Meriter West Washington is proud to welcome Dr. Sean Miran to its team of primary care physicians. As a family medicine physician, Dr. Miran welcomes patients of all ages. Dr. Miran has special interests in sports medicine, musculoskeletal conditions, preventive cardiology, adolescent medicine and teaching patients the importance of food as medicine.
During his free time, Dr. Miran enjoys reading, college football and staying physically active.
Dr. Miran encourages patients to schedule a free Meet and Greet visit. Lean more by calling the clinic at 417-8300 or vising meriter.com/seanmiran.
Meriter – UnityPoint Health is pleased to announce that our Heart & Vascular and Stroke units have been recognized in the annual U.S. News & World Report for their strict adherence to research-based treatment guidelines, as outlined by the American Heart Association/American Stroke Association (AHA/ASA).
In 2015, Meriter’s Heart & Vascular and Stroke units have been awarded the following recognitions by the AHA/ASA:
The Get With The Guidelines Gold Achievement for achieving two or more consecutive years of 85% or higher adherence on all achievement measures applicable to heart failure.
The Get With The Guidelines Silver Plus Achievement for achieving 12 consecutive months of 85% or higher adherence on all achievement measures applicable and at least 75% or higher adherence with five or more select quality measures in stroke.
The Target: Stoke Honor Roll Elite Plus for achieving at least four consecutive quarters of 75% or higher achievement of door-to-needle times within 60 minutes AND 50% achievement of door-to-needle times within 45 minutes in applicable stroke patients in addition to current Silver or Gold Get With The Guidelines-Stroke recognition status.
Irritable Bowel Syndrome can affect men and women at any age.
Q: What is IBS?
A: Irritable Bowel Syndrome (IBS) is not a disease – it is a set of symptoms or conditions caused by dysfunction of the GI tract that can affect men and women at any age. IBS may be characterized by sporadic and oftentimes unpredictable symptoms such as abdominal discomfort and pain, altered bowel habits, gas, bloating, diarrhea or constipation, to name a few. If you experience any of these troublesome symptoms several times each month, IBS may be the culprit.
However, it’s important to have a doctor rule out more serious conditions, like Crohn’s disease, ulcerative colitis, bowel infections, celiac disease and colon cancer.
Q: What are some common triggers for IBS? A: Many IBS sufferers learn to avoid certain foods, beverages, and medicines that aggravate their symptoms. Some patients have found it helpful to keep a diary tracking the foods they eat and any resulting symptoms—essentially a cause-and-effect.
Unfortunately, it may not be that simple. One common trigger for sufferers is the act of eating—sometimes anything! Eating induces squeezing of our GI tract, which is normal. In those suffering from IBS, eating may cause severe contractions or spasms in the colon, often accompanied by cramps, urgency and diarrhea.
Because of the unpredictability, by the time patients come to see me, they’re practically terrified of all food and are often taking a highly restrictive diet. They’re so worried about an embarrassing attack of urgent diarrhea or gas they begin to avoid nearly everything. Such a restrictive diet may be unhealthy and may result in low blood sugar, poor nutrition, discomfort and, of course, decreased enjoyment of life!
Another common trigger is stress. Because IBS is a functional bowel disorder, it can only be intensified—not caused—by emotions and stress. Many have found gut-focused relaxation and stress-management therapy to be helpful.
Q: Is IBS dangerous? A: People frequently express concern that IBS is a harmful health issue that can eventually lead to serious conditions like inflammatory bowel disease or colon cancer. Although IBS can greatly interfere with a person’s quality of life and ability to function on a day-to-day basis, it is not life-threatening. It does not progress in severity, change into another condition or disease, or damage the intestine. IBS does not cause colon cancer nor any other disease. However, even if you’ve had a past diagnosis of IBS, be sure to talk to your doctor if your symptoms change or worsen.
It’s very important to understand that because IBS does not damage the intestine, it does not cause the colon to bleed. If you see blood in the stool or on toilet paper, please seek medical care immediately.
Q: How is IBS treated? A: It may be tempting to control what you believe are IBS symptoms with over-the-counter antidiarrheal or laxatives. Although they will make you feel better, the fix is typically temporary. If you find yourself relying on over-the-counter medications, it’s essential to talk to a doctor to find a safe and healthy approach to managing your symptoms.
Because IBS varies so much from person to person, there is no one-size-fits-all cure. I urge you to be skeptical of any claim that seems too good to be true or a magical cure. However, symptoms of IBS are manageable! The treatment of IBS is based on the severity and the nature of each person’s symptoms and may include thoughtful dietary modifications, lifestyle changes, traditional medicine, alternative medicine and behavioral therapy.
If you believe you have IBS, I encourage you to seek help. It’s not something that “you just have to live with.” With appropriate treatment, you can manage your symptoms, get back to feeling like yourself again, and enjoy life.
If you are experiencing any of the symptoms generally associated with IBS several times each month, call us!Meriter-UnityPoint Health’s dedicated IBS Program can apply proven techniques to help you successfully manage your condition. Learn more today.
ACL tears are one of the most common sports-related knee injuries.
Jordy Nelson, a wide receiver for the Green Bay Packers, recently tore his ACL. This, unfortunately, is a season ending injury. ACL tears are one of the most common sports-related knee injuries and occur most frequently in athletes who play football, soccer and basketball.
What is the ACL?
• ACL stands for anterior cruciate ligament and is inside the knee joint. It connects the thigh bone (femur) to the shin bone (tibia).
• It is a strong stabilizer of the knee and helps prevent forward movement of the shin bone relative to the thigh bone.
• There is also a PCL (posterior cruciate ligament) which is not injured as often in sports.
How do you injure your ACL?
• Most commonly the ACL is torn following a pivoting mechanism when the foot is planted but the knee is not (cutting, decelerating, hyperextension, landing improperly from a jump). It can also be due to a contact injury.
What does an ACL tear feel like?
• Typically there is immediate pain with a large amount of swelling.
• Athletes often report hearing a “pop” then have difficulties with instability.
How are ACL tears diagnosed?
• Usually they can be diagnosed with a health history and physical exam.
• There is a test performed on the knee called Lachman’s test in which the shin bone moves forward much more than it should when the ACL is torn.
• ACL tears are confirmed on MRI.
Does everyone need surgery?
• No, ACL tears do not have to be surgically reconstructed but will greatly limit the type of activity a person can do if left alone. There are braces to help with stability for those who do not want surgery.
• Most athletes elect to have ACL reconstruction.
Why does an ACL tear mean an athlete will be out for so long?
• Surgery should not be done immediately because it increases the risk of a condition called arthrofibrosis which is when scar tissue forms inside the joint which could cause long term loss of motion at the knee.
• Delaying surgery after an ACL tear allows for the inflammation and swelling to resolve thus allowing for improvement in motion before surgery. It is important to have good motion before surgery to serve as a good starting point for after the surgery.
• Another reason why ACL tears are often season-ending is because of the length of time the ligament needs to regrow. ACL tears cannot be stitched back together (that’s why the term “reconstruction” is used, not “repair”). A graft must be used. Grafts are usually taken from another site from the person’s body and generally are taken from the patellar (kneecap) or hamstring (muscles on back of the thigh) tendons. The graft acts as a foundation or scaffolding to allow the ligament to regrow.
• Ligament regrowth takes 6-9 months. Physical therapy (PT) is needed along the way to restore motion, strengthen the surrounding muscles, as well as, a program to help strengthen the new ligament. PT focuses on hamstring strengthening, correction of knee mechanics and a progressive return to sport-specific drills.
Is there a way to prevent ACL tears?
• Yes, there are many ACL-prevention programs available and should be done as part of preseason conditioning.
• ACL prevention programs are very important for female athletes who have up to a 9 time higher risk for ACL tears when compared to males. The increased risk is due to anatomic differences, as well as, decreased neuromuscular control.
Meriter – UnityPoint Health welcomes endocrinologist Dr. Kenneth Ligaray to our Meriter West Washington clinic, located at 345 West Washington Avenue in Downtown Madison. He helps patients treat and manage a variety of concerns, including diabetes, high blood pressure and cholesterol, pituitary and adrenal disorders, and low testosterone.
Dr. Ligaray takes the time to listen to his patients’ individual concerns and determines how best to help them feel better. He strives to empower patients by educating them about their condition and treatment options to help them make informed health care decisions.
Both Mom and baby will be able receive care at the new clinic
Meriter – UnityPoint Health is proud to announce a new, expanded After-Hours Clinic inside Meriter Hospital opening January 2016 that will serve adults and children.
“When you’re in need of care urgently after normal clinic hours, whether it’s a sprained ankle or a cut that needs stitches, you shouldn’t have to wait to see a doctor or be forced to pay higher co-pays simply because it’s a weekend,” said Art Nizza, CEO of Meriter – UnityPoint Health. “We’re devoted to providing innovative ways for our community to access the care they deserve.”
The After-Hours Clinic, which will be conveniently located at Meriter Hospital, will be open on weeknights, weekends and holidays. Patients are welcome to walk-in or may schedule an appointment. Co-pays at the After-Hours clinic are the same as a primary care visit, typically far less than a visit to an emergency room or, depending on your insurance, less than an urgent care visit. Any insurance accepted at a Meriter primary care clinic will also be accepted at the After-Hours Clinic.
Meriter already offers a Pediatric After-Hours Clinic, as well as same-day appointments and extended hours on weekdays at primary care clinics throughout Dane County to ensure patients can receive care when they need it. Current wait times for the After-Hours Clinic will be published on the homepage of meriter.com, just as ER wait times are available now in near real time.
Meriter’s Patient Family Advisory Council and Meriter Medical Group physicians will play an integral role in helping design the clinic to ensure it is patient-centered and physician friendly.
More details will be available closer to the clinic’s official opening in early 2016.
School has begun and that means soccer practice, homework, play practice, games, play dates and so much more! All this running around also means meals-on-the-go, BUT I am not talking about greasy fast-food. According to data from the USDA, the higher the intake of fast food the less likely children are able to get the recommended servings of three key food groups: fruit, vegetables and milk. So, challenge yourself this year to steer clear of that drive-thru and focus on healthy food on-the-go from home! Here are healthy lunches, snacks and breakfasts you can try when running out the door:
Try a blueberry and yogurt parfait by mixing vanilla or fruited yogurt with frozen berries and high fiber granola (Kashi has some good options) and voilà!
How about a homemade Egg McMuffin? Start by throwing a whole-wheat English muffin in the toaster and then spray a small ramekin (or coffee cup) with cooking spray and crack an egg into it. Scramble the egg and stick it in the microwave for 35-40 seconds. When finished top the egg with some part-skim mozzarella, throw it on the English muffin and you have a healthy, homemade Egg McMuffin. Another option is to have hard boiled eggs ready to grab from the fridge either paired with an English muffin or to pair with a zucchini muffin (see next tip).
Having a fruit or zucchini muffin on hand serves as a great “grab and go” breakfast. I love zucchini muffins with peanut butter. If that is too much prep, have whole-wheat waffles on hand to top with peanut butter.
All you need is five minutes to get a healthy personal pizza ready for an on-the-go lunch. Start with a whole-wheat English muffin, add pizza sauce, part-skim mozzarella and some turkey pepperoni and pop it in the toaster oven to warmup.
Burritos are easy and portable for a quick lunch. Start with a whole-grain or corn tortilla, spread vegetarian or fat-free refried beans on top and then sprinkle with some cheddar cheese and salsa. Place on a microwave safe plate and microwave for about a minute. Roll it up in a napkin and it’s good to go!
Wraps are also an easy on the go meal. Start with a whole grain wrap and spread with hummus or pesto and add part-skim cheese and lean lunch meat. Top with your children favorite veggies, roll-up and enjoy!
Cold grain or pasta salads are great on the go also. I love tabbouleh because you can add lots of veggies and beans to make it an all-in-one meal.
Dippers: Pack celery or a cut up apple to dip into any nut or soy butter or even hummus. Have small containers on hand for easy portability. You could also pack mixed nuts instead of nut butter to eat along with the celery or cutup apple.
Stick yogurt or a Go-gurt in the freezer to make a delicious frozen treat on-the-go.
String cheese is always an easy thing to grab along with whole-wheat crackers for a quick snack.
Makes about 18 muffins
1 cup all-purpose flour
1/2 tsp. baking powder
1/2 cup whole-wheat flour
1 cup old fashioned oats
1 tsp. baking soda
1/2 cup brown sugar
1/3 cup sugar
1 1/2 tsp. cinnamon
1/3 cup canola oil
1/2 cup natural applesauce
2 tsp. vanilla
2 cups shredded zucchini
Optional: Add ½ – 1 cup golden raisins and/or walnuts
Preheat oven to 350F.
In a large bowl, combine flours, brown sugar, sugar, cinnamon, baking soda, baking powder. Stir in oatmeal.
In a small bowl, whisk together the eggs, oil, applesauce and vanilla. Make a well in the center of the flour mixture and pour in the egg mixture; stir lightly. Stir in zucchini. Do not over mix.
Transfer to lined or sprayed muffin tins. Baked for 15-20 minutes or until a toothpick inserted in the center comes out clean.
Neck and back pain are very common conditions that can negatively impact your quality of life. If left untreated, it can result in a loss of productivity at work, inability to participate in the activities you enjoy and can lead to frustration, anxiety or depression.
Our providers work together to provide the most advanced treatments, to decrease pain, maximize therapies, and improve patients’ function and quality of life. Patients are empowered to become active participants in their care for the best possible treatment outcome. The steps in a typical treatment plan include:
Visit your primary care physician: If you are experiencing low back pain typically your first visit is with your primary care doctor. During this visit your health history will be obtained and a physical exam will be performed.
Physical Therapy and/or Chiropractic Treatments: Typically your primary care doctor will prescribe physical therapy and/or recommend seeing a chiropractor for four to six weeks along with medication to help with the pain.
Diagnostics if pain persists: After the four to six weeks of treatments, if the pain and weakness is still significant, X-rays and possibly a MRI may be ordered.
Nonsurgical treatments: Depending on what the results of the X-rays and MRI, you may be referred for injections to relieve the pain.
Surgery may be an option: If all nonsurgical methods have been tried and were unsuccessful, then surgery may be an option. The most common type of spine surgery is a decompression where pressure is removed from the spinal cord or nerves. If your surgeon is concerned about the spine becoming unstable, a spine fusion surgery may be recommended to stabilize the spine. Occasionally, an artificial disc is recommended if you have a cervical disc herniation.
With breakfast being offered at many schools, some children may eat as many meals at school as they do at home during the school year. Ensuring your child eats healthy at school can be a challenge.
Most school age children have two choices when it comes to lunch – either a lunch from home or the lunch provided by the school. Historically, school lunches have a bad rap for being unhealthy. That being said, there are regulations from the USDA that schools need to follow, and these guidelines have been updated in an attempt to make the meals that school provide healthier and more balanced.
The guidelines for lunches are fairly complicated, although in simplified form, school lunches are required to have 5 components – fruits, vegetables, grains, meat (or meat alternative) and milk. There are requirements that not only need to be met daily, but also during the course of a week. What is used to fulfill these requirements is dependent on the school, although there policies regarding this as well. For example, a variety of vegetables need to be offered during the week, including dark green vegetables, red/orange vegetables, legumes and starchy vegetables. Also, while fruit juice will count as a fruit serving, it has to be 100% juice, and no more than half the fruit served can be in juice form.
When it comes to lunches from home, there is a wide spectrum of what kids are getting. From my experience, many students who are bringing lunch from home are not eating meals that are more nutritious than school lunches, and in fact, are even less healthy. Researchers found that many lunches from home were most often missing vegetables (only 11% of lunches had them!). Only about 25% of the lunches met three of the five components that school lunches need to include, and they often included extra snacks and desserts.
Making Healthy Lunches
Honestly assess whether you (or your child, if they are helping make their own lunch) are able to pack a variety of healthy foods – essentially, hold yourself to the same standards the schools are being held to. One way our family combats this issue is to use lunch containers with different size compartments. My kids know which kind of food needs to go in each one, and this ensures they get a good variety. Plus it’s very easy for them to follow and be independent with it. I also browse the internet frequently to look for ideas to keep my kids from getting bored – there are tons of ideas out there. If you’re new to packing lunches for your child, it takes a little time and energy at first, but after a while, it does get easier.
When to Skip Packing Lunches or Mix It Up
If you don’t feel that you’re able to consistently provide the variety that is recommended, then school lunches may be the better route for your family. Many schools in the Madison area offer more than one option for lunch, so I encourage parents to review the offerings together with their child to get a sense of what their preferences are, and to help guide their choices. It’s also okay to mix things up and bring a lunch from home some days, and get lunch from school on other days.
Before you know it, school will be back in session, and you’ll have some hungry kids ready for a snack the minute they walk in the door. Dietitian Dena Person recommends the following ideas for healthy treats that your child will actually want to eat.
Veggies and dip might not be the most appealing to your little ones, but including vegetables in muffins is an easy way to help them reach their daily recommended servings.
• 1 cup – flour, whole wheat
• 1 cup – flour, all-purpose
• 3/4 teaspoon – baking soda
• 1/2 teaspoon – salt
• 1/4 teaspoon – nutmeg
• 1/4 teaspoon – cinnamon
• 1/2 cup – sugar
• 4 tablespoon – butter, unsalted
• 2 large – egg
• 1 teaspoon – vanilla extract
• 1/2 cup – broccoli, florets
• 1 medium – zucchini
• 1 1/2 medium – carrot
• 1/2 medium – apple
• 1 medium – banana
• 1/8 cup – apple juice
• 1/4 cup – applesauce, unsweetened
• 1/4 cup – yogurt, plain
1. Preheat oven to 350 degrees F.
2. In a medium size bowl, mix together flours, baking soda, salt, nutmeg, and cinnamon. Set aside.
3. Soften butter.
4. In a mixer or another bowl, mix the sugar, butter, eggs and vanilla. Beat well.
5. In a food processor, combine steamed broccoli, zucchini, apple, banana, apple juice, and applesauce. Pulse until thoroughly mixed.
6. Shred carrots. If you don’t want the shreds in your muffin, combine your carrots with the rest of the fruits and veggies in the food processor.
7. Combine the fruit and veggie puree, carrots (unless you already added them with the puree), and yogurt, into the wet ingredient mixture (sugar/butter/eggs) and beat until mixed. 8. Finally, add the dry ingredients and mix just until combined and wet.
9. In a muffin tin, place muffin papers or spray with cooking spray.
10. Scoop the mixture into a prepared muffin pan. Fill each spot about 3/4 of the way full. 11. For mini muffins: Bake in a 350 oven for 15-20 minutes for mini-muffins
For regular size muffins: Bake in a 375 degree oven for about 20-25 minutes.
12. Bake until the tops are slightly brown and a toothpick comes out clean or they bounce back when you touch them with your finger. These freeze great! Put them in a freezer-safe bag and freeze for up to 3 months.
For a Family Activity: Whole Wheat Veggie Pizza
Making a snack is a great time to connect with your kids and an opportunity to teach them about healthy eating.
• ½ tsp Hidden Valley Ranch(R) Seasoning
• ½ C 0% Fat Greek Yogurt
• Whole Wheat Bread
• Cookie Cutters
• 1/4 cup chopped broccoli
• 1/4 cup chopped cauliflower
• 1/4 cup shredded carrots
• 1/3 cup diced cucumbers
• 1/3 cup cheese
Mix the Hidden Valley Ranch(R) with the Greek yogurt. Cut out shapes of bread using a cookie cutter. Spread 1 teaspoon of Ranch mixture onto the pizza shapes and let the kids top with their favorite vegetables. Make sure to press firmly so the veggies stick. Top with some cheese. Enjoy!
For Kids on the Go: Apple Moons
You don’t always have time to make something fancy between school and soccer practice, so these treats are an easy way to give your kid a little extra energy before meal time. Ingredients:
• 2 apples, sliced into wedges
• 1/4 cup peanut butter or sunflower butter
• 1/4 cup sliced nuts, granola, or trail mix your favorite
Coat tops of apple wedges in peanut butter and sprinkle with nuts, granola or trail mix and cinnamon.
Ready or not, the new school year is right around the corner! Parents may be anxious for their kids to get back to school and back into a routine, but the kids may be anxious about going to school. While some children are comfortable in new situations, others are more anxious. School anxiety is common, and parents can help alleviate their child’s concerns in a number of different ways. However, up to 5% of children will develop school avoidance, also known as school refusal or school phobia. Here are some of the signs to look for and ways to help your child manage both school anxiety and school refusal.
It is completely normal for children to be nervous, stressed or anxious at the beginning of a new school year, particularly when starting kindergarten or making the transition into middle school or high school. They might be worried about who they will play with at recess or sit with during lunch. This type of school anxiety is typically short-lived, resolving within a month of the start of school. However, up to 13% of children may develop more prolonged anxiety related to school. Kids with school anxiety may complain of physical symptoms before school or repeatedly ask to visit the school nurse. Common complaints are headache, stomachache or nausea. Sometimes these symptoms are made up to try to get out of school. But other times they’re real, brought on by nerves. If the child is allowed to stay home or to leave school, the symptoms often disappear quickly but return when it’s time to go to school again. Elementary school aged children may become overly clingy at school drop-off, experience difficulties sleeping, or exhibit low self-confidence. As children get older, they may withdraw or appear uninterested, develop eating disorders or experiment with drugs or alcohol.
As a parent, here are some things that might help relieve, or at least improve, the anxiety:
Listen to your child’s feelings and worries;
Encourage them to focus on the positive aspects of school;
Stick to a routine in the mornings and after school;
Encourage healthy habits by having a strict bedtime, limiting screen time, and making sure kids are eating a filling, well-balanced breakfast before school;
Do not let your child stay home from school which may just reinforce their anxiety; and
Make sure their teachers and guidance counselors are aware of the situation as they can help provide extra support and direction.
School avoidance is when school anxiety escalates to that point that children start refusing to attend school or create reasons why they shouldn’t go. They may complain of physical symptoms that are vague (headaches, stomachaches, nausea, dizziness) and are typically absent on weekends or holidays. More concrete symptoms like fever or weight loss are unusual. These physical symptoms are often the child’s way of communicating their emotional struggles with things like bullying and fear of failure.
In addition to the ideas listed above, here are some guidelines for helping your child with this problem:
Talk with your child about why they don’t want to go to school. Be sympathetic and supportive. Try to help them work through the problems that are causing their anxieties.
Insist on the child attending school and stay firm, particularly in the mornings when they may start to exhibit symptoms. If they are well enough to be up and about at home, they are well enough to go to school.
Discuss the situation with the teachers, counselors and the principal at school. They can help formulate a plan for return to school and provide support.
Help your child develop independence in a setting outside the home through clubs, sports activities, and outings with friends.
If your child’s school avoidance lasts more than a week, they have a fever or weight loss, or if you have any other concerns, your child needs to be seen by their primary care physician (PCP). Their PCP can help reassure your child, diagnose any possible underlying medical conditions, and also help formulate a return to school plan.
With the support of their parents, teachers, and physician, children can overcome both school anxiety and school refusal. If you have any questions, please do not hesitate to call your child’s PCP. Have a safe and happy school year!
The FDA has recently updated a warning that certain pain relievers can increase your risk of heart attack or stroke. The warning now includes some over the counter medications. Warning labels on these medications will be updated to include the heart attack and stroke risks.
Drugs Included in Warning
Included are 15 pain relievers, all Nonsteroidal Anti-Inflammatory Drugs (NSAIDS), such as over-the counter ibuprofen (Advil, Motrin or generic) and naproxen (Aleve or generic). In addition, prescription drugs such as Celebrex, Cambia and Voltaren have warnings. Acetaminophen (Tylenol or generic) and aspirin are not included in this warning. Also, check your medicine cabinet, as some cold and flu medications may also contain one of the drugs in the warning.
Risks Associated with These Drugs
People without a pre-existing condition who take these drugs have a small, increased risk of a heart attack or stroke. The risk increases if you take these over a longer period of time or in a larger dose. If you have a family history of heart conditions or stroke, you should talk to your health care provider before taking these medications. Patients taking these drugs who have chest pain, shortness of breath, weakness or slurred speech should get care immediately.
What do I do if I’m taking these medications?
Patients with heart disease should talk to their doctor or pharmacist about other options. There are other pain relievers you can take instead. If you do decide to stay on these medications, minimize the risk of these side effects by discussing what the minimum effective dose may be. Reducing the length of time that you take these drugs may also minimize your risk.
Should I stop taking these medications?
Not necessarily. Taking these for occasional use, like a headache, isn’t likely to cause a problem. However, if you have heart disease or any other concerns, talk to your doctor or pharmacist about other options.
The prevalence of Type 2 diabetes is on the rise. More than 29 million Americans or 9.3% of the U.S. population have diabetes. In addition to the 29 million who already have diabetes, another 86 million (1 out of 3) American adults, have pre-diabetes, a condition in which blood glucose levels are higher than normal but are not high enough for an official diagnosis of Type 2 diabetes. Of those with pre-diabetes, 9 out of 10 do not know that they have prediabetes. Those with pre-diabetes are at increased risk of going on to develop full-blown Type 2 diabetes, if steps are not taken to stop it in its tracks. Although the genes you inherit may influence the development of type 2 diabetes, they are only one piece of the puzzle and they take a back seat to behavioral and lifestyle factors.
Below are simple steps you can take to head in a healthy direction. Making small changes in lifestyle habits can not only prevent pre-diabetes from becoming diabetes, but can also return blood glucose levels to the normal range. These same changes can also prevent the development of complications if you already have Type 2 diabetes and can ward off many other health problems including heart disease and some cancers.
Know Your Numbers
Many diabetes symptoms are silent, but a simple blood test can reveal whether blood sugar levels put you at risk for the condition. Obtaining regular checks of blood cholesterol levels and blood pressure can also be useful. Having healthy levels of these three indicators significantly reduces your risk of diabetes. If you know that your numbers are high, you can get yourself on track before diabetes sets in and medications may be necessary.
Inactivity promotes Type 2 diabetes. Every two hours you spend sitting instead of pursuing something more active increases the chances of developing diabetes by 14%. If it’s been a while since you exercised, start by building more movement into your routine by taking the stairs, parking further away, dancing to your favorite songs, or marching in place during TV commercials. Long bouts of rigorous, sweaty exercise are not necessary. Several studies show that walking briskly for a half hour every day reduces the risk of developing type 2 diabetes by 30%.
Dietary changes can have a big impact on the risk of type 2 diabetes. Studies show that people who eat a variety of food are healthier, live longer, and have a reduced risk of disease, including diabetes. Food variety means including foods such as fruit, vegetables, whole grains, legumes, lean meat, fish, seafood, nuts and seeds, and dairy products. Eat plenty of fruit and vegetables since they are not only full of vitamins and minerals, but they contain beneficial phytonutrients – which can defend against disease. Read the ingredient list so that you are more aware of what you are putting into your body. Skip the sugary drinks. Choose whole grains and avoid highly processed carbohydrates. Opt for good fats (poly and monounsaturated fats found in liquid vegetable oils, nuts, and seeds) instead of bad fats (trans fats found in many margarines, packaged baked goods, and fast foods and saturated fats found in high fat red meat, butter, and cheese).
Manage Your Weight
Excess weight is a significant contributor to the development Type 2 diabetes. Being obese can make you 20 to 40 times more likely to develop diabetes than someone in a healthy weight range. If you’re carrying excess weight, you might not have to lose as much as you think to make a difference. The Diabetes Prevention Program found that overweight individuals who lose even 5-7% of their total body weight through exercising and healthy eating cut their chances of getting diabetes by 58%. Don’t consume yourself with restrictive dieting. Instead, practice mindful eating and aim for balance, variety, and moderation. Get moving and support Step Out Walk to Stop Diabetes on August 23 in Olin Park.
Add Type 2 diabetes to the long list of health problems linked with smoking. Smokers are roughly 50% more likely to develop diabetes than nonsmokers, and heavy smokers have an even higher risk.
Stress has both a direct and indirect effect on blood sugars. When you’re stressed, your body is primed to take action and releases extra glucose into the bloodstream. Stress can also have an indirect effect by detracting from your overall self-care by triggering you to grab fast food, skip your exercise class, drink more, etc. Don’t fret though, relaxation exercises and other stress management techniques can help you control blood sugar levels and set you on a healthier, calmer path. Try taking three deep, slow breaths any time you feel your tension level rising (before answering the phone, starting the car, when waiting in line, or any other activity).
Moving more, eating better, and stressing less is always easier if you have others helping you out, holding you accountable, and cheering you on. Consider joining a group where you can pursue a healthier lifestyle in the company of others with similar goals. Fortunately, Meriter has a variety of programs to help you with making lifestyle changes to improve your health. If you are interested in learning more, check out (link for pathways to good health).
Adjust Your Mindset
It’s not always easy to make changes in health habits; however, you are more likely to be successful if you give yourself permission to focus on small changes. Be realistic with your expectations and remember to focus on one goal or change at a time. Break down your goals into small, manageable steps that are specifically defined. Anything you can do today that was healthier than yesterday is a step in the right direction.
Meriter Heart & Vascular has again been recognized by the American College of Cardiology, receiving the NCDR ACTION Registry–GWTG Platinum Performance Achievement Award for 2015. Meriter Hospital is one of only 319 hospitals nationwide to receive the honor.
The award recognizes our commitment and success in implementing a higher standard of care for heart attack patients and signifies that we have reached an aggressive goal of treating these patients to standard levels of care as outlined by the American College of Cardiology/American Heart Association clinical guidelines and recommendations.
Learn more about Meriter – UnityPoint Health’s award-winning Heart & Vascular program at meriter.com/heart.
During the warm summer months, you might be getting outside to hike or camp. While enjoying these activities you may also come across some plants that can cause rashes, especially May through September.
Common Irritants & Symptoms
Poison Oak & Poison Ivy can be found along hiking trails and near camping areas. Both present with similar symptoms. They can causes blisters to appear with redness and swelling of the skin. This helps differentiate from other rashes as redness and itching can be present with just about anything. Symptoms from these plants generally appear in 12-24 hours of exposure.
Wild Parsnips are often found in sunny areas along highways and prairies. Encounters with wild parsnips can result in a sunburn type rash, discolored skin and even blisters. Symptoms occur after contaminated skin is exposed to sunlight. Rashes from parsnips will likely appear within 12-24 hours.
Poison oak, poison ivy and wild parsnip rashes are all treated in similar ways.
Wash clothes and skin immediately: The oils from poison oak and poison ivy can stay on clothing and your pets for up to a year. Be sure to thoroughly wash your clothes, shoes and pets if you’ve come in contact with an irritant. Try an oatmeal bath for young children as a gentler alternative to soap.
Cool compress: Use a wash cloth soaked in cold water to sooth the irritated skin.
Apply anti-itch medicine: A cream such as Corticosteroid or Calamine lotion will help reduce itching.
When to seek medical attention
Despite efforts with in-home treatments, it may be necessary to seek out medical attention if:
Severe blistering, swelling, or itching occurs;
sensitive areas such as the eyes are effected;
you’re experiencing a fever;
the rash is long lasting or covers a large portion of your skin; or
We fit into YOUR schedule. Trying to juggle work, school and soccer practice is hard enough. Where exactly does a doctor appointment fit in? We are proud to offer extended hours at most of our clinics so you can make appointments early in the morning or in the evening. We also have a Pediatric After Hours clinic for evening and weekend visits.
Same day appointments. If you’re sick today, you can see us today. Just call and we’ll get you in. There’s no need to wait days or weeks for the care you need if you’re not feeling well.
Ready for emergencies. Our 24/7 emergency room has a Pediatric Center with its own private waiting room and is staffed by a care team specially trained to care for children. Plus, current ER wait times are always available on meriter.com.
Convenient locations. No matter where you live in Dane County, we have a clinic close to you. Our primary care clinics are located throughout the greater Madison area to be near your home and work.
Free meet and greets. It’s important you have the right doctor for your little one. That’s why we offer free Meet and Greets so you can have a chance to find a doctor who fits your family before you schedule an appointment.
You’ve already trusted us with the BIG moment. Meriter Hospital delivers more babies than any other hospital in Wisconsin, so there’s a good chance your baby was born here. You’ve already trusted us with your child’s biggest life moment so far, so let us partner with you for all the big and small moments to come.
Our patients are happy. Need a second opinion? Ask someone who’s visited a Meriter clinic. Our patients rated us highest in the nation for Pediatric Doctor Rating for two consecutive years, according to the National Research Corporation.
Not just your average doctor. Interested in a doctor who serves double-duty as a lactation consultant to help with breastfeeding? How about one who is certified in travel medicine for your globetrotting family? Need an Olympic caliber athlete who can relate to your active teenager? Our doctors have a unique set of skills and capabilities to meet your needs.
Access to Madison’s only 100 Top Hospital. Meriter Hospital is the only 100 Top Hospital in Madison, according to Truven Health Analytics. And if your kiddos need specialized pediatric care, our doctors work closely with the American Family Children’s Hospital to seamlessly coordinate your child’s care.
We can care for YOU, too. It’s not just about the kids for us. It’s about the whole family! Many of our primary care doctors can treat both you and your child to make sure everyone is healthy and happy.
When the topic of health comes up, we immediately think about exercise and diet, which is usually appropriate. However, even with exercise there is a flip side, so to speak, that is often forgotten. Just as we need to move around physically every day, we also need appropriate down time, rest, relaxation, and sleep. Like most things, getting too much or too little sleep leads to problems, and a balance must be struck. As part of Meriter – UnityPoint Health’s Formula for Good Health, we’re focusing on prevention, including healthy sleep.
Health Consequences of Poor Sleep
An overly busy and stressed life also contribute to poor sleep and our 24/7 “around-the-clock” access to technology and increased or fragmented work schedules are partially to blame for the increased rate of sleep disorders in recent years. Over time, this becomes a very important issue because chronic sleep deprivation, or “sleep insufficiency” contributes to a number of chronic conditions such as hypertension, diabetes, depression, anxiety, osteoporosis, obesity, cancer, and decreased quality of life. Unfortunately, research also shows that insufficient sleep also increases unhealthy choices such as smoking, high-risk alcohol consumption, and being physically inactive.
Productivity Consequences of Poor Sleep
Employers are also beginning to recognize that workers who don’t get enough restorative sleep at night are less productive. Being sleep deprived affects our memory and thinking as demonstrated by one study showing that people who regularly slept less than 5 hours a day performed far worse on thinking-performance tests.
There are some good strategies that can help. Finding balance in one’s life is a good starting point. Whenever possible, it is best to start with things that we have immediate control over. For most of us, it appears that getting 7-9 hours of sleep a night is best. Here are some suggestions to help you get adequate sleep:
Wear Socks: During colder weather, try wearing socks to bed, which has been shown to speed up how quickly you fall asleep.
Shut the curtains: Keep the bedroom as dark as possible to help boost your own natural melatonin levels.
Turn off electronics: Keep electronic devices away from your head and pillow. Research shows that electromagnetic fields (EMFs) from even the smallest electronic devices can disrupt REM and non-REM sleep, as well as inhibit melatonin secretion by the pineal gland.
Turn on the fan: Use white noise such as a fan or air purifier to create a soothing atmosphere and block out disruptive noises.
Turn down the temp: Keep the room cool-er (not too warm or cold!).
Exercise: Exercise regularly, with more vigorous exercise happening earlier in the day, and more restorative exercise (e.g. yoga, walking etc.) in the evening.
Limit Naps: Limit daytime naps to 30 minutes or less to avoid disrupting your circadian rhythms and sleep cycle.
Get outdoors: Get sunlight as early in your day as possible to help stimulate serotonin levels for increased alertness and wakefulness.
Limit Alcohol: Avoid excessive alcohol intake, which initially makes us sleepy, but over time interferes with sleep.
Limit Sleep Aids: Avoid taking sleep aids every night, especially benzodiazepine medications which are now known to block deep stages of sleep over time, and have an association with dementia if used daily for years.
If you’re still having problems falling asleep, talk with your doctor if you have ongoing or other concerns.
Sleeping by the Numbers
According to CDC, and estimated 50-70 million Americans have sleep problems.
We’ve been getting less sleep every year since 1985.
23% of us report difficulty falling or staying asleep due thinking too much about something while lying in bed.
35% of US adults get less than 7 hours of sleep a night
More than 30% get less than 6 hours a night (young kids and teenagers typically need 10 or more hours of sleep a night).
A 2010 study found that those of us who routinely slept less than 6 hours a night had a 21% higher risk of sudden death, with all other factors being controlled for.
Another study found that middle-aged and older adults who got less than 6 hours of sleep a night over time were 4 times more likely to suffer a stroke, even though they were not overweight and had no family history or stroke!
A 2012 review study found that lack of sleep increases the hunger-stimulating hormone ghrelin and decreases the hunger-suppressing hormone leptin.
The Department of Transportation estimates that drowsy driving accounts for over 40,000 non-fatal and fatal motor vehicle injuries per year in total.
Meriter -UnityPoint Health was recognized for the fifth year in a row as one of the nation’s “Most Wired” by Hospitals & Health Networks magazine. Meriter, who received this year’s award as part of the UnityPoint Health system, received the honor for its ability to leverage information technology to improve care.
“Everything we do aims to coordinate care across multiple settings so that our patients can be as engaged as possible during their wellness journey,” said Arthur Nizza, DSW, President and CEO of Meriter – UnityPoint Health. “This recognition is a testament of our dedication to using the latest technologies and tools to care for our patients where and when they need us, whether that’s in our clinics or on the go.”
The 2015 Most Wired™ survey and benchmarking study, in partnership with CHIME and sponsored by VMware, is a leading industry barometer measuring information technology (IT) use and adoption among hospitals nationwide. The survey of more than 741 participants, representing more than 2,213 hospitals, examined how organizations are leveraging IT to improve performance for value-based healthcare in the areas of infrastructure, business and administrative management, quality and safety, and clinical integration.
Most parents worry about their children getting head lice during the school year. The majority of cases of head lice are acquired outside of school, however. I found myself thinking more about it earlier this summer as I watched kids on my son’s baseball team passing around the same batting helmet. I voiced my concerns to my husband who then proceeded to tell the story of when his entire little league team got head lice for precisely that reason.
If you are like me, you are probably itchy just thinking about it. However, it is important to remember that lice are really just a nuisance. A few months ago the American Academy of Pediatrics (AAP) published updated guidelines for the treatment and prevention of head lice. The big theme of the guidelines is encouraging the removal of the stigma surrounding head lice (they are not a sign of disease or poor hygiene) and encouraging schools to abandon their “no nit” policies. It has yet to be determined how schools in our area will adjust their policies, if at all, based on these updated recommendations.
Treatment: Treatment should start with over-the-counter (OTC) medications that contain 1% permethrin or pyrethins. The package instructions should be followed exactly for best results, then the nits should be removed and the wet hair should be combed thoroughly. The treatment should be reapplied on Day 9 and again on Day 18 if lice or nits are still present.
Some areas of the country have a known high incidence of resistance to OTC treatments. Patients in those areas or patients who still have lice despite use of the OTC products should talk to their primary care provider about the possibility of trying a prescription medication.
Treating the family and your home: When a family member has been identified as having head lice, all other household members should be checked. Bedding, recently worn clothing and frequently loved stuffed animals should be washed thoroughly in hot water. Stuffed animals can also be stored in an air tight bag for at least 3 days if they are unable to be washed or dry cleaned. Hair brushes, combs and accessories should be soaked in rubbing alcohol or medicated shampoo for at least 1 hour, or simply throw them away.
Prevention: Preventing all cases of head lice is not possible but know that lice do not have wings and spread mainly through direct head-to-head contact or by sharing of personal items such as combs, brushes and hats. Teach your children not to share such objects. Needless to say, after my son’s baseball practice, we went to the sporting goods store and bought him his own helmet!
Join us as we work together to raise awareness and create a healthier community
Take steps toward a healthier future and find a cure for diabetes by participating in and supporting the American Diabetes Association’s Step Out: Walk to Stop Diabetes. Beginning at Olin Park, enjoy a one or three mile walk along John Nolan Drive with breathtaking views of the Capitol, Lake Monona and Monona Bay! Invite family and friends, and arrive early to enjoy breakfast and entertainment before the walk begins.