Treating pain–ankle sprains

By Julia Neppl PT, LAT | May 7, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

Sprained ankles are the bane of many athletes and weekend warriors. If you think you’ve sprained an ankle, you should see a clinician for proper healing and to avoid future injury.

When you sprain an ankle, one or more ligaments of your ankle become overly stretched or even torn. Although it is possible to sprain the ligaments on the inside or outside of your ankle, the ligaments on the outside are most commonly sprained. They most often occur when your toes are on the ground, the heel is up and you are walking or running on an uneven surface. The ankle can turn inward, damaging the ligaments causing the sprain.

Ligaments in your ankle provide stability and motion, so when they are hurt, you are at an increased risk for more damaging injuries.

Sprain Severity
The severity of an ankle sprain is determined by a grading scale. Each grade has appropriate treatment.
Grade 1: Stretching of the ligaments. Treat by using RICE (Rest, Ice, Compression, Elevation)
Grade 2: Stretching and some rupture of the ligaments. Treat by using RICE and by allowing additional time to heal. A sprain of this severity may need to be splinted.
Grade 3: Greater rupture of the ligaments. You may need to wear a brace for 2-3 weeks while the injury heals. Repeated ankle sprains may require surgery to repair the ligaments.

Recovery
After treatment, most people need to follow through with rehabilitation, with exercises to strengthen the muscles around the ankle and learn to use the ankle more efficiently. With any type of sprain the ankle needs sufficient time to recover. It is important to remember that even if the pain has gone away you still need to follow the correct recovery procedure in order to for your sprain to heal properly.

For sports- or work-related injuries, a physical or occupational therapist, or licensed athletic trainer, can be integral in returning to pre-injury capacity. Our Therapy & Sport Center provides treatment and rehab for injuries from the simplest sprain, to a full joint replacement. If you’re hurt – don’t hesitate to call. Waiting often only leads to further damage.

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Give birth to hope—Cord blood donation

By Nancy Aguirre, MD | April 30, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

Quick, easy, painless, and saves lives. You would want to know more, right? New mothers have the opportunity to save the life of someone who may need a stem cell transplant by simply donating cord blood, a simple and painless process.

What is cord blood? In the past, a baby’s umbilical cord was disposed of following delivery, but today, blood from the cord can be collected after your child’s birth and donated to a public cord bank. A baby’s umbilical cord contains special cells that can be used in transplants to treat certain types of leukemia and other blood diseases. When stem cells divide, they have the potential to either remain a stem cell or become another type of cell with a more specialized function, such as muscle cell, oxygen carrying blood cells, or a brain cell; they can even fight disease, repair bone and tissue damage, and stop bleeding.

Who benefits? What are your options? Donating is simple, but receiving can be everything. A happy event for you and your child could become the same for someone in need. The National Marrow Donor Program® estimates that 45,000 to 50,000 stem cell transplants are performed annually worldwide to treat patients with life-threatening diseases. Today, expectant parents may choose from the following options:

  • Donate to a public cord bank. When you donate for public use, it is free-of-charge and the cord blood is available to any patient who needs a transplant. Cord blood stem cells are successfully used today and have been saving lives for over 20 years. As a new mother, donating cord blood increases the chances that patients who might benefit from stem cell transplants are able to have one quickly.
  • Store in a family (private) cord bank. Mothers can also choose to store the cord blood cells to potentially use in case of a life-saving transplant needed by the newborn baby or family member. Although a fee is charged for collection and storage, privately storing your child’s cord blood cells should be taken into special consideration for families with a history of hereditary diseases which can be treated with stem cells.
  • Save for a sibling who has a medical need. At the time of birth, if a biological sibling has a disease that may be treated with a cord blood transplant, parents can choose to save their child’s cord blood for direct donation with little or no cost to eligible families.
  • Do nothing. This is always an option, where the umbilical cord blood will be disposed of after birth.

Cord blood donation is a simple process with life-changing potential. If you are interested in pursuing cord blood donation or have further questions, please contact your Fort HealthCare provider.

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Fueling Your Fitness

By Lisa Michaels-Bilgrien, RCEP | March 14, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

Supplementing your exercise routine with proper nutrition and hydration plays an integral role in maintaining and enhancing your total fitness and boosting your body’s ability to perform at its maximum capability.

A HEALTHY DIET
Eat the rainbow! Eating a variety of healthy and colorful foods is key to maintain the right energy levels.  To receive the proper amount of nutrition, it is vital that you consume at least three meals per day. Snacking on nutritious foods between meals can even contribute to a healthy diet, increase metabolism, and prevent overeating during the next meal.

Eat high-protein, low-fat items such as fish, beans, whole wheat pasta, egg whites, skim or 1 percent milk, and low fat yogurt. Try to avoid items such as fried foods, high fat meats, egg yolks, and whole milk.

For a good source of vitamins, eat a diet rich in raw or steamed vegetables, green leafy romaine, whole grain breads, and fruits with skin. Avoid fried vegetables, iceberg lettuce—containing no nutrients, white bread, and canned fruits in syrup.

There are good and bad fats? Try to choose non-trans fat bread spreads and heart-healthy margarine. Cook with olive oil or sunflower oil, and omit lard and meat fat. Limit or omit creamy salad dressings high in fat content, cookies, cakes, pies, and pastry goods. Likewise, avoiding fast food is always a good way to cut down on your fat intake.

Before a workout, you should eat a small serving of complex carbohydrates such as whole grains, fruits (apricots, oranges, plums, pears, grapefruits, prunes), vegetables (broccoli, cauliflower, spinach, potatoes, yams, corn, carrots, onions, etc.), legumes (lentils, kidney beans, black beans, peas, soy beans, etc.), dill pickles, soy milk, low-fat yogurt, or skim milk. After a workout, stick with the standard fruits, vegetables, and of course, water.

HYDRATION
The proper amount of water can help regulate your body temperature and combined with the proper fuel it can help you reach your fitness potential. During exercise your body reacts to the increase in temperature by sweating in attempts to cool you off. Since sweat is primarily water you must replace it by drinking more water. If you do not replace the water you have lost, it can lead to poor performance and possible injury. It is recommended that you drink water before, during, and after exercise to prevent dehydration and help improve performance.

PLAN AHEAD, MAKE MEALS READY-TO-EAT
“I don’t have time to cook nutritious meals.” We have all said this at one point; however, if you can manage to take some time the night before or even on the weekend to pre-cook some nutritious meals, you, your family and your wallet can greatly benefit. You can even utilize that overflowing Tupperware drawer that everyone seems to have—cook up some meals and then stock up the fridge for the week. This leaves you with plenty of meal options to choose from if you are crunched for time. By preparing these meals ahead of time, you are less likely to grab something unhealthy. It also allows more time for your workout—no excuses!

Whether you want to learn how to shop better for your family at the grocery store or find a way to a healthier diet, Fort HealthCare offers nutrition programs among the many health and wellness classes offered throughout the year. Additionally, registered dietitians are available for private consultation to assist both adults and children with healthy eating, living with dietary restrictions and creating personalized dietary programs. A referral from your doctor is needed for insurance coverage.

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Potty Training—ditching the diapers

By Laurie Runte, PNP | March 14, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

Is it time to ditch the diapers? It probably seems like just yesterday you were changing your toddler’s first diaper, and now you are wondering if it is time to start potty training.  Potty training is a big step, and it can be a difficult and frustrating process for both children and parents alike.  No child is alike, so mothers, new or experienced, may be wary about where and when to start and unsure about how to tackle the daunting task. These basic tips will get you started on the right track and help you and your little one find potty training success.

Wait until your child is ready.
There is no magic age to start potty training, however, most children are ready between 2 ½ to 3½ years old.  It is a process, so start slow, and to pique interest, place the potty chair you’ve chosen in the bathroom, make it part of your regular routine at bath time, bedtime, or even before leaving the house, and encourage good hand washing afterward.

Look for the signs.
When is it time to start potty training?  It is different for every child, so it is important to look for signs that may indicate your child is ready.  Some good indicators are:

  • You’re changing fewer diapers which may be dry after a nap, or even overnight
  • Your child’s bowel movements are predictable or regular
  • Your child understands bathroom lingo
  • Your child can perform simple undressing

Choose the right toilet-training potty.
Here is how to pick one to guarantee toilet-training success:

  • Shop for a potty in person and take your child with you
  • Perouse the store’s stock, let your child sit in any that they seem interested in, and look for one’s that fit them comfortably
  • Check for features like a removable bowl and splash guard
  • Let your child decorate the potty with markers or stickers—let them make it their own

Be patient—every child is different.
Potty training is a normal process that is different for each child.  It is important to begin when you believe your child is ready, be active and aware throughout the process, and be patient.  If you push the process too hard, you may end up back at square one.

Motivate with rewards.
For most kids, kisses, hugs, tickles, and praise is motivation enough, but some toddlers may need a little extra incentive.  Some parents swear by sticker charts, while others use other small treats for motivation, but whatever road you take, be sure to emphasize what the child accomplished rather than the reward.

Understand accidents.
A few toddlers start using the potty and never look back; however, for most, accidents are bound to happen.  At such a delicate phase of development, there are many things that can be an obstacle or cause a setback.  Chances are your toddler will be upset after an accident, so the more subdued your reaction, the better.  Offer comfort and reassurance, and help restore your child’s sense of control.  Dealing with the causes of such accidents is instrumental to putting potty training back on the road to success, so be aware of the common triggers such as stress, fatigue, parental pressure, excitement, and other major changes.

For more information about toilet training, consult with your Fort HealthCare family physician, visit forthealthcare.com, or check out this video about toilet training your toddler.

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Breastfeeding Benefits for Both

By Jackie Wolff-Ellifson RN, LC | February 28, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

Breastfeeding is one of the most natural and beneficial ways a mother can care for her baby.  The experience of breastfeeding is very special and while some may feel breastfeeding is unnecessary, it provides endless value for your child, and is just as rewarding for you, too.  It may be challenging at first, but you and your baby can succeed and find value in the numerous benefits of breastfeeding.

Benefits for Baby
–The colostrum – a yellow, watery pre-milk – that your breasts make for the first few days after birth helps your newborn’s digestive system grow and function.
–Breast milk has antibodies that help your baby’s immune system fight off sickness. Babies who are breastfed also have a lower risk of asthma, obesity, allergies, and colic.
–The protein and fat in breast milk are better used by the baby’s body than the protein and fat in formula.
–Babies who are breastfed have less gas, fewer feeding problems, and often less constipation than those given formulas.
–Breastfed babies have a lower risk of sudden infant death syndrome (SIDS).
–Breastfeeding provides contact that babies yearn.  Frequent skin-to-skin contact with Mom is calming and comforting.

Benefits for Mom
–It is convenient – Your baby’s food is always available and ready at the right temperature.
–Breastfeeding releases the hormone oxytocin, which makes the uterus contract and helps it return to its normal size more quickly.
–It may decrease your risk of some forms of cancer and other illnesses.
–It may help you lose weight gained during pregnancy faster than you would if you were bottle-feeding.
–It is less expensive than bottle feeding with formula.
–It creates a special bond between you and your baby.

With help from our Fort HealthCare lactation consultants, 80-90% of mothers begin breastfeeding their babies shortly after birth, and studies have shown that 91% of mothers who deliver their babies Fort Memorial Hospital Great Expectations Birthing Center are successfully breastfeeding at both two- and five-weeks after birth.

At Fort HealthCare, breastfeeding is discussed throughout pregnancy, and more information is presented both in person and through our childbirth preparation classes.  Fort HealthCare’s Breastfeeding Support Group meets the last Thursday of every month from 1:30-3:00 in the OB Classroom at the hospital. There is a lactation consultant who can answer questions and perform infant weight checks. Moms who attend are typically nearing the end of their pregnancy or have a nursing newborn, infant or toddler. All nursing or curious moms are welcome! As always, moms are invited and encouraged to call our Lactation department (920) 568-5396 for guidance on any breastfeeding related issue.

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Staying Fit with a Family

By Laurie Runte, PNP | February 21, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

From the moment you become a parent, activity and healthy living choices seems to come second to the needs of your children.  Even parents with a strong commitment to physical activity before parenthood may struggle to find the time and energy to stay fit.  But when it comes to abandoning activity, you are hurting more than just yourself.  Physical activity can help you stay healthy so you can keep up with your child’s needs and be around when they get older.

Even though most parents feel like they are always on the go, studies have shown that physical activity declines among the majority of new parents.   Here are some tips to stay active and healthy for you and your family.

Be active all day.
You don’t have to go to the gym to be physically active.  There are lots of little things you can do to incorporate activity into your day.  Go for a walk with your child, take them to the park, take the stairs, park further away from your destination, or do a few exercises in between your daily routines.  Make these small changes and commit to being active throughout your day—we think they will add up!

Don’t let time be an excuse.
Although your children take up a lot of the time you once had for yourself, it is not impossible to stay physically active during parenthood.  It does not take a lot of time at the gym to reap the health benefits of exercise.  Focusing on quality instead of quantity, a few short workouts every week can help you stay motivated and avoid burnout.

Find social support.
Having a friend, family member, or neighbor to who you can trust to care for your child is vital.  Few exercise facilities provide childcare services, so this dilemma becomes a problem and long-term excuse for many parents.  Establish a network of friends that you could trade off child care responsibilities with.

It is also helpful to find social support through an exercise partner that has similar goals.  By making a commitment to exercising with someone, people feel more accountable and are more likely to follow through with their workout.  Exercise partners can also provide continuous motivation and support.

Make it a family affair.
The best way to show your children the value of fitness is to be physically active with them.  Take infants or toddlers for walks in their stroller or fit in quick exercises during their nap.  Take your older children to the park or enjoy the opportunities that your community provides.  Take advantage of each season—ride bikes in the spring, swim in the summer, take a scenic hike in the fall, and go sledding or ice-skating in the winter.  Doing these physical activities will feel more like fun than exercise and can instill great habits in your children at a young age.

Set goals for yourself.
Motivation comes from within, so the first step to physical fitness is to have a reason to want it.  It is important to set short-term goals that are measurable and attainable.  Start with small, manageable goals and go from there.  Continue to monitor your progress and set new goals accordingly.  Don’t get discouraged if you don’t meet your exercise goal for a week.  There is no reason to completely drop out; reevaluate and work hard next week!

Be a role model.
You serve as a huge role model in your child’s life, and your actions have a huge impact on the habits that they will form.  Your children will likely mimic your behaviors, including physical activity practices; therefore, when teaching discipline, it is important for you as a parent to have some as well.

Fort HealthCare supports a parent’s decision to be physically fit with fitness classes, events, and challenges to help jumpstart and maintain a healthy lifestyle.

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Heart-Healthy at Any Age

By Aaron Beck, MD | February 19, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

You are never too young or too old to take care of your heart.  People at any age can benefit from simple steps to keep their heart healthy, and making smart choices at an early age can create healthy habits to help prevent heart disease and other cardiovascular diseases.

Tools for all generations to take to heart:

In Your 20s

  • Have regular wellness exams: Establishing a relationship with a doctor means you can form heart-healthy habits early and easily monitor possible changes in the future.  Talk to your doctor about you diet, lifestyle, and checking your blood pressure, blood sugar, cholesterol, heart rate, body mass index, and waist circumference.
  • By physically active: Mix up your exercise routine and find new motivators to keep your workout interesting.  It is much easier to stay active throughout your life if you start at a young age.
  • Avoid secondhand smoke: If you picked up smoking as a teen, now is the time to quit.  Even secondhand exposure poses serious health problems, so try to avoid it at all costs.

In Your 30s

  • Make it a family affair: You can benefit from instilling heart-healthy habits in your children.  Explore a nearby park or encourage your kids to help you cook in the kitchen, and take these healthy steps together.
  • Know your family history: Dig into your past to learn about your family’s health history.  A family history of heart disease increases your risk, so take control by making healthy choices and inform your doctor.
  • Control your stress: Long-term stress can increase your heart rate, blood pressure, and long-term heart damage.  Learning stress management techniques can be vital to your heart’s health, so breathe deep and find some time every day to do something you enjoy.

In Your 40s

  • Watch your plate—and weight: Your metabolism starts slowing down in your 40s, but you can avoid weight gain by getting plenty of exercise and sticking to a healthy diet.  Stay motivated by trying new recipes and activities, or find friend to share your new plan and help each other stay on track.
  • Have your blood sugar checked: You should have your fasting blood sugar (FBS) tested for the first time around age 45; this is often the first check for (pre)diabetes and will provide a baseline for future tests.

In Your 50s

  • Learn the warning signs: Not everyone experiences tell-tale symptoms of a stroke and heart attack, so it is important to know the warning signs.  Women can also experience different symptoms than men.
  • Follow the treatment plan: If you have been diagnosed with a condition that increases your risk for heart disease or stroke, closely follow your prescribed treatment plan, including diet, lifestyle plans and medication.

In Your 60s+

  • Have an ankle-brachial index test: In addition to eating healthy, exercising, and managing any health issues that arise, you should also have your first ankle-brachial index test, which helps diagnose peripheral artery disease (PAD), a lesser-known cardiovascular disease.  This test should be performed every one to two years as part of a regular physical exam.

With age comes an increased risk for heart disease, but by taking these steps and making simple heart-healthy choices, you can help prevent heart disease at any age. Talk with your doctor or call Fort HealthCare’s Integrated Family Care for an appointment.

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Valentines SHOULD be pink and red, not your child’s eyes

By Katherine Lemon, MD | February 8, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

PinkEyeSharing butterfly kisses with your kiddo? Who doesn’t? It’s a great way to bond, cuddle…and potentially to spread conjunctivitis.  Also known as pink eye, this contagious infection causes irritation or infection of the membrane that covers the white of the eye and inside the eyelid.  It is very common in both children and adults, but with proper precaution and care, you can protect yourself and your child from catching and spreading the infection.

How did my child get pink eye?
There are many different causes of pink eye, including bacteria and viruses.  The infection can be spread from person to person, or it can develop on its own.  Children in daycare centers or school are exposed to more germs and may be more likely to pick up pink eye.

What are the symptoms?
Pink eye can be mistaken for general irritation or redness in the eye, but the following are some signs:

  • Redness in and around the eye
  • Eyes that are puffy and sore
  • Itching, burning, or stinging eyes
  • Watery eyes or yellow, pus-like discharge from the eye
  • Eyelids that are crusty or stuck together following sleep

How do I treat pink eye?
Though it’s a minor infection, it is very important to see a doctor if symptoms are present to prevent damage to the eye and stop the spread.  After it’s confirmed as pink eye, antibiotic ointment or drops will be prescribed to stop the infection.

Can I prevent pink eye?
Pink eye is highly contagious and can be spread through contact with the eye drainage that contains the bacteria or virus.  To prevent the spread of the infection, it is important to thoroughly wash hands and bedding, do not share towels, washcloths, contact lens equipment, eye makeup or eye medicine. Women should stop using any eye cosmetic products or tools (eyeliner, mascara, lash curlers, etc.) that may have been in contact with the infection.  If anyone else in the household shows symptoms, contact the doctor to begin treatment right away.

If you suspect pink eye in your child, talk to your family practice provider or pediatrician right away.  After antibiotics are started, drainage and irritation typically begin to subside in about 24-48 hours, though antibiotics should be continued for the duration stated by the provider.

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Got Milk? With the right breast pump you will!

By Beverly Haferman RN, LC | January 22, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

Got Milk? With the right breast pump you will!At some point in time, almost all mothers have to leave their infant and need to have pumped milk available.  Like most decisions for first-time mothers, purchasing a breast pump can be a daunting task.  With pressure to do what is best for mom and baby, we hope these tips can help you make a purchase you’re comfortable with.

Manual or Electric?
If you are only planning to occasionally pump, a manual pump might be the right fit.  They are fairly inexpensive and many do a good job.  Moms who use the Avent “Isis” pump report that it works well and is available at most of the big box stores.  No matter what pump you choose, look for adjustable suction and ease of operation and cleaning.

If you need to pump on a daily basis, it will be well worth the money to invest in a double-electric breast pump.  Many available in the lower price range do not stand up to daily use or provide poor suction and ease of use.  Among others, Medela “Pump in Style”,  Ameda “Purely Yours” and the “Hygeia” pumps meet the criteria of durability, strength and ease of use.  It may seem like there are endless options out there, but just remember, you get what you pay for.

New or Used?
Pumps are designed to last for approximately one year of use.
If you are pumping only 2-3 times per week, you may be able to use the same pump for several children but if used daily, you may find that the suction strength becomes insufficient over time.   Due to the high cost of good electric pumps, you may be tempted to buy a used pump; however, viruses (like hepatitis) can be cultured from pumps years after use, so if the used pump does NOT have a HEPA  filter that prevents the transmission of viruses into the motor, it is NOT recommended.  The Ameda “Purely Yours” (available from the Fort HealthCare Lactation department) does have a HEPA filter and can be used between multiple moms.

Supply and Demand:
Breasts are designed to alter the type and volume of milk produced.  The more frequently they are emptied the more milk you make.  When you are pumping it is important to increase the frequency of pumps when you see your infant increase the amount they are taking in.

Further Questions?
There are many sites online that compare various pumps, we strongly encourage visiting these sites, and asking other mothers for their opinion.  Fort HealthCare’s Lactation department provides the “Pump in Style” and the “Purely Yours” for purchase, at cost, to all of our clients.  Please call our Lactation department for pricing and purchasing information.

Fort HealthCare’s Breastfeeding Support Group meets the last Thursday of every month
from 1:30-3:00 in the OB Classroom at the hospital.  There is a lactation consultant who can answer questions and perform infant weight checks. Moms who attend are typically nearing the end of their pregnancy or have a nursing newborn, infant or toddler. All  nursing or curious moms are welcome! As always, moms are invited and encouraged to call our Lactation department (920) 568-5396) for guidance on any breastfeeding related issue.

 

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Late-talking toddlers: Should parents worry?

By Rebecca Reim, MD | January 16, 2013 | Comments (0) | Share Twitter Facebook Pin This! linkedin Print

We parents love to chart our children’s developmental milestones. From the first little smile,  to the first tooth, to the first steps – we look forward to these important moments
as our children grow.

First words are among the more memorable milestones, and when they’re late to arrive, parents may worry. Like everything else, language develops at different rates for different children – but, as parents, we  cannot help but compare our children to their peers or older siblings.

Here’s some good news for parents of toddlers with few words: a recent study reports that late talking does not foreshadow problems down the road.

The study looked at two-year-olds with language delays and checked in with them in elementary and high school. As toddlers, these children had more problems getting along with others and managing their behavior – which the researchers chalked up to the frustration of having few words. But, as they grew (and caught up in language development,) the late-talkers were just as well-adjusted as their peers.

This does not mean we should ignore language delays. If you are concerned about your child’s late talking, talk to your child’s doctor – either a family medicine physician or a pediatrician. It’s important to monitor  overall development to ensure that any problems are identified and addressed as early as possible.  As long as children have the vocabulary they need when kindergarten rolls around, parents can rest assured that their late talkers will do just fine.

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