Healthy Teeth for Your Baby and Toddler: When to See the Dentist, How to Prevent Cavities, & Other Dental Issues

Healthy Teeth for Your Baby and Toddler: When to See the Dentist, How to Prevent Cavities, & Other Dental Issues

by | Jul 15, 2019 | Expert Health Tips

If you’re the parent of a baby or toddler, you may think you have plenty of time before making her a dental appointment. After all, if she doesn’t have any teeth coming in, what’s the point? But that’s not necessarily the case. In fact, it’s never too early to get a good start on healthy teeth.

How Soon Should My Baby or Toddler See the Dentist?

As a pediatric dentist, I recommend getting kids in for their first dental checkup before their first birthday. This way we can make sure we’re preventing cavities before they occur. And for the teeth that are already in, we get a chance to see what the enamel looks like. At this age we also can determine if there is a higher risk of your child getting cavities. If we see issues that could lead to cavities we will visit with you about your child’s diet and oral hygiene, because these are important for developing healthy teeth.

And once children begin going to the dentist, I urge parents to bring them in every six months. If we identify that a child has cavities starting to form, we can catch them early.

 

Ways You Can Help Prevent Cavities and Other Dental Issues for Your Infant or Toddler

Diet

  • Reduce or eliminate sugar from their diet. You might be surprised to learn that some things that seem healthy really aren’t, because they contain a lot of sugar. This is especially true with juice and chocolate milk. My recommendation is not to give kids juice. If I give my little three year-old a small glass of juice, she’ll drink it and want more before you know it! It’s too much sugar.
  • Get them started on water. It’s a healthy habit for all of us. Having your child drink water at an early age builds healthy habits for life, plus it helps their body function properly.
  • Mind the temptations. Once kids move to solid foods, temptations are everywhere. Whether it’s coming from grandparents or parents, we like to spoil our kids. So it’s tough to want to spoil them, but then also be mindful of the sugar they’re taking in. I urge parents to be mindful of candy, cookies and chips – all of the processed treats. That includes gummies and fruit roll ups! They sounds healthy, but I call them the ‘dreaded fruit snacks’ because they create a lot of cavities. As a parent, I get it. They’re easy. But please, try to avoid purchasing those fruit snacks!

Dental Hygiene

  • Brush those teeth twice a day as soon as they come through the gum tissue, using a soft toothbrush. Your child’s age doesn’t matter. Once they get teeth, we’ve got to take care of them.
  • When you brush your child’s teeth, just gently massage the teeth. At this point you’re getting rid of plaque and keeping everything clean and healthy.
  • Use a very small amount of fluoride toothpaste. For your infant, who is not able to spit out the toothpaste, just a tiny bit of fluoride toothpaste, the amount of a grain of rice, is plenty. This is enough to help prevent decay.
  • Use whichever flavor your child likes or will tolerate. My daughter says our mint toothpaste is too spicy! She likes the fruity flavored toothpastes and those are just fine.

 

A Word About Pacifiers and Thumb Sucking

Parents often ask me about these behaviors and how they affect dental development. The question I get most often from parents is: Will this cause their teeth to grow in out of line? Unfortunately, it can. When a thumb or pacifier is in your child’s mouth, it pushes on structures in the mouth, whether it’s the teeth or bone structures, and moves them. Timely intervention is really important here.

  • Pacifier – Try to wean your child from this early on. At around a year or 18 months old, I like children to be done with the pacifier. It could be molding the upper arch and changing the shape of your child’s palate.
  • Thumb Sucking – The longer your child sucks his thumb or fingers, the higher the risk of changing the shape of his arch or palate. I recommend parents work on this habit and get it conquered by age three.

Start Early for Your Child’s Good Dental Health and Habits

I hope these tips are helpful for you. Taking your kids to the dentist early on gives them a good start on great dental health and habits, and helps get them comfortable with the environment of a dentist’s office. This also helps them have great dental experiences when they come to their dental home.

Want more dental care tips for your infant or toddler?

Get even more information from our ten minute podcast!

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Marty Killeen, DDS

Marty Killeen, DDS

Marty is a pediatric dentist with Wilderness Station Pediatric Dentistry.

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8 Ways You Can Prevent & Manage Diabetes

8 Ways You Can Prevent & Manage Diabetes

by | Jun 10, 2019 | Expert Health Tips

Diabetes is a silent disease affecting the lives of millions each year. Chances are you know someone with diabetes—a friend, family member or maybe even you. I am one of the millions living with diabetes. As a certified diabetes educator, I work to educate myself and others about how to prevent diabetes from impacting your life and how you can take care of yourself and improve your health if you have diabetes.

What Is Diabetes?

Diabetes happens when your body does not properly use the sugar in your body. The different types of diabetes are related to the reasons the body is not using the sugar. This excess sugar causes clogs in the blood stream, leading to complications.

Type 2 diabetes is the most common. With type 2 diabetes, the body either doesn’t produce enough insulin, or it resists insulin. Insulin helps keep your blood sugar level from getting too high.

Symptoms of Type 2 Diabetes

  • Increased thirst
  • Frequent urination
  • Hunger
  • Fatigue
  • Blurred vision

However, in some cases, there may be no symptoms.

Risk Factors for Developing Type 2 Diabetes

  • Having prediabetes
  • Being overweight
  • Being 45 years or older
  • Having a parent, brother or sister with type 2 diabetes
  • Being physically active less than three times a week
  • Previous gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than nine pounds
  • Being African-American, Hispanic/Latino-American, American Indian or Alaska Native (some Pacific Islanders and Asian Americans are also at higher risk)

How Do I Manage Diabetes?

We must help our bodies use the sugar. When I think about how best to care for diabetes I think about BALANCE. It’s all about eating healthier, exercising more and taking better care of ourselves.

Balance in diabetes can mean a lot of things – both in terms of preventing diabetes and taking care of yourself if you have diabetes. We all know if we don’t care for ourselves, then we can’t care for others. Here are eight areas that I focus on and share with others to take care of yourself.

1. Eat Mindfully

  • Don’t eat in front of the TV
  • Take small bites
  • Taste your food
  • Add protein and fiber to feel full

2. Take Time to Exercise & Be Active

  • Park farther away
  • Stand during commercials
  • At a minimum, commit to five minutes of exercise
it’s better than zero

3. Be Consistent When Taking Medicine

  • Place your medicine where you will see it
  • Use an alarm to remind yourself when to take your medicine
  • Mark your calendar so you know you took your medicine
  • Follow your doctor’s advice

4. Find Ways to Decrease Stress

  • Take ten deep breaths
  • Get five minutes of quiet—put yourself in timeout if you have to! (your kids will find this intriguing)

5. Add Vegetables so Meals Aren’t Meat or Carbohydrate-Heavy

  • Add lots of color
  • Make a meal plan
  • Don’t fight it
just get creative!

6. Find Ways to Keep Your Whole Family Active

  • Go swimming together
  • Go to the zoo
  • Take the kids shopping
  • Use active video games like Wii or YouTube

7. Find Ways to Eat at Home, Even When You Don’t Want to Cook

  • Cook freezer or microwaveable meals
  • Cook in the crockpot
  • Plan ahead and prepare the day or weekend before

8. Eat More Fruits & Vegetables

  • Look for sales (canned and frozen often are on sale)
  • Take vegetables from neighbors or coworkers who grow them
  • Grow your own garden
  • Buy what’s in season

Taking a Goal & Making It SMART

Much of what I do in my job is help people figure out how to achieve their goals. For instance, I would love to lose ten pounds. How can I do that? I can exercise more and eat less. However, these plans are vague. When making goals, we have to make the goal SMART.

S – Specific: I will increase my exercise by five minutes each day.
M – Measurable: I will exercise an extra 25 minutes per week.
A – Achievable: I can add five extra minutes of exercise per day while watching TV.
R – Realistic: I can add five minutes in the evening and increase my exercise. I don’t have time to increase my exercise by 30 minutes a day, but I can add five minutes a day.
T – Time-bound: I will increase my exercise and reevaluate by the end of the month. If no improvement is seen, I will change my goal strategy.

Get the Help You Need to Prevent or Manage Diabetes

Bryan offers several physician clinics that provide comprehensive diabetes care for patients. At these clinics, patients receive coordinated care important to diabetes management that includes their provider as well as certified diabetes educators, registered dietitians, social workers, care navigators and pharmacists.

Additionally, the Bryan Diabetes Center offers many special programs, as well as individual consultations, to help you focus on areas such as nutrition, exercise, lifestyle changes, carbohydrate counting, medications, insulin pump use and more.

Ask your provider for a referral to Bryan Diabetes Center today! We have four locations:

We’re here to help you manage your diabetes or get on track to prevent getting diabetes in the future.

Bryan Health Diabetes Center

Learn more about how diabetes impacts your life, get management tips, and easily schedule an appointment to speak with a diabetes expert at Bryan Health today!

Learn More

Check out these resources:

Samantha Beckler

Samantha Beckler

Health Expert

Samantha Beckler is a Certified Diabetes Educator with Bryan Diabetes Center.

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Relieving Lower Back Pain

Relieving Lower Back Pain

by | May 14, 2019 | Expert Health Tips

As an interventional radiologist, I see many patients who suffer with lower back pain. It is immensely rewarding to offer my patients treatment options that:

  • Are effective
  • Done as an outpatient procedure with short recovery times
  • Provide immediate pain relief
  • Reduce the need for opioid pain medications

An interventional radiologist is a doctor that performs minimally invasive procedures through small nicks in the skin while using image guidance such as real-time x-ray, ultrasound or CT. Most procedures are outpatient and can be performed with just a local anesthetic.

Causes and Treatment Options for Lower Back Pain

A good physical exam with the addition of proper imaging of the spine when needed helps determine the cause of back pain. Initial diagnostic and treatment options may include:

  • Fluoroscopy – A technique that uses x-rays to obtain real-time moving images of the body
  • CT-guided steroid facet joint injections – Facet joints are part of the spine’s bony framework; the injection uses local anesthetic

Low Back Pain and SI Joint Pain

The sacroiliac joint (also known as SI joint) is the joint between two bones which are located in the back of your pelvis, on the left and right side. SI joint pain includes lower back pain that feels dull and aching. It can also spread to the hips, buttocks and/or groin. Some of the most common areas where you might feel SI joint pain is in the buttocks, lower back or side of the thigh.

Low Back/SI Joint Pain Treatment

If steroid injections relieve lower back pain for only a short time, a rhizotomy procedure can be performed to relieve the pain for a longer period of time. A rhizotomy procedure involves placing special needles that heat up the sensory nerves. This effectively burns a small segment of the nerve so that pain impulses can’t be sent. Pain relief lasts until the small segment is healed, which usually takes one to two years.

Sciatica

Sciatica is pain, numbness or tingling caused by a problem with the sciatic nerve. This is a large nerve that runs from the lower back, through the buttocks and down the leg. Sciatica is most commonly related to a compressed nerve in the lumbar spine from a herniated disk.

Sciatica Treatment

If physical therapy or over the counter anti-inflammatory/pain medications have not been effective, an epidural injection of steroid/anesthetic can help confirm the diagnosis and offer temporary and sometimes long-term relief.

Lumbar Spinal Stenosis

Lumbar spinal stenosis is narrowing of the spinal canal, or passageways in the spine. These passageways contain the spinal cord and nerves. The narrowing is most often caused by degenerative changes in the spine as we age. The spinal cord and the nerve roots that exit the spinal canal can become pinched. Symptoms include pain, numbness and/or cramping in the legs when walking or standing. Sometimes the symptoms can be relieved by leaning forward when sitting or walking, such as leaning over a shopping cart to decrease the pain.

Lumbar Spinal Stenosis Treatment

For moderate spinal stenosis, a small implant about the size of a dime can be placed between the bones (spinous processes) in your lower back. These bones can be felt by placing your fingers down the center of the back. The implant increases the space where your nerves exit the spine, relieving your pain.

Diagram of lower back pain

Osteoporosis

Osteoporosis affects more than 50 million people in the United States. As we age, our bones become thinner, increasing the risk of spinal compression fractures. These fractures can result from a fall, lifting something or sometimes from no event at all. If you have severe back pain that gets worse when you move, this could be caused by a compression fracture.

Treating Compression Fractures of the Spine

Minimally invasive treatments such as kyphoplasty and SpineJack vertebral augmentation stabilize the fracture and decrease pain. These procedures insert bone cement into the proper areas of the spine to ease your pain. The procedures take less than an hour. Most patients have immediate pain relief and go home the same day.

View videos to learn more about these procedures and how they relieve pain

Kyphoplasty Treatment: Esther’s Story

SpineJack Treatment: Duane’s Story 

Get Relief for Your Lower Back Pain

If you suffer from back pain and would like to learn more about our minimally invasive therapies to relieve your pain, call Bryan Interventional Radiology at 402-481-3095.

To schedule a consultation, call the Bryan Scheduling Center at 402-481-5121.

Call Now!

Interventional Radiologists

Advanced Radiology at Bryan Medical Center

The interventional radiologists of Advanced Radiology at Bryan Medical Center offer expertise and options to treat your back pain.

Being at the forefront of advances in medicine allows Advanced Radiology to offer patients the latest treatments in addition to current treatments. Dr. Budler was one of the first 10 physicians in the United States and the first in Nebraska trained on the SpineJack procedure. The Advanced Radiology team has the most experience in Nebraska in performing vertebral augmentation procedures like the SpineJack to relieve back pain.

Meet interventional radiologists of Advanced Radiology at Bryan Medical Center: Michael Budler, MD; John Allen, MD; Kyle Pfeifer, MD; Jeffrey Himmelberg, MD!

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Foods & Exercises to Reduce Your Arthritis Pain

Foods & Exercises to Reduce Your Arthritis Pain

by | Apr 16, 2019 | Expert Health Tips

The pain and discomfort of arthritis can have a big effect on your quality of life. A good exercise program and a healthy diet have been shown to increase your mobility (ability to get around) and provide medication-free pain relief.

3 Areas of Focus to Reduce Your Arthritis Pain

As a nurse practitioner, I believe knowledge is power. Here are three items I share with my patients to improve their daily life with arthritis:

  • Foods to avoid because they can increase inflammation and arthritis symptoms
  • Foods that can decrease some of your arthritis pains
  • Exercises you can do without causing stress and pressure on your joints


Foods to Avoid if You Have Arthritis

There are certain types of foods that are considered pro-inflammatory, meaning they can increase inflammation. In general, more inflammation equals more pain, specifically in your joints.

Limit the following in your diet to avoid inflammation:

  • Sugar
  • Saturated fats
  • Trans fats
  • Refined carbohydrates
  • MSG
  • Aspartame
  • Alcohol

Foods high in sodium also have been found to increase inflammation, so it’s important that you try to limit these types of foods in your diet.

Most people in America tend to have diets that are high in saturated fats and trans fats. A good step is to look at food labels and make sure these are limited, if not completely eliminated from your diet.

In general, try to avoid the inner aisles of the grocery store. Most foods in this area contain refined carbohydrates and things we need to avoid because they increase inflammation. Plus, this is where you’re more likely to find processed foods. For the most part, if you can’t pronounce the ingredient on the label, it’s probably not a good choice.

Foods and Supplements that Help Arthritis Pain

Many foods are considered to be anti-inflammatory. Lowering inflammation can decrease arthritis pain.

Include these foods in your diet to help fight inflammation:

  • Omega 3s, such as fish like salmon, dark leafy greens, olive oil and nuts
  • Cherries 
  • Green tea
  • Whole grains
  • Citrus fruits like pineapple and oranges
  • High fiber foods

Glucosamine and chondroitin supplements

Our general rule with supplements like glucosamine and chondroitin is to give it a try for about three months. If you do not notice a difference in your joints and your joint pain, stop taking it. Many times people find that after they stop taking it, they notice it really was working and making a difference. I have several patients that absolutely swear by glucosamine and chondroitin.

Exercises to Ease Joint and Arthritis Pain

Low impact exercises that don’t put a lot of pressure on your knees and ankles are good options if you have arthritis.

Low impact exercises include:

  • Swimming – try lifting weights in the water for an added workout
  • Machines like a NuStep, where you’re moving back and forth and not putting weight on your knees
  • Gentle walking
  • Weight lifting with the guide of a trainer who can show you ways to lift weights and still protect your joints
  • Yoga and Tai Chi

Take Steps to Control Your Arthritis Pain and Feel Better

By reducing inflammation, you’ll have more energy to get out and walk, stretch and do other activities. If you need a bit of direction, working with a personal trainer or a nutritionist is a wonderful option.

Knowledge is power. The more you know about your disease process, proper nutrition and exercise, the better prepared you’ll be to take steps toward feeling better and living a more active, less painful life.

Want More Information on the Ways to Manage Arthritis?

Listen Now!
Jaimie Russell

Jaimie Russell

APRN-NP

Jaimie Russell, APRN-NP, is a nurse practitioner with the Arthritis Center of Nebraska

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Advice about Eating Fish: What Pregnant Women and Parents Should Know

Advice about Eating Fish: What Pregnant Women and Parents Should Know

by | Mar 18, 2019 | Expert Health Tips

Can you eat too much Salmon or Tilapia?

A healthy diet during pregnancy is important for the proper growth and development of your baby. As a specialist in Maternal-Fetal Medicine, I am often asked about eating fish during pregnancy. 

  • How much fish can I eat?
  • Can I eat sushi?
  • Are there “good” and “bad” fish to eat during pregnancy?
  • Is fish good for my baby’s brain development?
  • What about mercury? That’s bad, right?

Luckily, there are some clear guidelines about eating fish for pregnant women, infants and children, and people in all stages of life!

How does eating fish affect my baby’s health and brain development during pregnancy?

  • Fish, including finfish and shellfish, is low in saturated fat, high in protein and healthy to eat during pregnancy. It is also the primary dietary source for two n-3 (also called omega-3) long-chain polyunsaturated fatty acids.
  • For your baby’s optimal eye and brain development, moms need to include foods with omega-3 fatty acids in their diet.
  • Omega-3 fatty acids are especially important for moms during the last trimester of pregnancy and while breastfeeding as this is when your baby’s brain is rapidly developing.
  • Omega-3 fatty acids are also available as supplements and in fortified foods such as milk, yogurt, bread and even chocolate. You’ll just need to read the nutrition label to find out if the food includes omega-3 fatty acids. This can be an alternative source of omega-3 fatty acids for women who cannot or choose not to consume fish.

What about mercury?

  • While mercury is present in all fish, the levels vary depending on the type of fish.
  • One to three servings per week of a variety of seafood high in omega-3 fatty acids and low in mercury are recommended by the United States Food & Drug Administration and Environmental Protection Agency.
  • Mercury, also called methylmercury, is toxic to your baby’s developing brain. For this reason, it is important to avoid eating fish high in mercury. It cannot be ‘cooked out’ of the fish, and over 95 percent of it is absorbed. You want to gain the benefits of omega-3 fatty acids that fish provide while limiting the negative side effects of mercury.
  • Avoid eating fish high in mercury such as: king mackerel, marlin, orange roughy, shark, swordfish, tilefish (Gulf of Mexico), tuna and bigeye.

Can I eat fish caught at a lake, river or coastal area?

  • Fishing is a popular pastime for many Nebraskans.
  • Check for advisories about the safety of eating fish caught in areas where you plan to fish. This can usually be found on websites or through a Google search.
  • If no advice is available, the United States Food & Drug Administration recommends limiting the amount of fish you eat caught in these areas to six ounces (one average meal) per week and not eating any other fish during that week.

What about sushi?

If you’re pregnant, you should only eat cooked fish. And if you love sushi, don’t worry! There are many sushi options that use cooked fish. You can usually find these options on the menu or you can ask your server.

Which fish are good for me, my baby and family?

To answer the question in this blog title, Salmon and Tilapia are in the Best Choice category, and two-three servings per week is recommended.

The following table sums it up nicely!

Advice for eating fish.

Follow this link for more advice regarding eating fish from the FDA.

What is a Maternal-Fetal Medicine doctor?

Learn more
Benjamin Byers, DO

Benjamin Byers, DO

Maternal-Fetal Medicine Specialist

Dr. Byers is a Maternal-Fetal Medicine specialist with the Center for Maternal & Fetal Care, part of the Bryan Physician Network.

He has been in practice in Lincoln since 2014. Before this, he was a doctor in the US Army for 13 years, achieving the rank of lieutenant colonel. Although native to Iowa, he is an avid Cornhusker fan!

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It’s Not Your Mother’s Mammogram Anymore!

It’s Not Your Mother’s Mammogram Anymore!

by | Feb 18, 2019 | Expert Health Tips

If it’s time for your first mammogram, don’t be afraid to make your appointment because everyone is telling you “horror stories” about how painful mammograms are. Or, if you had a mammogram years ago and will not have another one because of a bad experience, don’t despair. Read More

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How to Promote Healthy Screen Time for Your Kids

How to Promote Healthy Screen Time for Your Kids

by | Jan 22, 2019 | Expert Health Tips

Today’s children are growing up immersed in digital media. In the past couple years, we have seen an explosion of social media, different devices and ways for kids to interact with technology.

The concept of screen time is also changing. Kids used to spend their screen time watching TV. Now with computers children and teens are not really watching as much TV, although they are watching shows on their computers. And of course they’re watching YouTube! They’re also on Instagram and Snapchat. Plus, a lot of their schoolwork and homework is done on the computer.

All of this changes how we look at screen time.

Changing Times and a New Way to Look at Screen Time

In the past, the recommendation was two hours of screen time a day, and that was pretty straightforward. Nowadays, if we set a two-hour limit a lot of kids would hit that before lunchtime because they’re doing homework on screens in their classrooms. So we have to look at screen time differently. Rather than a specific number of hours per day, we need to look at what types of media children are using and the value of the interaction.

Think of Screen Time like the Food Pyramid

There are things we should have sparingly and there are things that should fill more of our plate.

At the top of the pyramid, the fats and sweets of screen time use, is mindless watching. This is where a child sits in front of the TV (or on an iPad or computer) and watches cartoons. This is fine when parents need to make dinner, or the child needs a break to watch their favorite show. It’s just not something you want to do all the time.

Below that on the food pyramid I think of watching shows with your child. This is better because you’re able to engage with your child. Instead of your child just sitting there, you can enjoy the show with them. You can ask, “What would you do if that happened to you?” Or, “What do you think she’s going to do next?” This creates a conversation and encourages your child to think about different things while watching something fun.

Below that, and even better, are educational games where your child can either learn something or solve puzzles. This engages your child’s mind. So when you’re breaking up screen time, you can allow more time for activities versus mindless show watching.

Guidelines for Screen Time by Your Child’s Age

Under 18 months

Use screens as sparingly as possible. Sometimes younger children will be exposed to screens when older siblings are watching TV or are on the computer. I would try to be aware of this and prevent it from happening as much as possible.

Around age 2

You can start to introduce screen time. I encourage parents to be very consistent and thoughtful about what types of digital media your children are exposed to. Giving a child a cell phone at a restaurant to help them wait until the food arrives, that’s fine. I worry more when kids are at home and instead of playing with a parent, sibling or toy, they’re in front of a TV or tablet.

Early Tweens and Older Children

Starting in the early tween years (and even around age 8), I would definitely have a very close eye on your child’s screen time use. This is where children develop a lot of habits they might have for the rest of their life in terms of screen time and the way they interact with others online.

For older kids, there’s Instagram, Snapchat and a million other social media platforms. Being very careful about how much time you allow your child to have on these platforms is critical. It’s also important to make sure they aren’t replacing all of their interaction with their friends and peers with online interaction.

Guidelines for parents:

  • Know your child’s passwords
  • Be able to look at their phone/device at any time
  • All devices should sleep, meaning charge somewhere other than the bedroom so notifications don’t disrupt sleep
  • Children should use their screens in public places in the house, the family room or kitchen table

Setting guidelines gives your child some autonomy and also protects them from some of the dangers that exist with social media.

Be a Role Model

The other thing I share with parents is being a role model for your child. So if I as a parent tell my children to get off their screens, but then I’m getting notifications and looking at my phone at the dinner table, or pulling my phone out when we’re having family time, I’m not modeling what I want my children to do.

It’s very important to have time where we say no phones, and we put them in a basket or a different room, and sit down for dinner or a nice conversation without anyone getting notifications or hearing text message dings. We have to model self-control as parents and say, “Okay, I’m going to put my phone on silent so we can talk, relax, watch this show together, read books or go play outside.” This shows your child what’s important to you.

Set Family Rules for Screen Time

Whatever you decide for your family, I encourage you to sit down and talk about it together, write it on a piece of paper, put it on the fridge and say, “This is our plan for screen time.” It shows your children that screen time is important for all of us.

Setting rules for everyone, and modeling that behavior as parents, reinforces that while screens are useful and have a lot to offer us, there are more important ways to interact and more important things to do than be consumed with our screens all the time.

Join our Facebook Group

Phil Boucher, MD is a pediatrician with Lincoln Pediatric Group. You’re invited to join his Facebook group for parents called “Present and Productive Parents.”

Join today, start learning and connecting with other parents.

Join now!
Phil Boucher, MD

Phil Boucher, MD

Pediatrician with Lincoln Pediatric Group.

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How old is too old to have a baby?

How old is too old to have a baby?

by | Dec 12, 2018 | Expert Health Tips

My wife Tracy and I had our last child Zoe when she was almost 41 (although I still don’t think Tracy looks a day over 29). That was 11 years ago. Today, school events are interesting when I go to pay for something and they see my AARP card* and think I’m Zoe’s grandfather. (*Just kidding! I haven’t joined yet but I could.) Read More

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The Final Piece of Your Bucket List

The Final Piece of Your Bucket List

by | Nov 14, 2018 | Expert Health Tips

Creating a bucket list is fun! It’s great to think about and list all the things we want to do in life. What isn’t so much fun is thinking about the health care we do or don’t want during an emergency or as we near the end of life. Read More

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The Best Skin Care Routines for Your 30s, 40s, 50s and Beyond

The Best Skin Care Routines for Your 30s, 40s, 50s and Beyond

by | Oct 8, 2018 | Expert Health Tips

Invest in Your Skin—It’s With You for Life

Investing in your skin at any age can payoff in the long run. Take it from me, the teenage sun-soaker with good ole baby oil and iodine. Sound familiar? Not until my early 30s did I start to see the damage creep up to the visible layer of my skin. I was mortified. It was also at about that time I was completing my physician assistant program (career #2).

Taking Control of My Skin Care Routine

Several light therapy laser treatments and a new medical grade product line later, I was finally reaping the benefits of my investments. No more brown splotches, no more gaping pores. I was on track.

Fast forward to today
If I had a dime for everyone who asks me how they can get their skin to look as good as mine (disclosure: I’ll be 50 next week), I’d back down to working only 10 hours a week. That being said, very few people can start out with the complexity of my daily product routine without having major anxiety.

Four Simple Skin Care Steps For Every Age Group

If you’re interested in improving your skin, here are the four overall steps I recommend to everyone.

  • Cleanse Your Face: Morning and Night
    Yes, two times even if you aren’t wearing makeup or are just waking up for the day. Don’t tell me you don’t brush your teeth twice a day!
  • Use Vitamin C: Morning
    (Or equivalent antioxidants)
  • Moisturize: Morning and Night
  • Sunscreen: Morning and Before Going out in the Sun

That’s it! If you can do this at any age, five or more times a week, you are doing better than 80% of the population.

Let’s Talk About Cleansers

First things first, please don’t use body soap on your face. Use face-specific products so you don’t strip your skin and dry it out.

RELATED5 Crucial Numbers Every Woman Needs to Know

Here’s what you can do in your:

  • 20s: This depends on your skin type. For oily or acne prone skin, a cleanser with salicylic acid is beneficial to address these issues and cleanse your skin. For normal skin, a simple foaming cleanser is a good choice.
  • 30-50s: I recommend a cleanser with glycolic acid to help exfoliate dead skin.
  • 50 and up: I typically recommend the glycolic based cleansers OR a gentle cleanser depending on your skin.
  • For those with dry or sensitive skin: A good ceramide-based or gentle cleanser works wonderfully.

Vitamin C & Antioxidants

Antioxidants help protect your skin against free radicals and conditions in our environment such as dirt and air pollution. These rob your skin of oxygen and steal electrons from healthy cells. Topical Vitamin C is best known to protect your skin against these stressors. There are also some other new products now available.

Here’s what you can do in your:

  • 20s-mid 30s: At this age, you can get by with a product that contains 10% or 15% Vitamin C. The maximum percent that your skin can absorb is 20%.
  • Late 30s and up: This is the time to really step it up with a multi-defense antioxidant product that contains Vitamin C and may also include Vitamin E, Ferulic Acid or Resveratrol. These are just a few ingredients that provide an extra boost to your skin.

Be aware: Not all Vitamin C is created equal! To penetrate your skin and make a difference, it has to be formulated in a serum that has a pH of 3.5 or lower. Spoiler alert, over-the-counter products can’t achieve this!

Moisturizers are Simple!

Easy tips for all ages:

  • Find one that fits your skin needs, or come ask me.
  • Medical grade products are able to offer more specialized components not found in over-the-counter products to address specific needs.
  • SPF is not needed in your moisturizer because you simply don’t need it at night and it is intended for reapplication throughout the day.

SPF – It’s Not Your Mom’s Sunblock Anymore!

This brings me to the last and most important step, SPF! It is crucial to start using this every day of your life, no matter what! If you like a tan face, use a bronzer or self-tanner.

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Did you know?

  • SPF only rates UVB rays, not UVA.
  • SPF 32-50 provides the most effective protection and are essentially of equal value.
  • Infrared (IR) light and blue light (think computer screens and phone screens) contribute to skin damage.

Two specific sunscreens that should be in everyone’s arsenal for the face are:

How to Start Your 4-Step Routine or Step Up Your Game

I recommend you find the right products for your age and skin in each of these four areas and begin using them every day! If you’re confused or don’t know where to start, I’m happy to visit with you. I take the time to get to know your current routine (or lack thereof) and go from there. At The Spa at Bryan LifePointe, we offer free consultations to help you determine what’s best for you.

To learn more about services to enhance your skin, visit bryanlifepointe.org/spa.

Carrie Kleinschmidt

Carrie Kleinschmidt

PA-C, Bryan LifePointe MedSpa

Carrie earned her physician assistant degree in 2001 from Union College after working as a registered dietitian for eight years. Following graduation, she worked in both family practice and aesthetics offices. Her experience in aesthetics led her to The Spa at Bryan LifePointe. Carrie enjoys working individually with patients to help them look and feel their best.

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The #1 Deadly Condition Treated in the Hospital May Surprise You

The #1 Deadly Condition Treated in the Hospital May Surprise You

by | Sep 10, 2018 | Expert Health Tips

It’s unknown to most people but serious and life threatening.

Being an ICU nurse, I have seen it all. I’ve seen young children come in struggling to breathe due to an asthma attack. I’ve seen elderly people come in after having CPR to restart their heart. I’ve helped bring people back to life. But, the thing that I have seen most in the hospital might surprise you. When you think of what the number one cause of death in the United States would be, what comes to mind? Cancer? Heart disease? While those are prevalent throughout the United States, it might surprise you to know that sepsis is the leading cause of death in United States hospitals.

So, What in the World is Sepsis?

With September being Sepsis Awareness Month, I feel it is important for you to know what sepsis is and how to prevent/detect sepsis in yourself or your loved ones. So, what in the world is sepsis? In general, it is the body’s overwhelming response to an infection that can lead to tissue damage, organ failure, amputations, and even death.

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You may have never even heard of sepsis. Most people haven’t. Yet, it is the number one killer with people coming to the ER when they are already in organ failure. Like a heart attack or stroke, time is of the essence when treating sepsis. This is necessary to protect your organs from going into failure.

Do You Know the Warning Signs and Importance of Immediate Treatment?

Here are some facts that may surprise you:

  • Less than 1% of the population can name the signs and symptoms of sepsis
  • Death from sepsis increases by as much as 8% for every hour that treatment is delayed
  • Most cases of sepsis begin at home (up to 87% of sepsis cases) and not in the hospital
  • As many as 80% of sepsis deaths could be prevented with rapid diagnosis and treatment

Most people either don’t know about sepsis or they assume it only happens to a vulnerable population. The truth is, sepsis knows no age discrimination, it doesn’t affect men more than women, and it doesn’t affect the older generation more than young children.

What are the Warning Signs?

Sepsis can start with something as simple as a small cut or a toothache that can develop into an infection. Now, not every cut or toothache develops into sepsis, but it is important to know what to look for as a possible indication of sepsis. So you may be asking, what are the signs and symptoms?

Think SEPSIS

S – Shivering, fever, or very cold

E – Extreme pain or general discomfort (“worst ever”)

P – Pale or discolored skin

S – Sleepy, difficult to rouse, confused

I – “I feel like I might die”

S – Shortness of breath

Take ACTION

If you see a combination of these symptoms and suspect sepsis, see a medical professional IMMEDIATELY.  The sooner treatment gets started, the better chance you or your loved one has at surviving and making a full recovery.

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When caught early, immediate administration of IV antibiotics and fluids can be all you need to make a full recovery. However, if organ failure has already started by the time someone comes to the hospital, they may need to come see me in the ICU. You may need medications to raise your blood pressure or have a breathing tube hooked up to a ventilator to help provide the oxygen you need. 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 a nurse, I have made it my job to tell all my friends and loved ones about the signs and symptoms of sepsis, and ways to prevent it.

Prevention starts with something as simple as washing your hands and cleaning any cut/injury. A lot of people don’t realize that bacteria naturally lives on your skin and given the right circumstances can grow into an infection from something as little as a cut or burn.

I urge you to tell everyone you know about the signs and symptoms as well as the ways to prevent sepsis. 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 latest Bryan Health podcast. Bill Johnson, MD, Nebraska Pulmonary Specialties shares how you can spot this condition, and emphasizes how early diagnosis and treatment can be lifesaving.

Listen Now
Paige Fellers

Paige Fellers

RN, ICU

Paige Fellers is a registered nurse in the ICU at Bryan Health.

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If you could prevent your child from getting cancer, what would you do?

If you could prevent your child from getting cancer, what would you do?

by | Aug 14, 2018 | Expert Health Tips

You have the power to prevent cancer your child could get later in life

The dog days of summer are upon us and my family of six has spent countless days at the pool, baseball games and summer camps. Now a new school year is starting, and it’s a good time to make sure our children are up to date on their check-ups with the doctor, dentist and optometrist. As a parent of kids ranging in ages from eight to 13, this year also included discussions about the importance of getting the HPV vaccine for cancer prevention.

What is HPV, and how does it lead to cancer?

HPV stands for the human papillomavirus. It includes a group of more than 150 related viruses. Some types of HPV can cause warts or papillomas, which are non-cancerous. Most of the time our body’s natural immune systems can fight off the infections the virus can cause. But, some types of HPV cause cancer in both men and women. According to the American Cancer Society (ACS), HPV causes most cases of cervical cancer, and nearly all cases of pre-cervical cancers. It also causes many vaginal, vulvar, anal, penile, throat and tongue cancers.

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As I began to learn more about HPV, I found myself wondering how common is the virus. What I found was astounding:

  • Each year in the United States 31,500 people are diagnosed with a cancer related to an HPV infection.
  • The virus spreads through skin-to-skin contact. Any man or woman who has ever had sex, including vaginal, anal or oral, can get the virus.
  • Four out of five people will have HPV at some point in their lives, according to the latest estimates. The virus is so common that the best way to prevent an HPV infection is to get vaccinated.

Is the HPV vaccine safe?

This is the first thing I wanted to know after hearing about this cancer prevention vaccine! I felt comforted knowing that more than 270 million doses have been given around the world since 2006, according to the Centers for Disease Control (CDC). As a registered nurse, I understand any vaccination has potential side effects. Yet many people who get the HPV vaccine report no side effects. Potential side effects of the HPV vaccine have been mild like other vaccines. The HPV vaccine is approved by the CDC, and like all vaccines, receives ongoing monitoring.

So how can I prevent cancers that my kids could get later in life?

As a cancer nurse navigator and a mom of four children, I was very interested in the current recommendations to prevent HPV related cancers. I started by having a conversation with our family doctor. I learned my kids could receive the two series vaccination (six-12 months apart), as early as age nine or ten. The CDC highly recommends kids be vaccinated at ages 11 or 12, as that is when the vaccine has been shown to be the most effective. If a child starts the vaccination series between the ages of 15-26, a third vaccination is recommended.

The HPV vaccine prevents infections from nine HPV types that cause HPV cancers. According to the American Cancer Society, receiving the vaccine before being exposed to the virus can prevent up to 90% of HPV cancers!

As I was making doctor’s appointments for my kids, my almost 11-year-old son openly shared his disgust in having yet another “shot” scheduled with his upcoming appointment. This brought up a great moment to have a conversation about the purpose of this vaccine in preventing certain cancers later in life. He has heard many of my stories over the years of people struggling with cancer. He asked several great questions about the vaccine, and I didn’t hear him complain again.

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A week later his sister was giving him a hard time that he was the ONLY kid who needed a shot this year. He promptly responded, “I’d rather have a two-second sting than a cancer that I didn’t need to have!” Proud mom moment!

I have had the personal experience of caring for patients with HPV related cancers. With this new cancer prevention vaccine, I feel so lucky to live during a time where these types of cancers could be greatly reduced or even eliminated in my kids’ generation!

My suggestion for parents is to talk with your child’s doctor about the HPV vaccine, and to your children about why “another shot” is so important. For more information, check out the links below.

www.cancer.org/hpv

www.cdc.gov/hpv

*Information for this blog provided by American Cancer Society.

Carmen Orr

Carmen Orr

RN, Cancer Nurse Navigator

Carmen Orr is a Bryan Medical Center oncology nurse navigator, which is a  specially trained nurses who are here to help you and your family through each step of your cancer journey.

How Important is the HPV Vaccine?

Listen to our podcast with Dr. Philip Boucher, a pediatrician with Lincoln Pediatric Group, to learn more about the importance of the HPV vaccine, research done on its effectiveness and tips on talking to your child about why they are getting the vaccine.

Listen Now!

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