Learning About Life Through Travel

Learning About Life Through Travel

I’ve listened to Matthew McConaughey’s audiobook Greenlights three times since I bought it in March. He starts out his memoir by discussing his approach to life and explained that he remembered more of his life than he forgot through reading his journals. This had me pondering what I wrote in my journals. This line caught my attention and I read it multiple times:

“I live life forward but I learn about life backwards.”

I don’t necessarily know why I wrote this as the writing around it did not go together. However, I do think there is some truth to this—learning about life backwards. Looking back, dots started connecting a long time ago to the trip my husband and I are on now.

Connecting the Dots

The dots to what this passage is teaching me started connecting three years ago after my mom passed away. I took my kids on the trip of a lifetime to all of my mom’s favorite places on the East Coast she dreamed about going to. It was nearly two weeks of learning and experiencing life in seven different states. Our family took the trip—mom never got to take the trip—but we did.

The dots continued connecting last May. After the end of the unprecedented school year, my husband took a five-day trip of self reflection. Even though I was completely nervous to send him on a trip of unknown roads across Nebraska, he needed this trip. He needed to reconnect with his purpose in life and look at life through his camera lens. I may have been scared for him, but I encouraged him and he chose to take the trip.

In November, the dots continued to connect. Our oldest daughter applied and accepted a summer position at a Christian camp in Texas. This is one experience we told her she could not turn down. She was excited about this opportunity but as time drew closer, nervousness crept in. We hugged her and gave her all of our love. Yet, she is the one who chose to get in her car and drive to this amazing experience.

Choosing to Take the Trip

Now here we are in May—one year after my husband’s trip. A trip to Jamaica with our friends, one we have planned since January. Through all of the unknowns and thoughts of “will we even be able to go?”, we passed our travel authorizations, took our COVID tests and took the trip. We chose to take the trip.

When we choose to take the trip, we live life forward and we experience life. Yet, when we look backward, we learn why choosing the trip is so important. Self-discovery, pursuit of passions but most of all, for me it’s the need to fill my bucket. As a mom and an introvert, I get emptied out quite quickly, and I needed the time of laughter and tranquillity.

When I choose to take the trip, life teaches me what I need to know at that moment. I just learn about life looking back. Next time life gives you a trip no matter how short or how long, choose to take it.

Shelly Mowinkel

Shelly Mowinkel

K-12 & Teens

My husband and I have three kids. Our oldest is a freshman in high school, and our youngest is in second grade. Most days, I feel like we are a “tag-team chauffeuring” service, yet I wouldn’t have our life any other way. Not only I am a business/technology teacher at Milford, I am also the district technology integration specialist. I love teaching because I get the opportunity to make those around me better. My hope is that, through my blogging, I am able to inspire, encourage, and share with you my adventures of being a wife, mother, and professional.

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Are You Getting Enough ‘Vitamin N’?

Are You Getting Enough ‘Vitamin N’?

‘Vitamin N’ is Nature. And nature is nurture.

Our weather is getting nice for outdoor activities, and guidelines for COVID-19 are starting to ease. What better time to take it outside for a rejuvenating, wellness-boosting nature break?

Research Shows Nature’s Health Benefits

Walking, gardening, hiking, biking, bird watching and other outdoor activities all offer health benefits. Take a walk or a bike ride on our trails or around an area lake, start up a game of Frisbee, or find a serene spot for yoga or stretching. These activities not only help increase our fitness but are excellent ways to relax and relieve tension.

Research shows there are many therapeutic benefits to being in nature: helping with sleep, boosting energy and decreasing stress hormones among them. Studies point out that just a 20-minute ‘nature pill’ can reduce stress hormones. Add several of these sessions per week, and research says you might see decreased depression, anxiety and negative thinking. Time in nature can lower blood pressure and even help with blood sugar control for those with diabetes.

Your physical fitness will improve, too. Get outside to help with weight loss goals, as well as reduce your risk of heart disease. Look to local and state park organizations for programs and trails; it can make for a great family and friend activity, too. Area lakes are another healthy source for fresh air, sunshine and movement.

How to Stay Safe Outside

Here are some things to remember to ensure your safety in the great outdoors:

Use Sunscreen

Choose a broad spectrum sunscreen that blocks both UVA and UVB rays, and make sure it’s a minimum of SPF 15. If you plan to spend the day outside in the sun, boost that to at least SPF 30. Make sure you apply it to all areas of sun-exposed skin, and don’t scrimp! Sunscreen helps prevent the immediate pain from a sunburn, as well as skin cancers related to sun exposure.

Stay Hydrated

Bring plenty of water on your adventure. If you’re exercising or working in the garden, this is doubly important. Most healthy adults should drink about 2 liters of water per day. This need increases with strenuous activity or time spent in the heat. Sports drinks replenish electrolytes lost through sweating and may be useful if you’ve been exercising or if you’re prone to sweating a lot.

Signs of heat-related illness may at first be mild. However, symptoms can become progressively worse and may involve elevated temperatures, lightheadedness, nausea, vomiting and muscle cramps. Severe dehydration often requires emergent treatment and IV hydration. The best treatment for dehydration is truly prevention.

Remember Insect Spray

This is especially important if you’re hiking or spending time in more undeveloped areas, like lakes and wooded parks. Mosquitoes, spiders and ticks can be more trouble in warmer weather. While most bug bites are only a nuisance, some can cause more serious diseases such as West Nile, Zika and Lyme disease. Choose an Environmental Protection Agency-registered repellent that has DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), para-menthane-diol (PMD) or 2-undecanone as the active ingredient.

Always read the label, but some general precautions include:

  • If using both sunscreen and bug repellent, apply the sunscreen first
  • Do not use insect repellent on children younger than age 2
  • Keep repellent out of the eyes, nose and mouth
  • Do not apply bug repellent on children’s palms
  • Clean your hands after applying
  • Do not apply repellent under clothes

Get Back to Nature for Your Mental & Physical Health

Our culture promotes too many indoor, sedentary activities. It’s time to promote a “back to nature movement” and reap the positive contributions of ‘Vitamin N’.

Whether you go it alone or with others, when you do more activities out in nature, you’ll gain improved fitness and energy, while reducing tension and depression.

Julie Wiekamp, PA-C

Julie Wiekamp, PA-C

Julie Wiekamp, PA-C, is a physician assistant at Cheney Ridge Family Medical Clinic. She cares for patients of all ages and has a special interest in women’s health, nutrition, high blood pressure and diabetes.

Learn more about Julie and the care she provides.

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Getting the COVID-19 Vaccine and Giving Back as a Volunteer

Getting the COVID-19 Vaccine and Giving Back as a Volunteer

I can’t believe COVID-19 is still here. I don’t know what I expected back in March 2020, but I never imagined it would grow to such a threat and become so devastating to the world.

I frequently will remark to my grandkids about the pandemic and how I’ve never seen anything quite like it. I remind them of past pandemics, and they do care and listen to me, but they are quickly diverted to work, school and probably social media. I’m fine with it as long as they are safe and taking care of themselves.

Getting Our COVID Vaccines

Last month, my husband and I received our second Pfizer vaccine. It’s funny, I felt such a relief and an overwhelming joy. We took selfies and sent them out to our kids and grandkids. Everyone sent well wishes and their excitement for our achievement. We did joke about our pictures. They said “I knew you were old, but I didn’t realize you’d be in THAT group!” and “Do they give you suckers after you got your shot?”

“Your bandaid is pretty small. Either your arm is buff or the shot is really little.” It was the usual banter we have with each other.

I will frequently check in with the grandkids to see how they’re doing and if they have made plans for getting their vaccines. Their responses vary, but certainly they’re moving in the right direction. Earlier this spring, their focus was on school and sports. None of their schools were offering vaccines to students, but it’s slowly changing. Slowly changing and just in time for summer vacation.

The grandkids run the gambit of where and when they’re getting their vaccines. The oldest will receive her second dose next week, while another grandkid was in sports and tested three times a week. Team members didn’t get their vaccines because of possible reactions. Now that volleyball is over for the year, she’ll decide if she’ll stay a few weeks longer in Kansas City to receive her shot or wait until she comes home for summer vacation. The youngest will wait until summer vacation. It sounds like everyone has a plan, and I hope everything works out accordingly. I think I’ve said the same thing about a grandkid’s plan when I don’t want to get too nosy but still want to know. Yep, I’m a grandma!

Volunteering at a Vaccine Clinic

Last week I volunteered at Pinnacle Bank Area (PBA) on the day that first and second doses were being given. After my personal experience, I wanted to give back to the Lancaster County Health Department. I was assigned a spot near the entrance of PBA. My group of volunteers decided to trade off duties throughout the day, which was a delight! I first provided directions to the clients with my green flags. Next, I handed out clipboards and pens to those getting their first dose, and I ended the day cleaning off the clipboards and pens.

I told the grandkids about my volunteering, and they told me “congratulations, good job,” but they also thought my tasks sounded a bit boring. I told them that it could be boring if you let it be boring, or it could be hilarious if you put some effort into it.

Handing out clipboards and saying good luck was important as I knew the gesture would be calming. Big smiles can work wonders. And I had a great time waving the green flags in the manner of the flag person at a NASCAR race! It was probably too much fun, as I laughed the whole time. Some of the clients enjoyed my enthusiastic performance, but I quickly changed to a more somber routine when I detected a bit of confusion or fear on some faces.

The grandkids understood my need to keep smiling and laugh because it’s the same thing I do with them. Laughter, positive thoughts and family will get us through this pandemic and future national and world crises. Keep on smiling and carry on. The grandkids said they would carry on the tradition!

Nancy Becker

Nancy Becker

Grandkids & Grandparents

I have four grandchildren ages 14-17. In some ways, I’m a very typical grandma, always proud of everything the kids do and wanting to help support them in whatever way I can. In other ways, I’m not very typical. My goal as a blogger is to share my thoughts and experiences that I think are funny and meaningful as I adventure through grandmahood.

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What Is a Thyroid & How Does It Affect My Health?

What Is a Thyroid & How Does It Affect My Health?

Although small, your thyroid has a big impact on your overall health. When it’s working as it should, most people don’t think about the role of their thyroid. As an endocrinologist, my specialty is the diagnosis and treatment of hormone-related conditions.

So, let’s talk more about this little gland and how it helps your body.

What Is a Thyroid?

The thyroid is a butterfly-shaped gland that sits in the front of the neck. Its job is to make thyroid hormone (T4) which circulates through the blood to the rest of the body. This hormone helps your body use energy.

How Does the Thyroid Work?

The thyroid works by creating T4 (which has 4 iodine molecules) that the body converts to T3 to use as energy when needed. The pituitary, which is a small gland in the brain, regulates how much thyroid hormone is created by producing thyroid stimulating hormone (TSH). There is a feedback loop created to keep everything in balance.

Drawing that illustrates how the thyroid works.

If the TSH increases, then the thyroid responds by making more T4. If the T4 increases, then the pituitary responds by reducing the amount of TSH produced. It’s like a faucet; the TSH turns on the T4 and the T4 turns off the TSH.

What Is Hypothyroidism?

Hypothyroidism is when the body does not have enough thyroid hormone (T4). This causes an increase in the TSH. It might also be referred to as an underactive thyroid.

Drawing of how hypothyroidism works.

Diagnosing hypothyroidism: Diagnosis is made when laboratory blood tests show an elevated TSH and a low T4.

Symptoms of hypothyroidism can vary but include: Feeling colder, getting tired more easily, drier skin, becoming depressed and developing constipation.

Some causes of hypothyroidism are: Hashimoto’s disease, surgical removal of the thyroid, radioactive iodine, thyroiditis, some types of medication and damage to the pituitary gland.

  • Hashimotos is an autoimmune disease where antibodies (TPO or thyroid peroxidase antibodies) cause damage to the thyroid, making it unable to produce thyroid hormone. This can happen quickly or over several years. It is more common in women and tends to run in families.

Treatment of hypothyroidism: Prescription levothyroxine (T4). It is important to take this medicine first thing in the morning without any other medications, supplements or food.

What Is Hyperthyroidism?

Hyperthyroidism is when the body produces too much thyroid hormone (T4) which results in a decreased TSH. It might be referred to as an overactive thyroid.

Drawing that shows how hyperthyroidism works.

Diagnosing hyperthyroidism: Diagnosis is often made when laboratory blood tests show a low TSH with an elevated T4 and/or T3. Some patients may need an ultrasound and thyroid uptake scan to diagnose toxic thyroid nodules or thyroiditis.

Symptoms of hyperthyroidism can include: Nervousness, anxiety, increased sweating, palpations (which can cause an irregular heart beat), hand tremor, difficulty sleeping, muscle weakness (especially upper arms and thighs) and increased frequency of bowel movements.

Some causes of hyperthyroidism include: Grave’s Disease (autoimmune), toxic nodules, thyroiditis or too much thyroid hormone replacement.

  • Grave’s Disease is an autoimmune disease and the most common cause of hyperthyroidism. It is caused by an antibody called TSI (thyroid stimulating immunoglobulin) that triggers the thyroid to produce too much thyroid hormone. It can also be associated with an eye disease that causes bulging of the eyes.
  • A thyroid nodule is an abnormal growth of tissue within the thyroid gland. A toxic nodule causes the thyroid gland to produce excessive amounts of thyroid hormone without the influence of TSH.
  • Thyroiditis is an inflammation of the thyroid gland that results in damage to the thyroid cells. It can be caused by several things including infection, autoimmune disease or some medications. Some women may also experience thyroiditis within a year after giving birth. Symptoms are usually those of hyperthyroidism initially and then hypothyroidism as the thyroiditis runs its course. In most people, thyroiditis resolves itself.

Treatment depends on the cause of hyperthyroidism: If the cause is Grave’s Disease, it can be treated with medication, radioactive iodine or surgical removal of the thyroid gland. A toxic nodule is treated with surgical removal of the nodule. Thyroiditis usually improves on its own with treatment of the underlying cause, and patients often receive treatment only for symptoms they are experiencing.

What Should I Do if I Think I May Have a Thyroid Problem?

Consult with your doctor about your symptoms and/or concerns.

Madeline Jones-Ryan, DO

Madeline Jones-Ryan, DO

Madeline Jones-Ryan, DO is an endocrinologist with Complete Endocrinology, part of Bryan Physician Network.

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

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

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

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

Here are some other questions you may have:

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

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

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

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

Answers to Common Colon Cancer/Colonoscopy Questions & Misperceptions

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

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

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

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

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

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

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

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

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

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

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

You Have the Power to Prevent Colon Cancer

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

I hope you will go home, talk with your family and add regular screenings to your 2021 calendar—so we can stay strong and healthy for ourselves and families.

To learn more, visit the American Cancer Society.

See a Colonoscopy

Bryan patient Ruth Van Gerpen and her doctor, Mark Griffin, MD, gastroenterologist, share details about this important screening for colon and colorectal cancer. Hear about the prep, see the actual procedure and how potential polyps (growths) can be discovered and removed.

Colon Cancer: Preventable. Treatable. Beatable.

10-minute podcast with David Newton, MD, gastroenterologist with Gastroenterology Specialties

Get the facts about colon cancer screenings including differences between home tests and colonoscopies, new details on how cases in younger people are increasing, insurance coverage and key points you need to know, and more.

Breanna Nedved, RN

Breanna Nedved, RN

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

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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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Fighting COVID-19 Fatigue

Fighting COVID-19 Fatigue

The notecard says “unplug and be thankful.” Life as we knew it changed in March. Our family made a choice to seek simplicity, extend grace and find joy in the quiet. Our family made the commitment to be intentional with our time together. Yet, this fall I faltered and gave into fatigue, gave into the negative. COVID-19 fatigue is real. It was (and still is) hard to be thankful.

There are days that I miss all the family time we encountered in the spring when COVID-19 halted our worlds. And honestly, I don’t want to lose those spring memories of how intentional our family was. Now, each day brings about feelings of being overwhelmed, exhausted and stressed. I could keep going on, however, I want to make a conscious effort to escape those feelings.

Therefore, I decided November was all about being intentional each new day. I want to be intentional about focusing on what I can appreciate this year instead of seeing the negative. I need to go back to the notecard, “unplug and be thankful.”

Being Intentional

When I focus on this mindset while not living my life on autopilot, I can see and appreciate how intentional my family is being right now. And seeing how intentional my family is during this time has been good for my soul and makes the feelings of being overwhelmed or exhausted melt away.

My husband and kids have made a conscious choice to be intentional. My husband has journaled every night since March reflecting upon his day. He has also been intentional about pursuing a doctorate degree in education even on those hard days. Our middle daughter has been intentional on healthy habits such as limiting her soda intake and a daily pushup routine. Our son has diligently been following his pushup routine while also finding time to read each day.

Fighting COVID-19 Fatigue Each Day

Nonetheless, being intentional is a choice. I long for simplicity. I long for love and being thankful. I long for grace. I long for a serving heart without compromising my own health. The choice is mine to make. The choice to unplug from the negativity and be thankful. The choice to not live my life on autopilot. The choice starts each morning with reading my notecard and ends each night with observing my family choosing to be intentional.

Those closest to me have been executing what I subconsciously have been telling myself I need to improve on. Their intentional natures will help me fight the negativity, fatigue and appreciate the good around me. And there is no better time to start being thankful than today.

Shelly Mowinkel

Shelly Mowinkel

K-12 & Teens

My husband and I have three kids. Our oldest is a freshman in high school, and our youngest is in second grade. Most days, I feel like we are a “tag-team chauffeuring” service, yet I wouldn’t have our life any other way. Not only I am a business/technology teacher at Milford, I am also the district technology integration specialist. I love teaching because I get the opportunity to make those around me better. My hope is that, through my blogging, I am able to inspire, encourage, and share with you my adventures of being a wife, mother, and professional.

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The Cycle of Emotions During the Pandemic: What You Can Do

The Cycle of Emotions During the Pandemic: What You Can Do

The world has become a very different place amid the COVID-19 pandemic. It’s only natural to experience different and possibly heightened emotions. According to the Centers for Disease Control (CDC), 40 percent of U.S. adults reported struggling with anxiety, mental health or substance use. The report in June 2020 shows a considerable rise compared to the same time period last year.

This statistic is important because it provides a glimpse into what people are feeling related to the pandemic and the changes it has brought to society. Along with depression and anxiety, people are feeling grief. There are different types of grief. The grief we feel when we lose a loved one is what we think of most often, but there’s also grief over how the world and our lives have changed. Another kind of grief, called anticipatory grief, happens when we’re uncertain what the future holds.

What Can You Do?

Understand the Stages of Grief

This will help determine if what we’re feeling is coming from one of these stages. Everyone goes through these stages differently and in no particular order. Kessler and Ross identified five stages of grief. Recently, Kessler added a sixth stage.

Here are some examples of how we might move through these stages related to the pandemic:

  1. Denial – “The pandemic is not going to impact me.”
  2. Anger – “You’re making me stay home. I can’t do the things I want to do.”
  3. Bargaining – “If I stay home for two weeks, all will be fine, right?”
  4. Depression/Sadness – “When will this end? There is no end in sight.”
  5. Acceptance – “This is real and I must accept it and find a way to move forward.”
  6. Finding Meaning – “What can I learn as a result of this?”

Find a Balance in Your Thinking

It’s easy to get pulled into negative thinking which can lead to negative feelings. One thing you can do to take control is actively practice positive thinking and even write positive daily messages in a journal.

Think About What You Can and Cannot Control

You can control the things you do – like following the advice of experts. You can wear a mask, wash your hands and social distance to keep yourself and others safe. You can learn new ways to connect virtually. You can’t control what others are doing. You can only control what you’re doing and lead by example.

Have Empathy

You will encounter people who are irritable and may catch you off guard if you’re used to them being kind. Remember the world we live in right now and show them empathy. They’re going through tough times, too. Offer support and encouragement.

Build Connectedness

This is key. Research shows the more connected we are to family, friends and the community, the less violent we’ll be toward others and ourselves, and the fewer mental health and substance use issues we’ll have.

Understand When to Seek Help

You may just need to reach out and talk to a friend, or you may need to seek help from a professional. Grief can sometimes lead to depression.

Know the symptoms of depression:

  • Persistent sad, anxious or “empty” mood
  • Feelings of hopelessness or pessimism
  • Irritability
  • Feelings of guilt, worthlessness or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy or fatigue
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering or making decisions
  • Difficulty sleeping, early-morning awakening or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts (call 1-800-273-8255 or go to nearest emergency department if experiencing this symptom)
  • Aches or pains, headaches, cramps or digestive problems without a clear physical cause and/or that do not ease even with treatment

Anyone experiencing symptoms for two or more weeks should seek professional guidance to determine if they’re experiencing depression. Bryan Medical Center offers free confidential online depression screenings.

David Miers, PhD, LIPC

David Miers, PhD, LIPC

Health Expert

Dr. Dave Miers, PhD, is the director of Bryan Behavioral Health Services. This includes mental health treatment and counseling, psychiatric evaluations including medication management, and substance use evaluations and treatment.

Learn More About Our Counseling and Mental Health Services

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Focusing on Positive Thoughts

Focusing on Positive Thoughts

As a coach, I tell my athletes there are always two things they can control: their effort and heart. In life, these are two things I can control — how much effort I put into my actions and whether I have positive or negative thoughts. A majority of the time, I consider myself a pretty positive person and look for the good in all situations, but goodness right now it is so bitterly hard.

Feelings of being overwhelmed, anxious, exhausted, concerned and finally tired. This school year has been all of these even when trying to look for the silver lining. As a teacher, I see all of the extras that are happening to keep our students and staff safe.

Worrying About Mental Well-Being

Yet, this is not what consumes my thoughts and tugs at my heart, it is the mental well-being of my colleagues and students. It is the mental well-being of my husband who is a principal. It is the mental well-being of my daughter, a freshman in college, who has all of her classes online other than a chemistry lab.

These are the moments where feelings of anxiousness, exhaustion and tiredness tug at my heart. I also find it hard to separate myself from the negativity that surrounds me. These moments seem to be more and more frequent. In these moments, I must go back to what I know: being kind, controlling my heart and controlling my actions. These three principles let go of the weight when the negative feelings keep crawling in.

The Importance of Taking Time to Recharge

No matter the busyness or how far behind I feel, taking time to recharge and be kind to myself is the starting point. The other night when all of our kids were home, we snuggled in our blankets with our hot cocoas and streamed a Christmas movie. Yes, a Christmas movie but we all needed the downtime to recharge. As a mom that is always serving our family, it is difficult to find time to recharge. Listening to encouraging podcasts while I clean, having a go-to playlist of encouraging music and focusing on positive/healthy daily habits are ways to recharge and reconnect with my life’s mission.

Two weeks ago, I went and visited my mom’s grave. I walked away from her grave site knowing that my purpose in life is still being fulfilled and I cannot grow weary in doing good. However I do need to intentionally think about my purpose. My mom always told me my purpose was to share joy. Joy comes from the heart, and I can control what my heart displays. When joy is not in my heart or negativity fills it, I need to be intentional. Intentionally seeking the good in our home, seeking the good in my classroom and seeking the good around me.

Intentionally thinking about what is on my heart and not letting negativity fill it is a challenge right now. Life is stressful and exhausting. However, I know by focusing on being kind, controlling my thoughts, while also developing positive daily habits, the weight of negativity will leave my heart and it will be filled with joy.

Shelly Mowinkel

Shelly Mowinkel

K-12 & Teens

My husband and I have three kids. Our oldest is a freshman in high school, and our youngest is in second grade. Most days, I feel like we are a “tag-team chauffeuring” service, yet I wouldn’t have our life any other way. Not only I am a business/technology teacher at Milford, I am also the district technology integration specialist. I love teaching because I get the opportunity to make those around me better. My hope is that, through my blogging, I am able to inspire, encourage, and share with you my adventures of being a wife, mother, and professional.

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FAQs for the Flu Shot in 2020

FAQs for the Flu Shot in 2020

Every year people have questions about the flu vaccine. With the COVID-19 pandemic, it’s more important than ever to be informed and take steps to protect yourself and those you love.

The flu virus can travel up to six feet when someone coughs, sneezes or talks. Droplets can land in the nose or mouth or be inhaled into the lungs. The flu is contagious – this means you should stay away from those who are sick, and if you are sick, you should not be around other people.

The flu shot/vaccine protects you from getting the flu. Here are answers to some of the most common questions about the flu vaccine.

What is a flu shot?

The flu shot is a vaccine given with a needle, usually in the arm. It protects against three to four influenza viruses. It is developed based on research that suggests which virus(es) may be the most common during the upcoming season. A high dose vaccine is available for adults over the age of 65.

Why do I need to get a flu shot every year?

Flu viruses change quickly, so last year’s vaccine may not protect you against this year’s viruses. When you get the vaccine, your immune system produces antibodies to protect you from the viruses. Over time antibody levels will decrease. This is why it’s recommended to receive a vaccine every year.

Why is it so important to get your flu shot this year?

It is very likely flu viruses and the virus that causes COVID-19 will spread together this fall and winter. Flu vaccines are approved by the FDA to prevent influenza. The flu vaccine will not prevent COVID-19. The CDC urges everyone to get their flu shot this year to reduce respiratory illnesses and the burden these illnesses can put on the health care system as we continue to treat COVID-19 patients.

Can I have flu and COVID-19 at the same time?

Yes, that’s another reason why getting the flu shot is so important this year.

Is the flu a serious illness?

Yes, the flu can be serious enough to hospitalize people, and for some, it can be deadly.

Can the flu vaccine give me the flu?

No, the vaccine does not cause the flu.

Do I still need to wear a mask if I get a flu shot?

Yes, wearing a mask is still recommended to protect yourself against other viruses, including COVID-19.

Who should get a flu shot?

Everyone six months of age and older should get a flu shot every year.

When should I get a flu shot? Is it too early to get a flu shot right now?

September and early October are usually the best times to get your flu vaccine. So now is the perfect time, preferably before October 31. You want to get your flu shot before the flu is widespread in the community, so you’ll be protected.

Does the vaccine work right away?

No, it takes about two weeks to build your immunity after getting the flu shot. That’s why it’s important to get your flu shot before the illness is widespread.

How long will the flu shot protect me?

Six months is the amount of time a flu shot is thought to offer protection.

What side effects can happen after a flu shot?

Common side effects include soreness, redness, swelling where the shot was given, nausea, headache, muscle aches and fatigue.

Where can I get a flu vaccine?

You can get your flu vaccine at many places including your doctor’s office, urgent care locations and pharmacies.

Michael Sayers, MD

Michael Sayers, MD

Michael Sayers, MD, is a board certified doctor with Family Medicine of Lincoln, part of the Bryan Physician Network.

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Learning to Be More Empathetic

Learning to Be More Empathetic

Early in my teaching career, I took a strengths assessment, and I was not surprised at what was at the top of my list: achiever, discipline, learner and focus. I can see the many times in my life where all of these qualities are alive and thriving. For this specific assessment, all qualities that were assessed were listed from top to bottom, and at the bottom of the list was empathy. Seeing this ranking of words stopped me in my tracks.

I was annoyed and confused. I am a parent, a wife, a teacher, a coach, so empathy cannot be at the BOTTOM of this list. I know empathy means being aware of, and/or being sensitive to the feelings, thoughts and experiences of another. Yet, this is a hard topic for me. I want to be empathetic, but it just seems like this quality will never be part of my personality.

Trying to Be More Empathetic

Ever since this assessment, I have challenged myself to become a more empathetic person. Recently, however, I realized I have a love-hate relationship with this word.

There are times where I want to give someone a hug or show I care in some form, but it rarely comes across that way. When I practice being more empathetic, I usually play out the conversation in my head to find the right words…this obviously is not working. I recall three different situations where I was really trying to help and ended up causing more stress and made the person feel worse rather than better.

Why I Have Trouble with Showing Empathy

Reflecting upon those situations, I came to the conclusion that it’s a learned behavior. I feel sorry FOR the person rather than empathizing WITH the person. I try to be too positive and put a silver lining on everything, or I try to relate with a story that really has no connection to the situation.

Both of these are not necessarily wrong—they just don’t help. I’m not connecting. What I’m actually doing is minimizing the discomfort for myself as I really don’t know how to show empathy.

There are days when I want to say being empathetic is just not part of my wheelhouse and I need to quit trying to care and be sensitive to those around me. But is that really the right thing to do?

What I Can Do in the Future

Yet, I can do something about it. I can love those people and acknowledge their pain. I don’t have to always be positive about the situation or connect with a story. I just need to learn to listen and let people share their feelings.

While I am still annoyed that empathy is at the bottom of the qualities I possess and annoyed I am not naturally empathetic, I do realize I can still show love by doing something. And ultimately, that is the route I need to go—be silent and show empathy through love by doing rather than by conversing and storytelling.

Shelly Mowinkel

Shelly Mowinkel

K-12 & Teens

My husband and I have three kids. Our oldest is a freshman in high school, and our youngest is in second grade. Most days, I feel like we are a “tag-team chauffeuring” service, yet I wouldn’t have our life any other way. Not only I am a business/technology teacher at Milford, I am also the district technology integration specialist. I love teaching because I get the opportunity to make those around me better. My hope is that, through my blogging, I am able to inspire, encourage, and share with you my adventures of being a wife, mother, and professional.

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Atrial Fibrillation (AFib): A Common, Treatable Heart Condition

Atrial Fibrillation (AFib): A Common, Treatable Heart Condition

If you have atrial fibrillation—also called AFib—you’re not alone. AFib is a common heart rhythm disorder. In the United States, more than 5 million people have atrial fibrillation.

As a cardiologist who specializes in heart rhythm disorders, I am seeing younger, healthier patients with atrial fibrillation than I did five years ago. There are many factors that can contribute to atrial fibrillation including: obesity, alcohol intake, high blood pressure, sleep apnea and genetic factors.

What is Atrial Fibrillation (AFib)?

Atrial fibrillation is a disorganized heart rhythm of the two atria of the heart. The atria are the upper two chambers of the heart that receive blood returning from other areas of the body. These disorganized electrical signals are then filtered to the bottom two pumping chambers of the heart, known as the ventricles. It is the job of the atrioventricular node (AV node) to keep the heart chambers synchronized. But in atrial fibrillation, this area gets bombarded by electrical signals. This leads to an irregular heart rate.

What health conditions should I be concerned about if I have AFib?

As the atrial (upper chambers of the heart) quiver, or fibrillate, the blood tends to move more sluggishly in this area. This sluggish movement allows the blood to clot along the walls of the atrium, which is a part of your heart. The most common areas to find blood clots are in the atrial appendages. As a result, atrial fibrillation contributes to an increased risk of stroke. In fact, the risk of stroke for people with atrial fibrillation is five times that of people who do not have this condition.

When my patients see me for management of atrial fibrillation, our first step is to assess their risk of stroke.

  • The most common way to manage stroke is with anticoagulation or ‘blood thinner’ medication. If the blood is thinned, it has less of a chance to clot and this helps prevent a possible stroke.
  • Another potential safety measure to prevent strokes due to blood clots forming in the atrial appendage area is covering the left atrial appendage with a device called a Watchman, made by Boston Scientific.

Once the assessment of stroke risk is complete, we then assess the heart rates. Generally, we want to keep heart rates between 60-100 beats per minute. People with atrial fibrillation can experience a much faster heart rate. When the atria are quivering, it can fibrillate at rates above 300 beats per minute. This causes the ventricles to move faster and the heart rate to increase.

By controlling heart rate during the atrial fibrillation events, we can help limit the symptoms of the arrhythmia. These symptoms include chest pressure, shortness of breath, inability to exercise, lightheadedness or feeling faint.

How is AFib managed?

No two patients are the same. I have discussions about rhythm control with my patients to discuss their needs and concerns. There are some folks where it is clearly better to try to control atrial fibrillation. There are some folks where stroke prevention and heart rate control are all that they need. Typically, the more symptoms someone has, the more aggressive we are about rhythm control.

The two main ways to control or manage atrial fibrillation are with arrhythmia medications or with ablations.

An ablation is the removal of body tissue. For AFib, this means to neutralize or silence tissue in key areas that trigger and maintain the arrhythmia or irregular heartbeats. This is accomplished by heating or freezing the atrial tissue.

A large part of my practice is doing ablations for atrial fibrillation. I like this approach as it avoids the risk and side effects of rhythm maintaining medication. Ablation has a good success rate in managing irregular heart rhythms, or AFib.

Generally, we are able to minimize atrial fibrillation in 75% of the patients who receive this treatment. This strategy works better when it is combined with lifestyle behaviors to address all factors related to the arrhythmia (or improper beating of the heart). This includes maintaining a healthy weight, regular exercise, minimal alcohol use, and treatment of associated conditions such as high blood pressure or sleep apnea.

Atrial fibrillation can feel scary; however this is a treatable heart rhythm. And, with proper treatment you will feel better and more comfortable doing the activities you enjoy in life.

Matthew Kapalis, DO

Matthew Kapalis, DO

Dr. Matthew Kapalis, DO, is a cardiologist at Bryan Heart.

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