re putting sugar into iced tea. If you use too much sugar, it all falls to the bottom and the only way to get it back is to put in more tea. Well that’s what happens with urine. You get too much unwanted stuff in the urine and it falls to the bottom, and forms crystals and stones.

How much water? We want people to hydrate to the point where their urine is pale yellow. The exact amount of water is individual; we can’t tell someone how much water to drink, exactly. But seeing pale yellow urine is a good goal. If you are someone with a lot of kidney stones, you may even have to get up in the middle of the night to drink water, because during the night is the longest time you go without liquid, and that’s when your urine becomes most concentrated and can potentially form a stone.

Eat Less Salt

As I mentioned earlier, excessive salt intake is the most common reason why people get stones. Salt affects other components of urine, like uric acid and other minerals, causing crystals and stones to form. I’m a very strong proponent of the D-A-S-H (Dietary Approaches to Stop Hypertension) diet, which has been shown to decrease the incidence of stone disease as well as reduce blood pressure. The National Institutes of Health did studies on this diet dating back to the 1990s; it’s been very good for lowering blood pressure as well as preventing kidney stones.

Dr. Leslie Spry, MD FACP FASN FNKF

Dr. Leslie Spry, MD FACP FASN FNKF

Dr. Leslie Spry is a Nephrologist with Lincoln Nephrology and Hypertension.

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The ‘Pet Effect’ and Its Impact on Your Mental Health

The ‘Pet Effect’ and Its Impact on Your Mental Health

If you’re on the fence about adding a pet to your family, here is something in the ‘plus’ category: Pets can be very good for your mental health and well-being. As a mental health professional for more than 27 years, I’ve seen in my practice as well as my own life, how pets can truly make a difference. Whether it’s a dog, cat, bird or fish, many studies prove the benefits of sharing your home with a pet.

Our little “shorkipoo,” Ollie, has been with our family for three years now. He was a gift to our youngest daughter, but this little guy with a big voice has brought a lot of joy and happiness to our family as well as to friends and our neighborhood. (I think more people know where “Ollie” lives than where we live!)

Pets Improve Our Well Being

Just ask nearly any pet owner and you’ll hear how spending time with an animal helps them relax and alleviate stress. While the phrase “emotional support animal” has become commonplace, the science behind the “pet effect” is beginning to back up the claim that pets improve our well-being.

So how about those studies? For starters, they’ve found that:

  • Service dogs aid treatment for military members and veterans struggling with PTSD
  • Pet ownership benefits those experiencing mental health problems
  • Therapy dogs reduce stress and increase feelings of well-being in college students

A lot of research is also being done on how animals can help children who have conditions like autism spectrum disorder, ADHD and others, be more comfortable and present in the classroom.

According to the Mental Health Foundation of the United Kingdom, “a pet can be a great source of comfort, companionship and motivation for their owners. In many ways, pets can help us to live mentally healthier lives.” I’ve seen this in my own life. My father lights up when we bring Ollie over for a visit. And when my late mother was ill with cancer, Ollie always put a smile on her face.

So What Is It about Pets that Makes Such a Difference?

Pet ownership creates a sense of responsibility. In turn, that sense of responsibility promotes many positive behaviors with benefits for both our behavioral and physical health. Regular exercise, for example, helps improve mood and well-being. When you take a nice long walk with your dog, you get a physical workout as well as the emotional satisfaction of bonding with and caring for your pet. I walk Ollie at least a couple of times a day, rain or shine, and have him to thank for sticking with my exercise routine!

Pet ownership has social benefits. Walking a pet gets you out of the house and into your community, where you can greet old friends, meet new people and interact with other pet owners. In our case, a walk around the block that should take three minutes can take 30 because every little kid wants to pick up Ollie or pet him.

Caring for a pet requires following a routine and building some structure into your day. While the schedule you follow actually may be one you set up for your pet, just having a regular routine in the first place can be an important accomplishment for many struggling with their mental health.

Stroking a dog, cat or other animal helps reduce stress. In fact, even just the companionship of having a pet around can be a source of comfort and relaxation. When my daughter comes home from school, Ollie is first on the scene, showering her with unconditional love and affection. What better way to decompress from the day?! Pet ownership can also counteract feelings of loneliness and help ward off anxiety, and can establish a sense of pride or achievement. This benefits all of us and can be very important to someone with depression or anxiety.

Volunteer or Visit

If you’re unable to have a pet, consider volunteering at a local animal shelter or visiting a friend with a pet. Many of the benefits of time spent with animals can be realized after even a short time spent together (though the effects tend to be strongest between a pet and its owner). If larger pets are out of the question, think about a guinea pig or fish. Even these more “low-maintenance” pets can help you de-stress and build resiliency.

David Miers, PhD, LIPC

David Miers, PhD, LIPC

Health Expert

David Miers, PhD, LIPC, is the Counseling and Program Development Manager for mental health services at Bryan Medical Center in Lincoln, Neb. 

Learn More About Our Counseling and Mental Health Services

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Is Weight Loss Surgery Right for You?

Is Weight Loss Surgery Right for You?

My passion for weight loss management started when I worked in a family practice doctor’s office. There was a definite correlation with obesity and an increase in chronic diseases and decrease in quality of life. Now that my main focus is helping patients reach their weight loss and long-term health goals, I realize how absolutely life changing it can be.

I will admit most patients come in feeling defeated and have given up hope. Patients feel like they have tried everything from fad diets, extreme exercise and basically starving themselves. And, nothing was working. Some of these approaches led to temporary weight loss. But, they were simply unable to maintain the weight loss and often gained back more weight than they lost. When I see these patients, we talk about the benefits of surgery and a structured weight loss program for long-term weight loss. And, after the first visit they are already starting to feel a flicker of hope.

Benefits of Weight Loss Surgery

Where do I begin? There are so many! One thing I hear over and over is, ‘why didn’t I do this sooner’. Patients feel they have more energy, confidence and overall a better quality of life.

Losing Weight Improves Your Health

Weight loss surgery can help improve or even diminish major health conditions associated with obesity. Body Mass Index (BMI) is the ratio of a person’s weight to height. It is used to determine if a person is at a healthy weight, overweight, obese or morbidly obese. BMI calculators provide an easy way for you to find out your body mass index.

Here are some of the many conditions that can improve with weight loss.

Diabetes

Weight loss surgery is an effective treatment option for obesity-related diabetes, especially Type 2. If you have a BMI (body mass index) of over 35, this type of surgery may be the right choice for you. After your weight loss surgery, your sensitivity to insulin will increase which means you should respond better to oral medication and any requirement for insulin injections will be reduced. Patients generally achieve a lower A1C after weight loss surgery.

Heart Disease

Losing weight makes a world of difference in helping to protect and maintain your heart health. Current research shows a significant drop in cardiovascular risk for those who have had bariatric surgery compared to those who have not. After surgery, losing weight takes a bit of strain off the heart and lowers the risk of heart failure.

High Cholesterol

We all know too much cholesterol can cause potentially serious problems. Conditions associated with high cholesterol levels include heart disease, stroke, diabetes and high blood pressure. After gastric bypass surgery, patients often achieve near normal cholesterol and triglyceride levels within just a few months. Lowering cholesterol levels helps to clear plaque and also reduces risks associated with cholesterol build-up in the arteries.

Sleep Apnea

Sleep apnea is when a person stops breathing while asleep. This can cause many health problems. Bariatric surgery is proven to reduce the effects of sleep apnea, and in some cases, cures sleep apnea.

Cancer

There seems to be a link between some cancers and obesity. However, according to several recent clinical studies, weight loss surgery reduced cancer mortality rate in patients from 29-89% when compared to a group of individuals with morbid obesity who have not had weight loss surgery.

Depression

Research shows depression and obesity are closely related. One is known to lead to the other, and vice versa. After bariatric surgery and lifestyle changes, self-esteem is known to increase. As a result, this type of surgery most definitely can help those with depression and low self-esteem related to their appearance.

Acid Reflux

Many studies have proven that gastric bypass surgery can give those with obesity excellent control of issues associated with acid reflux. In fact, weight loss surgery may be an even better option for acid reflux because patients will also benefit from significant weight loss.

Osteoarthritis

There’s a known link between obesity and osteoarthritis of the knee and hips. For those with obesity, knee or hip surgery to treat osteoarthritis may not be an option due to their weight. Weight loss after bariatric surgery can help improve osteoarthritis. This weight loss may also make a person eligible for knee or hip surgery, if it is still needed.

Qualifications for Weight Loss Surgery

You may qualify for bariatric surgery if:

  • You are 100 pounds overweight or more, with a BMI of 40 or greater, or
  • You have a BMI of 35 or greater with one or more serious health conditions linked to being obese, such as diabetes, high blood pressure or sleep apnea, and
  • You have not been able to lose weight in other ways, such as diet, exercise or medications

Other Considerations

There are several things to consider when contemplating weight loss surgery. You can look at it from two different angles both personally and financially. Here are a few questions you can ask yourself to help answer this question:

Are you looking to surgery for the right reasons? Bariatric surgery is meant to improve your overall health, it is not done for cosmetic reasons. Looking better is a “side effect”; feeling better is the goal.

Does your insurance plan cover weight loss (bariatric) surgery? Many insurance plans include bariatric surgery coverage. However, if you don’t have this coverage, we have other options available.

Do you have the emotional support you need? It is crucial that you have a strong support network of family and friends that will be there to help you through the process. We recommend close friends and family become educated about the lifestyle changes, risks and benefits of weight loss surgery so they can support you.

Ways the Bryan Bariatric Program Can Help You

At Bryan Bariatric Advantage, we have a specialized team to help you through your weight loss journey. This team includes a nurse practitioner, dietitian and surgeons. We also collaborate with mental health and exercise experts, as well as other specialty services as needed to ensure your success.

As the Bariatric Nurse Navigator, I can guide you through the entire process. Together, we can decide if surgery is right for you. We can also look at weight loss medication, if and when appropriate.

Our dietitian uses her weight loss nutrition expertise to prepare you for surgery and the life-long diet changes after surgery to achieve your goals. If surgery is not for you, she will help you to address your personal barriers with weight management and set goals to break through those barriers for good!

We’re here for you – to support and help you with compassion and expertise, and help you determine and navigate your best course to the ultimate goal of a long, happy and healthy life.

Learn More About Bryan Bariatric Advantage

Tara Wenta

Tara Wenta

APRN

Tara Wenta, APRN, works with Bryan Bariatric Advantage

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‘You Have Cancer’: What To Do When You Hear These Words, for Yourself or a Loved One

‘You Have Cancer’: What To Do When You Hear These Words, for Yourself or a Loved One

By Joanna Morgan MSN, RN, OCN & Joselyn Hayes BSW, CSW

For over 35 years, we’ve been helping people and their families through the many emotions and challenges that change their lives after hearing these three words. I’m Joanna Morgan, an oncology nurse navigator and I’m Joselyn Hayes, an oncology social worker, at Bryan Medical Center.

While each person and every situation is different, there are some strategies that seem to help everyone. We hope sharing these will help you – whether you’re the one receiving a cancer diagnosis or it’s a loved one.

What Do You Do When You Hear the Words “You Have Cancer”?

Breathe. Surround yourself with people you love. Allow others to help and support you.

Most people ask, why me? Most people wonder if they have done something to cause the cancer and come up with ideas of why it occurred. If you are having these thoughts you are not alone. Cancer is not a punishment for things you did or didn’t do. Blaming yourself doesn’t help and often makes you feel worse. It’s almost impossible to know exactly what caused the cancer. Instead, focus on taking care of yourself now, both your body and your mind.

Ways You Can Help Someone With a Cancer Diagnosis

When someone we care about is diagnosed with cancer, we want to help but often don’t know what to do or say.

According to the American Cancer Society, people with strong emotional support tend to adjust better to the changes that cancer brings to their lives, have a more positive outlook and report a better quality of life.

Here are some ways you can provide support:

Keep in Touch

  • Write, text, email or call often (try to keep it short) – this lets the person know you are thinking of them.
  • Call at times that work best for your friend.
  • Be available: When your friend calls or texts you, answer right away.

Visit

  • Call before you visit, and be understanding if your friend doesn’t feel well enough to visit.
  • Keep the visit short: understand they may be too tired to actively participate.
  • Don’t be afraid to touch, hug or shake hands.

Know What to Say (And Do)

  • Listen. Allow your friend to honestly share how they are feeling (good, bad or ugly).
  • Give advice only when asked. Don’t urge your friend to fight the cancer if that is not their goal, offer treatment suggestions or share negative stories from your experiences with others who have gone through cancer treatment.
  • Support your loved one’s treatment decisions.
  • Remember the caregiver and seek ways to support and help this person.
  • Stay connected throughout the entire treatment process and beyond – checking in regularly over time is very helpful and meaningful.
  • Let your friend know “we’ll get through this together.”

Know What Not to Say

  • “Everything is going to be fine.” We are often tempted to say it will be fine, but this can make the person with cancer feel like you’re unwilling to talk about the realities and challenges of a cancer diagnosis.
  • “You’ve got the good kind of cancer.” There is no ‘good kind’. Any cancer diagnosis causes fear and changes a person’s life.
  • Nothing at all. Say something, anything. It’s okay to admit you don’t know what to say. What’s most important is starting a conversation.
  • “Let me know how I can help.” People rarely reach out and ask for help. They are exhausted emotionally and physically and don’t have the energy to think about what you can do, and even if they did it’s hard for most people to ask for help. Instead offer concrete ideas of ways you can help, and when your friend takes you up on your offer, make sure you follow through!

How to Help

  • Offer to run errands – get groceries, pick up prescriptions or help transport to and from appointments.
  • Make meals or help coordinate meal drop offs from other friends.
  • Help with tasks – cleaning their house, lawn care, babysitting, pet sitting, walking the dog.

Ways the Bryan Cancer Program Can Help

At Bryan, we have specially trained nurses and social workers to help you and your family through each step of your cancer care. Our oncology certified nurse navigators can help you through all aspects of your cancer care, and especially decisions about treatment.

Oncology social workers have expertise to help you navigate the emotions, financial and insurance concerns, and other areas related to receiving the care you need.

We’re here for you – to support and help you with compassion and expertise, to relieve some of the stress and uncertainty in your life. And to help you determine and navigate your best course of treatment.

You are Not Alone. We’ll Travel This Road Together.

A cancer diagnosis can be overwhelming – the emotions, the unknown, the decisions. At Bryan, our specialty trained nurses and social workers are here to help you and your family through each step of your cancer care.

Talk to your doctor about a referral to this Bryan oncology nurse navigator and social worker program. This is a free service for our patients.

Joanna Morgan MSN, RN, OCN

Joanna Morgan MSN, RN, OCN

Oncology Nurse Navigator

Joselyn Hayes BSW, CSW

Joselyn Hayes BSW, CSW

Oncology Social Worker

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On the Road to a Healthy Heart: Dr. Keith Miller Takes His Own Advice

On the Road to a Healthy Heart: Dr. Keith Miller Takes His Own Advice

I started thinking a lot about my heart health because, at 52 years old (holy crap!), I have come to terms with the reality that I am not immune to the disease that I attempt to PREVENT and TREAT every day as a cardiologist. In short, I have been confronted with my own vulnerability.

So far, thank goodness, I haven’t had any health issues, but I want to be honest with myself and deal with my own future risk of heart attack, stroke and cardiovascular death.

Plus, there are a lot of people like me out there who are getting a little “middle-age-ish,” who may not fully appreciate their risk of cardiovascular disease.

So I thought it would be interesting, educational and perhaps inspirational to share my own personal experience of going through a risk assessment and trying to reduce my risk of heart and vascular disease. I’m focusing on lifestyle changes, but also evaluating whether I am a candidate for prescription medications (such as statins) to reduce my risk.

I had lab work done to find out my cholesterol levels and a coronary calcium scan to help define my risk. And, I have calculated my 10-year risk.

I also signed up for the Good Life Halfsy because I needed a goal to motivate me to exercise!

Identifying Your (and My) Risk for Heart Attack or Stroke

Using only a few, easily obtained pieces of information about your health, you can find out whether you’re on the right track or need some serious lifestyle intervention. You can determine if a little improvement in your diet and exercise program is enough, or whether you may benefit from a medication to lower your blood pressure or your cholesterol level.

If you are in your:

  • 50s or 60s – Age alone becomes a very important risk factor for heart disease. Even if you’re seemingly healthy you may be at risk. Let’s face it, cardiovascular diseases like heart attack, stroke and heart failure are extremely common and we are all at risk to one degree or another.
  • 40s – You aren’t off the hook, and depending on other risk factors, blood pressure or cholesterol lowering medications may help you.

Taking a Dose of My Own Medicine

I recently did my own cardiovascular health assessment.

Here are my stats:

  • 52-year-old white male
  • Total cholesterol – 255 mg/dL
  • HDL cholesterol – 71 mg/dL
  • LDL cholesterol – 168 mg/dL
  • Systolic blood pressure – 110 mmHg
  • Non-smoker
  • Non-diabetic without hypertension

My 10-year risk of having a heart attack or stroke was 3.2%. Not too bad!

I was a little disappointed that my LDL cholesterol was 168 mg/dL, which is definitely higher than I would like. A little improvement in my diet and exercise should do the trick to fix this.

If that 10-year risk number had been 5% or more, with other risk factors like family history, I might have considered going on a cholesterol medicine.

What Can Be Measured Can Be Managed

The point is, heart attack and stroke risk can be measured. And what can be measured can be managed. Lifestyle changes and blood pressure or cholesterol treatment have been shown to reduce the risk of heart attack, stroke and death from cardiovascular disease in people with elevated risk.

The question is, are you one of those people? Don’t wait to find out!

Find Out Your Risk & Take Action if Needed

If you don’t know your cholesterol numbers or you haven’t had your blood pressure checked in a while, talk to your doctor or consider taking part in a health screening offered by Bryan Health.

Find out if you’re at risk with our helpful cardiovascular risk estimator!

The next health screening where you can find out your cholesterol levels, A1c and other important health information is:

Thursday, Nov. 21, 7-9 a.m.

Bryan LifePointe Campus, 7501 S. 27th St.

To learn more and register, click below!

Other Free Risk Assessments

HeartAware

Offered by Bryan Health

Find out your heart age, risk for heart disease and steps you can take to improve your heart health.

If you are at risk, you can choose to have a free consultation with a nurse to discuss ways to improve your heart health.

My Life Check

Offered by the American Heart Association

Get a heart health score with recommendations to make improvements and track your progress.

Remember to Exercise!

Staying active is important for all of us, and any amount you do is helpful to your heart health. It doesn’t have to be a half-marathon! If you’re wondering how my training is going, here’s a photo of me after finishing this year’s Good Life Halfsy. I’m getting there!!

dr miller at the good life halfsy finish line

Let’s Improve our Heart Health Together

I hope you’ll join me so we can improve our heart health together. Take the screenings to find out your risk. Look for ways to improve your daily lifestyle. And, if you need help, don’t be afraid to ask for it!

I invite you to follow me and see more videos and blogs to inspire you to better health.

Dr. Keith Miller, MD

Dr. Keith Miller, MD

Health Expert

Dr. Keith Miller, MD, is a cardiologist with Bryan Heart.

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The Surprising Risk of Sepsis for Pregnant Women, New Moms and Newborns – What You Need to Know

The Surprising Risk of Sepsis for Pregnant Women, New Moms and Newborns – What You Need to Know

As an infectious disease pharmacist and member of Bryan’s Sepsis Committee, I have seen many cases of infections and sepsis in many different patients. I specialize in getting the right antibiotics to patients with severe infections like sepsis, and work mostly with adult patients.

Now that I’m a father and we are expecting again very soon, I started looking deeper into the risk of sepsis for pregnant women and newborns. And, I was surprised at what I found.

Infections are a Serious Risk for Pregnant Women and Newborns

Thanks to improved prenatal care, most pregnancies and deliveries happen without complications. However, infections are still a serious risk for pregnant women, new moms and newborns. In fact, recent data shows an increase in sepsis-related deaths for pregnant women in the United States.

Newborn sepsis remains a leading cause of death among infants. There are two times sepsis can occur in infants:

  • Before a baby is 72 hours old, called early-onset sepsis. This is usually the result of viruses or microorganisms passed from the mom to the baby in-utero or during delivery. The incidence of this type of sepsis has decreased considerably since the 1990s due to new health screenings for pregnant women
  • After a baby is 72 hours old, called late-onset sepsis. This is usually the result of viruses or microorganisms acquired in the environment or through invasive procedures

What Exactly is Sepsis?

Sepsis is a potentially life-threatening condition caused by the body’s response to an infection. Basically, it’s when your body “over-reacts” to an infection. This can cause your organs (i.e. heart, kidney, liver, lungs, etc.) to fail, and can lead to death. Sepsis can be thought of as the sickest a person can get from an infection. Lots of people get infections, but not everyone develops sepsis. Some people are at a higher risk of developing sepsis than others.

What Can Increase Your Risk of Pregnancy-Related Sepsis?

Many of the risks are associated with the individual person and the type of pregnancy, such as:

  • Have never delivered a baby before (called nulliparity)
  • Currently pregnant with or recently delivered twins, triplets, etc. (called multiple gestations)
  • African American race

Others are associated with the type of delivery or medical therapies, such as:

  • Cesarean-section delivery (i.e., C-section)
  • Assisted reproductive technologies (i.e., artificial insemination, in-vitro fertilization, etc.)

What Can Increase the Risk of Sepsis in Newborns?

Some are associated with mom:

  • A common bacteria called Group B Streptococcus (GBS), most of the time this is not harmful but it can cause a severe infection in some newborns
  • Inflammation of membranes surrounding the baby due to bacterial infection (this is called chorioamnionitis)
  • Currently pregnant with or recently delivered twins, triplets, etc. (called multiple gestations)

Some are associated with the birth:

  • Prelabor rupture of membranes (occurs when the amniotic sac breaks before labor begins)
  • Prolonged rupture of membranes (over 18 hours)
  • Preterm birth (defined as a birth before 37 weeks)
  • Low birth weight

Some are associated with procedures after birth:

  • Invasive procedures such as a cervical stitch
  • Prolonged use of antibiotics
  • Prolonged use of a catheter inside the baby’s body
  • Ventilator associated pneumonia

What are the Warning Signs of Sepsis?

The signs and symptoms are different for moms and babies. It’s important to know the warning signs and seek care immediately. The sooner you or your loved one receives care, the better the chance for a full recovery.

Sepsis symptoms in pregnant women or new moms:

  • Shivering, fevers, shakes or very cold
  • Extreme pain or discomfort (feel the “worst you have ever felt”)
  • Pale or discolored, or clammy/sweaty skin
  • Sleepy, difficulty waking up, confused
  • “I feel like I might die”
  • Shortness of breath
  • Decreased urination

Sepsis symptoms in newborns:

  • “Just not looking right”
  • Unusually sleepy, lethargic or difficult to wake up
  • Unusually irritable, inconsolable
  • Not feeding or eating normally, vomiting
  • Less than three wet diapers or stools in a day
  • Fever or hypothermia (low temperature)
  • Shivering, shaking or poor muscle tone
  • Respiratory distress (not breathing right)
  • Abdominal distention or bloating
  • Bulging fontanel (soft spot on a baby’s head)
  • Unexplained jaundice (yellow skin)
  • Blood in stools

Take Action

If you see a combination of the above symptoms and suspect sepsis, or just feel like something isn’t right, call your doctor or go to the emergency room IMMEDIATELY. It’s important to say “I’m concerned about sepsis”. The sooner treatment is started, the better chance you or your loved one has of surviving and making a full recovery.

When caught early, immediate administration of IV antibiotics and fluids can be all you need to make a full recovery. The longer someone delays getting treatment for sepsis, the greater the likelihood that the person will have severe complications such as kidney failure requiring dialysis or problems taking care of themselves (such as walking by yourself, bathing, brushing your teeth, etc.). It can even lead to death.

Be Informed, Tell Others – Let’s Raise Awareness and Save Lives

As an infectious disease pharmacist, treating sepsis and letting others know how to recognize the signs and symptoms of sepsis is my job. As a new father and husband, it’s my passion.

Sepsis is always a serious condition. The sooner signs and symptoms are recognized and treatment is sought, the better chance to save a life. Every patient is somebody’s loved one, and now that I’ve got two little ones depending on me, I feel even more responsibility to make sure people understand how serious and common sepsis actually is.

Prevention of pregnancy-related and newborn sepsis starts with good prenatal care, good hygiene and frequent handwashing. Bacteria and viruses are naturally found on surfaces and easily spread by unwashed hands.

I urge you to tell everyone you know about the signs and symptoms of sepsis as well as the ways to prevent it. With your help, we can increase awareness of sepsis so people will seek treatment sooner, and lives will be saved.

Learn More About Sepsis

To learn more about sepsis, listen to our Bryan Health podcast. Bill Johnson, MD, Nebraska Pulmonary Specialties, tells you how to spot sepsis, and how early diagnosis and treatment can be lifesaving.

Kevin Sponsel

Kevin Sponsel

Infectious Disease Pharmacist

Kevin Sponsel is an infectious disease pharmacist and a member of Bryan Health’s Sepsis Committee.

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Developmental Milestones for Your Baby & Toddler: When to Relax and When to Seek Help

Developmental Milestones for Your Baby & Toddler: When to Relax and When to Seek Help

A child’s first words and first steps are memorable events – and most parents want their children to reach these and other developmental milestones ‘on time’ or to achieve them early. So it’s natural to be concerned if your little one isn’t, in your view, keeping up with these milestones. But how do you know if it’s time to truly worry?

Children don’t always meet milestones at the same time or at the age range expected. That’s okay! It’s not a big deal to miss one or two developmental milestones. These milestones should be looked at as a range for developing skills.

Preemies are a special case. Babies who are born prematurely usually will not meet milestones on time. As an example, if your baby was born two months early, he may reach four-month milestones at six months. We generally adjust milestones for premature babies until they reach age two.

That said, when children who are not preemies miss most of the milestones in their age range, it’s worth talking with your child’s doctor.

Here are some milestones and red flags that will help you know if and when to take action.

Two to Four Months Old

Motor Skills: Holding items in the hand. Pushing the upper body with support of the arms when he’s on his tummy. Pushing down on his legs when his feet are on the floor, like when he’s placed in a walker.

Cognitive Skills: Responding to voices. Following movement with his eyes and watching faces. Making some eye contact. He can give a social smile when he interacts with his caregivers.

Language Skills: He should gurgle and coo. There may be some different inflection in his vocalizations.

Red Flags: Not responding to loud noises, interacting with caregivers or visually following movement.

Six to Eight Months Old

Motor Skills: Sitting unsupported for short periods of time. Passing objects from one hand to another. Grasping at things with her whole hand. She can probably roll over.

Cognitive Skills: She has gotten better at watching things. Her eyes track side-to-side, up and down, and in circular motions. Reaching for things that are in her field of vision.

Language Skills: Responding to sounds by “talking” back. Turning toward sound sources. She may repeat syllables, like “ma-ma,” “da-da” or “ba-ba”. She’s interested in social play—a fan of peek-a-boo or pat-a-cake.

Red Flags: Stiff or tight muscles. Sloppy or ragdoll-like movement patterns. Showing no affection for caregivers. Eyes turning inward or outward. Not responding to sounds.

One Year Old

Motor Skills: Crawling. Pulling himself up to standing with the support of furniture. Taking steps with help or support. Ability to grasp finger foods. Using both hands together to pick things up. Pinching things, poking things. Shaking, banging, throwing and dropping toys. Waving and clapping.

Cognitive Skills: Imitates gestures. More engagement in social play. Extending an arm or leg to help get dressed. May show some anxiety with strangers.

Language Skills: Speaking more. Maybe using noises as names, like “mama” or “dada”. Responding to “no”. Understanding simple verbal requests

Red Flags: Dragging one side of the body while crawling. Inability to stand with support. No words. Not seeking out a caregiver when upset.

Toddlers

Motor Skills: Younger toddlers should be mobile and walking, perhaps pulling toys along. Fine motor skills like scribbling and stacking blocks.

Cognitive Skills: Identifying body parts. Pretending. Starting to categorize things.

Language Skills: Using pronouns (I, me, he, she, for example.) Naming colors and objects. Listening to short stories. Creating simple sentences.

Red Flags: Extreme clumsiness. Inability to sit still for long periods of time. Not walking yet. Oversensitivity to light, sound or movement.

Tracking Milestones and Treatment

  • Many milestone checklists are available with a simple online search
  • Make note as your child attains new skills
  • Talk to your child’s doctor if multiple milestones are missed or you notice developmental red flags

If your child is missing milestones, your child’s doctor can evaluate his or her development and guide treatment as needed. Physical therapy can help with muscle tone, while occupational therapy can help your child develop fine motor skills. Speech therapy treats language development. If you are concerned about your child’s development, talk to your child’s doctor about potential needs for a therapy specialist.

More on Child Development

Want to learn more? Listen to a 10-minute podcast with Stacey Anderson, a pediatric occupational therapist at Bryan Health:

Stacey Anderson

Stacey Anderson

Pediatric Occupational Therapist

Stacey Anderson is a Pediatric Occupational Therapist with Bryan Health!

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Hugh Jackman, #WearSunscreen & Your Family: What Do You Need to Know?

Hugh Jackman, #WearSunscreen & Your Family: What Do You Need to Know?

My husband and I have four children, all ages six and younger (that’s what happens when you go to medical school). Right now, their favorite movie is “The Greatest Showman” starring Hugh Jackman. He is famous in the entertainment industry for his singing, dancing and acting abilities, along with his devilishly handsome good looks.

However, he’s also famous in the dermatology world as he has publicly battled basal cell carcinoma not once, but five times in the past including a recurrent basal cell carcinoma on his nose. Hugh posted pictures on Instagram with the hashtag #wearsunscreen to help raise public awareness and encourage good sun protection behavior.

Most Common Type of Skin Cancer

Basal cell carcinoma is the most common form of skin cancer. In fact, it’s the most common cancer overall. It develops after repeated sun damage over time. You might notice it as a pink scaly patch. Or, it might be a raised pearly bump, almost pimple-like that never seems to go away. Sometimes basal cell carcinoma will bleed after minor trauma or for no reason at all.

Second Most Common Skin Cancer

Are there other types of skin cancer? You bet! The second most common form of skin cancer is squamous cell carcinoma. This type of skin cancer may appear as a growing lump, often with a rough surface. But, it also could be a flat, reddish patch that grows slowly and may be tender. Sometimes these grow quickly on the skin in a volcano-like fashion. Squamous cell carcinoma can be serious in some cases and spread beyond the skin to lymph nodes if not treated properly or within a reasonable amount of time.

Most Well-Known Skin Cancer

Finally, the skin cancer with which most people are familiar, is melanoma. Melanoma can be a life-threatening skin cancer, especially if not caught early. The warning signs for melanoma are summed up in the “ABCDE” algorithm.

  • A = asymmetry (one half doesn’t look like the other)
  • B = border (irregular, ill-defined or funny-looking shape)
  • C = color (one spot that has multiple colors within it, such as different shades of brown or black. Red, white or blue colors are occasionally seen in melanoma)
  • D = diameter (a majority of melanomas are greater than 6mm when diagnosed, which is the size of a pencil eraser; however this doesn’t mean that smaller spots aren’t worrisome)
  • E = evolving (a mole that is changing in size, shape or color)

Ways to Protect Yourself and Your Family

So, what can you do to reduce your risk for skin cancer? Protect yourself! Make sun protection a priority, not only for yourself but for your family. If you have children, make it your goal to not let them burn. Like never. Never ever.

Here are some tips I use with my own family:

  • Everyone needs sunscreen when outside. This includes just playing outside, going to the pool, going on walks, whatever it may be. The two types of sunscreen available are:
    • Chemical sunscreens: (the active ingredients are long words that are hard to pronounce, such as oxybenzone)
    • Physical sunscreens: (the active ingredients are zinc and/or titanium, easy to pronounce)

I prefer zinc/titanium-based sunscreens because they stay on better, cause less skin sensitivity issues and are better at preventing sunburn in my opinion. Examples of this type of sunscreen include Neutrogena Sheer Zinc SPF 50 or CeraVe Hydrating Sunscreen SPF 50. Overall, any sunscreen is better than none. And don’t forget, it needs to be reapplied every 2-3 hours.

  • Make hats your friend. Put them by the door you use most often to go outside. Put one in your car. I don’t know HOW many times a patient has told me, “I didn’t plan on being outside that long!” Never travel without a hat!
  • Buy rash guard swim shirts or other sun protective clothing for yourself and your family. Yep, I make my kids wear long-sleeve swim shirts to the pool. Sorry kids, but you’ll thank me later. SPF 50+ clothing is available for swimmers, golfers, fishermen, etc., at local stores such as Scheels but also on well-known websites such as www.coolibar.com. Trust me, it’s worth the money to invest in good sun-protective clothing.
  • Put on a layer of sunscreen to your face and neck every morning. Use it before applying makeup. There are some really nice, light sunscreens available over the counter. My most recent favorites for this purpose are Neutrogena Sensitive Skin Face Liquid Sunscreen SPF 50 or La Roche-Posay Anthelios Ultra-Light Tinted Mineral Sunscreen SPF 50.
  • Finally, come see me! If you are worried, questioning a spot on your skin or just want a once-over, you should visit me at South Lincoln Dermatology or see a board-certified dermatologist in your area.
Gina Weir, MD

Gina Weir, MD

Dr. Weir is a dermatologist with South Lincoln Dermatology.

2625 Stockwell
Lincoln, NE 68502

402-421-3335

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