High Cholesterol in Kids

High Cholesterol in Kids

After celebrating Father’s Day, I realized how lucky I am to have my father in my life. About 15 years ago when I was a freshman in college, my day had a heart attack. He had to undergo a quadruple bypass surgery and wasn’t given very good odds of survival. He is now 67 and doing well.

However, this made me want to know everything about my heath and how to protect my heart. So I made a doctor’s appointment and did different testing. I wanted to be prepared. And now when I visit the doctor, I have to check the box, “heart disease in family.” However, it wasn’t until many years later that I thought about my kids having to check that box, too.

Checking Cholesterol Levels

Kids might not commiserate over their cholesterol levels on the playground like coworkers chatting about weight at a water cooler. Still, now that my children are older I realized that I needed to be aware of how their cholesterol today may affect them much later.

During Cohen’s 10-year wellness visit, the doctor wanted to check his cholesterol. Not because he is overweight but because I checked the box “heart disease in family.” The doctor told me that cholesterol levels in children are linked to three factors: heredity, diet, and obesity.

After his finger prick, Cohen’s levels came back slightly elevated and concerning. He has borderline high cholesterol. Luckily, he didn’t have to do the full test of fasting and blood draw but he will need to be tested every year. This made me think that adults are not the only people affected by high cholesterol.

The doctor handed me a pamphlet, and I took to the internet to see how I could help lower his cholesterol. Activity and healthy foods, that’s what I kept reading on what to do. He is pretty active with soccer, and we also make exercise a part of our family’s everyday routine. We make fitness time into together time. However, one thing I knew we could all probably do better at is eating. Like I said, he isn’t overweight, and we don’t have a family history of obesity, but we needed to change some habits to help lead heart healthy lives.

Changing Eating Habits

Here is what we decided to do. I myself try to lead a healthy lifestyle, but now I make sure to read the nutrition labels and check for cholesterol, as well as saturated and trans fat intake. We try to avoid foods that are high in saturated fats. That means doing things like choosing low-fat dairy products, steering clear of solid fats and choosing a variety of protein.

I decided to pack healthy lunches for school and summer camps and have him forego the junk food in the school cafeteria and choose healthier items instead. He now helps with meal planning. We make it a game or explore new recipes and foods as a family.

I know there’s a lot of pressure on parents to try to overhaul everything in their diet and perhaps set some pretty high standards for a family meal—standards that might be difficult to reach day after day. I think it’s important to set little goals and understand that getting fast food every once in a while is okay.

Embracing a Healthy Lifestyle

We have embraced lifestyle changes for the entire family. Now for dinner, we make one meal for the whole family. Planning meals in advance is a key strategy that helps my family get healthful meals on the table consistently. With busy schedules and everyone on the go, we eat in shifts, but if dinner is already made everyone can at least eat the same thing.

Lastly, and this was the hardest one for my kids, healthy snacks. We encouraged a gradual change that’s attainable. I set snack times instead of having them graze all day. Once snack time is over, the pantry is closed. Most meals and snacks include water. My kids rarely drink pop or juice.

I’m hoping by doing these heart healthy changes most of the time and continuing to get cholesterol checks, my kids will be far less likely to become a heart disease statistic down the road.

Mallory Connelly

Mallory Connelly

Babies & Toddlers

In addition to the time I devote to being a mom, I also work full-time outside the home, which means my day is hardly ever as simple as nine to five. With an all-too-established schedule, as soon as I walk through the door, my day doesn’t end, but rather just begins. It’s a balancing act, especially with two children, but being a mom is one full-time job that I never want to quit!

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Fish Oil Benefits: New Research May Surprise You

Fish Oil Benefits: New Research May Surprise You

Many of us have heard of fish oil and how it can benefit heart health, and as a cardiologist, I get asked a lot of questions about it. The truth is, studies vary on this supplement. Here is information from recent studies that provide insights into the benefits of fish oil.

It All Starts with Omega-3 Fatty Acids

Omega-3 fatty acids are most abundant in marine animals. A lot of the interest in omega-3 fatty acids and fish oils have come from observations that populations who eat a lot of fish are less likely to develop heart disease. Studies have shown that eating fish once or twice a week is associated with a reduced risk of heart disease. Other animal meats also contain omega-3, but fish, in particular, is a rich source of omega-3 fatty acids.

Research Trials & a Stunning Result

In nutrition and medicine, a lot of findings start with an observation and that’s exactly the way it was with omega-3 fatty acids. The observation being that people who eat more fish tend to live longer and have a lower risk of heart disease.

Out of this came a series of trials to study omega-3 fatty acid supplements because we think these polyunsaturated fatty acids are one of the main reasons fish is such a healthy food to include in our diets. So, the question became, “can we extract that out of the fish and use it as a supplement to try and protect us from heart disease?”

Many of the trials produced some conflicting results about whether these supplements are helpful.

But one trial had stunning results. This trial studied a prescription form of omega-3 fatty acids, called icosapent ethyl; the brand name is Vascepa. This product is highly regulated and highly purified, and the study showed it provided impressive heart protecting benefits.

Breaking Down the Research

The information about fish being a part of a healthy diet that protects us from heart disease has become so much a part of our understanding that omega-3 fatty acid supplementation is still a part of the American Heart Association guidelines to help prevent heart disease. And of course, we always recommend eating fish to protect against heart disease.

But, how effective are fish oil supplements? Three specific trials tested the fish oil supplement hypothesis. These were well-conducted studies published in the New England Journal of Medicine. Let’s break them down.

The VITAL Trial

This study was done using the types of omega-3 fatty acids you’ll find as over-the-counter supplements at the same dose recommended by the American Heart Association, which is one gram per day. These trials looked primarily at prevention for men over 50 or women over 55. Over 25,000 enrollees were followed for five years. Some received omega-3 supplements, and some received a placebo. This study showed no difference in major cardiovascular events (which included heart attacks, strokes and heart disease).

So, there was no benefit that they could document in this huge trial for five years.

The ASCEND Trial

This trial also used over-the-counter supplements but studied people with diabetes who did not have a history of heart disease. Over 15,000 people participated in the trial. They took the same dose of a fish oil supplement, one gram per day, and were followed for seven years. Again, the study did not show a significant reduction in cardiovascular events.

The topline data from these two studies is that over-the-counter fish oil supplements did not seem to protect people from cardiovascular events.

The REDUCE-IT Trial

The results of this study were positive and impressive. This was a highly credible study published in the New England Journal of Medicine. It included over 8,000 patients with established heart disease, or who had diabetes plus additional risk factors. They were followed for five years. These participants were already taking a statin, a cholesterol lowering drug, so they were already getting the standard protective, preventive therapy that we recommend for all patients who’ve had a cardiovascular event.

So, these patients were receiving good care, but they still had high triglycerides, which are associated with heart event risks. Omega-3 fatty acids are particularly good at lowering triglycerides, so the thinking was perhaps those who still had high triglyceride levels despite taking a statin would benefit from this specific form of polyunsaturated fatty acid. A key difference in this study is that patients took a highly purified form of omega-3 fatty acid. It’s called icosapent ethyl; the brand name is Vascepa. This prescription drug had already been approved by the FDA for treatment of patients with severe elevations of triglycerides, one form of circulating fats in the bloodstream. To test the effects of icosapent ethyl (Vascepa) on heart disease, subjects were given four grams a day versus a placebo, and were followed for five years.

The results were something we had never seen before related to benefits. They showed a:

  • 25% reduction in the combined end-point of heart attack, stroke, cardiovascular death and some coronary revascularization (i.e., getting a stent)
  • 26% reduction in just heart attack, stroke and death
  • 20% lower risk of death in people getting this highly purified form of omega-3 fatty acids versus a placebo

Impressive Outcomes for Highly Purified Prescription Supplement

We’ve never seen anything like these results in this area of study. It’s important to emphasize that the positive results of the REDUCE-IT trial came from a very specific form of omega-3 fatty acids in a highly purified prescription drug. This was a powerful study, and I think it will influence behavior and opinions about fish oil supplementation and omega-3 fatty acids. Over-the-counter supplements, which aren’t as highly purified or regulated, did not have the same result.

Ways to Improve Your Heart Health

If you have a history of heart disease of any kind, such as stents, angioplasties, bypass or a coronary event, you might want to discuss this purified form of omega-3 fatty acid, called Vascepa, with your doctor to see if it would be helpful for you.

As far as over-the-counter fish oil supplements, as a physician it’s difficult for me to make a strong argument for it. But if I have patients that feel it is beneficial for them in how they feel, I tell them that as long as it’s not causing you harm, ‘go for it.’ Especially if it’s not unreasonably expensive.

In cardiology and in our culture, we have a long history of trying to find that essential element out of the food and making it into a supplement, thinking that’s going to help our health. And for the most part, when put to a rigorous test, these generally fail to protect us from heart disease.

I would much rather see you eat a healthy, plant-based-leaning diet, with healthy fish and meat incorporated on a regular basis.

Dr. Keith Miller, MD

Dr. Keith Miller, MD

Health Expert

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

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Drinking In Front of My Kids

Drinking In Front of My Kids

With football season less than a month away (fingers crossed) and the potential for e-learning, there seems to be more alcohol in our household.

Let’s be honest, my children are the reason I drink; therefore, I can drink in front of my children. In fact, given the last several months, my glass of wine may be the reason we’re all still alive today.

Set Boundaries

I don’t judge people with kids who drink but the subject of alcohol when it comes to kids is still a touchy subject. For some, drinking in front of younger kids is an extreme no-no, whereas others might consider a glass or two to be fine when having dinner with family.

Some of my friends can’t imagine drinking an adult beverage in front of their kids. I’ve seen parents sneak a sip when their kids aren’t looking, or wait for when their kids go to sleep, and the coast is clear. However, recently in my mom’s group, this topic was brought up in discussion and I believe that hiding your drinking or waiting till your kids are in bed sends the message that drinking is wrong.

We all know that a glass of wine here and there is not bad for you. It can actually be good for your health. If you think that drinking in front of your children is considered “bad parenting,” I just want you to think about this question, “Is there a right and wrong way to do it?”

Kids Learn By Your Actions

If we, as parents, don’t teach them how to drink, then who will? Their friends? Their friends’ parents? Television? Or maybe behind the bleachers at a football game with a kid who stole his dad’s vodka bottle? When I was growing up there was very little alcohol in my household. I never knew what drinking responsibly really meant. Teaching kids how to drink responsibly is a valuable lesson.

So even now, when my kids ask about what mommy’s drinking, I know my kids are watching and learning from my behavior and I serve as their primary role model. Alcohol is not the problem but rather the abuse of alcohol is. So, when my kids see me drinking alcohol, they know that I am an adult and I am drinking responsibly.

Some days, the day stretches out so long that without the effervescent light at the end of the tunnel, we may not make it through the day. I am in no way advocating getting truly drunk in front of your little ones, but having a drink isn’t shameful or it doesn’t need to be done behind closed doors.

Show Them What Responsibility Looks Like

When my kids leave to go to a friend’s house or one day out on their own, I want them to be prepared. My child’s success depends a great deal on what they learn and see at home.

My husband and I teach them these things by drinking responsibly, by finding a designated driver when we’ve had one too many, and by not reliving our college days with old school friends. Drinking in front of your kids is not “bad parenting,” its “responsible parenting.”

Mallory Connelly

Mallory Connelly

Babies & Toddlers

In addition to the time I devote to being a mom, I also work full-time outside the home, which means my day is hardly ever as simple as nine to five. With an all-too-established schedule, as soon as I walk through the door, my day doesn’t end, but rather just begins. It’s a balancing act, especially with two children, but being a mom is one full-time job that I never want to quit!

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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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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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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

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!

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

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.

8 Ways to Take Care of Yourself

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

If you’re concerned about developing diabetes or struggling with your diabetes or weight management (which could lead to diabetes), there is help waiting for you. Bryan Diabetes Center has nurses who are certified diabetes educators and licensed medical nutrition therapists/registered dietitians who also serve as diabetes educators. Insurance often covers this kind of education.

Bryan Health Diabetes Center

Learn more about how diabetes impacts the lives of millions every single day, get management tips, and easily schedule an appointment to speak with a diabetes expert at Bryan Health today!

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

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

  • Bryan Medical Plaza, 1600 S. 48th St.
  • Bryan LifePointe Campus, 7501 S. 27th St.
  • NorthPointe Family Medicine, 5901 N. 27th St., Suite 102

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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Plastic Surgery after Babies…Yay or Nay?

Plastic Surgery after Babies…Yay or Nay?

Saggy breasts, excess skin and my favorite, the love pouch. Like most women, my body changed after having kids. It wasn’t until I knew I was done having babies that I considered plastic surgery.

Mothers, by nature, are givers. We take care of our children, our husbands, our coworkers, other family members and friends…all before we think of ourselves. It’s rare for a mom to schedule time or activities just for herself, without feeling some degree of guilt that she’s taking time away from her family or work.

My body image is directly related to my self-esteem and how I view myself. When I feel fit, healthy and sexy, everyone benefits. My family sees a happy, confident, energetic mother who serves as a great role model.

Finding Pride in a Mother’s Body

I am proud of this body. It made two beautiful children. This is the body God gave me and I’m grateful. I’ve put in the work, I’ve lost over 40 pounds in the last year and a half, and I continue to workout and eat healthy almost every day. I’m full of energy and overall happier with my transformation. Yet, the excess skin is still there, and I’m self-conscious of my mid-section and my nonexistent boobs. I want to look as good as I feel. My children see me push through every workout. They see me say no to desserts (most of the time). Now, I want them to see my happiness. I want to see my gains in the mirror but all I see is a big stomach.

It is NOT selfish or vain for a woman to want to look good! A mother deserves to look as fit, youthful and toned as she can. Who wouldn’t want to look their very best physical self?

How a mother feels about herself as a wife and a woman is integral to her body image and self-esteem. When we look our best, we feel more secure and reflect that to others, exuding confidence, happiness and overall attractiveness. When a mother feels confident about her body, she is happier overall, her marriage benefits and so does her relationship with her children.

The Pros and Cons of Having Plastic Surgery

I know the pros and cons of having plastic surgery but the struggle I can’t seem to come to terms with is: how can I explain to my daughter that you should love yourself the way you are and that the way you look on the outside doesn’t matter, then turn around and get plastic surgery to fix something about me? However, she sees me struggle and my want for something I can’t seem to obtain on my own. Should that be enough justification? Does it make me a bad mom to say one thing and do another?

For a mom to want to take care of herself and feel youthful, feminine and attractive is NOT self-centered or unreasonable.

Having a surgical procedure is a BIG DEAL. Surgery should not be taken lightly, and planning for recovery time and help with child care, driving and the usual activities of daily living after plastic surgery is extremely important.

As long as you can afford the time needed for surgical recovery, have help in caring for your children and understand fully the risks of surgery, I can completely understand why a mom would consider going under the knife! However, knowing that you should love your body and yourself is the main priority. If you’re happy with yourself but want to enhance or better your body, then there’s no problem with considering plastic surgery.

Schedule Your Free Consultation

Did you know Dr. Cassidy Mitchell, plastic and reconstructive surgeon, offers free consultations to answer your questions and help you decide if plastic surgery is right for you.

Mallory Connelly

Mallory Connelly

Babies & Toddlers

In addition to the time I devote to being a mom, I also work full-time outside the home, which means my day is hardly ever as simple as nine to five. With an all-too-established schedule, as soon as I walk through the door, my day doesn’t end, but rather just begins. It’s a balancing act, especially with two children, but being a mom is one full-time job that I never want to quit!

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Foods & Exercises to Reduce Your Arthritis Pain

Foods & Exercises to Reduce Your Arthritis Pain

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?

Jaimie Russell

Jaimie Russell

APRN-NP

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

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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

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.

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.

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.

Paige Fellers

Paige Fellers

RN, ICU

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

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5 Tips for Managing Stress & Staying Healthy

5 Tips for Managing Stress & Staying Healthy

Some days it can seem impossible to juggle work and life while trying to stay healthy at the same time. Between working, caring for your children, assisting aging parents, making time for exercise and eating healthy, there just doesn’t seem to be enough hours in the day. Read More

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I Feel Fine, But Could I Be at Risk for Heart Disease?

I Feel Fine, But Could I Be at Risk for Heart Disease?

Blood pressure, diabetes and family history are a few well-known risk factors for heart disease, but some little-known risk factors can also threaten your heart. The scary part is you may not even be aware of them. Read More

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