These days, it’s difficult to walk into a convenience store without confronting a big display of sports drinks and energy drinks. Marketing aimed at children and teens has become so intense that the American Academy of Pediatrics (AAP) in a May 29, 2011 report encourages physicians to discuss the use of these drinks with their patients during annual physicals.

Are the drinks a good idea? Probably not. First, let’s look at energy drinks. These are marketed under names such as Monster, Red Bull and 5 Hour Energy. They are full of stimulants and do not belong in the diets of children or adolescents.

Sports drinks are a somewhat different story. These beverages (Gatorade is one example) may contain carbohydrates, minerals and electrolytes, and are intended to replenish what’s lost during exercise. These drinks can be beneficial for young athletes during and after a tough workout, but are unnecessary for the average child engaged in routine physical activity. The bottom line is that sports drinks can add significant calories and contribute to weight problems in children.

The very best choice and the one I offer my own children? A tall, cold glass of ice water.

It’s hard to make time for exercise in our daily lives and even more so when you’re on vacation. However, if you do take a 2-3 day break (sometimes even more!) it can feel impossible to get back into the swing of things.

 Fitness experts believe that taking no more than 1-2 days off in a row will keep you in the fitness mode. But when planning a vacation, you can’t take a Zumba class with you and your treadmill will not fit in the overhead compartment, so find out what is available where you are going. 

Are you a member of a gym? Do they affiliate with other clubs around the area you are visiting?  Many places have away programs such as the YMCA, Curves and Snap Fitness – just to name a few. 

Are you going to a hotel?  Most hotels have a fitness center and some resorts even offer fitness classes for their guests. You never know who maybe in downward dog on the yoga mat next to you or where they will be from; you could make some interesting new friends!  If your hotel doesn’t have a fitness center, they may contract with a local gym to offer free guest passes.

If you’re in a beach area, take a walk or run along the beach. Camping? Go for a hike! On a long road trip? Make pit stops at places like a zoo where you can get some walking in. Too much time on a plane? While you’re waiting at the terminal, take a few laps through the gates. Grab your carry-on luggage for added resistance!

If all else fails, take your workout shoes and go for a walk through the area you are visiting. Always be aware of your surroundings. Take a cell phone, don’t go alone and make sure someone knows where you are and when you’ll be back. A long walk through a local neighborhood will give you a different flavor of the city you are visiting.  Also, don’t focus on the “workout” but instead just on being active. That way, you won’t have to feel guilty about that Crème Brule you ordered last night at dinner!

• Buy and serve more fruits and vegetables. Let your children choose them at the store.
• Buy fewer soft drinks and high-fat, high-calorie snacks like chips, candy and cookies. Not having these temptations in the house will make the healthy choice easier.
• Make sure your children eat breakfast every day. Breakfast provides your children with the energy they need to listen and learn in school. Skipping breakfast can leave your children hungry, tired and looking for less-healthy foods later.
• Eat fast food less often. When you visit a fast-food restaurant, encourage your family to choose healthy options.
• Offer your children water or low-fat milk more often than fruit juice. Juice that is one-hundred-percent fruit juice is a healthy choice, but it’s high in calories so serve it sparingly.
• Limit the amount of saturated and trans fat in your family’s diet. Instead, get your fats from sources such as fish, vegetable oils, nuts and seeds.
• Plan healthy meals and eat together as a family.
• Don’t get discouraged if your children won’t eat a new food the first time it’s served. Some kids need to have a new food served 10 times or more before they’ll eat it. Let your kids assist in preparing meals. They’re more likely to eat food chosen and prepared by them.
• Avoid using food as a reward when encouraging kids to eat. Promising dessert for eating vegetables sends the message that vegetables are less valuable than dessert.
• Start with small servings and let your children ask for more if they’re still hungry. They should determine the amount of food they need, and the amount a child eats can vary from day to day.
• Be aware that some high-fat or high-sugar foods and beverages are strongly marketed to kids. Usually these products are associated with cartoon characters, offer free toys and come in bright packages.
• Set a good exercise example. If your children see that you’re physically active and having fun, they’re more likely to be active throughout life. Fun physical activities that kids choose are often the best. Kids need about 60 minutes of physical activity a day, but this doesn’t have to happen all at once. Several short bursts throughout the day can be just as good, as is being active together as a family.

All of these tips can help you and your family stay healthy for years to come. By making small changes to your daily habits, your family can stay health and active. To learn more about keeping your family healthy, visit FortHealthCare.com/FamilyWellness.

Healthy leg veins contain valves that open and close to assist the return of blood back to the heart. Venous reflux disease develops when the valves that keep blood flowing out of the legs and back to the heart become damaged or diseased. As a result, vein valves will not close properly, leading to symptoms of:

• Varicose veins
• Pain
• Swollen limbs
• Leg heaviness and fatigue
• Skin changes and skin ulcers
• Tight feeling calves or itchy painful legs
• Pain during walking that stops with rest
• Brown-colored skin, particularly near the ankles

CVI occurs when the leg veins do not allow blood to travel back to the heart. Problems with valves in the veins can cause the blood to flow both directions, not just toward the heart. These valves that are not working properly can cause blood in the legs to pool. If chronic venous insufficiency is left untreated, pain, swelling, and leg ulcers may result.

CVI does not pose a serious health threat, but the condition can be disabling and cause pain. It is more common among those who are obese, pregnant, or who have a family history of the problem. Individuals who have had trauma to the leg through injury, surgery, or previous blood clots are also more likely to develop the condition.

Other causes of CVI include, but are not limited to, the following:

• High blood pressure in the leg veins over a long time, due to sitting or standing for prolonged periods
• Lack of exercise
• Smoking
• Deep vein thrombosis (a blood clot in a deep vein, usually in the calf or thigh)
• Phlebitis (swelling and inflammation of a superficial vein, usually in the legs)

Specific treatment will be determined by your doctor based on a number of factors, including:

• Your age, overall health and medical history
• Extent of the disease
• Your tolerance for specific medications, procedures, or therapies
• Your signs and symptoms
• Expectations for the course of the disease

The symptoms of CVI may resemble other conditions. You should consult your doctor for a diagnosis. You do not need to live with CVI or its symptoms.

Symptoms can worsen over time if left untreated and cause serious health problems. Fortunately, several minimally-invasive treatment options are available that are covered by many insurance plans, such as the VNUS Closure® procedure available through Fort HealthCare Surgical Associates. Visit FortHealthCare.com/VNUS to learn more, and link to the self-assessment tool available there.

The area receiving media attention lately is athletic trainers saving lives in the form of concussion recognition and care.  A concussion is a type of mild traumatic brain injury (MTBI) that interferes with normal function of the brain.  It can be caused by a bump, blow or jolt to the head or body. The head does not have to hit something to cause a concussion.  A force transmitted to the head can be enough to bounce the brain and cause a concussion.

Parents and coaches are not expected to be able to diagnose a concussion.  That is the role of an appropriate health care provider.  Many high school trainers are not actually athletic trainers. They may be skilled in first aid, but not certified to recognize a possible head trauma.  The Wisconsin Interscholastic Athletic Association (WIAA) currently recognizes physicians and licensed athletic trainers as appropriate sports medicine staff.

Parents, coaches and athletes should be aware of signs and symptoms of a concussion.  Symptoms include:

• Headache
• Nausea
• Dizziness
• Vision problems
• Sensitivity to light or sound
• Feeling foggy or sluggish
• Confusion
• Difficulty concentrating
• Changes in emotion

Athletes should never try to “tough it out” when experiencing concussion symptoms. If an athlete returns to activity before being fully healed from a concussion, he/she is at risk for a repeat concussion.  This can slow the recovery process and lead to long-term problems.  In the most severe case, it can lead to death.  Always remove an athlete from play if a concussion is suspected. 

Fort HealthCare offers ImPACT, a computerized neurocognitive assessment tool, which can be used to determine an athlete’s readiness to return to play after a concussion. Widely used by collegiate and professional sports teams, it’s the most scientifically validated computerized concussion evaluation system. Prior to a concussion, a baseline screening establishes an individual’s normal ImPACT score. Should a concussion occur, the test can be re-administered to assist health care providers in making return-to-play decisions. To learn more or to schedule a baseline screening, visit FortHealthCare.com/ImPACT.

Bring a list of questions or concerns and encourage your child, if old enough, to do the same. During an annual checkup, the doctor:

• Conducts a thorough physical exam. In addition to measuring your child’s height, weight and head circumference, the doctor will examine his or her skin, eyes, ears, heart, lungs, and musculoskeletal and neurological development. The doctor also will review your child’s health history and update immunizations.
• Orders screenings and tests. The doctor may prescribe vision and hearing tests; a lead screening; a tuberculin test; a urinalysis; and tests for anemia, cholesterol and blood sugar levels.
• Updates your plan for chronic conditions. Does your child have asthma, diabetes or another health concern? Have any symptoms changed? Discuss with the doctor how the condition affects your child emotionally.
• Promotes healthy lifestyle choices. Does your child hound you for candy or fast food or battle you over computer time? Your doctor can explain the importance of healthful eating and suggest appropriate physical activities for good health.
• Tackles tough topics. Parents may find it hard to bring up alcohol or drug use, smoking, sexuality, depression and more. Your doctor can discuss injury and violence prevention and explain puberty changes—especially important for a middle-schooler or teen who seeks advice from peers.

Yearly physicals offer a chance for your child to build a trusting relationship with another adult and establish a lifetime of healthy habits.

It’s not too early to start thinking about the next school year!
Spring and summertime is when you should schedule your child’s back-to-school and sports physicals. The State Department of Public Instruction sets the wellness exam requirements for school-age children, starting at the 4K level. At this type of well-child visit, your child’s physician will record your child’s height, weight, and blood pressure, and conduct a physical exam and vision test. If your child is due for any vaccinations, WIAA sports physicals, or other age-appropriate developmental screening questionnaires, those tests will take place as well. Your child’s back-to-school exam is also the perfect time to discuss any other health and wellness concerns with your child’s doctor.
   For more information about family wellness with Fort HealthCare, visit FortHealthCare.com/FamilyWellness.

A common misconception is that the weight of the baby on the nerve causes the pain, but it is more likely that the changes to the whole body to blame. Hormonal changes loosen the joints to help the body prepare for childbirth and create a shift in the pelvis and spine that may affect the sciatic nerve.  The increased weight and strain on the body also makes it more difficult to maintain good posture to hold the spine in a good position, and tightness in the hips and low back can also be a factor.  The actual source of the pain down the leg may also be in the back itself, such as from a bulging disc, and not due to injury or compression at the actual sciatic nerve.

To relieve the stress, be aware of your:

• Posture
• Positioning
• Body mechanics

This gets harder to do as your body changes, but try to keep your bottom tucked in and your shoulders back.  Pregnant women tend to arch their back and slump shoulders as their belly grows, putting more strain on the spine. 

Physical Therapy
Physical therapy can be helpful to anyone suffering from sciatica, especially women during pregnancy.  We can provide techniques to help better align your pelvis and spine, and provide stretching for the back and hips. We will also teach you gentle exercises to strengthen muscles to help you hold better posture.  Sometimes a maternity support brace is ordered to help support the belly and back, especially when standing and walking.

 When I was pregnant nine years ago, I couldn’t wear socks or tie my shoes the last three weeks of the pregnancy, but I also couldn’t see my feet so I figured “out of sight, out of mind!”  My doctor suggested special hose, laying on my left side and elevating my legs above my heart – easier said than done. Further, I had to watch my blood pressure because the swelling can be a symptom of preeclampsia.

For 80% of pregnant women, the question remains – what can be done about lower leg swelling?  First, you need to understand what is causing it. The lymph system is comprised of three parts the lymph fluid (the swelling you see around your ankles and feet), the lymph vessels (how the fluid moves from lymph nodes to lymph nodes) and the lymph nodes. We have about 300-500 hundred lymph nodes throughout our body.  There are major lymph nodes in the arm pit area (axillary) and in the groin area (inguinal.)  As baby gets bigger your thoracic area pushes down on the inguinal lymph nodes and stops the flow of lymph fluid out of the lower extremities, resulting in swelling. To completely get rid of the extra fluid would be to find a way to take the pressure off the inguinal lymph nodes and start the lymph flow again. Giving birth is one obvious way, but it may take up to two weeks to reduce the edema and actually slide into your pre-pregnancy shoes or jeans. 

 Another option would be to wear compression maternity panty hose or knee-highs, if you cannot tolerate pantyhose. If you’d like to explore compression garments, Juzo and Jobst offer a good quality product. Check online or with your local pharmacy.

 Last but not least…exercise! Try walking at least 10- 20 minutes per day because the calf muscles have a pumping effect on the lymph system and the motion helps to move the lymph fluid out of the lower extremities.

Cause
When food is digested, most of it changes into glucose (or sugar) in the blood.  Glucose is a much needed fuel for the cells in your body.  In order for the glucose to leave the blood and enter the body’s cells it needs the hormone insulin, which is produced in the pancreas. Pregnancy hormones can block the insulin from doing its job. Pregnant women may need up to three times as much insulin while their baby is growing and sometimes the pancreas cannot keep up with the demand. Glucose then builds up to a high level which is also called hyperglycemia (high blood sugar) and that’s when gestational diabetes starts.

Diagnoses
All pregnant women should receive an oral glucose tolerance test between 24-28 weeks of pregnancy to screen for the condition. Women who are at risk may be screened earlier in the pregnancy.

Risk factors
You are at greater risk for gestational diabetes if you:

• Are older than 25 when you are pregnant
• Have a family history of diabetes
• Gave birth to a baby that weighed more than 9 pounds or had a birth defect
• Have high blood pressure
• Have too much amniotic fluid
• Have had an unexplained miscarriage or stillborn
• Were overweight before your pregnancy

Affects on the baby
Most women with gestational diabetes are able to control their blood sugar with no harm to their baby. However, untreated or poorly controlled gestational diabetes may have possible consequences to the health of your child. This can increase the chance of problems at the time of delivery, including:

• Birth injury (trauma) because of the baby’s large size
• Delivery by c-section

Treatment
The goals of treatment are to keep blood sugar levels within a normal range during pregnancy. The most common way to check blood sugar levels is to use a glucometer, or glucose meter. Your healthcare provider should closely check both you and your baby throughout the pregnancy which includes fetal monitoring and often includes ultrasound and nonstress tests. If you are concerned about gestational diabetes, speak with your healthcare provider right away.

Gestational diabetes: post-pregnancy

Here are 5 things to remember:

1. You will provide only one teaspoon of milk per feeding for the first 2-3 days of your infant’s life.  All infants have enough fluid to last for 2-3 days but it is important to remember that frequent early feedings will help your milk come in sooner and more abundantly.  We recommend feeding per infant cues, but at least 8 times daily.
2. Infants are hardwired to breastfeed.  We can help this process by giving them early and unlimited access to the breast.  We initiate this with the use of skin-skin as soon as the infant is born.  This wakens the infant’s reflexes and we see infants breastfeeding more often and longer.
3. Your infant should stay with you.  Your baby knows you and wants to be with you.  He will know you by smell and sound. By staying close to you he will be happier and you will learn to read his cues.  Babies breastfeed better when Mom recognizes their feeding cues and puts to breast.
4. Your baby should not be given a bottle or pacifier without talking to a lactation consultant.  They may interfere with your baby’s ability to latch.
5. Breastfeeding should not hurt.  If you are having pain past the initial latch, call for help.  Remember this is new for you and your baby.  Don’t expect perfection.

Breastfeeding gives your new baby the very best start. It supplies food, comfort, and love. Experts agree: Breastfeeding is the healthiest choice for babies during the first year of life and beyond. It’s healthy for Mom, too. Breastfeeding may be challenging at first. But you and your baby can succeed together. 

If you are having difficulty breastfeeding, call (920-568-5300) one of our five certified Lactation Consultants to provide counseling. Often, simple adjustments can make a world of difference. Visit FortHealthCare.com/Baby to learn more about how we’re helping you have a healthier baby.