How to Survive the Holidays with Diabetes

How to Survive the Holidays with Diabetes

It’s that time of year when the leaves are falling, days are getting shorter and finally it’s jacket weather. For those living with diabetes this can be a tough stretch ahead…the dreaded Holidays.

Does this sound familiar? It’s much tougher to get that evening walk in after work when it is dark by 6 p.m. School and family activities are in full swing and there’s not a minute to spare for stress relief, let alone meal planning. Your workplace office starts piling up with not so healthy snacks. You get a call from the in-laws telling you they are going to park their RV in front of your house for the month of December. Wait…wasn’t that a movie from the 90s?

What You Already Know

You probably expect this article to focus on food and exercise. You are right, as both are necessary to control blood sugars, but just for a moment. Food choices are extremely important. I rely on our diabetes educators to teach patients the finer points of diet and carbohydrate counting, whereas I like to keep things as simple as possible.

Advice I Often Give to Patients Includes:

  • “Try to avoid the unhealthy carbs.”
  • “Drink more water.”
  • “Try eating your veggies and protein on your plate before you eat your mashed potatoes.”
  • “Move more.”
  • “Be less efficient.” As in park farther from the entrance, take the stairs instead of the elevator.
  • “Try walking for 5-10 minutes after each major meal to lower your post meal blood sugars.”

These can all be helpful, but frustratingly managing your blood sugars is more complex than this.

What May Surprise You

When I sit and talk with patients our conversations often drift towards personal stressors and how these affect blood sugars. The holidays can be overwhelming for everyone. For those living with diabetes, it’s extra challenging. Checking blood sugars and taking medications on time is often easier said than done. I’ve heard many patients describe having diabetes as another full-time job they don’t get paid for.

So How Does “Stress” Raise Blood Sugars?

What exactly does that mean? I often use a grizzly bear analogy, however, you can fill in the blank with your dreaded reptile/insect/animal. A person encounters a bear in the woods and a “fight or flight” mechanism is triggered. A series of neurological and chemical changes occur in our bodies. Our body wants to make sure that our muscles, brain, and heart all have the fuel (glucose) they need to run away.

  • Cortisol and adrenaline are released from adrenal glands into the bloodstream – raising blood sugars
  • Glucagon is released from the pancreas, freeing stored glucose from the liver – also raising blood sugars

Fortunately, most of us won’t run into bears this holiday season, but on a smaller scale, daily stressors (whether emotional or physical) can cause dramatic swings in blood sugar for those living with diabetes. This is very apparent to those who use continuous glucose monitors (CGM). One can often find dramatic differences in glucose readings on workdays versus non-workdays and days with family conflict versus those without. It’s very eye-opening.

Tips to Get Through this Stressful Time of Year

So what are a few tips to get through this stressful time of year?

  • Have a game plan – anticipate stressors, and pick your battles
  • Be prepared – don’t leave home without medications, spare testing supplies, etc.
  • Don’t beat yourself up – if you have some bad numbers it’s not a math test result, just a number. Keep testing!
  • You are not alone – you shouldn’t feel like you are on an island. Diabetes affects the whole family. Enlist their help in your preparation. Educate family members on your signs and symptoms of both low and high blood sugars
  • Go easy on the alcohol – it can mask symptoms of lows and highs, not to mention leading to poor food choices. Alcohol is known to worsen other health conditions common to diabetes such as high blood pressure, high triglycerides, depression, anxiety, and poor sleep quality.

Take It One Day at a Time

Knowing what can affect your blood sugar levels and focusing on this – even with little steps and small changes – can make a big difference in how you feel. Try to work in ways to get exercise, make good food choices and keep your stress at bay. Serenity now! Wait, wasn’t that another 90s show.

Happy Holidays!

Aaron Ward, MD, Internal Medicine

Aaron Ward, MD, Internal Medicine

Dr. Aaron Ward is an internal medicine doctor. He has a special interest in diabetes prevention and management. For those living with diabetes, he is dedicated to working with patients and using emerging diabetes technologies to improve health.

“I get so excited when my patients have breakthroughs with new technologies, or are able to prevent or cut back on medication use through lifestyle changes or new therapies.”

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Helping Our Kids Understand They Can Do Hard Things

Helping Our Kids Understand They Can Do Hard Things

There is a sign above my classroom door: “You Can Do Hard Things”. I see it every time I look up from my desk, walking around my classroom, or standing at the front of the room. The past handful of weeks, this statement has really struck a nerve with me. I find myself gazing at it and really focusing on those five little words. You. Can. Do. Hard. Things.

Doing the Hard Things

My husband definitely is doing the hard things. He balances many roles but the most important is being a dad, husband and principal all while he pursues an EdD. He is doing the hard things, however, the foundation of everything he does stems from one word: love. My husband loves all the roles he has and he understands the big picture.

He believes every student should leave Milford High School with a passion, purpose and one employable job skill. He does the hard things day-in and day-out even when his family does not see it. Yet, he knows he must model it not only for his family but also for the staff and students at Milford High School.

Have We Made Things Too Easy?

I often wonder, in today’s world, if we are lowering our expectations of our teenagers. Or have our teenagers lowered their expectations, knowing they can achieve the lower standard? It is becoming increasingly apparent that failing is not an option anymore. In general, our teenagers are afraid to fail.

So yes! Yes, our teenagers can do hard things. Here’s the deal, we should expect our kids to do hard things. The small hard things that we expect our kids to do today are going to help them develop the discipline needed to do those big hard things in the future. We should have the expectation that our kids can do the hard things asked of them. We can expect our kids to make their beds each day, turn in their homework on time, fail a project, or sit on the bench, but we can expect our kids to try and to ultimately care.

To do this, first though, as a parent, I had to learn to let go of fear. I remember teaching our kids how to ride a bike. At some point, I stepped away and let them ride down the street without me running behind them. Just like letting our kids bike, I had to quit being a band-aid for them. I had to let go of what could go wrong. I had to start thinking about what could go right.

Don’t Be Afraid to Push Your Kids to Do the Hard Things

Next, as parents we have to intentionally train our kids to do hard things. This is a great way to develop perseverance. But not only should we train them, but we also have to have tough, truthful conversations. We cannot sugar coat the demands of life. Life is hard. Growing up is hard. Having truthful conversations will teach our kids that life is always going to throw hard situations at them and that they may fail, they just cannot try. Hard work is part of life and is something that they cannot shy away from.

This parenting gig is hard. Even though we model doing hard things, we love that we can teach our kids to face life’s circumstances with a “what could go right mindset”. And somewhere in the middle of the hard things, our kids are going to find and pursue a passion and ultimately, they are going to realize that those hard things make the deepest impact on others.

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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Breast Cancer Awareness and Prevention: Be Your Best Advocate

Breast Cancer Awareness and Prevention: Be Your Best Advocate

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

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

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

Here are a few breast cancer facts to help you.

9 Factors that Increase Your Risk for Developing Breast Cancer

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

6 Factors that Decrease Your Risk for Developing Breast Cancer

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

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

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

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

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

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

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

Signs and Symptoms of Breast Cancer

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

Breast Cancer Screening

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

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

Follow up for the Care You Need

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

Take care of yourself and be your best advocate!

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

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

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

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

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

Learn more about Dr. Jendro!

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The Truth About Knee Pain

The Truth About Knee Pain

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

What Are the Causes of Knee Pain?

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

Why is Osteoarthritis So Painful?

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

What are the Signs and Symptoms of Knee Arthritis?

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

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

Who Is Most Likely to Get Knee Arthritis?

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

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

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

Treatment options include:

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

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

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

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

Brad Webb, DO

Brad Webb, DO

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

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Dealing with “Zoom Dysmorphia”

Dealing with “Zoom Dysmorphia”

I learned the meaning of a new phrase the other day. As a retired educator, I hope I continue to learn new words, theories and skills. You’re never too old. My grandkids continue to teach me new techniques for using the phone and live streaming on the TV. You’re never too old to learn, but remembering the new skills can be a challenge. Thus, all of my grandkids are on speed dial to assist me each and every day!

A Rise in “Zoom Dysmorphia”

The new phrase I learned was “Zoom dysmorphia.” The phrase refers to the anxiety individuals experience during a Zoom call or meeting where they are concerned about how they look and are being perceived by others. These individuals feel they are stuck inside a box and want to change their facial features, such as thinking their nose is too big and it needs to be reduced, getting rid of those unwanted wrinkles, etc. Thank goodness the Zoom shot is only of the shoulders up. As the Delta variant has brought back the mask mandate, it made me realize some of my groups may be returning to gathering by Zoom. How did my peers deal with Zoom meetings? How did I respond to seeing my picture on the laptop screen? How did using Zoom affect my grandkids with all of their remote classes last year and this year?

I recall some of my peers made tough decisions during the isolation time. Many chose not to Zoom. They didn’t like seeing their face on the screen and many others indicated they weren’t confident in joining a Zoom meeting. Where’s that “you’re never too old” attitude I try to overcome each and every day. I would try to coach them, but it was easier for them to opt-out of the meeting.

Making Myself More Comfortable On-Screen

I reflected on my experiences with Zoom and realized it made me stretch and grow. However, the dysmorphia points were well taken. I experimented with my lighting in the room and how far away from my laptop was from my face. If it was too close, yes, I could see nose hairs. If the laptop was too far away, I looked like a pinhead compared to the other participants, which wasn’t good. I found a happy medium and have stuck with it every time I used Zoom.

I asked each of my grandkids how they handled their Zoom meetings and classes. At first, I didn’t give them the definition of Zoom dysmorphia as I didn’t want their responses to only be a reaction to the phrase. Their answers were short and sweet like they usually are when they want to appease me. I could hear them thinking, ‘why does grandma want to know this?’, ‘does grandma want to Zoom again?’, ‘what’s wrong with FaceTiming together?’ No matter what they were silently thinking, they all responded to me.

“I didn’t like Zoom classes. I learn better in person.”

“I Zoomed, but I turned my camera off when I wasn’t talking.”

“When I Zoomed, I missed walking to my classes and seeing my friends.”

“Zooming is tough as it’s too easy to get distracted with other things, like my phone.”

Zoom Worries Aren’t Always Physical

It was obvious the grandkids didn’t like to Zoom, and probably still don’t, but it wasn’t because of Zoom dysmorphia and the fear of looking at themselves on their screen. It was because it was a change and they didn’t get to be together with their friends. I continued the conversation and I was proud of all four grandkids for their high self-esteem and confidence in new situations. I was also glad they aren’t thrilled with Zoom, and would rather be in person. I’m also very proud they have all been vaccinated and careful during this continuously dangerous time. Not everyone their age is so thoughtful and understanding of science. They are leaders!

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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Masks at School

Masks at School

I can’t believe it’s less than one month until kids are back in school. Summer break seems to fly by every year. On local parent forums, parents are excited about the planned return to full-time, face-to-face classes next month. Parents are engaging in the normal back-to-school chatter about teacher assignments, band camps, school supplies and one out-of-the-ordinary topic—whether or not to mask their unvaccinated child.

With school quickly approaching, I recently read the Lincoln Public Schools (LPS) official back-to-school plan outlining COVID-19 prevention protocols. Last year, I was very impressed with how the schools handled the pandemic, but this year, the kids and I are ready for some normalcy. But how normal?

Changes at Lunch & Recess

I know there are a couple of changes the kids are hoping return to normal like no more “zones” at recess. That was one of the “pandemic rules” my kids hated and that I heard the most about daily. My kids want to play with other kids in their grade and play where they want to play. Kids shouldn’t be restricted to where and who they can play with at recess. Recess is their fun time.

Another change they’re hoping to see is removing the plexiglass from the cafeteria tables. This was a big one for my son. Again, my son wants to sit with his friends and enjoy having a conversation at lunch. Last year, the plexiglass made it difficult to hear each other. Many conversations were had under the table. And I know both of these things were put in for safety reasons, but my kids are ready for food, friends and fun at lunch and recess!

As moms, we always worry about germs—and even more now. My kids don’t wash their hands as much as they should, but I applaud LPS for the amount of time that the teachers and staff allowed kids to wash their hands or use hand sanitizer. I felt comfortable sending my kids to school because of the amount of cleaning that was taken place in the building. Even my daughter was excited to pick out the sparkly hand sanitizer and the “squishy” carrier it fit in that attached to her backpack. Hand sanitizer is now a part of the supplies needed for back to school.

Wondering if Masks Will Be Required

Among the protocols LPS is suggesting for the return to school this year is that masks will be strongly recommended for unvaccinated students and required for unvaccinated staff. But masks are not mandatory—at least not yet. My children are still in elementary school, so they’re not vaccinated. Ever since the mask mandate was lifted, my kids no longer wear masks in public. Wearing masks has never been a problem for my kids. They never complained, they followed the rules, and they liked to pick out the masks they wore—unicorns for my daughter and a Denver Broncos mask for my son. Currently, my son wears a mask at his summer camp that he attends every day, which is a requirement. My daughter goes to an in-home daycare and does not wear a mask.

Last year, they were required to wear masks every day, all day! I appreciated the protocols. They never tested positive for COVID-19, and they were not sick once—not even a cold. So having them wear masks this school year would be beneficial. Also, COVID-19 is not going away, and since my children are not vaccinated, I’ll ask my kids to wear them, but my worry is that not all kids will be wearing masks.

If it’s not mandatory and my kids have an option, what will they choose? My son told me that he plans to wear his mask. “No big deal mom, I’m used to it,” he says. However, if my daughter’s friends aren’t wearing one, she probably won’t either. I’m still undecided if they’ll actually wear the masks this upcoming school year. But all of this could change if the COVID-19 numbers continue to rise. It wouldn’t surprise me if LPS makes masks mandatory for elementary kids.

Are other parents worried their kids won’t wear their masks if it’s not required? What are other parents planning to do? Let me know!

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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CBD Oil: Does it work? Is it Safe? What Do I Need to Know?

CBD Oil: Does it work? Is it Safe? What Do I Need to Know?

Many of us have been stuck in traffic and noticed roadside signs or smoke shops advertising for CBD oil. But, does it work? Is it safe? Is it legal? How is it different than marijuana?

As a doctor, I had these same questions and did my own research. Based on this, I can tell you that it’s legitimate and it works!

What Is CBD Oil?

CBD (or Cannabinoid) oil is extracted from the marijuana plant. The CBD portion of the plant is extremely valuable, particularly in treating pain. CBD oil is used to unlock the body’s own endocannabinoid system, which affects metabolism, diabetes, pain regulation, inflammation, digestion and so much more. Also, it’s important to know that CBD oil has none of the hallucinogenic properties typically associated with marijuana or THC.

Benefits of CBD Oil

Some of the many benefits of CBD oil include:

  • Natural
  • Powerful anti-inflammatory
  • Fewer/no side effects compared to current medications
  • No hallucinogenic properties
  • Pain relief

Who Can Benefit from CBD Oil?

In our experience, CBD oils work well for a number of people including those who:

  • Have chronic pain
  • Cannot tolerate non-steroidal anti-inflammatory drugs (NSAIDs)
  • Have allergies/dependence issues with opioids
  • Have tried numerous pain relief options unsuccessfully
  • Are not healthy enough for surgery or surgery did not successfully provide pain relief

How Do I Take CBD Oil?

There are a wide range of methods for taking CBD oil to experience its benefits. These include:

  • Sublingual – where you place the oil under your tongue so it dissolves and absorbs into your blood through tissues under the tongue. With this method, there are also many different flavors available.
    • At Capital Foot & Ankle, most of our sublingual options are full-spectrum, meaning they contain more of the hemp plant than just the CBD, including small amounts of THC (less than 0.3%). THC is the chemical found in marijuana. It can have side effects such as hallucination. Less than 0.3% of THC is a healthy amount.
    • We also carry isolated CBD sublingual oil, which contains no THC.
  • Gummies and soft gels that can be taken orally
  • Topical options which you apply to your skin

How Can I Learn More & Find Out What’s Best for Me?

Stop in and ask our experts. All of our staff are trained on the use of CBD oil and available to answer your questions. CBD oil is an over-the-counter product–you don’t need a prescription or an appointment to obtain and benefit from this natural remedy for many health conditions.

Capital Foot & Ankle:

  • Located at: 5055 A Street on the 4th floor of the 5055 Building
  • Hours: Monday-Friday, 8 a.m.-5 p.m.
  • Phone: 402-483-4485
Jeffrey Wienke, DPM

Jeffrey Wienke, DPM

Dr. Jeffrey Wienke, DPM, is a foot & ankle specialist at Capital Foot & Ankle.

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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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7 Ways to Strengthen Your Bones & Lead an Active Life

7 Ways to Strengthen Your Bones & Lead an Active Life

Our bones are amazing structures that keep us upright, and along with muscles, ligaments and tendons, they allow us to move and participate in activities that make life worthwhile!

Bones are made of minerals—calcium and phosphate—proteins, collagen and growth factors that stimulate growth of bone tissue. Just like your car needs routine maintenance, your bones also need care and attention.

Factors that affect the growth and strength of your bones

Healthy bone remodels, which means bone cells are formed and turned over in a metabolic cycle. This process can be affected by certain medical conditions, medications, age and habits.

Bone density is a measurement that shows the strength and thickness of your bones. Bone density is at its highest around age 25. After this, you lose about 0.5% of your bone mass each year until age 50. Then, the rate of bone loss increases. Osteoporosis occurs when you lose too much bone mass. This loss of bone density weakens your bones and can make them more prone to fractures. In fact, two million bones are broken each year due to osteoporosis.

As an orthopedic trauma surgeon, I fix broken bones, and many of my patients had fractures as a result of osteoporosis. If you break a bone, we work to take care of the fracture and to optimize your bone health during recovery and beyond. My ultimate goal is to help people take steps for healthy bones before a break happens.

Are you at risk for osteoporosis?

There are risk factors we can control, and some we cannot. Osteoporosis is more common after age 50, and affects women more than men. Smoking, drinking more than 2-3 alcoholic beverages per day, taking certain medicines, vitamin D deficiency, menopause, hormone disorders and poor nutrition can put you at risk of osteoporosis.

7 Steps You Can Take for Healthier Bones

1. Get a Bone Mineral Density Test (DEXA Scan)

What is a DEXA scan and when should I get one?

This test is the best way to determine your bone health. It uses low doses of X-rays to measure the amount of minerals – mainly calcium – in your bones. Test results show the strength of your bones and can help your provider know if you are at risk for osteopenia or osteoporosis.

Women should receive this test starting at age 65, or age 55 if you have high risk factors. Men should receive this test starting at age 70.

2 & 3. Get Enough Calcium & Get Enough Vitamin D

How much calcium and vitamin D do I need and how do I get this in my diet?

How much calcium and vitamin D you need depends on several factors. Women and men have different nutritional needs, and these vary based on your stage in life.

Daily dietary requirements for: Calcium Vitamin D
Infants None needed 400 IU/day if breastfed
Children 700-1,000 mg/day 600 IU/day
Teens and young adults 1,300 mg/day 600 IU/day
Adults under age 50 1,000 mg/day 400-800 IU/day
Pregnant women 1,500 mg/day 800 IU/day
Lactating women 2,000 mg/day 800 IU/day
Women age 50+ 1,200-1,500 mg/day 800-1,000 IU/day
Men age 50-70 1,000 mg/day 800-1,000 IU/day
Men age 71+ 1,200 mg/day 800-1,000 IU/day

Eating a well-balanced diet will help you get much of the calcium and vitamin D you need.

  • Dairy products such as yogurt, cheese, milk and even ice cream (yay!) are rich in calcium and vitamin D
  • Green veggies (spinach, broccoli), mushrooms, egg yolks and some fatty fish provide vitamin D
  • Look for fortified foods with added vitamin D such as tofu, plant milks, cow’s milk, orange juice, cereals and yogurt
  • For those who don’t get enough calcium and vitamin D in their diet naturally, supplements are available over-the-counter

4. Exercise

How much and what type of exercise do I need to keep my bones healthy and strong?

You should get 30 minutes of weight-bearing exercise most days of the week. Some examples include fast walking, light weight lifting, using resistance bands, dancing, yoga and riding a bike or stationary bike.

The good news is you can do most of these things in the comfort of your own home! There are also many great exercise programs available in the community for those who would like someone to guide them.

5. Prevent Falls

Why is this important and what can I do to reduce my risk of falling?

Falls are the #1 cause of osteoporosis-related fractures in men and women over age 55. Here are steps you can take to protect yourself and prevent falls.

Ways to prevent falls inside your home

  • Make sure you remove throw rugs and clear clutter on the floors and stairways
  • Don’t walk around in socks or slippers
  • Use rubber mats in the shower
  • Use nightlights
  • Be careful with your pets running around your feet

Ways to prevent falls when you’re outside

  • Wear shoes with good traction
  • Watch for slippery floors and curbs
  • Use a cane or walker if you feel unstable (especially in bad weather)
  • Have your vision and hearing checked regularly

Bryan offers balance testing and fall evaluations to access your risk of falling. This evaluation will look at your health history, assess your joint movement, muscle strength and test your mobility and walking skills. This information will allow your therapist to design a program to address your unique needs to help you get stronger and feel more comfortable on your feet.

Learn more and schedule an appointment today. 

6. Don’t Smoke

Smoking reduces the blood supply to your bones. It also decreases your body’s absorption of calcium, which is necessary for bone health. The nicotine in cigarettes slows production of bone-producing cells.

It’s hard to make lifestyle changes, especially when we’ve had a habit for many years. Talk to your primary care provider about programs or medications that can help you start the process of quitting. It’s also helpful to have a good support system around you to keep you encouraged and on the right track. Ask your significant other to quit with you!

7. Limit Alcohol Intake

Alcohol interferes with your body’s ability to absorb calcium and vitamin D. It also interferes with the hormones important to bone health which can lead to bone loss.

Limit alcohol intake to no more that 2-3 drinks per day (1 drink is 5 ounces of wine, 1.5 ounces of hard liquor, or 12 ounces of beer).

I’ve already been diagnosed with osteopenia or osteoporosis…is it too late for me to have healthy bones?

It’s not too late! Talk to your doctor about treatment options. This might include prescription medicine to increase your bone density. Also, make sure you take steps to optimize your nutrition, calcium and vitamin D intake. 50% of women with untreated osteoporosis will go on to break a bone – so taking these steps is important for your health.

Your bones need your support so they can work to support you!

The human body is an incredible machine, and it requires care and attention to run efficiently and stay healthy. Our bones need us to eat a well-balanced diet including enough calcium and vitamin D, exercise, and keep away from smoking and excessive drinking. Taking these steps will help us avoid bone loss and risk of fractures. It’s also important to get your bone density checked, and if diagnosed with osteopenia or osteoporosis to make sure it’s treated appropriately.

Taking care of your skeleton will help you keep doing the things you enjoy in life!

Alesha Scott, DO

Alesha Scott, DO

Dr. Scott is an orthopedic/trauma surgeon with Bryan Trauma.

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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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