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

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

by | Jul 20, 2021 | Expert Health Tips

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

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

What Is CBD Oil?

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

Benefits of CBD Oil

Some of the many benefits of CBD oil include:

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

Who Can Benefit from CBD Oil?

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

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

How Do I Take CBD Oil?

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

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

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

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

Capital Foot & Ankle:

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

Jeffrey Wienke, DPM

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

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High Cholesterol in Kids

High Cholesterol in Kids

by | Jun 28, 2021 | K-12

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

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

Checking Cholesterol Levels

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

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

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

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

Changing Eating Habits

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

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

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

Embracing a Healthy Lifestyle

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

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

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

Mallory Connelly

Mallory Connelly

Babies & Toddlers

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

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7 Ways to Strengthen Your Bones & Lead an Active Life

7 Ways to Strengthen Your Bones & Lead an Active Life

by | Jun 22, 2021 | Expert Health Tips

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

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

Factors that affect the growth and strength of your bones

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

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

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

Are you at risk for osteoporosis?

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

7 Steps You Can Take for Healthier Bones

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

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

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

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

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

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

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

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

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

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

4. Exercise

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

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

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

5. Prevent Falls

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

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

Ways to prevent falls inside your home

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

Ways to prevent falls when you’re outside

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

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

Learn more and schedule an appointment today. 

6. Don’t Smoke

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

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

7. Limit Alcohol Intake

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

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

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

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

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

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

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

Alesha Scott, DO

Alesha Scott, DO

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

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Learning About Life Through Travel

Learning About Life Through Travel

by | Jun 7, 2021 | K-12

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

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

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

Connecting the Dots

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

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

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

Choosing to Take the Trip

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

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

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

Shelly Mowinkel

Shelly Mowinkel

K-12 & Teens

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

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Are You Getting Enough ‘Vitamin N’?

Are You Getting Enough ‘Vitamin N’?

by | May 18, 2021 | Expert Health Tips

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

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

Research Shows Nature’s Health Benefits

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

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

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

How to Stay Safe Outside

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

Use Sunscreen

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

Stay Hydrated

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

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

Remember Insect Spray

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

Always read the label, but some general precautions include:

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

Get Back to Nature for Your Mental & Physical Health

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

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

Julie Wiekamp, PA-C

Julie Wiekamp, PA-C

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

Learn more about Julie and the care she provides.

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

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

by | May 10, 2021 | Grandparents

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

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

Getting Our COVID Vaccines

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

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

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

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

Volunteering at a Vaccine Clinic

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

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

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

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

Nancy Becker

Nancy Becker

Grandkids & Grandparents

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

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

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

by | Apr 21, 2021 | Expert Health Tips

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

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

What Is a Thyroid?

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

How Does the Thyroid Work?

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

Drawing that illustrates how the thyroid works.

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

What Is Hypothyroidism?

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

Drawing of how hypothyroidism works.

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

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

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

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

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

What Is Hyperthyroidism?

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

Drawing that shows how hyperthyroidism works.

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

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

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

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

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

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

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

Madeline Jones-Ryan, DO

Madeline Jones-Ryan, DO

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

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

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

by | Mar 15, 2021 | Expert Health Tips

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

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

Here are some other questions you may have:

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

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

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

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

Answers to Common Colon Cancer/Colonoscopy Questions & Misperceptions

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

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

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

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

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

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

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

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

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

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

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

You Have the Power to Prevent Colon Cancer

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

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

To learn more, visit the American Cancer Society.

See a Colonoscopy

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

Watch the Video

Colon Cancer: Preventable. Treatable. Beatable.

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

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

Listen to the Podcast
Breanna Nedved, RN

Breanna Nedved, RN

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

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Fish Oil Benefits: New Research May Surprise You

Fish Oil Benefits: New Research May Surprise You

by | Feb 15, 2021 | Expert Health Tips

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

It All Starts with Omega-3 Fatty Acids

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

Research Trials & a Stunning Result

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

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

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

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

Breaking Down the Research

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

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

The VITAL Trial

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

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

The ASCEND Trial

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

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

The REDUCE-IT Trial

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

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

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

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

Impressive Outcomes for Highly Purified Prescription Supplement

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

Ways to Improve Your Heart Health

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

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

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

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

Dr. Keith Miller, MD

Dr. Keith Miller, MD

Health Expert

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

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Fighting COVID-19 Fatigue

Fighting COVID-19 Fatigue

by | Nov 23, 2020 | K-12

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

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

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

Being Intentional

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

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

Fighting COVID-19 Fatigue Each Day

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

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

Shelly Mowinkel

Shelly Mowinkel

K-12 & Teens

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

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

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

by | Nov 9, 2020 | Expert Health Tips

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

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

What Can You Do?

Understand the Stages of Grief

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

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

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

Find a Balance in Your Thinking

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

Think About What You Can and Cannot Control

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

Have Empathy

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

Build Connectedness

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

Understand When to Seek Help

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

Know the symptoms of depression:

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

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

David Miers, PhD, LIPC

David Miers, PhD, LIPC

Health Expert

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

Learn More About Our Counseling and Mental Health Services

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Focusing on Positive Thoughts

Focusing on Positive Thoughts

by | Oct 26, 2020 | K-12

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

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

Worrying About Mental Well-Being

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

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

The Importance of Taking Time to Recharge

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

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

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

Shelly Mowinkel

Shelly Mowinkel

K-12 & Teens

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

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