Health365 eNews
September 2014 • Volume 5, Issue 12

Fort HealthCare Re-Aligns Behavioral Health for Integrated Approach

Prior to January 31, 2014, behavioral health services offered by Fort HealthCare will undergo a significant re-alignment, resulting in the closing of the 509 McMillen Street location in Fort Atkinson. In the new model of integrated care, the majority of outpatient clinical services will be incorporated into the regular office practices at select primary care locations- Fort HealthCare Jefferson, Fort HealthCare Cambridge and the Fort Atkinson locations of Fort HealthCare Integrated Family Care and Fort HealthCare Internal Medicine & Pediatrics.


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Prior to January 31, 2014, behavioral health services offered by Fort HealthCare will undergo a significant re-alignment, resulting in the closing of the 509 McMillen Street location in Fort Atkinson. In the new model of integrated care, the majority of outpatient clinical services will be incorporated into the regular office practices at select primary care locations- Fort HealthCare Jefferson, Fort HealthCare Cambridge and the Fort Atkinson locations of Fort HealthCare Integrated Family Care and Fort HealthCare Internal Medicine & Pediatrics.

Fort HealthCare’s mission is to improve the health and well-being of our community. By providing behavioral health services in these primary care physician offices, Fort HealthCare is following a new but proven trend in this important field of medicine. According to this model of care, patients with behavioral health issues are treated in a medical setting by psychologists, social workers, counselors, nurses and primary care physicians. Medical and psycho-social interventions are provided in a location more conducive to wellness programming and where the patient can establish a medical home. Psychiatric services are provided as an adjunct to care.

According to Edwin Fischer, MD, Fort HealthCare medical director, the integrated model of care will result in greater patient satisfaction. “The new program will provide more immediate, solution-focused strategies to address behavioral health needs, offer continued access to psychiatric services and improved communication and coordination of care between primary care clinicians, mental healthcare providers and agencies”, said Fischer. “Most important, we believe the model offers improved overall health for every member of our patient community by delivering preventive and acute behavioral health care in the timeliest manner.”

Based on the principal that mind and body wellness go hand in hand, and that emotional health is critical to good physical health, an integrated approach to holistic care is offered. It has been well documented that psychosocial factors are positively related to poor general health, functional disability, morbidity and mortality. This team approach to holistic medical care will be better able to meet each patient’s unique needs, in a familiar setting and with a team approach attuned to the patient’s physical and mental health needs.

It has also been shown that 70 percent of all health care visits are generated by psychosocial factors. Twenty-nine percent of adults with medical conditions also have mental health conditions. Sixty-eight percent of adults with mental health conditions also have medical conditions.

With these changes, Fort HealthCare Behavioral Health will no longer provide long-term treatment for patients with issues of alcohol and other drug abuse (AODA) and chronic mental health concerns.

Fort HealthCare is working with a number of local mental health organizations to care for those patients requiring this type of continuing care. Current patients of the Behavioral Health clinic are being contacted by letter and some by telephone regarding this change, and staff from the clinic is actively engaged with the patients, assisting them in this transition to new mental health providers and area agencies with capacity to meet their needs.

Beginning now and continuing through January 31, 2014, patients are encouraged to contact the Fort HealthCare Behavioral Health Clinic at (920) 563-9542 to arrange for a discussion of current treatment needs, future treatment options, and any questions or concerns related to behavioral health care.

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What is Low Testerone (Low T)?

We’ve all been bombarded by the ads on TV of sad middle-aged men that are tired. Tired and they can’t get erections and have a decreased libido (sex drive). Then there’s a promise of a virtual “fountain of youth” in the form of a daily gel applied to the underarm, groin, or shoulders…sometimes all three. Sad man turns into happy, newly moustached, fully-restored man that can now throw a football again.


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We’ve all been bombarded by the ads on TV of sad middle-aged men that are tired. Tired and they can’t get erections and have a decreased libido (sex drive). Then there’s a promise of a virtual “fountain of youth” in the form of a daily gel applied to the underarm, groin, or shoulders…sometimes all three. Sad man turns into happy, newly moustached, fully-restored man that can now throw a football again.

Low Testosterone is not a new medical diagnosis, but there just so happens to be four relatively new brands of testosterone gel, all vying for your (or your insurance company’s) dollars, hence the deluge of direct-to-consumer advertisements.

It’s important to remember that Low Testosterone is a lab value. If your testosterone is found to be abnormally low and you have symptoms, you could be a candidate for testosterone replacement therapy. Amazingly, over 25 percent of men prescribed testosterone replacement have not had their blood testosterone levels checked!

The symptoms of low testosterone include decreased libido, erectile dysfunction, difficulty recovering from exercise, decreased muscle mass, and decreased energy or “get up and go.” As you can see, many of the symptoms of low testosterone overlap with other unrelated conditions.

If you’re meeting with your primary care physician for an annual physical, do not assume that testosterone will part of the normal panel of labs. This is a separate, specific test done only in situations of men that are symptomatic. If you do have your lab work done, make sure to have your T checked within three hours of waking. This guarantees an accurate reading when your T is at its highest (there’s a scientific explanation for morning wood!) Usually there are follow up labs to determine if there is any other correctable cause to the low testosterone.

There are several potentially harmful side effects to testosterone replacement therapy. These may include fueling the growth of prostate cancer, worsening urinary symptoms related to enlarged prostate, and potentially an increased risk of cardiovascular disease. The effects of treating large populations of men with testosterone have not been extensively studied. In addition to the physiological side effects, testosterone gel is usually pretty expensive, so keep that in mind if you’re considering therapy.

As much as there is controversy to diagnosing and treating men with low testosterone (for good reason) some men truly benefit from carefully directed therapy.

The urologists at Fort HealthCare Urology Associates are dedicated to alleviate your concerns, provide thorough answers based on the latest advances and find the best, quickest solution for your urinary or genital issues. Patients can visit any of our clinics in Fort Atkinson, Whitewater or Johnson Creek.

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Knock Down the Hurdles to Breastfeeding

Breastfeeding is one of the greatest health advantages you can give your infant.

A breastfed baby may be less prone to ear infections and diarrhea. The child may also face less risk of developing diabetes, obesity, and asthma, the American Academy of Pediatrics (AAP) says. The AAP also recommends breastfeeding because of to its association with the reduced risk for sudden infant death syndrome (SIDS).


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Breastfeeding is one of the greatest health advantages you can give your infant.

A breastfed baby may be less prone to ear infections and diarrhea. The child may also face less risk of developing diabetes, obesity, and asthma, the American Academy of Pediatrics (AAP) says. The AAP also recommends breastfeeding because of to its association with the reduced risk for sudden infant death syndrome (SIDS).

Ideally, you should breastfeed exclusively for the first six months, with a goal of continuing breast milk for at least the first year. But you may face obstacles.

Both mom and baby must learn how to breastfeed in the first few days. This is the time when antibody-rich and easily digestible colostrum is produced. Some mothers worry that colostrum isn’t enough to nourish their baby, but it’s the perfect food for newborns. Breast milk comes in for most mothers from two to five days after birth. The physicians, nurses and lactation consultants at the Fort Memorial Hospital Great Expectations Birthing Center work together with families during the first hours of a baby’s life to establish infant feeding and a bond between mother and baby.

Moms who want to keep breastfeeding when they go back to work may face barriers such as a supervisor’s lack of support or rigid work hours.

Knowing the hurdles helps you find ways around them. Here are some tips:

  • Let your labor nurse know that you would like to have your new baby placed naked against your bare skin right after delivery. This skin-to-skin interaction calms your infant and helps in the transition to the new environment.

  • Tell the hospital you want only breast milk for your newborn. If someone recommends formula, discuss this with your pediatrician prior to feeding it to your baby. Sometimes, you can use your own milk to supplement rather than formula. Keep your baby in your room during your hospital stay. This will allow you to learn the signs that your baby is hungry and would like to nurse.

  • Don’t worry if you don’t have a lot of milk in the first 72 hours after the birth. You are making everything that your baby needs. The newborn stomach is very small and does not need much colostrum to fill it up.

  • If your baby isn’t latching on properly your nipples can get sore. Have an expert watch you feed your baby and offer suggestions.

  • Talk with your superiors and colleagues to arrange for breastfeeding or pumping at work. If you let coworkers know how important breastfeeding is to your baby, they’re more likely to help you.

  • You may experience minor pain from a plugged milk duct. Drinking lots of liquid and encouraging your baby to breastfeed frequently may resolve the problem. But if you’re achy or feverish, see a doctor. You may have an infection that requires medication.

  • Get information from sound sources. These include your pediatrician, the AAP, or a certified lactation consultant.

  • Take care of yourself. Continue taking your multivitamin, stay hydrated (drink a 10 oz. glass of water or noncaffeine fluid every time you breastfeed to keep up your milk supply), and try to eat healthy. Remember that nursing your baby is a time to relax and enjoy the bond of motherhood.

  • Be realistic about the hurdles of breastfeeding so you don’t give up. If you have questions or concerns, consult your health care providers before you discontinue nursing.

To help mothers learn and establish good breastfeeding practices and to be surrounded by other women in a similar situation, Fort HealthCare hosts a monthly Breastfeeding Support Group. Gatherings take place on the last Thursday of every month from 1:30 to 3:30 p.m. in the OB Classroom at Fort Memorial Hospital in Fort Atkinson – and babies are welcome!

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Maintain, Don’t Gain Over the Holidays!

You attend parties and office gatherings to share a few festive moments with family, friends, colleagues and lots and lots of food. But, when the holiday season is finally over, the bathroom scale reveals that you’ve gained weight again, much to your disappointment.


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You attend parties and office gatherings to share a few festive moments with family, friends, colleagues and lots and lots of food. But, when the holiday season is finally over, the bathroom scale reveals that you’ve gained weight again, much to your disappointment.

“Most Americans, who gain weight between Thanksgiving and New Year’s Eve generally don’t lose that weight ever again,” says Dr. Mehmet Oz, a cardiologist and talk show host. Some meals people eat during the holidays can add up to 2,000 calories or more, according to Dr. Oz, so they could actually put on an extra pound every day if they keep indulging. Once they become used to the higher calorie intake, it becomes normal and they continue on that level.

How can you try to maintain your weight and heart health during such a tempting time? Here are eight steps to survive the holidays and future ones to come:

  1. Get Moving: One of the most effective ways to maintain or lose body weight is to engage in regular, sustained aerobic activity. To burn off those extra calories, kick up your exercise. If you exercise for 30 minutes a day, increase it to 45 minutes. If you exercise three times a week, move it up to five times a week.

  2. Aim for seven-a-day: Making sure you eat seven or more servings of fruits and vegetables each day is a great way to help fill up your stomach, but not your calorie level. When compared to other snack foods like chips, crackers and cookies, gram for gram, fruits and vegetables contain fewer calories and many more nutrients. What’s more—the fiber in fruits and vegetables fill you up faster than traditional snack foods.

  3. Control the risk for temptation: Controlling even the slightest chance of coming in contact with ‘tempting’ foods is one way to effectively reduce your intake. While you won’t be able to control all situations, focus on the many you can. For example, make a pact with co-workers that goodies will be kept solely in the break room, not at the front desk. Mentally plan how you avoid tempting situations.

  4. Limit to one-a-day: While you can’t control every situation, you can control how much food goes into your mouth. If you are constantly bombarded with holiday parties and displays of desserts or candies, you can still prevent overeating and weight gain. Try the one-a-day method. Allow yourself one small serving of a cookie or a piece of candy each day during the holiday season. Remember that you may have to compensate for it later in the day by reducing your total caloric intake or by burning a few extra calories. If you aren’t confronted with holiday foods that day, just skip your one-a-day—but don’t compensate and double-up on your servings the next day.

  5. Always plan ahead–Never go to a party hungry: Before you go to a holiday party, eat a healthy snack such as a serving of your favorite fruit, fat-free yogurt or a low-fat, whole grain granola bar. When you arrive at the party, you won’t be craving hors d’oeurves.

  6. Be in charge of your party choices:

    1. Small plate, please. Be wise when choosing appetizers—a small portion of some appetizers may help you from overeating at dinner. Pick up a small plate and stick with veggies, but limit or avoid the creamy dips. Restrict your intake of butter crackers, chips, cheese and meats. If you must have a deep-fried treat, eat only one small serving. Never go back for seconds. For dinner, fill half your plate with salad and vegetables, one quarter with meat and the final quarter with starch.

    2. Avoid the sauce. Avoid sauces made from cream, half-and-half or meat drippings. For salads, use oil and vinegar, vinaigrette or low-fat dressings. Broth-based or vegetable sauces are fine.

    3. What about desserts? The best low-calorie choices are fruit, Jell-O, pudding, an unfrosted mini muffin, shortbread cookies or angel food cake. If you must have a dessert with frosting, butter cream, cream cheese or chocolate chips, limit yourself to one small serving or one thin slice.

    4. Watch the drinks. Besides restricting your alcohol to one or two servings, you also need to restrict the type of alcohol. For example, instead of high-fat eggnog, have a light beer or wine. After that, stick with calorie-free drinks such as water, unsweetened iced tea, hot tea or coffee.

  7. Say No, politely: Many times you feel forced to eat foods because people keep putting it in front of you. Learn to say no politely, such as “No thank you, I’ve had enough. Everything was delicious” or “I couldn’t eat another bite! Everything tasted wonderful.” You’ll find saying no isn’t so hard to do after all.

  8. Focus on socializing: Don’t stand around the food table when you’re at a party—focus your energies on making conversation with others rather than focusing on foods. Conversation is calorie-free! A season to savor! Focus on the nourishment inherent in the foods you eat during the holidays. Prepare your plate with artistry—and before you eat, take a moment to reflect upon the journey of the food to your plate—where was it grown and who prepared it? Be choosy and only eat foods you truly enjoy. Mindfully appreciate the aromas, flavors, colors and textures with each bite.

If you’re looking for help in establishing healthy eating habits throughout the holiday season and into the new year, contact Fort HealthCare’s Nutrition Services. Our Registered Dieticians treat healthy individuals as well as those being seen for acute or chronic illnesses or conditions. Our program is for anyone who has concerns and questions about their diet, feedings, foods, growth and development, special diets and healthy eating.

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A Winter Cold: Not Inevitable

For most people, catching the common cold is a common part of winter. Children have three to eight colds a year; adults get two to four. Although colds cannot be prevented–or cured–you can take precautions to reduce the chance of infection.


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For most people, catching the common cold is a common part of winter. Children have three to eight colds a year; adults get two to four. Although colds cannot be prevented–or cured–you can take precautions to reduce the chance of infection.

What is a cold?

A cold is a viral infection that affects the mucus in the lining of the nose and throat. A cold can last from a few days to a few weeks. Five types of viruses can cause colds, but at least one-third of all colds are caused by the rhinovirus ("rhin" is Greek for "nose") and there are more than 100 varieties of rhinovirus. Because so many viruses can cause a cold, there probably will never be a vaccine to prevent people from catching one.

You just have to wait out the cold, drink plenty of liquids, and rest as much as possible. According to the American Lung Association (ALA), an over-the-counter antihistamine/decongestant can reduce nasal congestion and clear up runny noses, but only the body’s own defense system can cure a cold. There’s no way to completely prevent someone from catching a cold, but there are some basic steps that can be taken to help people avoid getting sick.

How to protect yourself

The ALA offers the following tips for avoiding the common cold:

  • Wash your hands often or use alcohol-based hand cleaners, particularly if someone in your home has a cold or when you’ve been in public places. The cold virus is transmitted by person-to-person contact: For instance, someone with a cold rubs his or her nose, then touches your hand.

  • Keep your hands away from your eyes and nose. As soon as you touch these areas with germy hands, you’re infected.

  • Don’t share drinking glasses or eating utensils with someone who has a cold.

  • Encourage children to wash their hands and to avoid putting their fingers or toys in their mouths.

  • Avoid exposing infants to people with colds and crowded public areas, as they are more likely to experience complications than older children and adults.

Remember that colds and influenza (“the flu”) are both respiratory illnesses, and it can sometimes be difficult to tell the difference between the two. If your cold is accompanied by fever, extreme exhaustion and severe aches and pains, stay home and contact your physician.

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As Prescribed
Looking for timely and accurate health and wellness information from the Fort HealthCare clinicians you know and love? Visit FortHealthCare.com/Blog for updates on women's health, nutrition, skin care, foot pain and many other health topics.

Knowing Matters

One in eight women either currently has or will develop breast cancer in her lifetime.

If detected early, the five-year survival rate for breast cancer exceeds 96 percent. Mammograms are among the best early detection methods, yet 13 million U.S. women 40 years of age or older have never had a mammogram. The National Cancer Institute and U.S. Department of Health and Human Services recommend that women in their forties and older have mammograms every one to two years. A complete early detection plan also includes regular clinical breast examinations by a trained medical professional. In addition, monthly breast self-exams are strongly suggested.


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News

Fort HealthCare nurses honored for professional advancement

Recently, the Nursing Services department at Fort HealthCare recognized 42 registered nurses (RNs) who demonstrated both clinical excellence in the care of patients and also advanced the profession of nursing throughout the past year.


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HealthCare.gov assistance available from local organizations

Despite the initial problems with the federal government’s health reform website, www.HealthCare.gov, the website continues to improve and more and more individuals across the entire county are now able to sign up for new health insurance options made available by the Patient Protection and Affordable Care Act, or ObamaCare.


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Fort HealthCare Calendar wins international award

 A coveted Platinum Award was granted to the Fort HealthCare 2013 Calendar: A Year of Wellness in this year’s MarCom Awards. MarCom is an international competition for creative achievement in marketing and communications. Winners range from individual communicators to media conglomerates and Fortune 500 companies. There were more than 6,500 entries this year


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Fort HealthCare's Suttinger Earns CHT Certification

Laura Suttinger, an occupational therapist at the Fort HealthCare Therapy & Sport Center in Whitewater, has earned the distinguished Certified Hand Therapist (CHT) certification after completing all required examinations and clinical studies. The designation offers assurance to the public that the therapist treating them has achieved the highest recognition of competency in the profession.


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Fort HealthCare Spin to Win benefits Rock River Free Clinic

Fort HealthCare, in partnership with 2 Rivers Bicycle & Outdoor, hosted the Spin to Win Poker Pedal, a poker-run style 15K and 40K bike ride to benefit the Rock River Free Clinic in Jefferson.

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Fort HealthCare advertising receives statewide recognition

 Fort HealthCare recently received multiple awards in the 2013 Communications Review program sponsored by the Wisconsin Healthcare Public Relations and Marketing Society (WHPRMS). Winners were announced at the WHPRMS annual conference held October 23-25 at The Abbey Resort near Lake Geneva, WI.


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Upcoming Events
Fort HealthCare is proud to sponsor a number of community events. All year long, you can find a number of health and fitness related events and classes for the whole family. Check out Health365Events.com to find more activities throughout the community.
December 10 Basic Life Support (BLS) for Healthcare Provider Certification - Renewal Course
December 10 Having Healthy Babies
December 10 Affordable Care Act Seminar
December 11 AHA Heartsaver CPR/AED
December 12 Free Health Screening
December 18 Pediatric Advanced Life Support (PALS) - Renewal Course
December 18 AHA Heartsaver First Aid/CPR/AED
December 19 Basic Life Support (BLS) for Healthcare Provider Certification - Renewal Course
December 20 Blood Drive
December 28 Red Cross Babysitting
December 30 Basic Life Support (BLS) for HealthCare Provider Certification - Recognition Course
Recipes

Pumpkin Pie Pudding

Ingredients

  • ½ cup sugar, divided
  • 2 tablespoons cornstarch
  • 1 ¾ cups 1% low-fat milk
  • 1 large egg
  • ½ cup canned unsweetened pumpkin
  • 1 tablespoon vanilla extract
  • ½ teaspoon ground cinnamon
  • 1/8 teaspoon salt
  • 1/8 teaspoon ground nutmeg
  • Cooking spray
  • ¼ cup chopped walnuts
  • Dash of salt
  • ¼ cup heavy whipping cream 


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Ingredients

  • ½ cup sugar, divided
  • 2 tablespoons cornstarch
  • 1 ¾ cups 1% low-fat milk
  • 1 large egg
  • ½ cup canned unsweetened pumpkin
  • 1 tablespoon vanilla extract
  • ½ teaspoon ground cinnamon
  • 1/8 teaspoon salt
  • 1/8 teaspoon ground nutmeg
  • Cooking spray
  • ¼ cup chopped walnuts
  • Dash of salt
  • ¼ cup heavy whipping cream 

Preparation

1.Combine 6 tablespoons sugar and 2 tablespoons cornstarch in a medium saucepan over medium heat. Combine milk and egg, stirring well with a whisk. Gradually add milk mixture to sugar mixture, stirring constantly — bring to a boil. Cook for 1 minute, stirring constantly.

Remove from heat.

2. Combine pumpkin and the next four ingredients (through ground nutmeg) in a bowl, stirring well. Slowly add pumpkin mixture to milk mixture, whisking constantly. Place pan over low heat, and cook for another 3 minutes or until thoroughly heated, stirring constantly (do not boil).Divide pudding evenly among four dessert bowls and cover surface of pudding with plastic wrap. Chill.

3. Line a baking sheet with foil and coat foil with cooking spray. Place the remaining 2 tablespoons of sugar, walnuts and a dash of salt in a small nonstick skillet. Cook over low heat or until sugar dissolves and is golden (about 3 minutes) stirring frequently to coat the nuts. Transfer mixture to a prepared sheet and cool completely. Coarsely chop the nuts.

4. Place cream in a bowl. Beat with a mixer at high speed until stiff peaks form. Top each serving with 2 tablespoons whipped cream and about 1 tablespoon nuts.

Nutritional Information:

Calories: 228; Fat: 12.8g; Saturated Fat: 5g; Monounsaturated Fat: 3.1g; Protein: 6.9g; Carbohydrate: 38g; Fiber: 1.6g; Cholesterol: 78mg; Sodium: 190mg

Source: Eating Well

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Phone: 920.568.5000 | www.forthealthcare.com