By: Dr. Gretchen Diem, Health Psychology
Although holidays are supposed to be a joyful time, they can also feel overwhelming and stressful. There is often a dizzying array of demands – parties, shopping, baking, cleaning, family get-togethers, to name just a few and not enough time to do it all. For some, the holidays are especially hard as they are reminded that they are alone or of loved ones who are gone.
Here are some ideas that may ring true for you this year as you try to embrace all that the season has to offer.
- Have realistic expectations. No holiday celebration is ever perfect and it doesn’t have to be just like last year. As life changes and families grow, traditions and rituals often shift as well. Choose a few to hold onto, and be open to creating new ones.
- Keep things in perspective. Try to view inevitable mishaps as opportunities to find humor, and demonstrate flexibility and resilience. Burning the cookies, arriving late to a party, or coming down with a winter cold will not ruin the holidays. Instead it might just create a notable family memory.
- Honor your feelings. Just as it is a season of celebrating the many gifts in our lives, the holidays also can be a time that calls to mind what pains us. Remember that many people struggle with some loneliness or loss. Giving yourself and others some grace can make it easier to be present in the moment and to not be overwhelmed with the full spectrum of emotions that life has to offer.
- Give to those in need. The holidays are usually a time when everyone is focused on gift giving for families and friends; however, it is also a great time to consider giving to others. Helping those less fortunate is a wonderful way to teach children about the value of helping others and has the added benefit of making the “giver” feel good too.
- Do less. As hard as it is, give yourself permission to say no to requests that are going to add to your level of stress. You cannot be present for yourself or others if you feel resentful or over-burdened. Ask yourself, is this really necessary? Will this bring me or my family more joy or will it just add more pressure. Prioritize activities that are most meaningful.
- Focus on what really matters. The barrage of holiday advertising can make us overlook the true meaning of the season. The holidays are a time to reconnect with people we care about, give thanks, and celebrate. Take time to reflect on all the people, experiences, and things we have in our lives for which to be grateful. This can really shift our perspectives in a positive way.
Take time to stop, breath, reflect and enjoy – here’s to a wonderful holiday season and a Happy and Healthy New Year!
By: Dr. Luke Fortney, Family Medicine
When someone mentions the Great American Smokeout on November 20, do you feel inspired, annoyed, anxious, guilty or something else? If truth be told, many people who smoke have mixed emotions about smoking and quitting. The whole point of the Great American Smokeout isn’t to set unrealistic expectations. Quite the opposite! Here at Meriter – UnityPoint Health, we encourage you to look at this day as the starting point toward optimal wellbeing for the long-run.
According to WIPHL (Wisconsin Initiative to Promote Healthy Lifestyles), 40% of all deaths in Wisconsin every year are directly attributed to tobacco and alcohol. That’s a big number and a lot of unfortunate and unnecessary loss. However, it’s never too late to turn things around. This November, we encourage you to use the Great American Smokeout as a day to start thinking about, preparing for, and making plans for tobacco cessation at a time that is best for your schedule and your life.
The Great American Smokeout is just the starting point for you to become tobacco-free. Rather than quit cold-turkey on November 20th, we encourage you to begin preparing for a tobacco-free life. There are many ways to do this, and many tools to support you. Perhaps the Wisconsin Tobacco Quit Line or using OTC nicotine replacement will help you stay on track. You may even be drawn to our flagship Mindfulness Training for Smokers (MTS) class, which is a once-a-week, 7-weeks-long, group program combining medications and training in mindfulness to help manage cravings, withdrawl symptoms, smoking triggers, and stress. Whatever approach you choose, we will be here for you every step of the way, which also includes our monthly smoking cessation check-in group.
How does mindfulness help us break free from addiction? First of all, mindfulness is a psychology technique and practice that means paying attention in a particular way, on purpose, in the present moment, and without judgment. It provides us with a whole new skill set for dealing with triggers, urges, strong emotions, and stressors – whatever leads us to smoke. At the same time, it helps retrain certain dopamine mediated neuro-pathways so that cravings aren’t nearly as intense as they may have been during previous quit attempts. Learning to practice mindfulness in meaningful, everyday, and practical ways teaches us to pay attention to our experience so that we are able to thoughtfully respond to circumstances rather than automatically react. This awareness provides a pause or break in old habitual patterns, creating a chance to decide not to reach for that cigarette or chew.
If you’re having a hard time deciding where to start, we can help! This isn’t about trying the same old approach over and over again. The Great American Smokeout can serve as an opportunity for you to 1) begin thinking about, 2) prepare for and 3) empower yourself to finally be free of tobacco. We encourage you to take this opportunity to commit to a tobacco-free life, and most importantly enjoy the rewards of accomplishing something you may not have thought possible.
Give us a call at 608-417-7848 (QUIT). Together, we’ll help you come up with a plan for your success. What’s your starting point?
Fall and winter are all about comfort foods for most of us, so I have included some healthy alternatives to our everyday idea of what comfort food is. Now, these recipes will require slightly more prep time, but the benefits are worth it! The first one I will share with you is a twist on lasagna and pasta dishes.
I love using zucchini as a noodle base, and I love my Vegetti (the tool used to make thin spaghetti noodles). Here is one of my favorite recipes for zucchini lasagna; of course you can add/remove veggies as you wish.
Zucchini Veggie Lasagna
2 large zucchini
1 tablespoon salt
1 pound ground beef or turkey
1 1/2 teaspoons ground black pepper
1 small green bell pepper, diced
1 tablespoon fresh garlic
1 onion, diced
1 cup tomato paste
1 (16 ounce) can tomato sauce
1/4 cup red wine
2 tablespoons chopped fresh basil
1 tablespoon chopped fresh oregano
Hot water as needed
1 (15 ounce) container low-fat ricotta cheese
2 tablespoons chopped fresh parsley
1 (16 ounce) package frozen chopped spinach, thawed and drained
1 pound fresh mushrooms, sliced
8 ounces shredded mozzarella cheese
8 ounces grated Parmesan cheese
- Preheat oven to 325 degrees F (165 degrees C). Grease a deep 9×13 inch baking pan.
- Slice zucchini lengthwise into very thin slices. Sprinkle slices lightly with salt; set aside to drain in a colander. This prevents the dish from getting too much liquid.
- To prepare the meat sauce, cook and stir ground beef and black pepper in a large skillet over medium high heat for 5 minutes. Add in green pepper, garlic and onion; cook and stir until meat is no longer pink. Stir in tomato paste, tomato sauce, wine, basil, and oregano, adding a small amount of hot water if sauce is too thick. Bring to a boil; reduce heat and simmer sauce for about 20 minutes, stirring frequently.
- Meanwhile, stir egg, ricotta and parsley together in a bowl until well combined.
- To assemble lasagna, spread 1/2 of the meat sauce into the bottom of prepared pan. Then layer 1/2 the zucchini slices, 1/2 the ricotta mixture, all of the spinach, followed by all of the mushrooms, then 1/2 the mozzarella cheese. Repeat by layering the remaining meat sauce, zucchini slices, ricotta mixture, and mozzarella. Spread Parmesan cheese evenly over the top; cover with foil.
- Bake for 45 minutes. Remove foil; raise oven temperature to 350 degrees F (175 degrees C) and bake an additional 15 minutes. Let stand for 5 minutes before serving.
Another favorite of mine is a basic zucchini noodle topped with marinara sauce, Alfredo sauce or any other sauce you would like to incorporate. This can be topped with meat or strictly veggies. This recipe is very flexible! It can be served warm or cold. My favorite is sautéed lightly and then topped with a sauce of your choice. I would add feta cheese and chicken with this pesto zucchini recipe! Yum!
Simple Pesto Zucchini Noodles
Yield: 2 large bowls
2 large zucchini
Drizzle olive oil
1 carrot, shredded
Handful of your favorite mushrooms, sliced
2 tablespoons Basil Pesto (recipe below)
A pinch of sea salt
A pinch of freshly ground black pepper
Using a spiralizer, vegetable peeler or vegetti, cut zucchini into angel hair-like pasta and place in a bowl. Drizzle with a very small amount of olive oil, add carrot and mushrooms, and toss with Basil Pesto (homemade recipe is included). Season with sea salt and black pepper and serve.
Basil Pesto Recipe
1/2 cups pine nuts
1/2 cup fresh basil
1 clove garlic
1/4 tsp. sea salt, or to taste
1 teaspoon olive oil
In a food processor, combine pine nuts, basil, garlic, and sea salt. While mixing, drizzle olive oil into the food processor. Add more oil as needed to blend into a creamy paste. Season with additional sea salt as needed.
I love zucchini noodles for the sheer fact that it feels like comfort food and tastes like it too, but you reap the benefits of veggies in the cold and almost snowy weather when most of us slow down on our consumption. Once you make the noodles you can do a variety of different dishes with them. The dishes included are my personal favorites! Happy Cooking!
Meriter-UnityPoint Health is proud to announce that is has again been honored with three national eHealthcare Leadership Awards, presented by eHealthcare Strategy & Trends.
Meriter received the 2014 Silver eHealthcare Leadership Award for Best Doctor Directory, the 2014 Silver eHealthcare Leadership Award for Best Intranet and Meriter Foundation was awarded the Distinction award for Best Overall Internet Site.
Meriter’s physician directory conveniently allows patients the option to meet a Meriter physician online by viewing a physician’s photo, video and medical philosophy. Patients also have the option of conveniently requesting an appointment online with a Meriter physician.
Meriter’s intranet site was judge based on the organization’s use of internal networking to enhance employee productivity and satisfaction as well as reducing administrative costs.
By: Gena Van Kirk, Registered Dietitian/Diabetes Educator
When it comes to healthy eating, nourishing the body is the main concern. Our bodies require a certain quantity of nutrients to work at their best. This is largely about getting a well-balanced diet. We need to make sure we are bringing in enough energy, vitamins and minerals to meet our needs, but not so much that we exceed our needs. If we can accomplish this, we can also improve our diabetes outcomes. By eating healthy and maintaining a healthy weight, it is possible to slow down or reverse the progression of pre-diabetes to diabetes and to decrease complications related to diabetes.
What does eating healthy look like?
We can start by looking at our plates to see which foods we are choosing and what portion sizes we are consuming. The most recent guidelines suggest that we envision our plate as being divided up into four sections or quarters. One quarter of the plate should include a lean meat or protein food, and usually this food portion should be the size of a deck of playing cards. The second section of the plate should contain a starchy food or whole grain product such as a potato, noodles, rice or other bread product and take up the space equal to a computer mouse. The other half of the plate should consist of one cup of vegetables as well as a piece of fruit about the size of a tennis ball. In addition to this, you should incorporate 1 cup of low fat milk or yogurt. Remember, if you are adding any fats such as oil, butter or margarine to your plate, limit it to 1-2 teaspoons per meal. Eating in this fashion can assist in weight management and help to stabilize blood glucose (sugar) levels. It can also assist in heart disease prevention, which is of significance as people with diabetes have two times the risk of heart disease. Elevated blood sugar, blood pressure and cholesterol levels increase the risk of heart disease, so it is helpful to monitor your sugar, sodium and fat intake in the diet.
Making Healthier Choices
When choosing your meat or protein for the meal, be mindful of fats. If you can remove any visible fat from the meat before cooking it, do so. Also, if you are able to use a cooking method such as baking, broiling or boiling, you can decrease the amount of added fat to the product. Watch out for processed meats such as bologna or sausage and pickled meats such as herring because these meat choices tend to be higher in salt. Healthier meat choices include white meat chicken or turkey without the skin, round or loin cuts of beef or pork and fish.
When choosing your starch or grain for the meal, try to include dried beans (such as pinto, navy, garbanzo and kidney) and “whole” grains at least half of the time in order to incorporate fiber into the diet. Some whole grain choices would include low sugar whole grain cereals, whole wheat bread, brown rice, instant oatmeal, popcorn (be mindful of the added butter and salt), whole grain crackers and whole grain chips.
With your fruits and vegetables, the most important things to remember are to include a good variety of colors in the diet (in order to incorporate a larger number of vitamins and minerals in the diet) and to eat the whole fruit more often than choosing fruit juice. This will help to improve your fiber intake in the diet. Also, if you can choose fresh or frozen vegetables rather than canned vegetables, you will be decreasing the sodium content in your diet. Foods from the milk and yogurt group should be fat free (skim) or low fat (1%) for heart health. When you need to add a small amount of fat to your meal, lean towards heart healthy oils such as olive oil and canola oil, choose tub margarines rather than stick margarine, and limit butter and cream.
How do we make sure healthy food choices get to our plate?
I would contend that a good plan and regular shopping trips are the most important parts of the process. Set aside some time to plan your meals each week. You might want to start with just a few days. It may seem like a lot of work at first, but having a plan and writing a grocery list can save you time, stress and a lot of extra trips to the store. A good tip is to shop on the edge or perimeter of the grocery store. This area typically contains your breads, fruits, vegetables, dairy, and meats. Stick to your grocery list when venturing down the aisles of the grocery store as many of these foods tend to be low in nutrition. Try to avoid shopping when you are hungry as you might be tempted by a less healthy food.
There may be other times when it is difficult to make healthy food choices. A few examples would be snacking and dining out. Why not make it easy to find healthy snack foods in your kitchen? For example, when you get home from work or school, put some fresh carrots, grapes or pretzels out on the counter instead of a bag of chips. It can be helpful to prepare these items ahead of time, maybe on the weekend or on a day off. When dining out, ask if meats can be grilled rather than fried and request sauces and dressings on the side. Remember to choose fruit, salad or other vegetables as side items, rather than French fries. Order a salad or soup to start and then share an entrée. Save money, and lots of calories, by skipping or sharing a dessert.
For many years, the Goodman Community Center has provided groceries to families across Dane County so that they can also make a traditional Thanksgiving meal. This year, they hope to feed over 2,500 families.
You can easily make a big difference this year through supporting the Goodman Community Center by “liking” Meriter-UnityPoint Health on Facebook! For every “like,” we will make a $5 donation to the Goodman Community Center, and we will donate up to $2,500 before Thanksgiving. We hope you will help this year!
With the cold of winter upon us, enjoy a FREE night filled with ways to stay active indoors. Just because we are spending more time inside doesn’t mean you can’t find fun activities to keep you healthy. Join us for:
• Face painting
• Balloon artist
• Snacks and infused water
• Register to win prizes
• Learn more about Madison Moms Blog
Location: Meriter DeForest-Windsor
4200 Savannah Drive, DeForest
(near the intersection of Hwys. 19 & 51)
Date: Tuesday, November 25 from 5:30-7:30pm
This event is open to the community and the drawings are free, without any obligation.
Are you feeling daunted by the thought of the upcoming holidays? If so, you’re not alone. This season, choose to give yourself the gift of respite while developing skills that can take you from frantic and overwhelmed to mindful and stress-free.
Our 4-class Manage the Holidays Mindfully program encourages you to stay in the moment amidst the hustle and bustle of gift shopping, decorating and family get-togethers. In a relaxing atmosphere, you will learn how to use mindfulness as a tool to change the way you cope with holiday demands. The great thing is that no previous mindfulness experience is needed!
Each class will focus on a different holiday-related topic:
- Managing Expectations
- Time Management
- Relationship Issues
- Holiday Eating
Dates: Weekly on Tuesdays, Nov. 11, Nov. 18, Dec. 2 and Dec. 9 (No class will be held Nov. 25)
Time: 6:30 p.m. – 8:00 p.m.
Location: Meriter McKee Clinic
Come join us and be surprised how much more peace and joy you truly can have this holiday season. To register, please visit meriter.com/holidays.
At Meriter-UnityPoint Health, your health is our priority. We know that colon cancer is one of the most preventable, yet least prevented, cancers in the U.S. today. Unfortunately, only 1 in 3 people over the age of 50 are getting their recommended screenings. In order to increase these numbers and ultimately save more lives, Meriter is proud to now offer additional colon cancer screenings, including Cologuard: a new noninvasive option. If you are over the age of 50, please talk with your doctor about what screening option is best for you.
Patty Larabell, RDN
Halloween is a fun time for kids and families, but it often includes too many sugary treats. There are easy ways to turn a Halloween snack into a fun and healthy treat.
- Fill a clear cup with one layer of green grapes
- Cut a marshmallow in half and push the sticky side into the side of the cup. These will be the eyes
- Fill the rest of the cup with green grapes
- Draw a mouth and two eyes on the outside of the cup, making sure the eyes line up with the marshmallows
- Cut a low-fat cheese stick in half and cut long slices into it to look like broom bristles
- Push a small pretzel stick into the end of the cheese stick
- Peal a clementine
- Chop a celery into small pieces
- Stick the celery pieces into the top of the clementine for stems
By: Hanna Knurr, Pharmacy Practice Resident
Did you ever wonder how your nurse knows that he or she is giving you the right medications at the right times and at the right dose? Hospital pharmacists handle all things medication related!
What does a hospital pharmacist do? Many people think that a pharmacist is the person that you visit at the drugstore. That person, an outpatient pharmacist, manages the medications that you take at home. At Meriter-Unity Point Health, hospital pharmacists are an important part of the health care team.
Here are some of the things that hospital pharmacists do:
- Pharmacists are medication experts: All pharmacists have college degrees. In pharmacy school, students spend 4 years learning to be experts in medication management. Student pharmacists also spend their last year gaining valuable work experience in different settings, ranging from outpatient pharmacies to hospitals and clinics. After graduation, many pharmacists spend an extra year or two in residency programs, learning advanced skills.
- Medication monitoring: In many hospitals, including Meriter-Unity Point Health, pharmacists work on the inpatient floors, and in the inpatient pharmacy. The unit-based pharmacist works closely with doctors, nurses and patients. On many floors, the patient care team conducts daily “rounds”. During rounds, the pharmacist makes recommendations and answers questions about medications for the rounding team. For many medications, the hospital pharmacist helps to choose the correct dose.
- Patient Education: The hospital pharmacist is a great person to inform you about your medications. They know what medications you are taking, why they have been prescribed, and what side effects you might experience. The pharmacist can teach you how to safely and effectively take your medications at home. If you have questions about your medications, just ask your nurse if you can speak with the pharmacist.
- Making sure that you are getting the right medication for you: Medications are complicated. At Meriter-Unity Point Health, our pharmacists review each patient’s current medications every day. When a doctor prescribes a new medication, your hospital pharmacist will check your medical chart and review your other medications to make sure that the new medication is the best choice for you. For some drugs, doses may change a lot from person to person. For those drugs, your hospital pharmacist can order lab tests to determine if these doses are high enough to be effective, but not too high that you are at risk of side effects. If a pharmacist finds that a medication is not effective or is causing side effects, he or she will contact your doctor to discuss a better option for you.
- Helping to keep you safe: Every medication that you receive in the hospital is labeled with your name and double checked by a pharmacist. From the pharmacy medications are sent to your floor, where your nurse can access them and then give them to you. For an extra layer of safety, Meriter-Unity Point Health uses a barcode scanning system to make sure that the medication your nurse gives to you is the one your doctor prescribed. Hospital pharmacists are constantly looking for ways to improve medication safety.
- Making sure that you have access to medications at home. Often, a doctor starts a patient on a new medication that will need to be continued when that patient goes home. When money is an issue, the hospital pharmacist can look at insurance information to find out if the drug prescribed is covered. If insurance coverage is an issue, the pharmacist may be able to recommend a less expensive alternative. For patients who might not have any insurance, the hospital pharmacists at Meriter are aware of programs to help patients get the medications that they need. We want you to have access to the medications that you need.At Meriter, we also work closely with our outpatient pharmacy to make sure that you can get your home medications before you leave the hospital. The outpatient pharmacist can even come visit you in your room, bring you your medications, educate about how to take them and what to expect.
At Meriter Unity-Point Health, our hospital pharmacists work hard 24 hours a day, every day, to make sure that our patients are getting the most benefit from their medications. There’s always a hospital pharmacist nearby– feel free to ask us about your medications or what we can do for you.
Halloween is one of my favorite holidays. At my house, we are currently in negotiations with my 9-year-old about whether a Zombie costume is appropriate to wear this year when we are out Trick-or-Treating. As a pediatrician, I am always thinking about safety on any outing with the kids, and here are some ways to help keep all of our children safe this Halloween.
- Try to plan for a costume that is bright or reflective. If that isn’t an option, glow sticks that you can make into a necklace or bracelet are $1 a packet at the Dollar Store or Target and work great to find your little goblins at night.
- Don’t let costumes hang below a child’s ankle height. This will help prevent falls while walking the neighborhood.
- Try to use face paint instead of a mask for the costumes. Masks can limit your eyesight when Trick-or-Treating.
- Make sure to pick up anything that a child could trip on when coming to your home. Clear away any lawn decorations that might block a safe entry and exit to your front door.
- Restrain pets so they don’t jump at any princesses at your door.
- Replace outdoor lights that have burned out bulbs.
- Avoid using candles for your pumpkins and instead use battery operated LED candles.
- Have small children draw a face on pumpkins instead of having them carve pumpkins.
- A parent or responsible adult should always walk with children while they are trick-or-treating.
- Use flashlights or headlamps to light the trail around the neighborhood.
- If older children are going alone, plan for designated meeting times at local neighborhood haunts.
- Do not go up to a house that does not have a porch light on when trick-or-treating.
- Only cross the street at designated intersections.
- Carry a cell phone in case of emergency.
- Always sort the treats with your children and consider donating your child’s Halloween candy to a local organization that is accepting candy donations. Meriter West Washington Clinic will be accepting candy donations between 9:30-11:30 a.m. on Saturday, Nov. 1 at the 3rd Annual Candy Trade-In Party. The candy will be donated to U.S. troops overseas through Operation Gratitude.
- Drive slowly in any neighborhoods during trick-or-treat times as well as exit and enter driveways carefully.
If you are experiencing pain or injury that is limiting your running or just have questions about your running form sign up now for an appointment at the Meriter–UnityPoint Health Sports Medicine Running clinic. You will meet one on one with one of our sports medicine therapists who will screen your flexibility, strength and running mechanics and help you establish a program to improve any limitations. In addition, we will have access to our video analysis system to help identify problem areas within your running mechanics.
Date and Times: October 29, 2014 at 5:30, 6:00, 6:30 or 7:00 PM
Location: Middleton Therapy Clinic
Attire: Wear running clothes and have running shoes with you
Space is limited so sign up today.
Save the date to bring in your extra candy to our 3rd Annual Halloween Candy Trade-In Party on Saturday, November 1, 2014 from 9:30 to 11:30 a.m. at the West Washington clinic.
Candy will be donated to U.S. Troops overseas through Operation Gratitude. Kids will recieve one prize entry ticket for each pound of candy they bring in.
So far, prizes include:
- 20″ kid’s bike – donated by Pacific Cycle
- 4 tickets to The Christmas Carol at Overture Center – donated by Children’s Theatre of Madison
- Free passes – donated by Pump It Up
- Gift card – donated by CVS
- Family bowling passes – donated by Entercom Communications
- And many, many more great prizes to come …
Already planning to be downtown for the Farmer’s Market or Kids’ in the Rotunda? You’ll be right near our party! Stop in! Free parking is provided to our guests in the ramp under our clinic.
We hope to see you there!
You have a spot on your mammogram. You have breast cancer.
No two sentences can strike more fear in a woman than those above. Sometimes that fear prevents a woman from actually getting a mammogram in the first place. Yet we know that diagnosing a breast cancer early with a screening mammogram helps with treatment options, surgery and an eventual cure.
Breast cancer is treatable and curable most of the time, especially when it is small and found early. Sometimes the mammogram will find a cancer so early that it is not even physically noticeable to the woman or her doctor. Most breast cancers will occur after age 50 (postmenopausal) and are not genetically associated. The recommendation is to start mammograms at age 40 and repeat every two years until age 50. Then you should obtain yearly mammograms after that. If there is a strong family history of breast cancer, then it is recommended to start yearly mammograms at age 35.
Some women are afraid of the radiation from a mammogram – but rest assured that a mammogram is now digital and even with extra imaging it has minimal radiation risk.
So, I encourage you to get your mammogram as recommended. An abnormal mammogram, or even a palpable lump, will lead to a biopsy, but most biopsies (>85%) are benign! Whew.
The Breast Team at Meriter-UnityPoint Health includes screening mammography at Meriter Monona, diagnostic mammogram and possible biopsy as needed at 1 S. Park UW Breast Center radiologists, Meriter Medical Group Surgical Consult as necessary and reconstruction consultation with Reconstructive Plastic Surgery at Meriter Monona. We work closely with the UW Oncologists making the process seamless.
As a plastic surgeon, I have the privilege of treating women who suffer from breast cancer, a potentially life-threatening disease that is becoming all too common. After the general surgeon completes the cancer removal operation, I am tasked with the job of restoring patients with an appearance that is natural. I believe that my best result is the one that patients barely notice because there is such a small difference between their body before and after cancer.
The most important thing to me as a reconstructive surgeon is for patients with breast cancer to know that there are reconstructive options. Even in a country like the United States, less than 50 percent of women are counseled regarding their reconstructive options before undergoing surgery.
Reconstructive options begin for women that are undergoing a “lumpectomy” procedure or a procedure where the cancer is completely removed but the remainder of the breast is left intact. Occasionally, these operations may result in a deformity that can be corrected or improved with reconstructive surgery. Also, many patients are surprised to learn that in cases where the cancer is only on one side, the opposite breast (without cancer) can be reduced or reconstructed in an effort to restore symmetry between the two sides.
For patients who are undergoing a mastectomy for their cancer treatment, the reconstructive options are broad, and even patients who have decided against reconstruction may benefit. As described above, if a patient has their breast removed on one side, a breast reduction on the opposite, non-cancer, side may help patients fit into clothes better and feel less unbalanced after their mastectomy operation.
Patients that pursue reconstruction have options that fall into three categories: using the patient’s own tissue, using breast implants or a combination of both. When patients decide to use their own tissue, it typically comes from the abdomen. The skin, fat and muscle from the abdomen can be used to reconstruct one or both breasts in a procedure called a TRAM flap operation. In recent years, a procedure that spares the muscle and just uses skin and fat, called a DIEP flap operation, has gained in popularity, and it is one we are proud to offer at Meriter Hospital. For patients who pursue reconstruction with breast implants, this reconstruction typically begins by placing an inflatable implant at the time of the mastectomy. Over a period of several weeks after surgery, this implant is inflated in the plastic surgery office, restoring the dimensions of the original breast pocket and creating a space for a permanent implant that is placed in the second stage of reconstruction. Finally, in some patients who cannot have reconstruction using their abdominal tissue, a procedure that combines both the patient’s own tissue and the use of an implant is available where an implant is placed and is covered using skin, fat and muscle from the patient’s back.
It is important to emphasize that there is no reconstructive option that is “better” or “worse.” Every patient is different, and the plastic surgeon helps patients pursue an option that is best suited for her body and the desires she has for her own reconstruction. Similarly, while there are many reconstructive options available, it is also important to recognize that not every option is available for every patient. The patient’s weight, breast size, whether or not they have had radiation therapy and even previous surgical history may have an impact on the type of reconstruction that is best for her. Finally, if a patient has been treated for breast cancer in the past but did not pursue or was not offered reconstruction at the time and has now become interested, she still has options available to pursue after a “delay” in reconstructive treatment. It is as simple as setting up an appointment with a plastic surgeon to discuss these options.
One of the first plastic surgeons in history described our specialty as one that “restores and makes whole.” This goal holds true today, especially in my practice as I have the privilege of treating women who suffer from breast cancer.
The PA of the Year award annually honors an outstanding physician assistant who demonstrates excellence in service to patients and the community, promotes awareness of the PA’s role in healthcare to the general public, and bolsters workforce development by educating potential future PAs.
A certified wound care specialist, Laura started the Wound Care Clinic at Meriter – UnityPoint Health, the region’s only comprehensive wound care program led by certified wound care providers. Laura has a proven record of success caring for a vast array of wounds, from simple to very complex.
She is also a critical part of Meriter’s vascular surgery program as a surgical resident trained PA. She cares for patients in the clinic as well as first assisting in surgery. Many of her patients require enhanced circulation to allow their wounds to heal and benefit from her dual training.
An incredible asset to the organization, we are delighted that she has received this well-deserved nomination. The award recipient will be announced on Thursday, October 9, 2014 as part of the annual WAPA Foundation Awards Banquet in celebration of PA Week.
At some point in our lives, most of us will be personally affected by our own or a loved one’s mental illness. In fact, 1 in 4 adults will experience mental illness in their lifetime.
Depression and anxiety are common, and tend to go hand in hand.
Many people are reluctant to ask for help or are unsure when to ask for help. The good news is that in addition to psychiatrists, primary care providers have the knowledge and experience to address these concerns and do so on a daily basis.
It is generally understood that anxiety and depression can be caused by psychological factors, biochemical factors or some combination of both. Treatment depends on the underlying cause and may include counseling, medications, exercise and a host of holistic practices.
Here is an example. Grief is the normal human reaction to loss. This may be due to the death of a loved one, divorce or separation from a partner. Mourning and the passage of time are what’s needed for the healing that may take months or sometimes years. But we know that about 25 percent of people will go on to develop what we call a major depression.
So what’s the difference?
Grief involves intense sadness, it is very painful, but it makes sense and does not include a loss of self esteem.
Major depression on the other hand often involves significant sleep disturbance, especially early morning awakening, loss of interest in usual activities, erosion of self esteem, anxiety, agitation or even thoughts of suicide.
What else causes depression and anxiety?
We are still learning but much is known: Family genetics, naturally sad or very stressful events that we don’t bounce back from, biochemical changes and a history of abuse or trauma may all contribute.
We may put off care for months believing that we ought to be able to just buck up and tough it out. Well meaning friends or family may say things to discourage us from taking a medication or seeing a counselor.
When depression takes hold we naturally escalate caffeine use, which at first acts as a mild antidepressant, but when caffeine exceeds 250 mg a day (6 oz coffee =125 mg, caffeinated 12 oz soda 50 mg, Black tea 50 mg ,Energy drink 12 oz 200 mg, choc bar 20mg) or is consumed later in the day it can reduce the amount of time spent in deep restorative sleep and inadvertently worsen depression.
We may unconsciously self medicate with alcohol. Alcohol increases the neurotransmitter Serotonin in our brains and we temporarily feel better, but the net affect is increasing depression.
Be on the look out for these signs of depression and anxiety:
Losing pleasure in simple things, feeling irritable, crying, sleeping more, hardly sleeping at all, or worst of all, believing life is no longer worth living.
If you recognize these signs in yourself or a loved one I hope you will seek help. Every primary care provider at Meriter can help you get started on a path to feeling better. Please don’t wait.
September is National Suicide Awareness Month. Join us on Oct. 5 for NAMI Walks at Olin Turville park.
Did you know that Wisconsin is a national leader in fall-prevention research and that the state’s Aging and Public Health networks are leaders in providing evidence-based, fall-prevention programs to older citizens? A reduction in disability and death due to falls for older adults is a priority of the State Health Plan, which is known as “Healthiest Wisconsin 2020.” Wisconsin joins the National Council on Aging’s Fall Prevention Day and Month awareness effort to be “Strong Today, Falls-Free Tomorrow.”
Why is this so important? More than one-third of people age 65 and older fall each year, and falls are a leading cause of injury and hospitalization for seniors. Roughly 20-30 percent of people who fall suffer moderate to serious injuries such as head trauma or hip fracture. Even when no injury occurs after a fall, many people become less active and experience reduced mobility due to fear.
As a partner in statewide efforts to help older citizens remain injury free from falls, Meriter — UnityPoint Health supports a community-based approach to fall reduction. The Stepping On Falls Prevention Program will be provided at the Meriter Monona clinic beginning October 2 and runs for seven weeks through November 13. Stepping On empowers older adults to carry out health behaviors that reduce the risk of falls.
At Stepping On classes, seniors learn balance and strength training. The program covers fall prevention both inside the home and while out in the community. It also teaches participants how to remove hazards from the home environment. Participants also learn about the role vision plays in maintaining balance, how to select safe footwear, and they will gain understanding of how medication can contribute to falls.
Classes are highly participatory and provided in an atmosphere of mutual support which helps to build confidence in the ability to manage health behaviors to reduce fall risks. The goal of the program is to assist individuals in maintaining active, fulfilling lives.
You or someone you care about may benefit from this program–your parents, grandparents or neighbors.
More information about this community-based workshop is available by visiting meriter.com/classes or calling Stephanie Erickson-Brown at (608) 417-8273.
Regular exercise is one of the key components to living a happy and healthy lifestyle. Unfortunately developing a consistent routine can be difficult and often time injuries provide an additional barrier to starting or sustaining a successful exercise program.
Meriter in-conjunction with Harbor Athletic club, is excited to offer a new exercise program opportunity for the community. Finding Fitness After 40 is a class designed for adults who have not participated in a regular exercise program in the past, or for individuals that may have stopped exercising due to an injury or health concerns.
The goal of this class is to provide participants with a basic foundation for successful exercise and exposure to alternative modes of exercise through a combination of lecture and guided exercise instruction. In addition, all participants will receive a FREE 1 month membership to Harbor Athletic Club for the duration of the class. Space is limited to 20 participants, so sign up today and get started on the path to health and happiness.
Date: Thursday October 16 through Thursday November 13 (No Class on Thursday 10/30)
Time: 5:50 to 7:30 PM
Location: The class will meet each night at the Meriter Therapy Middleton (behind the Harbor Athletic Club) for the lecture components and then transition over to Harbor Athletic Club for the guided exercise instruction
Parking – please utilize the Meriter Therapy Middleton parking spaces
What to Wear:
• The class will include 30-40 minutes of guided exercise each night so please where loose, comfortable close and athletic shoes.
• You may want to bring a water bottle and towel
Did you know that flu activity can begin as early as October and occur as late as May? According to the Centers for Disease Control, the timing of the flu is very unpredictable and can vary from season to season. It is recommended that everyone 6 months and older get the flu vaccine.
Are you unsure about getting the flu vaccine? Read the five reasons below to help you decide if you should get the flu vaccine this year.
- Keeps you from getting sick. The flu vaccine can help keep you from getting sick from influenza. Symptoms of influenza can be quite severe and lead to sick days with loss of work. It sometimes can take weeks to get your stamina back.
- Makes the illness milder. The flu vaccine can make the illness much milder if you do get sick with influenza.
- Protects others around you. In protecting yourself by getting the vaccine, you also help protect those around you.
- Protects people who are at a greater risk of serious illness. The flu vaccine is very important in helping protect people who are at greatest risk of getting seriously ill from influenza. This includes children, pregnant women, those with chronic medical conditions and older adults.
- Prevents serious complications. The flu vaccine can help prevent serious influenza complications including hospitalizations and deaths.
Meriter – UnityPoint Health’s Stepping On Program empowers older adults to carry out health behaviors that reduce the risk of falls. This community-based workshop is offered once a week for 7 weeks using adult education and self-efficacy principles. In this small-group setting, older adults will learn balance exercises and develop specific knowledge and skills to prevent falls.
Older adults who are encouraged to join this program are those who:
– Are at risk of falling
– Have a fear of falling
– Who have fallen one or more times
Location: Meriter Monona Clinic
Dates: Thursdays from October 2 to November 13
Time: 9:30 a.m. to 11:30 a.m. (October 23 class will be from 9:00 a.m. to 10:30 a.m.)Cost: $35 per person
Registration: Contact Krista Spiro by phone at (608) 417-8272 or by email at email@example.com.
To learn more, please visit meriter.com/classes.