My Frustration With Fluctuating Weight

My Frustration With Fluctuating Weight

I can’t lose weight like I did in my early thirties.

My Frustration with Fluctuating Weight

An influencer that I follow was my size. I felt seen. She was all about body positivity. But recently, she had the mommy makeover and for some reason it made me angry. I know it’s her life and she doesn’t need to explain her decision to schedule weight loss surgery. I think I was just jealous.

I took a year off from the gym I had been going to for more than 10 years. I loved the people at this gym. My core group is still with me, I just couldn’t swing the after-work classes with two kids and the money it cost to be a member. Why is trying to be healthy so expensive?

Seven years ago, I lost 40 pounds. However, within the last year I gained almost half of it back. I had been working out in my basement, but I knew something needed to change. I didn’t want to continue gaining weight. It’s not that I didn’t like who I was, but my body was telling me something needed to change.

New Beginnings & Recent Setbacks in My Weight Loss Journey

Recently, I got a promotion at work and knew I needed to prioritize me. I wore jeans to work one day, and I was miserable because they were tight. I signed up at a new gym that night. This gym offers noon classes and helps with nutrition. I schedule gym time into my day so it doesn’t take time away from my family or me playing taxi for my kids.

Several weeks into the new program, the scale wouldn’t budge. I am supposed to weigh myself every Saturday, but the same number keeps popping up! One day after I weighed myself with no change, I headed to the gym and had a minor breakdown.

What I see in the mirror is different than how I feel. I say horrible things about myself in front of my daughter. I need to be more aware and body positive, but it’s a mind game as well as a physical battle. I don’t want my daughter to have the same struggles I have with food and think the number on the scale defines her. This setback made me realize something important. My health journey isn’t just about the physical results.

From Scale Obsession to Self-Love

Just as I want to be conscious of my eating habits—like the type of food and substances I put in my body—I must be aware of the negative words I say about myself. A good first step was recognizing my identity is better defined by my emotional and mental attributes than my physical appearance. In other words, I need to try not to focus on what I think I need to “fix” or change about my physical self, rather, I need to believe those who tell me they love me for who I am—because they do. And I need to love me for who I am.

I keep telling myself that numbers on a scale should not control my life. I am mindfully eating what I am supposed to, hitting my calorie and macro goal and working out four times a week. I remind myself to never worry about the scale. It only tells one side of the story, and it doesn’t define my success. Every day and every meal is a fresh start. That is my mental challenge over my physical one. I am trusting in the process, putting in the work and hoping my body and mind will align. My children see me making healthier choices. And they see me loving myself.

Finding My Why to Living a Healthier Lifestyle

I found my why. I took back my life and I started prioritizing me. My family needs me to be the best version of me. It is a mental and physical change that I am hoping to continue.

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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8 Tips to Avoid Injury: Insights from Sports Medicine Trainers

8 Tips to Avoid Injury: Insights from Sports Medicine Trainers

Whether you’re a weekend warrior, a recreational sports enthusiast or professional athlete, we can all use tips to avoid injury and stay healthy. We asked our athletic trainers to share some of their best tips.

1. Listen to Your Body & Address Pain or Discomfort Early

Grant Rider, athletic trainer at Seward High School

Pain is a message from your body that something is wrong and you should take a break before it worsens. Listening to your body and addressing pain or discomfort early will prevent minor issues from becoming major issues. It’s better to take a short break and avoid a more serious injury than to play through pain and cause a bigger problem later.

2. Stretch Before & After Activities

Terry Adair, athletic trainer at David City Aquinas and David City Public Schools

Stretching is essential to improve your flexibility and reduce your risk of injury. It also helps you warm up before exercise and cool down afterwards. Stretching improves blood flow and reduces muscle stiffness that can lead to injuries. Here are a few tips to get the most benefit from stretching:

  • Relax into your stretches
  • Don’t bounce while stretching
  • Hold each stretch for 30 seconds

3. Add Foam Rolling into Your Daily Routine

Ashley Elwell, athletic trainer at Crete High School

Foam rolling is a self-massage release technique. By using a lightweight cylindrical tube made of dense foam, you can roll over tight spots to help reduce muscle tightness, soreness and inflammation. Foam rolling is an effective tool to add to your warm-up and cool-down routines.

4. Drink Half of Your Body Weight in Water Each Day

Stacy Dahlkoetter, athletic trainer at Lincoln Christian and Parkview Christian Schools

If you participate in exercise or activities where you sweat a lot, your hydration need may be higher, and you will also need to replace electrolytes. Energy drinks do not count as a hydration drink. They actually dehydrate you and you will need to drink more water. To make sure you get enough water, drink half your body weight in water each day. So, if you weigh 120 pounds, you should drink 60 ounces of water a day.

5. What You Put into Your Body Matters

Kyle Younkin, athletic trainer at Lincoln Lutheran and Parkview Christian Schools

Maintaining a healthy diet with a good balance of carbs, proteins, fats, vitamins and minerals will keep you in your best shape. Complex carbohydrates from pasta, whole-grain breads and rice provide energy, fiber, vitamins and minerals without a lot of fat. Choosing lean meats will give you protein without contributing to issues like weight gain or high cholesterol.

6. Sleep Is Important

Choc Bowen, athletic trainer at York High School

Lack of sleep and/or poor sleep quality can impair muscle strength, speed and other aspects of physical performance. Sleep issues can also impair recovery following injury. Aim for 8-10 hours of sleep each night to ensure the proper amount of rest and to allow your muscles to recover.

7. Allow Time for Rest & Recovery

Bethany Dolezal, athletic trainer at Kinetic Sports Complex

Give your body what it needs to recover between training/exercise. Eat well, sleep well, stretch well and take rest days to avoid overdoing it. Don’t feel guilty if you take a day off. It is good for your mental and physical health to take time when you need it. Athletes should also take time between seasons to recover and prevent injuries.

8. Share Any Pain, Discomfort or Injuries with a Health Expert

Cassie Metzner, athletic trainer at Waverly High School

Everyone wants to get back to sports or activities. If injured, seek help from a professional—an athletic trainer, physical therapist or other health expert. Be honest with them about your injury and how you are feeling so that they can best help you recover and return to the activities you love.

Bryan Health/Nebraska Orthopaedic Center

Athletic Trainers

The Bryan Health Center and Nebraska Orthopaedic Center team of certified athletic trainers brings to our region’s youth extensive knowledge, experience and passion for working with young athletes. Learn more about Ashley Elwell, Bethany Dolezal, Cassie Metzner, Choc Bowen, Grant Rider, Kyle Younkin and Terry Adair.

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New Advances in Care: What Do I Need to Know If Someone I Love Is a Past or Current Smoker?

New Advances in Care: What Do I Need to Know If Someone I Love Is a Past or Current Smoker?

We all know it — smoking is not good for you. Yet for many, it is a reality of our daily lives. Let’s face it, it’s addictive and it’s often not easy to stop. And some people don’t want to quit. Given all of this, what’s a person to do? What steps can you take to make a difference in your life?

Screening & Follow-Up Are Key

There are several ways testing or a screening can help provide early detection. One of the most common is one you may not know about — an incidental finding. A low-dose CT scan is another important screening.

Incidental Findings

An incidental finding happens when you are being treated for one condition and receive an x-ray or CT scan and the doctor notices an abnormal growth in your lung. At Bryan Health, we have a team that follows up on these findings with our patients.

This can be life-changing and life-saving. Here’s a perfect example of the power this has on a life. ‘Suzie’ is a smoker, but she doesn’t have any symptoms of lung cancer. While being seen in the ER, a chest x-ray is done and an abnormal growth is found. She does the follow-up testing and finds out she has very early-stage lung cancer. Because the follow-up testing is done with an advanced robotic procedure and it’s found so early, we can move quickly through staging and resect (remove) the tumor early. The cancer doesn’t grow or metastasize (spread), and further treatment is not needed.

Low-Dose CT Scan

This is a test specifically designed for early detection of lung cancer. Current guidelines for who should receive this screening are:

  1. A daily smoker within the last 15 years
  2. Age 50-80
  3. Smokes at least one pack a day for 20 years or two packs a day for 10 years

A low-dose CT scan is recommended yearly unless it has been more than 15 years since the person has used tobacco. If you qualify for this screening, talk to your doctor about ordering this test.

3 Reasons People Avoid Screening & 6 Reasons to Get Screened

If you or a loved one have any of these thoughts, consider the following.

Reason One: I Know Smoking is Bad For Me. I’m Not Going to Quit/I Already Quit So Why Get Screened?

  1. Getting screened for lung cancer is about life — your life. And, using the latest technology can catch cancer early, so you can go on enjoying life.
  2. If you no longer smoke, that’s great. But you are still at risk and should be screened. Think of it as an extension of your healthy habits.

Reason Two: I Don’t Have Any Symptoms

That’s exactly when you should be screened for two reasons:

  1. You could find out you don’t have cancer and your lungs are fine.
  2. You could find cancer before any symptoms occur, when it can be treated quickly and easily.

Reason Three: I Don’t Want to Know. What If They Find Something?

  1. If something is found that requires a biopsy (further testing), 95% of the time it is not cancer.
  2. If it is cancer and it’s found early, the five-year survival rate is 92%.

New Advances in Diagnosing & Treating Lung Cancer

When it comes to diagnostics (biopsy) to determine if a nodule (growth) is cancer, there are three options.

  1. A biopsy with Interventional Radiology (IR) — This is the most common and is usually a same-day procedure.
  2. Surgical resection is also an option, though it is much more invasive and requires a hospital stay.
  3. A new advancement in bronchoscopy (a way to look at the lungs with a small camera) — This has been a significant enhancement in care and is generally a same-day procedure.

IR Biopsy

A typical IR biopsy identifies just the lesion (growth) in question. Then a separate procedure is needed to determine the stage of cancer (i.e., no cancer or how much cancer there is and if it has spread) followed by surgery, if needed.

Bronchoscopy Advancement

This advancement is robotics, and the platform we use at Bryan Medical Center is Ion. The benefit of this type of procedure is in its completeness. With robotic-assisted bronchoscopy and the Ion platform, we are able to reach nearly anywhere in the lung for the nodule, although there are some limitations.

Where Ion and bronchoscopy really shine is not just in the identification of the nodule, or spot, on the lung. In the same procedure, we do a staging — determining if the cancer has spread — for all patients with biopsy of the lymph nodes in the chest. This reduces the need for staging after the initial diagnosis. As a combined procedure with Ion, we can reduce the time from nodule-to-knife (diagnosis of the lesion to when it can be surgically removed).

Take Advantage of Advances in Care

There are exciting advances in medicine that allow us to diagnose and treat lung cancer to make a significant difference in a patient’s life. The key is early diagnosis.

Ryan Martin, MD

Ryan Martin, MD

Pulmonologist

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How to Avoid Burnout in Work & Life

How to Avoid Burnout in Work & Life

Do you feel sluggish and exhausted? Can simple tasks seem overwhelming to complete? Have you found yourself so stressed out that you quickly become angry or frustrated? If you’ve noticed feeling this way, you might be experiencing burnout.

Burnout can be difficult to describe to others. According to the American Psychological Association, burnout is defined as “physical, emotional, or mental exhaustion, accompanied by decreased motivation, lowered performance and negative attitudes towards oneself and others.”

Burnout Can Be Caused by More Than Your Work

Most people associate burnout with a stressful job. However, burnout can affect many aspects of your life, from being a parent to your relationship with your significant other or even being a caregiver for an elderly parent. Understanding the symptoms of burnout and what you can do about it can improve your mental health and quality of life.

Over the last few years, burnout has been developing more and more as work-life balance gets out of sync. This is because of the increase in remote work and technology that does not let us “turn off” and reset from our workday or slow down and manage our personal lives along with our work demands.

Signs You May Be Experiencing Burnout

There are many physical, emotional and behavioral signs that could mean you are experiencing burnout.

Physical Signs:

  • Feeling tired all the time
  • Frequent headaches
  • Changes in appetite or sleep habits

Emotional Signs:

  • A sense of failure and self-doubt
  • Detachment and feeling alone
  • Feeling trapped or defeated
  • Loss of motivation
  • Decrease of satisfaction and sense of accomplishment

Behavioral Signs:

  • Withdrawing from responsibilities
  • Isolating from others
  • Procrastinating to get things done
  • Taking frustrations out on others
  • Skipping work or coming in late and leaving early

Although many of these symptoms may line up with depression, causes of depression tend to be broader whereas burnout symptoms can be pinpointed to specific reasons or triggers in a person’s life.

Burnout Happens When Work-Life Balance Is Out of Sync

This may be due to:

  • Working too much without enough time to socialize or relax
  • Lack of close, supportive relationships and not reaching out to others for help
  • Not getting enough rest to recharge
  • Taking on too many responsibilities at work and home

Ways You Can Manage Burnout

Here are ways you can deal with burnout and perhaps prevent it in the future.

Recognize the Warning Signs

If you are feeling that there are no boundaries between your personal and work life or if you sense that you have been going 100 miles per hour and it would be impossible to slow down to even 85 miles per hour, this might be a sign that you are depleting your physical and emotional reserves and need to reach out for some support.

Reach Out for Support

Focusing on day-to-day activities might give you clues on what you need to work on to make substantial changes in your life. Sometimes talking to a friend about how you are feeling can really improve your outlook. There are other times when it is important to reach out for professional help from a therapist. The nice thing about therapy is that you have a safe place to talk with someone who is not a family member, friend or coworker.

Improve Your Self-Care

One of the best starting points is building personal check-ins into your schedule. Taking a step away from the computer or whatever your source of stress is and asking yourself daily, “How am I doing emotionally? How am I doing physically?” is a perfect first step.

Adding some physical exercise into your routine can definitely improve your outlook. “Regular exercise can reduce stress, anxiety, and depression” according to the American Psychological Association. Exercise is also an essential part of a wellness journey. There are many ways to be physically active—from walking your dog to walking with a work friend at lunch to release some excess stress.

Establishing a healthy daily routine for sleep, diet, movement and non-work time is crucial for your well-being. It is critical to tell yourself, “I have worked hard today, now I need to stop, change gears and attend to the social and personal aspects of my life. I need to do things that are fun and relaxing.”

We’re Here for You

If you think you might be experiencing burnout or would like to explore talking to a therapist about symptoms you are having, please reach out to Bryan Counseling Center at 402-481-5991. You can also take a free mental health screening on our website.

Stacy Waldron, PhD

Stacy Waldron, PhD

Dr. Stacy Waldron provides treatment for individuals of all ages across the lifespan and specializes with adolescents and adults. She offers individual and family therapy to help clients with stress , anxiety, mood disorders, life transitions and chronic pain. This includes helping individuals with stress management, assertiveness training, communication and problem solving skills as well as relaxation training. She also provides psychological assessments that include bariatric surgery evaluations, spine surgery, and spinal cord stimulator evaluations.

Waldron earned a doctorate in counseling psychology from the University of Southern California in Los Angeles. She serves on the Board of Psychology for the State of Nebraska, the Board of Directors for the Midwest Pain Society, and the Association of State and Provincial Psychology Boards.

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Let’s Talk Osteoporosis: How to Keep Your Bones Strong

Let’s Talk Osteoporosis: How to Keep Your Bones Strong

It might seem hard to believe but we reach our peak bone mass in our late 20s or early 30s. From there, men and women start to lose some amount of bone density throughout their lifetime. The loss in bone density causes an abnormal structure and ultimately weakens our bones, increasing the chance of osteoporosis and a bone fracture.

What Is Osteoporosis?

Osteoporosis is the loss of density or mass within our bones.

To illustrate, picture a healthy bone as a honeycomb and then put a bone with osteoporosis next to it. The bone with osteoporosis will have much larger holes than the healthy bone.

Osteoporosis affects all of our bones. But the ones most likely to fracture due to osteoporosis are in your spine, wrist, shoulder and hips.

Most Common Osteoporosis Risk Factors

There are many risk factors that can lead to osteoporosis.

  • More common in women
  • 50+ years old
  • Post-menopausal
  • Caucasian
  • Low body weight
  • Undergoing chemotherapy for cancer treatment
  • Certain diabetes and seizure medications, and some medications that cause immunosuppression
  • Current or previous use of tobacco/nicotine products

Ways You Can Slow Bone Density Loss

Here are some ways you can help your bones stay strong and slow bone loss.

  • Avoid drinking alcohol/drink alcohol in moderation
    • Alcohol affects your nutrition level, which can mean your bones don’t get the adequate nutrients to stay strong
  • Avoid smoking
  • Make sure you get the right amount of vitamin D and calcium
  • Stay active
    • Weight-bearing and strengthening exercises at least three to four times a week

Screenings to Diagnose Osteoporosis

Screenings for osteoporosis risks include a FRAX score and DEXA scan.

FRAX Score

This screening should be done when you reach menopause. It involves reviewing risk factors and answering a series of questions with your provider. With this information, your provider can determine your FRAX score. This will help to understand your chance of having a fracture within the next 10 years.

DEXA Scan

This screening typically begins at age 65, unless your FRAX score is higher than the recommended level. A DEXA scan tells us the quantity or amount of bone. It’s a bone mineral density test. The DEXA scan looks at the bone density of your lumbar spine, and then usually at a hip or wrist or forearm. It’s noninvasive, similar to having an x-ray.

Possible DEXA scan results:

  • Normal, meaning you don’t have osteoporosis.
  • Osteopenia, meaning your bone density is in between normal and osteoporosis.
  • Osteoporosis, meaning your bone density has reached the level to be diagnosed with osteoporosis.

Based on the results, DEXA scans may be repeated every couple of years to monitor your bone density.

Treatment & Prevention of Osteoporosis

Medication to Treat

Medications typically are not started until you are diagnosed with osteoporosis. The exception to this would be if you have osteopenia and have a fragility fracture. A fragility fracture is a fracture from a fall at standing height or less. It can be both a sign and a symptom of osteoporosis.

Diet & Exercise to Prevent & Treat

It’s really important to make sure you have a well-balanced healthy diet and are getting enough protein, calcium and vitamin D. Most of our vitamin D comes from the sun, so in the fall and winter months, a vitamin D supplement may be beneficial. It is possible to get too much of these vitamins, so it is important to talk to your health care provider to make sure you’re taking the correct amount.

Staying active is also important. Exercise, walking and generally taking care of our bodies helps not only to slow our bone loss down, but also helps us to prevent falls.

Megan Simpson, APRN-NP

Megan Simpson, APRN-NP

Bryan Primary Care

I believe in a collaborative approach to care, and want to create a partnership with my patients. It’s important to me to provide each patient with the knowledge they need to make decisions that are best for them and their health.

I’m here for my patients – to listen to you and your concerns and answer questions you have at the office or after you go home.

Care for:

  • Toddlers age 2 and older
  • Children, teens and adults of all ages
  • Preventative care, wellness checks and screenings
  • Chronic conditions like high blood pressure and diabetes

It’s a privilege for me to help people of all ages live their best lives.

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Multiple Sclerosis and Dietary Changes

Multiple Sclerosis and Dietary Changes

As a neurologist and subspecialist in multiple sclerosis, I am dedicated to helping patients with MS live their best lives. Many patients have questions about how dietary changes can impact their life. You will find that a well-balanced diet fuels your body and becomes a trusted companion in navigating the challenges posed by MS. It’s a flavorful quest where each meal becomes a small victory, a step towards a healthier, more vibrant life.

Dietary considerations are very important in most chronic medical conditions. From a nutritional perspective, what we expose our system to can have an important impact on our symptoms and sometimes in the course of the chronic medical condition. Multiple sclerosis is no different.

Here are answers to common questions about diet and MS.

Should I Be Supplementing My Diet with Vitamins and Other Supplements?

As a rule of thumb, I do not recommend multivitamins to all my patients with multiple sclerosis. I tend to screen for specific vitamin deficiencies. If a patient has one or more vitamin deficiencies, I recommend direct supplementation of that vitamin. I recheck the vitamin level in the future to adjust the dose.

What about Vitamin D? Which Vitamin D and How Much Should I Take?

Most patients with multiple sclerosis will be deficient or relatively deficient in vitamin D. I tend to recommend vitamin supplements with vitamin D3, which can be obtained over the counter. The goal is to have a vitamin D3 level from 60-80 ng/mL. To reach this goal, patients may need to take 2000-5000 international units of vitamin D3, particularly if they live in Nebraska or the Midwest.

Can I Take Too Much Vitamin D3?

Yes, and many of the symptoms of vitamin D3 toxicity may mimic chronic symptoms of multiple sclerosis, such as muscle aches, fatigue and even weakness.

Can Diet Decrease Inflammatory Activity and Relapses?

So far, there is no good evidence that dietary changes alone can directly modify the course of the disease and prevent inflammation and relapses (flares). However, maintaining a healthy body weight has been shown to decrease the risk of MS-related disability. A good diet and healthy body weight decreases the risk of other serious conditions such as cardiovascular and cerebrovascular conditions. This leads to improved overall health and decreased disability.

What Else Can Diet Do for Me and My Multiple Sclerosis?

Dietary changes have been shown to improve the overall quality of life and fatigue and, in some instances, hand dexterity. More than 50% of patients with multiple sclerosis suffer from MS-related fatigue. Unfortunately, the medications we use to treat fatigue in multiple sclerosis do not have great evidence backing their efficacy. Therefore, dietary changes have an important place in treating MS-related fatigue.

What Is the Best Diet for Multiple Sclerosis?

I always say that there is no one-size-fits-all when it comes to MS drugs/treatment, and I also apply this to diet. I recommend that my patients select one diet they can adhere to and follow long-term. Very restrictive diets and strict products may not be easy to obtain or even affordable.

Diets like the Mediterranean diet are easier to follow because they do not require complex planning and are more intuitive to follow. Other diets may also benefit multiple sclerosis, such as paleolithic, low-fat and intermittent fasting.

Where Can I Learn More About Diet and Multiple Sclerosis?

A good place to start is the National Multiple Sclerosis Society. The diet and nutrition section on this website has plenty of written information and pre-recorded webinars about diet and multiple sclerosis.

Daniel Crespo Artunduaga, MD

Daniel Crespo Artunduaga, MD

Neurologist, Bryan Neurology

Dr. Daniel Crespo Artunduaga is fellowship-trained in Neuroimmunology/Multiple Sclerosis and a neurologist at Bryan Neurology.

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Straight Talk on Mammograms and Breast Cancer

Straight Talk on Mammograms and Breast Cancer

The primary focus of most women is not themselves. Women for the most part are focused on taking care of their family and put themselves at the bottom of the list. It is time to change this way of thinking and put you and your priorities at the top of your list! You must take care of yourself. No one is going to do it for you!

Why Should You Get Your Mammogram?

  • Mammograms detect breast cancer before it can be felt
  • Early stage breast cancer has a great prognosis (outcome)
  • The earlier breast cancer is identified the less invasive the surgery can be
  • Early stage breast cancer may be less likely to require chemotherapy

When Should I Start Getting My Mammograms?

  • Start getting your mammogram at age 40 and have them every year
  • You may need to start having your annual mammograms earlier than 40 if you have a family history of breast cancer
  • Start your monthly self breast exams in your 20s

What Factors Increase My Risk for Breast Cancer?

  • Family history of breast cancer
  • Alcohol intake
  • Smoking tobacco
  • Not having children
  • Prior chest radiation
  • Starting your menstrual cycle before age 12
  • Starting menopause after age 55 (longer exposure to estrogen in your life)
  • Taking hormone replacement therapy
  • A sedentary lifestyle
  • Having a breast cancer gene mutation such as BRCA

How Can I Decrease My Risk for Breast Cancer?

  • No tobacco
  • Minimal alcohol
    • Women who have three alcoholic drinks per week have a 15% higher risk of breast cancer
  • Four to seven hours of exercise per week can lower your risk of breast cancer by 20 to 30%
  • Weight management. Overweight 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
  • Breastfeeding can lower breast cancer risk, especially if a woman breastfeeds for longer than one year

What Are the Surgical Options for Breast Cancer Treatment?

  • Lumpectomy
  • Mastectomy without reconstruction (removal of all of the breast tissue)
  • Mastectomy with reconstruction (removal of all of the breast tissue and rebuilding of the breast)
  • Oncoplastic reduction (bilateral breast reduction and lift at the same time as the lumpectomy)

What Is Involved with a Lumpectomy?

  • Removal of the breast cancer and a small amount of surrounding tissue
  • Removal of a few axillary (underarm area) lymph nodes
  • Usually followed by radiation therapy
  • There is a 20% chance the cancer will reoccur after a lumpectomy alone
  • Radiation therapy can reduce the recurrence risk to 7-10%

What Is Involved with a Mastectomy?

  • Removal of the breast
  • Removal of a few axillary (underarm areas) lymph nodes
  • You can have reconstruction at the same time

There is no difference in survival rates or prognosis (outcome) with a lumpectomy and radiation versus a mastectomy. The surgical choice comes down to patient preference and breast size in relation to tumor size. You have to do what is best for you and no one else in that moment.

Take Care of You

I encourage all women now to take care of themselves. We are often focused on taking care of others, but to take care of others and be there for them, you have to take care of yourself! Take that step now and schedule your mammogram.

If you’re curious or nervous about a mammogram, here’s what to expect and how to prepare.

Dr. Rachel Jendro, DO, FACOS

Dr. Rachel Jendro, DO, FACOS

Bryan Breast Surgical Specialists

Dr. Rachel Jendro, DO, FACOS is proud to be the first fellowship trained Breast Surgical Oncologist to serve the community of Lincoln and greater Nebraska. Her motivation for serving the women of Nebraska is due to her lifelong mission to provide evidence-based medicine to enhance the standard of care through surgical expertise, compassion for women’s health, and emotional support. As an osteopathic surgeon, Dr. Jendro brings enhanced surgical training and vast experience from accredited medical institutions, and is committed to her patients through their entire journey.

As a native of Kentucky, Dr. Jendro attended the University of Kentucky. She graduated magna cum laude with a Bachelor of Science in Biology. Dr. Jendro received her medical degree from the Kentucky College of Osteopathic Medicine. Her general surgery internship and residency were completed at Grandview Medical Center in Dayton, Ohio. Dr. Jendro was selected as chief resident in her general surgery residency program at Grandview Medical Center. Dr. Jendro is board certified by the American College of Osteopathic Surgeons.

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Don’t Let Balance Issues Hold You Back

Don’t Let Balance Issues Hold You Back

Now is a great time to get out and enjoy opportunities for fun. Maybe it is a walk in the park, looking around and enjoying the birds and nature. Or it may be watching your child or grandchild’s soccer game or even playing lawn games like bocce ball at home! Or maybe it is getting out and enjoying dining in a restaurant with friends or a musical performance.

But if you feel your balance is not good and you are worried about a fall or injury, you may miss out on all these and many other fun opportunities. Don’t let concerns about balance hold you back! You can improve your balance. The first step is determining the cause and then developing a plan to address it.

Here is information to help you get back to activities that are important to you.

Common Conditions that Affect Your Balance

Balance is a broad term and can be affected by so many factors. Your balance can be affected because of:

  • Tight/inflexible muscles
  • Weaker muscles
  • Abnormal sensation (numbness/tingling)
  • Visual problems
  • Inner ear problems
  • Anxiety or fear of falls

These factors play a role on how we are able to sense information for balance and then how our muscles and nerves respond. Sometimes if those systems aren’t giving us fast enough or accurate information, we cannot react fast enough and feel unsteady.

Emotions also play a role. If we have a history or near falls or instances of instability, we may be anxious or fearful of falls. Then we self-limit, meaning we stop doing these or other activities because of this fear. As we decrease our activity, our muscles can get weaker and our joints/muscles get less flexible which makes activities that were previously easier to do harder. It is a circle that just keeps expanding and can eventually have some significant negative impacts on our mobility and overall health!

Ways to Improve Your Balance

There are several activities that can help improve your balance. You can do these on your own, or you may want to have an assessment by a physical therapist trained in balance problems to identify specific causes and create a customized program to improve your balance.

Activities You Can Do on Your Own

  • Walking, biking and climbing stairs are good ways to strengthen muscles in your lower body; a recumbent bike is a safe way to start if you have significant concerns about your balance
  • Stretching loosens your muscles and can reduce tightness and inflexibility
  • Yoga strengthens and stretches muscles; Tai Chi moves, which are gradual shifts in weight from one foot to another with additional moves, offers a good approach to improve balance

Benefits of Working with a Physical Therapist

Physical therapy is a way to identify factors that affect your balance and help you gain confidence with your activities. A physical therapist can help assess areas that can play a role in your day-to-day activities.

Stretching programs and certain strengthening activities can help target those areas if needed. Other activities can be designed to increase stability when doing specific tasks that you have avoided because of your balance such as walking and turning your head, walking on unlevel/unpredictable surfaces or being able to adjust your body positioning when in crowded areas.

In addition to strengthening exercises, physical therapy teaches you ways to make adjustments as needed based on your activities! We want you to be able to enjoy your life and not miss out on all those important and fun times!

Take Steps Now to Improve Your Balance and Your Life

Bryan Health has physical therapists trained in balance problems to help you on the path to a life with better balance. The Bryan Center for Dizziness and Balance provides more information about balance, ways to improve it and innovative treatment approaches.

Laura Corbridge

Laura Corbridge

Bryan Health Physical Therapist

Laura Corbridge received her master’s degree in physical therapy from the University of Iowa in 1999. She has worked with both adult and pediatric patients and specializes in treating those with neurological disorders including traumatic brain injury, stroke and other progressive neurological disorders. She also treats patients with chronic lung conditions. Laura has had advanced training in balance and vestibular rehabilitation including Neurocom Balance master integration training and Emory University’s certification of vestibular competency. Laura provides comprehensive vestibular balance testing services and pulmonary therapy.

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Exercise Is the Best Way to Manage Arthritis Pain

Exercise Is the Best Way to Manage Arthritis Pain

Your knees, hips or back are stiff and sore and sometimes hurt with certain movements, so why would you want to strength train or do other types of exercise? Simple: Exercise is crucial for people with arthritis of all kinds because it:

  • Increases strength and range of motion
  • Reduces join pain
  • Helps to combat fatigue
  • Keeps your muscles and surrounding tissue strong to support your bones
  • Helps with weight management, which puts less stress on your joints
  • Improves balance
  • Improves sleep
  • Eases depression

If you don’t exercise, your supporting muscles weaken, creating more stress on your joints. Alternatively, when you move more throughout the day, you increase the lubrication in your joints so everything is easier to do!

Useful Exercise Tips to Get the Relief You Need

  • Start slowly and warm up with some range of motion exercises for your joints.
  • Stay within a pain-free range of motion and progress as your strength increases.
  • Use a supportive sleeve or elastic wrap around your affected joint to keep swelling down and make exercise more comfortable.
  • Plan light, moderate and heavier exercise days throughout the week to help with recovery and progression.
  • Wear proper footwear with support and cushion when doing weight-bearing exercises.
  • Strength train two times a week with an exercise for every major muscle group. Just don’t do this two days in a row. Give your body a recovery day.
  • Keep impact activities low.
  • Train at a time of day when your symptoms are better.
  • Use heat prior to exercise and ice afterwards.
  • Progress slowly in intensity and/or duration. This is key!

It is very common to have muscle soreness as you adapt to the exercise, but you should not experience sharp pain. If you have a flare up, take a rest day, do an activity that is low impact or shorten your duration and/or intensity.

Benefits of Exercise for Arthritis

Exercise is one of the best treatments for arthritis. Starting with light cardiovascular activity and easing into strength training will help reduce inflammation that causes pain. You may think exercise will aggravate your joint pain, but that is not the case. It is the lack of exercise that can make your joints even more stiff and painful.

For best results, attend a class specific for arthritis. A warm water class can be a great way to start. Ideally, find a qualified trainer to create a program for your specific needs.

Personalized Arthritis Care at Bryan LifePointe

Our certified exercise professionals will create a training and exercise program that can help you transition into regular physical activity. Making activity a routine in your lifestyle is the best way to manage arthritis. We can help you create a program that is specialized to you. Below are services specific to arthritis plus much more.

To learn more about Bryan LifePointe services and how we can help with your arthritis pain, give our team a call at 402-481-6300 or visit our office in Lincoln today!

Cindy Kugler, MS, Bryan LifePointe

Cindy Kugler, MS, Bryan LifePointe

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

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How to Be Your Own Best Advocate at a Doctor’s Appointment

How to Be Your Own Best Advocate at a Doctor’s Appointment

Have you ever gone to your doctor’s office and thought, “I have several questions I want to ask” and then gone home and realized you forgot to ask them? This happens to many people for multiple reasons. You may feel anxious during your appointment. You may feel uncomfortable asking a question. Or you may feel overwhelmed, answering so many questions about your health that you may simply forget the questions you wanted to ask. Whatever your reason is, here is what you can do to better self-advocate at your next appointment.

Prepare to Answer Basic Questions First

Knowing what to expect up front can help alleviate some anxieties. So, this is the basic process to expect during a doctor’s visit.

  1. In today’s world, you’ll start with COVID-19 questions, insurance information, emergency contacts and verifying your address.
  2. You’ll go to the scale. This part always makes me nervous because I don’t want to look.
  3. Your vitals are taken—blood pressure, temperature and pulse.
  4. You’ll review your medications and how you take them. It’s very important that you also share information on vitamins, natural supplements and any over-the-counter items you take. This helps your doctor make sure nothing interacts.

It’s a lot to go through, and all of this can occur before you get to the reason for your visit. While it may feel overwhelming now, there are steps you can take to be more confident and get the most out of your visit.

You & Your Doctor Are a Team

You both have a common goal—to take care of your health. To achieve that goal, you have to work together. This starts with being honest and sharing information with your healthcare provider. By being forthcoming, it helps them examine, diagnose and treat the problem. If you feel too uncomfortable sharing information, the doctor can’t do their job, let alone offer you optimal care.

Here’s what to do to avoid “losing your voice” when the white coat walks into the room:

  1. Prepare a list of questions before your visit. Write them down and bring that list with you to the doctor’s office. Having that list to reference will make sure you get all of your questions answered.
  2. Bring a friend or family member with you if you know you’re going to be overwhelmed. They can help you listen and ask the questions. Having a support person with you can be very comforting during a doctor’s visit.
  3. Be patient while the receptionist and nurse ask you questions. Your answers will be passed along to the doctor. This information also helps correctly pay for your bill so you don’t have to worry about it later.
  4. Write down the information you receive during the appointment. You can bring a notepad or use the notes app on your phone. Taking notes will help you remember everything that was said during the visit, including instructions for a treatment plan.
  5. Call back or send a message through your patient portal if you have questions after your visit. We want you to follow your care plan, so we’re happy to clear up any confusion. You can only follow our recommendations if you fully understand what we suggested.

These tips will help to make you feel empowered the next time you step into a doctor’s office. After all, you are your best advocate! If you or someone you know could benefit from a professional consultation, take our free, confidential mental health screening online from the comfort of your home today.

Stacy Waldron, PhD

Stacy Waldron, PhD

Licensed Psychologist, Bryan Medical Center Counseling Center

Dr. Stacy Waldron provides treatment for individuals of all ages across the lifespan and specializes with adolescents and adults. She offers individual and family therapy to help clients with stress, anxiety, mood disorders, life transitions and chronic pain. This includes helping individuals with stress management, assertiveness training, communication and problem solving skills as well as relaxation training. She also provides psychological assessments that include bariatric surgery evaluations, spine surgery, and spinal cord stimulator evaluations.

Waldron earned her doctorate in counseling psychology from the University of Southern California in Los Angeles. She serves on the Board of Psychology for the State of Nebraska, the Board of Directors for the Midwest Pain Society, and the Association of State and Provincial Psychology Boards.

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What’s Weighing Heavy on Your Heart? How Weight Impacts Your Heart Health

What’s Weighing Heavy on Your Heart? How Weight Impacts Your Heart Health

Obesity in the United States is increasing at an alarming rate and is a primary cause of our country’s current health crisis. More than 40% of Americans are now obese, rising from 23% in 1990. Many times the terms “overweight” and “obese” seem interchangeable. However, the CDC has specific definitions for each depending on a person’s Body Mass Index (BMI):

  • Overweight = BMI of 25.0 to < 30
  • Obese = BMI of 30.0 or higher

About three out of four adults in America are presently overweight, and the trend is only expected to increase. Obesity promotes buildup of cholesterol in your arteries, leading to heart attacks and strokes. It also gives way to high blood pressure, sleep apnea, depression, poor physical health and diabetes. As a heart doctor, the majority of diseases that I treat every day are partially due to obesity.

3 Steps to a Healthy Weight and Happy Heart

  1. Calculate your Body Mass Index (BMI): Use this BMI Calculator. It’s a quick and easy way to assess if your weight could cause health issues. It assesses your weight-to-height ratio. A healthy BMI is less than 25.
  2. Measure your waist circumference: This is measured just above your hip bones after exhaling. A waist circumference measuring over 35 inches for women or over 40 inches for men places a person at a higher risk for developing heart disease and type 2 diabetes.
  3. Increase exercise and reduce calorie intake: Increasing exercise and reducing calorie intake are great ways to lose weight. In general, we recommend the Mediterranean Diet, which is high in fruits, vegetables, whole grains, nuts and beans. It includes fish, poultry and dairy products with only limited red meat. This diet is associated with a lower risk of heart disease, strokes and several cancers.

Losing weight can be difficult for many. If you find yourself in need of a healthy change and are discouraged by the lack of results you’re seeing, know that you’re not alone. Bryan Health is here to support you along your journey.

Resources Available to Take Control of Your Weight

Bryan Health offers a multitude of resources and support when it comes to weight loss. Our team of professionals will provide education and lifestyle changes to embrace healthy eating habits, increase activity and promote positive behavior patterns you can live with for the rest of your life. We’re here to assist you in exploring which weight loss option is right for you.

Online Risk Assessment

A great first step towards a healthy weight is to take Bryan’s free WeightAware Risk Assessment. This assessment will only take seven minutes to complete, and at the end, you will receive personalized, confidential information that will help you:

  • Learn your current health status
  • Assess and identify your potential risk for conditions impacted by weight
  • Identify medical and lifestyle factors to reduce your risk of developing certain health conditions
  • Take action to reduce your level of risk through the many services available at Bryan Health

Bryan Bariatric Services

Bryan Health offers weight loss surgery, along with the education and support for your success. Call us at 402-481-5454 to schedule a consultation today.

Bryan LifePointe

Bryan LifePointe offers many services to help you on your weight loss journey. Wellness Revolution, our newest program, provides exercise, nutrition and health coaching for your overall success. Learn more at Wellness Revolution by calling 402-481-6300.

Joseph Kummer, MD, FACC

Joseph Kummer, MD, FACC

Bryan Heart Cardiologist

Born and raised in Omaha, Nebraska, Dr. Joseph Kummer attended Creighton Prep High School and the University of Nebraska Medical Center. After subsequent training in Chicago and Detroit at Northwestern Memorial Hospital and Henry Ford Hospital, Kummer became a diagnostic cardiologist at Bryan Heart. He specializes in heart catheterizations to find blockages in arteries and cardiovascular clinical work like treating hospital patients for rhythm disorders, heart failure, chest pain, and more. Kummer finds his work deeply rewarding because he can help people resolve their problems with the best quality cardiology care in Nebraska.

Learn More About Joseph Kummer, MD, FACC

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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 three, I understand that life gets busy and our own wellness is easy to put off for a later time! Whether we are busy with work, carting kids to activities, attending social events or our ongoing daily to-do lists, the one thing we all have in common 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 calendar—so we can stay strong and healthy for ourselves and families.

To learn more, visit the American Cancer Society.

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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