Dr. Dana Johnson: With Possible Concussions, It’s Better to Sit Out

Featured in the Wisconsin State Journal on September 5, 2013.

Dear Dr. Johnson:
How do I know if my child has a concussion?

Dear Reader: Concussions have been in the news a lot lately. There has been more focus on the long-term effects for professional athletes especially NFL football players. Fortunately, there has also been more focus on younger athletes and concussions. A child or adolescent’s brain is more susceptible to injury as it is still developing.

A concussion is any injury to the brain that disrupts normal brain function. They are typically caused by a blow or jolt to the head. While usually the head is impacted, it doesn’t have to be. A jerking motion that causes the head to come to an abrupt stop can also result in a concussion. The blow also doesn’t have to be to the scalp region. Hits to the face and neck can also result in a concussion.

Concussions cannot be diagnosed just by the type of hit or injury. Two children can suffer very similar blows to the head. One may have a concussion and the other not. Most of the time those that have concussions were not knocked out or unconscious.

There is not an imaging test (X-ray, CT scan, MRI, etc.) that can reliably diagnose a concussion. The diagnosis is based upon the signs and symptoms the person is having.

Common symptoms of a concussion are:

• Headache
• Nausea and/or vomiting
• Dizziness, lightheadness, or balance problems
• Changes in vision (often double or blurry)
• Sensitivity to light and/or sound
• Feeling dazed, stunned, foggy or just “off”
• Difficulty concentrating or remembering
• Confusion
• Forgetfulness
• Difficulty with school work
• Changes in mood – more irritable or emotional
• Drowsiness
• Sleeping more or less

If a concussion is suspected, the individual should be removed from play and should visit a doctor to confirm the diagnosis and determine when it’s safe for an individual to return to activity. All concussions are serious. If a second concussion is suffered before fully recovering from the first, permanent brain damage and even death can occur.

The treatment for concussions is physical and mental rest. Some children need to stay at home from school for a period of time with gradual return. Video games, television and other mentally stimulating activities should also be avoided. Once symptoms have resolved and a doctor has cleared the individual, a stepwise return to physical activity is recommended.

If symptoms recur at any point, activity should be stopped as this is an indication that the brain has not fully healed. A computer based test is sometimes used to further evaluation if mental function has returned to baseline. The most common test used in Madison is the ImPACT test. This test is most valuable if the individual took a baseline test prior to ever having a concussion for comparison.

Once an individual has suffered a concussion, they may be more susceptible to another one in the future.

“When in Doubt, Sit Them Out!”

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Meriter Helps Quintuplets Reunite

Meriter hosted a very special family reunion over the weekend as a set of quintuplets met their whole family for the first time.

Local couple Cassie and Frank Vanderwall had five babies at a hospital in Arizona last month. Mom, Cassie stayed in Arizona with the babies and Frank traveled back and forth. As the babies grew stronger, they were transfered to Meriter NICU. Over the weekend, the whole family was reunited at Meriter, including a first meeting with grandparents and great grandparents.

A big THANK YOU to all of our hardworking NICU staff for making the family’s transition back to Madison as smooth as possible and taking excellent care of our tiny patients as they grow stronger each day.

Click here to watch WKOW’s story about how these four girls and one baby boy made their way to Meriter.

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Back-to-School Advice

Dr. Kathryn Cahill of the Meriter West Washington clinic gave back-to-school advice on WKOW’s Wake Up Wisconsin.

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Meriter Patient Beating Diabetes

originally published on Fox47.com

Watch the Fox47 Story

MADISON- Diabetes is a growing problem in the US. More than 25.8 million adults and children are living with diabetes, while more than 7 million of those are undiagnosed.

A local retired cop is one of those living with diabetes while proving you can take control of your health.

Phil little says he’s 74, but you’d never know it looking at him. He’s turned his life around after realizing there wasn’t any choice but to get up and take control of his life. He’s retired UW Police, Chief of Police of Shorewood Hills and a Chief Deputy Coroner position. After learning he was living with diabetes he now spends his days working out.

“I was up to 320 pounds and every time I would walk somewhere, I would have to stop and catch my breath, no fun at all,” said Little.

Phil progressed during 10 years to needing about 300 units of insulin per day.

“Used to be a day of food, if I went to McDonalds, it would be 2 big macs and 2 quarter pounders with cheese, fries, perhaps,” said Little.

Little said he was also a peanut butteraholic, going through a large jar of peanut butter a week

Now, he’s watching what he eats and eating a lot more fruits and vegetables for fillers, cereals, just watching what he eats and learning about portions.

He’s down 66 pounds in just13 months and plans to continue on. Most importantly, he’s turning around his health.

“In the process of losing this weight, I am now off all diabetic medication,” said Little. “So, I’m a diabetic, but it’s controlled by diet.”

Dr. Gerhard Kraske, an internist at Meriter Health said Phil took the right route.

“Alot of people when they first hear the diagnosis, the first thing that comes to mind is shots and insulin and that’s not necessarily so,” said Dr. Kraske.

Dr. Kraske said American Diabetes Association guidelines recommend trying to get the patient to lose weight with the help of a nutritionist.

“I try to tell them this is not a death sentence, this is a wake-up call to a healthier lifestyle. “It entails eating better, watching portion size, exercising, losing weight, we can come to grips with this condition.”

The ADA estimates 79 million people are living with prediabetes. Dr. Kraske sais doctors need to do a better job screening for diabetes.

Dr. Kraske estimates by the time doctors pick up a diabetic, they actually already lived with diabetes for about 10 years.

Little said he was one of those who didn’t know he was living with diabetes, but after all his hard work.he hopes to never go back.

“The penalty of going back is still fresh in my mind from what I experienced, and I don’t think I ever will, but you never know.”

The Diabetes Step-Out Walk is August 25th. It’s not too late to join. Register to walk on a team or as an individual or donate as a virtual walker.

Register at diabetes.org/slashmadisonstepout

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Healthy Back-to-School Snacks

Recipes recommended by Dietitian Krista Kohls and featured on WISC-TV.

No-Bake Energy Bites

 Makes about 20-25 balls

Ingredients

  • 1 cup (dry) oatmeal (I used old-fashioned oats)
  • 2/3 cup toasted coconut flakes
  • 1/2 cup peanut butter or almond butter or soynut butter
  • 1/2 cup ground flaxseed or wheat germ
  • 1/2 cup chocolate chips or cacao nibs or ½ cup craisins or raisins (optional)
  • 1/3 cup honey or maple syrup
  • 1 Tbsp. chia seeds (optional)
  • 1 tsp. vanilla extract

Directions:

  1. Stir all ingredients together in a medium bowl until thoroughly mixed. Cover and let chill in the refrigerator for half an hour.
  2.  Once chilled, roll into balls of whatever size you would like. (Mine were about 1″ in diameter.) Store in an airtight container and keep refrigerated for up to 1 week.

Compliments of gimmesomeoven.com

Roasted Honey Cinnamon Chickpeas

Makes about 4 servings

 Ingredients:

  • 15-ounce can organic garbanzo beans
  • 1/2 tablespoon olive oil
  • 1 tablespoon honey
  • 1/2 teaspoon cinnamon
  • 1/8 teaspoon nutmeg
  • 1/8 teaspoon sea salt
  1.  Preheat oven to 375 °F. Line a baking sheet with parchment paper or a Silpat silicone mat.
  2. Drain and rinse the chickpeas in a colander. Place them on a towel to dry off.
  3. Spread chickpeas on a baking sheet in a single layer. Bake for approximately 45 minutes or until crispy. Test one, and if it’s still soft, bake for longer
  4. While the chickpeas are still hot, toss them in a bowl with the oil, honey, cinnamon, nutmeg, and salt. Enjoy as is or for a caramelized effect, place them back in the oven for another 10 minutes or so.
  5. Store leftover chickpeas in an airtight container.

 Compliments of Modern Parents, Messy Kids

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Welcome Dr. David Daiga

The Meriter Medical Group would like to welcome David Daiga, MD to the Meriter Specialty Clinic. He is the third Neurologist on staff, joining Dr. Ross Levine and Dr. Stephanie Rothman.

Dr. Daiga was always drawn to the fields of science and medicine. During his residency, he found that neurology was both interesting and logical. The field blended his love of science and problem solving. Dr. Daiga’s medical specialty encompasses general neurology, including headaches, stroke/TIA, Parkinson’s disease, tremors and other movement disorders, epileptic seizures, multiple sclerosis, memory loss, spinal cord injury, and dizziness. He has a special interest in peripheral neurology, including neuropathy, myopathy, neuromuscular junction disorders (i.e. myasthenia gravis), and motorneuronopathy (i.e. ALS). 

Dr. Daiga’s patients find him to be both easy to work with and easy to understand thanks to his excellent communication skills, use of common terminology and ability to relay information to family members. He takes the time to listen to his patients and explain their condition until they thoroughly understand the diagnosis and treatment options. He cares for his patients both physically and also emotionally. He builds a relationship of open communications with his patients so they can mutually work towards a positive solution.

Please join Meriter in welcoming Dr. Daiga!

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Gallbladder Removal Through the Belly Button

Meriter is proud to announce its entire Meriter Medical Group General Surgery team now offers a single-incision approach to gallbladder surgery. Dr. Susan Toth, Dr. Kenneth Foster and Dr. Daniel Mansfield are the only surgeons offering single-site surgery in the Madison area.

What is single-incision gallbladder surgery? Watch Dr. Toth explain in the video below.

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Donate to the Community Blanket and Diaper Drive

Meriter is pleased to host a Community Blanket and Diaper Drive from August 1–31 in partnership with the UW’s Department of Obstetrics and Gynecology (OBGYN). The Healthy Women, Healthy Babies Fund actively works with women of all ages and communicate the importance of a healthy lifestyle.

Make a Donation
New diapers and new and gently used blankets can be dropped off at the following locations in the Madison area:

Meriter Hospital
Meriter DeForest-Windsor
Meriter McKee
Meriter Monona
UW Hospital and Clinics
UW Health 20 S. Park Clinic
UW Health East Clinic
UW Health East Towne Clinic
UW Health Fitchburg Clinic
UW Health West Clinic
UW Health West Towne Clinic

This year, we are introducing a new opportunity for the community to be able to donate online to the blanket and diaper drive.

Donate online to the blanket and diaper drive

The dollars raised will be used to purchase additional diapers and blankets for:

• South Madison Health and Family Center
• Wisconsin Women’s Health Foundation First Breath Program
• March of Dimes

Thank you for supporting the Healthy Women, Healthy Babies Fund.

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Yoga is in Full Bloom

The wholesome benefits of this ancient health practice are found in scientific journals, fitness periodicals and wellness magazines. But the stated advantages are true.

With few exceptions, yoga is healthy for every one of every shape, size and fitness level. Yoga is good for balance, flexibility, strengthening, and stress reduction. It can help with controlling weight, lowering blood pressure, improving sleep and enhancing mood.

Yoga poses encourage the natural range of motion that the body is designed to do.  You move slowly, allowing your body to lead.  Yoga is not a hard-driving, gym-like experience. There is no pushing yourself or comparing what you do with the person on the mat beside you. Yoga is a personal experience. The only expectation is that you move within your own level of comfort. Modifications of the poses allow you to maximize the stretch, enjoy the exercise and leave the session refreshed and re-energized.  Simply put, yoga doesn’t discriminate – it helps everyone to feel vital and rejuvenated.

Meriter offers a variety of yoga classes because we believe that getting healthier and stronger and can begin with only 45 minutes a week.

Below is the list of our current class options. Each yoga program is scheduled as a 4 week class, offered consecutively throughout the year.
Yoga Basics – Wednesdays, 10:30 – 11:15 am, Meriter Wellness Center, 2501 W. Beltline Hwy, Suite 207 (the corner of Todd Drive)

Yoga Basics at Noon – Wednesdays, 11:45 am – 12:30 pm, Meriter Business Center, 2650 Novation Parkway (off Rimrock Road) 

Mom & Baby Yoga – Wednesdays, 10:30 – 11:15 am, Meriter Business Center

Prenatal Yoga – Fridays, 12:00 – 12:45 pm, Meriter Business Center

To register, visit meriter.com/classes, or call the Women’s Health Education Department at 608.417.8446. These classes are reimbursable through Physicians Plus and Unity.

Sincerely,
Tish Lafferty, RN, MSN
Coordinator and Nurse Educator
Women’s Health Education

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Six Reasons to Go Soda Free

As the days get warmer, we often find ourselves reaching for a nice cold beverage.  For many of us, that is often a soda. Did you know that soda is the no. 1 source of added sugar in the American diet? Did you know that drinking just one soda per day means over the course of a year you will have ingested over 35 pounds of sugar? Have you ever considered the effects that drinking soda has on your body? For example:

  1. Dehydration. Because caffeine is a diuretic, it leads to an increase in urine volume. So, when you drink a caffeinated soda to quench your thirst, you will actually become thirstier.
  2. High calories. A can of regular cola contains over 150 calories. Not only are these calories devoid of any nutritional value, but they also deplete your body of vital nutrients
  3. Caffeine addiction. Researchers at Johns Hopkins University state when people don’t get their usual dose of caffeine; they can suffer a range of withdrawal symptoms including headache, fatigue, muscle pain and inability to concentrate.
  4. Acid=Tooth Decay. The amount of acid in soda is enough to wear away at the enamel of your teeth, making them more susceptible to decay. In tests done on the acidity levels of soda, certain ones were found to have pH levels as low as 2.5. To put that into perspective, consider that battery acid has a pH of 1 and pure water has a pH of 7.
  5. Mineral depletion. Colas contain phosphoric acid and caffeine, which drain calcium from the bones. Also, because caffeine increases urine volume, more minerals end up leaving the body before having a chance to be properly absorbed.
  6. Acid reflux. The carbonation can react harshly with the stomach, causing distension. The feeling is painful until the air is released.

And have you considered what ingredients are in your soda?

  • Brominated Vegetable Oil (BVO). Mountain Dew, Fresca and other citrus-flavored soda contain BVO which has been banned in over 100 countries, but not in the US. Studies show that BVO, which is a flame retardant, can cause damage to the heart and other muscles, liver damage, neurological conditions, memory loss, skin lesions and more.
  • High-Fructose Corn Syrup. Many sodas are sweetened with high-fructose corn syrup, a heart harming, man-made compound derived mainly from genetically engineered corn.  Long term effects of high-fructose corn syrup and genetically engineered foods are just starting to be known.
  • Artificial sweeteners. Many people opt for diet sodas to cut out the calories, but some research shows the sweeteners may cause additional harm, such as cancer, while others dispute any risk. The jury is still out.

Consider pledging to reduce or eliminate soda from your daily choices this summer. Try pledging with your family or coworkers for added support.  Track your soda consumption for the next month on a calendar.  Write your goal on the calendar related to reducing or eliminating soda, just remember to be specific: only 1 soda per day/week/month, no soda or reduce consumption by half each week. Put the calendar somewhere you will see it often to remind yourself to choose your beverages wisely.  Each time you have a soda, mark the calendar. If you indulge in a soda, don’t give up, but be mindful of what triggered your choice or got you off track.

Plan ahead to make sure you have plenty of non-soda beverages on hand at home, on the road and at work. Try to keep a refillable water bottle close by at all times to remind you to keep swigging! Here are some simple beverages to keep on hand for soda substitutes:

  • Infused water-spice up your plain tap water with fruits, herbs and veggies! Try pairing watermelon and basil, or lemon, mint and cucumber, the possibilities are endless.
  • Juice or vinegar spritzers-Try mixing 1 part 100% fruit juice or fruit vinegar with 3 parts seltzer water for an easy homemade soda!
  • Infused iced teas-for variety, try different teas: green, black, white and add slices of lemon or orange for an added kick!
  • Milk and milk alternatives-try almond or coconut milk for a light, refreshing treat

Cheers to your health and wellness!

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Dr. Dana Johnson: Road Trips

Published in the Wisconsin State Journal on July 25, 2013

Dear Dr. Johnson: My family is planning a road trip for later this summer. What can I do to make it more enjoyable for my 3-year-old and myself?

Dear Reader: Many families choose to travel during the summer, whether to explore new places, visit family or return to the annual vacation spot. With my son’s closest grandparents being a 10-hour drive away, we have gone on long road trips since he was an infant. I have learned a few tips and tricks over the years.

Safety should always be first. Children need to be in age-appropriate car seats and buckled in at all times. If they need to come out of the car seat for any reason, it’s time for a stop at a rest area, gas station or restaurant.

All older children, adolescents and adults should use seat belts. The driver should be well-rested and distractions should be limited.

Have realistic expectations for children. If your toddler has never been in a car for more than 20 minutes, a 12-hour car ride may not be the best first road trip. A shorter trip might be more ideal.

It is best to have two or more adults when traveling with young children — one adult to drive and the other to entertain and meet the child’s needs.

Expect to take breaks. Whether a year old or 10 years old, children need breaks from the car and opportunities to stretch their legs. The younger my son was, the longer the trip took due to the number and length of pit stops.

A good rule of thumb is one stop every two hours. We have become very familiar with most of the rest areas between Madison and my parents’ home. Tree tag is a favorite way for all of us to exercise our travel-weary bodies (the trees are “safe”). We took a football on our most recent trip and played a modified version of two-hand-touch football.

If possible, bring some healthy snacks. A day of eating nothing but fast food can make the body feel even worse.

Bring entertainment — coloring books, books to read, toys, activities and movies. Whether it’s on a portable DVD player or a tablet loaded with movies, a film can keep some children entertained for a couple of hours.

Remember the road games you played as a kid or look for a few ideas online. Point out interesting sights along the way. A young child may find cows along the road entertaining. We’ve counted semi trucks, played the alphabet game (find each letter of the alphabet on signs), looked for license plates from various states and numerous other games.

Expect to have some complaining or crying from smaller children and to hear “are we there yet?” from older children. If crossing multiple states, you can talk with older children about the order of states you will go through so they can gauge how close you are getting to your destination. You could also do this with large cities. If your child is particularly interested, giving them a map so they can follow the route may be entertaining.

Traveling with children can be challenging but also fun. I hope you have a safe and enjoyable trip!

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Meriter Named Most Wired 2013

For the third consecutive year, Meriter is proud to announce it’s been named “Most Wired” by Hospitals & Health Networks magazine (H&HN).

The magazine partners with the American Hospital Association, the College of Healthcare Information Management Executives (CHIME), AT&T, and McKesson to review hospitals between January and March of each year regarding their health IT initiatives.  Hospitals are evaluated in four categories: infrastructure, business & administrative management, clinical quality & safety and clinical integration.

More than 1,700 hospitals were surveyed, but less than 300 were recognized for successfully planning and implementing information technology. Additional honors were given to 25 small, rural hospitals, as well as 25 hospitals in the most improved category.

This award is a tribute to Meriter’s hard-working IT leaders and staff, along with our engaged clinical staff and physicians who adopt technology to improve the delivery of care.  We will continue our efforts as a system to improve the services we provide our patients through the thoughtful and appropriate use of health IT.

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Dr. Felz Discusses the ADA Walk on WKOW

Dr. Ken Felz discussed Meriter and Physicians Plus’ involvement in the American Diabetes Association’s Step Out Walk to Stop Diabetes on WKOW’s Wake Up Wisconsin.

Click here to watch the interview.

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Donate to Dr. Stanley Phillips III Memorial Fund

 

The Meriter Foundation has created a fund in honor of Dr. Stanley  Phillips III, a neonatology fellow who tragically passed away after an accident involving a NICU transport ambulance. The Dr. Phillips Memorial Fund will sustain his values by supporting a neonatology lecture/conference to improve the care of our tiniest patients and to support the hardworking NICU staff.

To donate to the Dr. Stanley Phillips III Memorial Fund, please click here.

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Meriter McKee Welcomes Dr. McGowan

Meriter McKee is pleased to announce that Meghan McGowan has joined the team. Dr. McGowan specialty is obstetrics and gynecology. Meriter now offers OB/GYN services at three clinics: Meriter McKee, Meriter Monona and Meriter DeForest-Windsor.

Dr. McGowan has always been passionate about women’s health and enjoys working with women of all ages. The broad field of OB/GYN allows her to manage a variety of issues including low- and high-risk pregnancies, annual exams, cervical cancer screening, menopause symptoms and sexual dysfunction. She has special interest in minimally invasive surgery and is a trained robotic surgeon. 

Away from the clinic and hospital, Dr. McGowan is a classically trained violinist and a bluegrass fiddle champion. When time allows, she enjoys playing the violin, cooking, biking and especially spending time with her young family.

Dr. McGowan is currently accepting new patients. To schedule an appointment, call the clinic at 608.417.8800 or learn more at meriter.com/doctors.

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Attend our Injury Clinic for Runners

You have the opportunity to meet with a sports medicine professional to evaluate your running related injuries. If you are having a problem that limits your training, now is the time to address it so you can reach those racing goals! Sign up for a 20 minute session and receive:

- Musculoskeletal screen
- Running assessment
- Individual program of corrective exercises

Date: July 31
Location: Meriter Therapy Middleton, 2521 Allen Blvd. Middleton, WI 53562
Cost: $25 and space is limited

Register today

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Buttermilk Chicken Kebabs with Chopped Salad

Adapted from EveryDay with Rachael Ray

Makes 4 servings

Prep: 25 minutes

Cook: 15 minutes

 Ingredients:

  • 2/3 cup low-fat buttermilk (you can also use 2/3 cup skim/1% milk mixed with 2 teaspoons vinegar)
  • 3 tablespoons olive oil
  • 1 tablespoon chopped fresh thyme
  • Zest of 1 lemon, plus 3 tbsp. juice
  • Salt and pepper
  • 1 ½ pounds boneless, skinless chicken breasts, cut into 1 1/2-inch pieces
  • 1 head romaine (or any other type of greens you have on hand), cut into 1-inch pieces
  • 1 large cucumber, halved lengthwise, seeded and sliced 1/2 inch thick
  • 1/2 small red onion (or you could use green onions), thinly sliced
  • 1 cup red grapes, halved
  • 3-4 salad turnips, cut-up (optional)

 

Directions:

1. Preheat a grill or grill pan to medium-high.

2. In a small bowl, mix buttermilk, olive oil, thyme, lemon zest and juice; season with salt and pepper. In a medium bowl, toss the chicken with half of the buttermilk mixture.

3. Thread chicken onto 8 skewers. Grill, turning frequently, until cooked through and browned in spots, 13 to 15 minutes.

4. In a large bowl, toss together the romaine, cucumber, onion and grapes. Drizzle with the remaining buttermilk mixture; season. Serve the salad with the kebabs

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Dr. Byfield Talks Chronic Pain on NBC15

Dr. Gretchen Byfield visited NBC15 to talk about how Meriter helps patients dealing with chronic pain. She was joined by Hayley Weaver, who became a patient at Meriter after a car accident when she was a teenager and is now a student of Dr. Byfield.

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Meriter Shines in Patient Experience Survey

Meriter Medical Group provides one of the best patient experiences in the state, according to a new report from the Wisconsin Collaborative for Healthcare Quality (WCHQ).

Meriter Monona

Meriter Monona

“At Meriter, we strive to make sure each patient and their family receives the best possible care on every level,” said Dr. Pam Wetzel, Senior Medical Director of Meriter Medical Group. “It’s not only about clinical excellence; it’s about making sure we’re taking care of the whole person and being a trusted partner in their care.”

Meriter Medical Group, a group of more than 120 specialty and primary physicians who practice at Meriter Hospital and clinics, was ranked first or second in the state in every category measured.  It was the only medical group in Wisconsin to consistently rank so highly.

  • Follow-up on test results-96.0% (Highest reported score in the state)
  • Willingness to recommend-93.7% (Highest reported score in the state)
  • Getting timely appointments, care & information-77.4% (Highest reported score in the state)
  • How well providers communicate-92.7% (Second highest reported score in the state)
  • Helpful, courteous and respectful office staff-94.7% (Second highest reported score in the state)
  • Rating the provider “9” or “10” on a 0-10 scale-85.1% (Second highest reported score in the state)

The data was collected from patient responses to surveys in an outpatient setting.  Scores indicate the percentage of patients who reported the best possible experience in each category, using the Clinician & Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey about the patients’ most recent visit to their provider. The full report can be found on www.wchq.org.

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Dr. Dana Johnson: How Can I Prevent My Child from Getting Mosquito Bites?

Originally published June 27, 2013, in the Wisconsin State Journal. Dr. Dana Johnson is a pediatrician at the Meriter McKee clinic.

Dear Dr. Johnson: How can I prevent my child from getting mosquito bites?

Dr. Johnson

Dr. Johnson, Pediatrician, Meriter McKee

Dear Reader: It is that time of year. According to expert predictions, mosquitoes will be worse this year given the mild temperatures and all the wet weather. How to avoid the pesky insects and their itchy bites has been a frequent topic of discussion in the clinic recently. While I have discussed this topic before, I thought sharing it again might be helpful.

Children are especially vulnerable to insect bites. They may be too young to let you know they are being bitten or they may be playing too hard to be aware of it. Many young children also will have a more profound reaction to mosquito bites, with redness and swelling. They also are more likely to scratch the bite, which can introduce bacteria under the skin and cause an infection.

So do I recommend keeping your child inside to avoid these pesky critters? Quite the contrary. While it might be best with very small children to avoid being out at sunrise and sunset, when mosquitoes tend to be the worst, I recommend playing outside as much as possible. But take steps to be sure you and your child are less appealing to the mosquitoes and other biting insects looking for dinner.

There are many products marketed to repel mosquitoes. While some may be beneficial, the products containing the chemical DEET have proven to be the most effective. The percent of DEET correlates to the duration of protection. Products with about 10 percent DEET provide about two hours of protection. Products with 20 percent DEET would provide about four hours of protection. However, more than 30 percent DEET has not been shown to provide additional protection.

Bug spray should mainly be applied to clothing and shoes, with a small amount to the skin. Avoid spraying directly on the face. You can spray it on your hands and then rub in on your child’s face. Do not apply to anything that may go in the mouth, such as a child’s hands. If your child is in a stroller, spray the stroller.

A few words of caution: Do not use bug sprays on infants under 2 months of age. Young children should not be allowed to apply their own bug spray. And try to avoid inhaling the bug spray.

Also, do not use combination sunscreen and bug spray products, as sunscreen needs to be reapplied frequently and bug spray does not.

If your child does get bug bites that itch, topical over-the-counter hydrocortisone ointment can help. For kids over age 2, oral diphenhydramine (Benadryl) also can help with severe itching. I do not recommend Benadryl ointments or creams, as how much is absorbed through the skin is variable. If the area becomes painful or has increasing redness or thick pus drainage, seek care because it may have become infected.

Have a great summer enjoying the outdoors with hopefully few mosquito bites.

This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Johnson to people submitting questions.

Read more: http://host.madison.com/news/local/ask/dr-johnson/dr-dana-johnson-how-can-i-prevent-my-child-from/article_e48fb5ed-7a98-5941-8c97-b8bc48fa2e23.html#ixzz2XpCNtA2s

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Meriter Encourages Rooming-In

After you deliver your baby at Meriter we recommend “rooming-in.”  This means you keep your baby with you in your private room the whole time you are in the hospital.

This is a healthy choice for families because it lets you care for your new baby.  Rooming-in will help you learn to care for all your baby’s needs while staff is around to help if you need it. This will help you feel more comfortable taking care of your baby once you go home.

When you room-in:

  • You can more easily hold, cuddle, look at, learn to respond to, and get to know your baby
  • Your baby can get to know you more easily
  • Your baby should cry less than babies who are away from their mothers
  • Your baby can learn to breastfeed faster and gain weight sooner
  • You should feel more able to take care of your baby when you go home

Research shows rooming-in has these benefits:

  • Being close to mom makes it easier for babies to get used to life outside the womb
  • When babies feel their mom’s warmth, hear her heart beat and smell her, they feel safe
  • Babies get to know their mom by using their senses. They are able to tell the difference between their mother’s smell and that of another woman by the time they are one to two days old.
  • Baby’s attachment instinct is highest during the first days of life. Early attachment has a positive effect on baby’s brain development.
  • Frequent breastfeeding will help to produce milk and keep up milk supply
  • Rooming in helps babies regulate their body rhythms. This includes heart rate, body temperature and sleep cycle. Nurseries have lights, noise, and other distractions that can interfere with body rhythms.

What you can expect:

  • You and the staff will work together on bonding with your baby, providing care for your baby, keeping your baby warm, and, if you choose, breastfeeding
  • Most tests your baby needs (like hearing screen and lab work) can be done right in your room
  • Most times your baby’s doctor will do any exams needed right in your rooms so you can watch and ask questions you may have  (exams needing special equipment may need to be done in a different room, you can come along if you choose)
  • If your baby will be circumcised (boys only) that will be done in a procedure room, you are welcome to come with your baby if you choose

Your nurse is available to care for your baby outside of your room when necessary:

  • if you are not feeling well
  • if your baby’s condition requires he/she be more closely watched

What else you need to know:

  • You might think you will get less sleep if your baby is with you.  However, studies actually show that mothers get more sleep with their baby in the room.  We encourage that you cuddle often, keeping your diapered baby directly against your skin (called skin to skin) while you are awake.
  • When you are sleeping, we ask that you put the baby in the crib next to your bed to assure the safest sleep for you and your baby

We want this to be the best possible experience for you. If you have any questions, please ask the nurse who is caring for you.  Rooming-in is just a small way to get to know your baby in the very precious first days of life.  It will promote bonding, help you learn about your baby’s behaviors, let you begin to understand what your baby’s noises mean, and see the many things your amazing baby can do.

Sincerely,
Jan McIntosh  BSN, RNC-OB, C-EFM
Nurse Manager

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Meriter Board Member Receives United Way Woman of Year Philanthropy Award

Meriter Health Services (MHS) is proud to announce Meriter Health Services board member Holly Cremer Berkenstadt has been honored with the United Way of Dane County’s Woman of the Year Philanthropy Award.

“Holly exemplifies Meriter’s values of service and excellence,” said Jim Woodward, Meriter Health Services CEO and President. “We are honored to have her as a board member. She is an asset to the community and we can’t congratulate her enough on this award.”

Cremer Berkenstadt has been committed to improving lives in Dane County throughout her lifetime, with an emphasis on causes devoted to helping women.  She currently serves on several boards in the Madison community including Meriter Health Services Board of Directors, the United Way of Dane County Foundation Board of Trustees, DAIS Board of Trustees and DAIS Capital Campaign and Madison Area Technical College Foundation Board of Trustees.

Cremer Berkenstadt received the award at the United Way Women’s Leadership Council Annual Breakfast in late June.

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Healthy Recipe: Chinese Chicken Salad

This is a great salad for those participating in a CSA (Community Supported Agriculture) because it uses lots of veggies that are currently in season. As the summer continues, make adjustments to this salad according to your CSA box.

Recipe is adapted from Barefoot Contessa. Recommended by Krista Kohls, RD, CD, Meriter Registered Dietitian

Makes: 12 servings

Ingredients:
4 split chicken breasts (bone-in, skin-on) or one purchased rotisserie chicken (using edamame instead of chicken is a good substitute to make this salad vegetarian)
Olive oil
Salt
Freshly ground black pepper
1/2 pound asparagus, ends removed, and cut in thirds diagonally
1 red bell pepper, cored and seeded
Salad turnips or radishes cut to bite sized pieces
Chinese cabbage or any type of lettuce
2 scallions
1 tablespoon sesame seeds, toasted (or raw works too)
Cilantro or parsley, handfull, chopped (both are optional)

Dressing:
1/2 cup vegetable or canola oil
1/4 cup apple cider vinegar
3 tablespoons soy sauce
1 1/2 tablespoons dark sesame oil
1/2 tablespoon honey
1 clove garlic, minced
1/2 teaspoon peeled, grated fresh ginger
1/2 tablespoon sesame seeds, toasted (or raw works too)
1/4 cup natural peanut butter
Salt to taste
1/2 teaspoon fresh ground black pepper

Directions:
1. Preheat oven to 350 degrees F.
2. Place the chicken breasts on a sheet pan and rub the skin with olive oil. Sprinkle with some salt and pepper. Roast for 35-40 minutes, until the chicken is cooked. Set aside until cool enough to handle. Remove the meat from the bones, discard the skin, and shred the chicken in large bite-sized pieces.
3. Blanch the asparagus in a pot of boiling water for 3-5 minutes until crisp-tender. Plunge into ice water to stop the cooking. Drain. Cut the peppers in strips about the size of the asparagus pieces. Combine the cut chicken, asparagus, peppers, turnips, cabbage (or lettuce) in a large bowl.
4. Whisk together all of the ingredients for the dressing and pour over the chicken and vegetables. Add the scallions and sesame seeds and season to taste. Serve cold or at room temperature.

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Are allergies bothering your family?

Jeremy Bufford, MD - Allergist & Immunologist

No matter the time of year, we can’t hide from allergens, both indoors and out.  The Asthma and Allergy Foundation of American has ranked Madison the 12th worst city in the nation for those who suffer from allergies.  It’s that time of year for seasonal allergies to outdoor pollens and molds.  Indoor allergens are present year-round and include pets, dust mites, mice, other rodents, molds and cockroaches. Here are some tips to help your family manage seasonal and year-round allergies:

  1. See an allergist to identify your triggers/sensitivities through skin or blood testing.
  2. Limit activities in the early morning hours since pollen counts are usually higher between 5 and 10 AM. 
  3. Keep your windows closed and use your air conditioner, preferably with a good allergen filter.  Keep humidity below 45% in your home.
  4. Take a shower in the evening to rinse off pollens and regularly wash pets that spend time outdoors.
  5. Keep furred pets out of the bed and bedroom, or remove them from the home entirely. 
  6. Consider an air purifier with a HEPA filter in your bedroom.
  7. Encase pillows and mattresses in allergen-proof covers.
  8. Wash sheets in hot water and dry them on high at least weekly.  Don’t hang bed linens outside to dry.
  9. Vacuum carpet weekly and let air settle for at least 30 minutes before returning to the room, or better yet, replace carpet with hard surface flooring.
  10. Clean obviously moldy surfaces, fix any moisture problems, and maintain adequate ventilation.
  11. Keep kitchen clean and don’t leave food lying around.  Keep food in sealed containers.
  12. Use OTC antihistamines, allergy eye drops, and sinus rinses. Use prescription medications including nasal steroid sprays or antihistamine nasal sprays. Consider allergy shots or immunotherapy to reduce your sensitivity to environmental allergens.

For more information, visit the American Academy of Allergy, Asthma and Immunology web site:  www.aaaai.org

To schedule an allergy appointment for an adult or child, please contact any of the clinics below:
Meriter Monona: 417.3000
Meriter Deming Way (Middleton): 417.8388
Meriter DeForest-Windsor: 417.3300

Yours in good health,

Jeremy Bufford, MD
Allergist & Immunologist

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Meriter’s New Children’s Center Becomes Community Benefit

Meriter’s new Children’s Center, on the corner of Mills and Mound Streets, won’t be complete until this fall, but it’s already improving the care of children throughout Madison.

The center, one of only six percent of all child care facilities in the state with a five-star YoungStar rating, just donated dozens of  children’s toys and pieces of equipment to two other child care facilities in Madison  in order to help them achieve their five-star accreditation as well.

 “We are able to offer the best care in the state to our employees and their children,” said Meriter Children’s Center Manager Martha Harrison. “But at the end of the day, Meriter wants all children in our community to have access to that same level of care, especially those who might not otherwise be able to afford it.” 

With her children’s center preparing to move to a new home near around the corner, Harrison began taking stock of the all the equipment and toys the center owned. When it became clear that not everything could make the move and might have to be discarded, Harrison instead worked with a child care accreditor from the city of Madison to find new homes for these items.

The center’s accreditor told Harrison about two other centers in Madison, Sandbox and Precious Moments, which provided great care in low-income areas but were unable to reach the top rating simply because they didn’t have the right supplies. That’s where Meriter stepped in.

“My accreditor put me in touch with Meriter. I informed Meriter of the different items Sandbox required, and they invited me over and told me that I could take anything I needed,” said Angela Ferguson, owner of Sandbox.

Thanks to the donations from Meriter, everything from play kitchens to books to shelving units, Sandbox has reached full accreditation and Precious Moments is going through the accreditation process right now.  This means children in low-income areas of Madison now have access to the highest level of care and for many; it’s even more affordable now.

“I have some parents who don’t qualify for state funding,” said Ferguson. “Because our center is now accredited, they are eligible to receive assistance from the city of Madison to help them pay for childcare.”

Meriter’s mission to minimize waste in the new facility doesn’t stop there.  Drop side cribs that had been recalled will be repurposed as plant supports in a new garden, where children will grow vegetables for their own snacks.  In addition, the Children’s Center will be partnering in Meriter’s CSA program, utilizing unclaimed produce as the foundation for their Friday lunch menu, educating children on the importance of fresh food.    

Two homes on S. Mills Street were demolished in late 2012 to make room for the new Children’s Center, but even those became a community benefit.  Habitat for Humanity ReStore salvaged many items from the two homes, while the Madison Fire Department used both buildings for training exercises.

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