Growing Old Gracefully

Growing Old Gracefully

The other day my oldest granddaughter complimented me on my flexibility. I told her I try to work on my good health and wellness each and every day. She said I was a good role model and hoped she could grow old gracefully and follow in my footsteps. I told her by the time she was my age, living to 100 would be normal. I don’t know if living to 100 is a good thing or not, but medicine will become more exact and I’m sure she will make it if she puts her mind to it.

I know she complimented me because she’s my grandchild and she is very caring and nurturing. Her comment, “You have great flexibility!” Was probably followed with a comment made under her breath, “For an old lady,” or maybe not. It did make me smile, however, and her comment, “Growing old gracefully” did make me pause. What does growing old gracefully actually mean? I don’t think I’ve ever done anything gracefully and I certainly don’t think growing older is one of them.

Anymore, I try to remember to use a railing while walking up and down steps. I don’t always need the railing, but I know I should use it. Is using the railing growing old with grace?

Practicing Health & Wellness

I try to exercise each and every day, whether it’s walking, playing pickleball or taking a class at the YMCA. During nice weather, I like to ride my bike, but not when it’s cold or the wind is howling. Is exercising growing old gracefully?

I also focus on giving back to the community and others not as fortunate. Volunteering in my church and the Lincoln community brings me great joy.

I decided I need to find a new word for my daily progression in life. I googled the term, growing old gracefully and came upon a website about a new class led by Maria Shriver, which focuses on radically redefining age. Of course, the web class was earlier in the year and it probably cost a jazzilion dollars, but I did see a note about not surrendering your passions or your abilities as you age. I need to remember that and share it with others.

Finding New Hobbies

I told my granddaughter, I need to keep challenging myself and search for activities or people to keep me smiling and happy. She told me to let her know if there was anything she or the other grandkids could do to help. I told her they would be the first I’d contact if I felt that need.

The next day I was shopping at Walgreens for face cream. I was frustrated as each face cream I looked at was labeled, “Anti-aging.” Why? What’s so bad about aging? I need happy face cream, not Debby Downer face cream. I wanted somewhere over the rainbow face cream, not you’re on death’s doorstep face cream. I called my granddaughter and told her about my ah-ha moment and my need for face cream. She calmly told me to take a deep breath and relax. She reminded me why products are labeled and it was all about them trying to sell more and cash in on the big bucks. I thanked her for her wisdom, grabbed a face cream and immediately removed the label when I got home. That’ll show those whippersnappers!!

Nancy Becker

Nancy Becker

Grandkids & Grandparents

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

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What Can I Do to Improve My Sleep?

What Can I Do to Improve My Sleep?

Do any of these scenarios sound familiar?

  • It’s Sunday afternoon and while sitting in my recliner watching television, I end up taking a nap over two hours. Why am I not able to fall asleep at my normal bedtime hour?
  • I had to work late and ended up eating later than normal, then watched TV and browsed on my iPhone. Why am I not able to fall asleep?
  • I had a cup of coffee or a caffeinated product during an evening meeting. Why am I not able to sleep?

It can be very frustrating when you can’t get sleep. And often, the more you worry about not being able to get to sleep the worse it is! Most people don’t realize that simple changes in your daily habits can have a big impact on your sleep.

3 Ways to Improve Your Sleep

Sleep is a vital human function just as important as the oxygen we breathe, the water we drink, and the food we eat. Here are some helpful hints on how to improve your sleep:

Keep a Consistent Sleep Schedule and Make Sleep a Priority

    • Find the amount of sleep you need to help you feel refreshed and energized during the day. Sleep needs vary for each person; there is no magic number.
    • Get up at the same time each day.
    • Avoid naps if possible. If you need a nap, limit the nap to less than an hour and no napping after 3 p.m. A nap longer than an hour or after 3 p.m. will alter your sleep-wake schedule and make it more difficult to fall asleep at night.

Develop Healthy Habits

    • Exercising regularly will help you sleep more soundly.
    • Eat regular meals and do not go to bed hungry. If you are hungry before you go to bed, eat something that is easily digestible, such as a piece of toast (carbohydrate).
    • Avoid excessive liquids before bedtime. This will reduce the number of times you wake up to go the bathroom at night.
    • Decrease caffeine products. Caffeinated beverages and foods (such as coffee, tea, cola, and chocolate) can make it difficult to fall asleep. Caffeine will affect your sleep for up to eight hours after consumption.
    • Avoid alcohol, especially before bedtime. Alcohol may help you fall asleep more easily but will wear off, causing you to wake up more.
    • Smoking may disturb sleep. Nicotine is a stimulant that could interfere with falling asleep.

Create the Right Sleep Environment

    • Make your bedroom comfortable and free from light and noise. Room-darkening shades, earplugs, and/or white noise may help.
    • Have a comfortable mattress and pillow.
    • Find a bedroom temperature that works for you. Cooler rooms often promote better sleep.
    • Stop using your electronic devices 30-60 minutes before your bedtime. The screens on the devices emit a blue light that suppresses the production of melatonin. Melatonin is a natural hormone produced to regulate our 24-hour sleep-wake cycle. Think of it this way: lights off=melatonin on, lights on=melatonin off
    • Do not take your problems to bed. Plan time earlier in the day to work on problems or plan your next day activities.

Take Steps for a Good Night’s Sleep – ZZZs, please!

When you get a good night’s sleep, it’s amazing how much better you feel the next day. It also improves your overall health.

In some cases, there are health conditions that can prevent you from getting the sleep you need, even when you adjust your daily habits to improve your sleep. If this is the case for you, it’s important to talk to your doctor to determine what might be impacting your sleep.

Cindy Dahl

Cindy Dahl

Registered Sleep Technologist

Registered Sleep Technologist, Bryan Center for Sleep Medicine

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The Birds and the Bees

The Birds and the Bees

The dreaded question, “where do babies come from?” Cohen starts middle school next year and I think it’s time to have the talk.

Yes, the “TALK” talk.

The talk that no parent looks forward to, but all parents know it’s critical.

Having “The Talk”

There is no perfect or single best time for “the talk.” In fact, I think it should be a series of conversations you have with your child.

Too many parents wait for the “right” time to come along for the talk, only to find that it never does—and then they don’t have the talk at all.

My parents never sat me down and talked about sex. And I realized that if parents don’t teach their kids about personal health and sex, someone else will.

So, take a deep breath and don’t let that uncertainty hold you back. The truth is that there isn’t one “correct” way to teach your kids about sex and you can chart your own course.

I wanted my kids to learn about their wonderful, incredible, perfectly-made little bodies from the people who love and value them more than anyone else on this planet—me.

We just told Cohen about Santa. I mean, #LetThemBeLittle, right? And now, it’s time for the sex talk.

He’s already had the puberty talk in school, I gave him a heads-up of what was coming and told him to write down any questions he had, and we could discuss. And to my surprise he did. He and his father chatted while playing video games and I was okay with that.

Answering Questions

So here we go. After talking with some friends who’ve already had the “talk”. I gave up on the idea of presenting the subject in one big talk – I didn’t want to overwhelm him with more bewildering and even distasteful information than he could process at once. Instead, I bought ice cream, made sure Collyns, his little sister, was gone for the evening and we began. We had a gentle conversation that I think will continue over several months or perhaps even years. I wanted to keep our explanations as simple and specific to the discussion as we could.

The hardest part, of course, was staying composed. We tried to respond to his initial question without turning red or acting as though some momentous exchange was about to take place; we didn’t want to suggest that sex is linked to feelings of shame. We remained calm and spoke naturally. We didn’t want this important message to make Cohen feel nervous or uncomfortable because we wanted this to be an ongoing conversation. It’s something we can talk about.

When we arrived at the point of giving a technical description of “the Act,” we said something simple like, “Look, I know this sounds gross to you now, but – trust me – it will seem different when you’re older.” We tried to be straightforward and honest, so we could get through it.

Pause, ready? Here we go.

“When a man and a woman decide they want to have a baby, the man’s penis goes inside the woman’s vagina, and sperm comes out of the man’s penis. Sometimes the sperm joins with one of the tiny eggs inside the woman’s body, and that makes the egg begin growing into a baby. This happens in the special place women have called a uterus.”

An Ongoing Conversation

Once we made it through this, Cohen looked both dumbfounded and suspicious, especially since it probably dawned on him that his parents have done this thing at least twice. He suddenly changed the subject, and said, “I got it.” We ended the conversation with letting him know that we are both here to answer any questions and that we loved him. We let him leave. We knew he heard us and needed time to let it all sink in.

So, the “talk” may be over but hopefully, there will be an ongoing conversation. And when he gets a little older and starts noticing girls, the “talk” will continue. But for now, I can breathe again.

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

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

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

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

Here are some other questions you may have:

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

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

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

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

Answers to Common Colon Cancer/Colonoscopy Questions & Misperceptions

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

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

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

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

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

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

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

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

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

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

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

You Have the Power to Prevent Colon Cancer

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

I hope you will go home, talk with your family and add regular screenings to your 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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Should I Take Aspirin to Prevent a Heart Attack?

Should I Take Aspirin to Prevent a Heart Attack?

There’s been a hot and cold romance with the daily use of aspirin to prevent heart attacks and other conditions for years. On one hand, it’s been shown to reduce the risk of a stroke or heart attack. On the other hand, it’s been shown to increase the risk of bleeding, especially in the brain and gastrointestinal tract. And, of course, all of this leads to confusion. How do you know what’s best for you?

Follow the Research

The answer is, there is no one right answer for everyone. Many factors can play into what’s best for you – your age, current health condition, past health history and more.

Your Age

New research found that the risks of daily aspirin begin to outweigh the benefits starting at age 60. This research released in October 2021 by the United States Preventative Task Force showed the risk of aspirin causing potentially life-threatening bleeding in the brain or gastrointestinal tract increases with age. So this is definitely something for you and your doctor to consider, especially if you have a history of bleeding.

Your Health History

What if you’ve had a heart attack or stroke in the past, or you have heart disease? Does this change what you should do? Yes. If you’ve had a heart attack or stroke, taking low-dose aspirin has been found to be beneficial.

In medicine, randomized controlled trials provide the best information in terms of providing scientific data to guide decision making. Multiple trials have shown two things:

  • Aspirin is not beneficial for primary prevention. Primary prevention means preventing a first-time stroke, heart attack or other cardiovascular condition. If you don’t have a heart condition, most people would not benefit from taking aspirin daily.
  • On the other hand, if you’ve had a heart attack, stroke or heart disease, aspirin is used for secondary prevention. This means to prevent a second heart attack, stroke or other condition. Why? Because once you have these conditions, you are at a higher risk for them to occur again.

To Use or Not Use Aspirin

This can be a complex decision. The best way to decide this is to talk to your doctor to assess your risk level. Each person is slightly different. Some people have higher risks of stroke and heart attacks, while others have higher risks of bleeding.

Your doctor can provide information on the risks and benefits for your specific situation to determine if taking aspirin is right for you.

Dr. Zach Singsank

Dr. Zach Singsank

Interventional Cardiologist

Zach Singsank is an interventional cardiologist with Bryan Heart.

https://www.bryanhealth.com/find-a-doctor/profile/zach-singsank/

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Women Don’t Talk About it but They Should Know About it: Gynecological Cancer

Women Don’t Talk About it but They Should Know About it: Gynecological Cancer

Compared to other cancers gynecologic cancer is relatively rare, but it is still important for women to know about it and take action for prevention and treatment. Some forms of it can be prevented by taking simple steps. Others have no preventative measures and require awareness of symptoms to seek treatment.

As a gynecologic oncology surgeon, I want women to know the facts, be aware of the role they can play, and be able to have access to the best treatment when needed.

Gynecologic Cancers in Nebraska

  1. Endometrial cancer – This is a type of uterine cancer and is cancer of the lining of the uterus. This is the most common gynecological cancer treated in Nebraska.
  2. Ovarian and fallopian tube cancers – These are the most lethal gynecological cancers we treat.
  3. Cervical cancer – This is actually the most common gynecological cancer worldwide, but it’s the third most treated in Nebraska.
  4. Vulvar cancer – This is a rare skin cancer.
  5. Vaginal cancer – This cancer is also rare.

What You Should Know about these Gynecologic Cancers

Endometrial (Uterine) Cancer

Prevention: There is no specific prevention for this type of cancer. However, it is seen more frequently in women who are obese and have diabetes or other medical conditions that go along with obesity. This is likely due to prolonged estrogen stimulation from fatty tissue.

Warning signs: Post-menopausal bleeding is the most common warning sign. If you experience any bleeding, even minor spotting or a discharge after menopause, this needs to be evaluated to rule out uterine cancer. When following up on this symptom, about 75% of the time uterine cancer can be diagnosed at an early stage.

Ovarian Cancer

Prevention: If you carry the BRCA (BReast CAncer gene) one and two or BRCA genes, you should talk to your doctor about risk-reducing surgery because for certain groups of patients this may be something to seriously consider. It is clear that removing the ovaries and fallopian tubes reduces the risk of ovarian cancer significantly.

Warning signs: Unfortunately, there are no early warning signs. Ovarian cancer grows silently and spreads extensively before it causes much in the way of symptoms. And when symptoms occur, they are very common such as constipation, bloating and pelvic pressure. It’s normal for these symptoms on their own to come and go. But if you experience these symptoms and they persist, and continue to progress – for example, first you have constipation, and then you also have bloating and then you have nausea or vomiting, that is a reason to see your doctor.

Cervical Cancer

Prevention: There is actually a vaccine that is very effective against the human papillomavirus (HPV), which causes cervical cancer. This is an amazing step forward. A recent report shows cervical cancer is declining and this is likely due to the vaccination.

Screenings/Early Detection: A Pap smear or test is a very effective screening test for cervical cancer. While this test doesn’t diagnose cancer, it alerts your doctor to take a closer look. It’s also important to know that the vast majority of women who have an abnormal Pap smear do not have nor do they ever get cervical cancer. Even after the age where Pap smears are recommended, women should continue to have yearly exams with their doctor so that symptoms they may or may not be aware of can be evaluated.

Warning signs: Abnormal bleeding at any time (before or after menopause).

What Can You Do

The 3 most important things women can do are:

  • Get your regular Pap screenings for cervical cancer; continue yearly exams after Pap tests are no longer recommended.
  • Be aware of warning signs and if you experience them, talk to your doctor – don’t put it off.
  • Know your family history.

You know your body and are the best one to be aware, take steps where you can and seek medical advice for early detection.

Dr. Peter Morris

Gynecologic Oncology Surgeon

Dr. Peter Morris is a gynecologic oncology surgeon with Cancer Partners of Nebraska. He is specifically trained in the surgical and medical treatment of gynecologic cancers, which include the uterus, cervix, fallopian tubes, ovary, vagina and vulvar area.

This is a very narrow field of specialty with extensive training. After medical school, there is a four-year residency in general obstetrics and gynecology followed by a three-year fellowship in gynecologic oncology.

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Listening to Your Body – Living with Endometriosis

Listening to Your Body – Living with Endometriosis

Imagine being a senior in high school excited for your senior prom then hearing the words, “You might not be able to have kids.” That was me. Obviously, as an 18-year-old I wasn’t thinking about my future children right then but as previously mentioned, when asked what I wanted to be when I grew up, all I wanted to do was be a mom. So here I was in high school and hit with the thought that my dream may never come true.

Getting Diagnosed

Throughout my senior year, I would have this sporadic pain in my stomach. It was so debilitating I had to stay home from school. It would come and go, and I didn’t think it wasn’t associated with my cycle. I saw multiple doctors, but no one could diagnose my pain. Luckily, my mom believed me and fought for her child. We eventually saw a gynecologist in hopes she could figure it out. After several tests with no results, the gynecologist didn’t think the pain had anything to do with my ovaries or lady parts and the ultrasound didn’t show anything. I was sent home with the response “come back next time you have this pain.” But since the pain would come and go and I had no indication of when it was coming it took several more months for anything to be diagnosed.

People say it all the time — “listen to your body.” Some people feel really in tune with their bodies, others feel like they’re completely disconnected. Sometimes the phrase feels like it’s lost its meaning altogether. Especially when doctors keep telling you nothing is wrong.

The next time I had the pain we went back to the gynecologist, still with no conclusive reason. The doctor scheduled me for a laparoscopy. Through this procedure, she eventually diagnosed me with endometriosis. My first reaction was, “I’m not crazy – there’s really something wrong here!” My next response was to learn as much as I possibly could about the disease and its treatment.

Endometriosis is a chronic and painful disease that occurs when the endometrium (tissue that originates from the lining of your uterus) starts growing outside of your uterus, where it doesn’t belong. The endometrial tissue that grows outside of your uterus is called a lesion or an implant. These lesions are fueled by a sex hormone called estrogen. When estrogen levels rise, these lesions (patches of endometrial tissue) can grow. Later in the menstrual cycle, they may break down and shed. This can cause pain throughout the month.

Through this procedure, the doctor saw that the lesions were so severe they had to open me up through a bigger incision and remove my left ovary and fallopian tube. The lesions were encapsulating both and they couldn’t be saved. Not only that, but the doctor also didn’t want the lesions to come back so they prescribed a hormone treatment that put my body into menopause for a year.

Here I was, spring semester of my senior year going through menopause. On the plus side, I wouldn’t have a period for the next year. However, with menopause came hot flashes, mood swings and other symptoms. Try explaining that to your friends. The doctors also said conceiving a child may be difficult, but we’ll have to wait and see.

After a year of menopause, I was put on birth control to regulate and somewhat control my periods. I didn’t have any problems. I was in college and felt like my normal self again. Fast forward several years, the good news, my periods are back to normal, and I didn’t have any problems conceiving. We are blessed with 2 beautiful children.

Managing My Endometriosis

But here I sit at the age of 35 with this sporadic, debilitating pain in my lower abdomen again. After seeing the gynecologist and doing an ultrasound, once again there was nothing suggesting why there is pain. So, the doctor gave me my options: 1) exploratory surgery 2) hysterectomy 3) deal with the pain every so often.

Right now, I am dealing with the pain. The doctors and I agreed that a hysterectomy was probably in my future but wanted to wait until I was closer to 40. So, I started to keep a pain journal. I’ve found this to be very important both in managing my own illness – I was able to see, for instance, a link between my caffeine and alcohol consumption and pain – and in helping doctors to see patterns that can guide treatment. People, doctors and friends alike also take you more seriously when you’re able to demonstrate exactly what you’re experiencing and when you felt it. I made a chart based on a 28-day cycle and kept track of things I ate or drank that might be potential triggers, when I had discomfort, and what seemed to make me feel better.

I sought out the support of other women with endometriosis. No one can really understand until they’ve been through it themselves. In the meantime, I keep looking after myself! A diagnosis of endometriosis may feel like the end of the world, especially at first, but I continue to find that it’s not!

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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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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