Advance Care Planning 101

By: Jennifer Gotto, Social Worker and Advance Care Planning Facilitator


Advance care planning is one of the best gifts you can give the people you love, and it starts with a conversation.

In honor of National Health Care Decisions Day on April 16, we would like to help you begin the conversation with loved ones about your health care wishes if left unable to communicate due to illness or injury - a process called advance care planning. Many times, families do not talk to each other about their wishes until a medical incident has already happened. As a social worker and advance care planning facilitator, I have seen how this creates very stressful and emotional situations for the patient and their families. 

What is Advance Care Planning?
Advance care planning provides information about your wishes for treatment to your family and health care providers in case illness or injury prevents you from telling them yourself. Indicating your own treatment wishes with advance planning ensures you get the care you intended. When you put these wishes in writing, it is called a Power of Attorney for Health Care. The best time to do this is before a medical crisis occurs. 

Reflect on Your Values
Who you are, what you believe and what you value are all shaped by your experiences. Has anything happened in your past that shaped your feelings about medical treatment? Do you have health issues now? What kinds of activities bring you so much joy that if a health problem prevented you from doing them, life would have little meaning? Reflecting on your experiences will help you clarify your beliefs and decide what is most important to you. 

Choose a Health Care Agent
An important part of planning is to appoint someone to make health care decisions if you are unable to communicate. Many people select a close family member or friend. Advance care planning focuses on not only appointing an agent that is able to carry out your wishes, but also talking with that person and making sure they are willing to serve as your agent and are truly prepared to make decisions for you. 

Some questions you may reference when you are thinking about someone to appoint are: 

  • Are they willing to accept this responsibility?
  • Is this person willing to follow your wishes, even if he or she does not always agree with them?
  • Can this person manage conflict and make decisions in sometimes difficult situations?

If you’d like to learn more ways to start planning, we offer free visits with a trained advance care planning facilitator. At these visits, you will have the opportunity to discuss your treatment preferences, appoint your health care agent and complete your written Power of Attorney for Health Care. For more information, please call Nursing Services at (608) 417-6010 or visit

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Walk for a Cause – May 2

Let’s take a walk to cure arthritis on May 2.

This year Meriter’s Dr. James Bowers is the Medical Honoree for Walk to Cure Arthritis. Walk to Cure Arthritis is the Arthritis Foundation’s annual 5K walk. The funds raised from the 5K support finding a cure for arthritis, America’s leading cause of disability.

Register to join Dr. Bowers’ team at
• Click I agree, then Join a Team
• Click Show All and select Team Meriter
• Once you are registered, ask your friends and family to donate to your walk.

Register to walk with Dr. Bowers on May 2.

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Welcome Dr. Miller to Meriter Middleton


"My life's work is to partner with you, providing the support and information you need to live your healthiest, happiest life."

Meriter – UnityPoint Health welcomes family medicine physician Alisha R. Miller, MD, to our Meriter Middleton clinic, located at 7780 Elmwood Avenue in Middleton. She cares for patients of all ages, from newborns to seniors, and enjoys seeing families as a whole.

Dr. Miller works together with patients to discuss and decide on the best treatment options for their individual needs. She is interested in forming a relationship with her patients based on mutual respect, trust and open communication in order to help them live longer, healthier lives.

Within family medicine, Dr. Miller has special interests in:
•    Women’s Health
•    Pediatrics
•    Preventive Care
•    Managing Chronic Conditions

To schedule an appointment or free Meet and Greet with Dr. Miller, call (608) 417-3434 or visit

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International Travel in Your Future?

By: Dr. Kristin Millin, Travel Medicine Physician

Finally, spring is here, and it is the time of year when many of us start to think about summer travel. Whether leaving the country for business or pleasure, you may need to protect your health with certain vaccinations or preventive medications – even if you’re going to a location that may seem fairly developed. In fact, any time you plan to cross an American boarder, I strongly encourage you to check-in with a travel medicine specialist to ensure that you’re adequately covered.

Often, travelers need to receive vaccines and preventive medications that are not part of routine immunizations in the United States. The Centers for Disease Control and other experts recommend that international travelers visit a Travel Medicine Clinic to receive appropriate counseling on risk avoidance and to receive the proper vaccines and prescriptions for their specific travel plan.

Prior to your first appointment with a travel medicine physician, a nurse will discuss with you your travel plans and itinerary. This way we can determine whether an appointment is really necessary. Then a travel physician will gather information about health concerns in regards to your travel destination. The travel physician will also review your medical information so that at your travel visit, there can be an informed discussion with you about your risks and health concerns when traveling. At the end of the visit, you will then receive the appropriate medications and vaccinations that are needed to help you stay healthy during your next travel experience. Sometimes at travel medicine appointments, vaccines and medications can be covered by your insurance, but you’ll want to be sure to check with your insurance plan first.

Remember that it’s important to schedule your travel medicine appointment well ahead of your travel plans – ideally 6-8 weeks. Depending on where you’re going, it may take that long for your vaccine to be effective during your visit. If your departure is less than 6 weeks away, still give a travel medicine office a call, as that amount of time might not be required for the vaccines you need.

Some of the most common health concerns while traveling include insects, food, and sun. Insects can carry an array of different illnesses with them that you need to be aware of, such as Malaria, Dengue and Chikungunya. Many times, these illnesses can be preventable through vaccines or medication, but in some cases, there are no vaccines available for these types of illnesses. In that case, you have to do your best to avoid insect bites and depend on insect repellents. I often recommend insect repellents for adults with 30% DEET to prevent bug bites, although you want to be sure to apply it in a well-ventilated area over your clothes and be sure to rinse off after you return from your time outdoors.

Underprepared food and a lack of clean water are concerns for travelers going to resorts, cruises or local restaurants in underdeveloped areas. I always recommend that my patients take an antidiarrheal medication with them, as Traveler’s Diarrhea is a real concern. If you come down with Traveler’s Diarrhea, it’s much easier to have medication with you from the get-go, rather than having to track it down in a foreign country.

Many of us go on vacation for the sole purpose of getting some rest, relaxation and sun. But we need to remember to be careful in the sun – especially when you’re in areas of the world closer to the equator. I recommend using a 30 SPF and being sure to reapply it every 3 hours, including immediately after you get out of the water.

There are very good web sites available to travelers to help keep informed about travel concerns and safety during travel. I recommend viewing the following sites prior to travel:

As someone who has spent a lot of time in developing countries – and has experience with malaria first-hand, I certainly am an advocate for doing as much pre-travel preparation as possible. Travel is a fantastic way to experience the world around us and with a small amount of pre-planning, you can be healthy (and worry-free) during your adventure.

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11 Illnesses that Fiber Could Help Prevent

Did you know that foods high in fiber can help prevent certain illnesses and diseases?

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How to Prevent A Urinary Tract Infection

Anyone handling the catheter and tubing should cleanse their hands before and after touching it to reduce the risk of a catheter-associated urinary tract infection.

By: Katelyn Harms, Infection Prevention and Control

Have you ever experienced pain or burning while urinating, the urge to urinate frequently, or lower abdominal pain and fever? These could be symptoms of a urinary tract infection.

A urinary tract infection, also known as a UTI, occurs when bacteria or other germs enter the urinary tract. The Center for Disease Control reports that these infections commonly occur in the hospital and account for most than 93,000 infections each year.

Sometimes, a drainage device to remove urine from the body is needed for a patient in a hospital or other care facility. This tube is called a urinary catheter, and it is inserted through the urethra by specially trained healthcare personnel. The catheter is connected to a drainage tube and a bag. The urine is emptied regularly from this drainage bag. It is estimated that 15-25 percent of hospitalized patients and 5 percent of long-term care residents have one of these catheters.

Because the catheter provides a direct pathway for the germs to travel into the bladder, there is an increased risk of a UTI. When this occurs, it is called a catheter-associated urinary tract infection or CAUTI.

The staff caring for a person with a urinary catheter is taking measures to reduce the chance of a CAUTI.

  • First and foremost, the catheter should only be used when absolutely necessary! The staff should check every day if it is still needed. Many hospitals have developed protocols so the nurse can decide when to remove the catheter.
  • Anyone handling the catheter and tubing, including you, should cleanse their hands before and after touching it.
  • The catheter and drainage tubing should remain connected—no separating the device to put on clothes or collect specimens.
  • Urine should flow freely; this means that there should be no kinks in the tubing and the bag should not be placed on the bed.
  • The bag should be below the bladder (but not on the floor).
  • The catheter should be secured to the person’s leg to reduce friction on the urethra.
  • Simple cleaning of the area where the catheter enters the body should be done with soap and water. Ask the staff to assist you with this.

CAUTIs can be treated, but they increase the time you spend in the hospital. If you or a loved one needs a urinary catheter, talk to the healthcare team and ask when it can be removed. Also ask what other options are available; for example, a temporary catheter may be inserted and removed as soon as the urine drains. For men, an external catheter, much like a condom, can be placed over the penis instead of in the penis. If you are sent home with a catheter, be sure to learn how to care for the catheter before leaving the facility and where you will get catheter supplies.

Each day you have a catheter increases the risk of a CAUTI, so work with your healthcare team to reduce this risk. You can also find additional information in this FAQ document.

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Honor your MD for National Doctor’s Day

National Doctor’s Day is March 30, 2015

National Doctor’s Day recognizes the contributions of doctors to individual lives and communities. Physicians diagnose and prescribe the cure for today’s ever changing diseases and illnesses. It is a thankless job that few outside of the field can imagine the pressure of.

Take a moment to say thanks to these dedicated professionals and send him/her a note that conveys your respect and admiration.

Click here to send your doctor a thank you note. Please include your doctor’s first and last name.


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Meriter Monona is Pleased to Welcome Dr. Makeba Williams

Makeba Williams, MD, has started seeing patients at Meriter Monona. She is replacing Dr. Sabo, who is retiring. Dr. Williams was attracted to the field of obstetrics and gynecology because of the bonds and relationships she can form with her patients. She enjoys seeing a broad range of females for health matters related to pregnancy, menopause, menstruation and general women’s health. Whether it is an annual check-up, the delivery of a child, or treatment of complex gynecological conditions, patients can trust Dr. Williams will guide their care to achieve the best quality outcomes.

Dr. Willams has special interests in the following areas:
•             High- and low-risk obstetrics
•             Pre-conception counseling
•             Minimally invasive gynecologic surgery
•             Peri-menopausal and menopausal issues
•             Irregular menstrual bleeding
•             Management of abnormal pap smears
•             Exercise, including during pregnancy

Dr. Williams is accepting new patients to schedule an appointment call Meriter Monona at (608) 417-3000.

Please join us in welcoming Dr. Williams to Meriter Monona!

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Visit us at the Madison Kids Expo

Meriter – UnityPoint Health will be at the Madison Kids Expo March 21 and 22. Stop by to enjoy ways for kids to “unplug”. You can also have your photo taken with fun props in our photo booth.

On Saturday, March 21 from noon until 2pm you can learn CPR.

We hope to see you at the Madison Kids Expo!

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March is Healthy Baby Month

Meriter works to ensure that every baby is born healthy. At Meriter, we support mothers and provide them with early and consistent prenatal care at our Center for Perinatal Care. We also deliver more babies that any other hospital in Wisconsin and care for over 500 babies each year in our state-of-the-art newborn intensive care unit. If a child is born premature, we have programs to help families successfully navigate through this challenging time.

Meriter is proud of our commitment to family centered care provided by highly qualified staff and providers. We create a foundation that helps families build a lifetime of health, growth and happiness.

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What You Should Know About the MMR Vaccine

Consult your baby's pediatrician for more information on how to protect your baby from measles.

By: Kris Fedenia, RN

For the past several weeks, vaccines have been in the news — particularly the measles, mumps and rubella (MMR). All of this media coverage has stirred up controversy over what to do about outbreaks of measles, concerns over those who are not immunized and how best to protect your baby.

This topic was of special concern to members of our Mother Baby Hour groups whose babies are 0-9 months old. They asked, “What do you need to know and how do you make an informed choice?”

The History of the Disease Before the Immunization
In the decade before the live measles vaccine was licensed in 1963, an average of 549,000 measles cases and 495 measles deaths were reported annually in the United States. However, the number may have been much higher because most cases were not reported. Of the reported cases, approximately 48,000 people were hospitalized from measles and 1,000 people developed chronic disability from acute encephalitis (brain swelling).

There has been a 99% decrease in the reported incidence in the United States since the vaccine was first licensed in 1963. In 1989, the American Academy of Pediatrics recommended a second dose of MMR, which further reduced the incidence to less than 1 case per million. Measles was considered eliminated from the United States in 2000 due to use of the MMR vaccine.

The current outbreak is due to people with measles visiting this country, spreading it to unvaccinated people and people with unknown vaccination status. It can also be spread by unvaccinated Americans bringing it back to the United States after visiting other countries, and a small number of cases have occurred in those who have been vaccinated.

How Does This Disease Spread?
Measles is one of the most highly communicable infectious diseases. It is transmitted by direct contact with droplets when an infected person sneezes or coughs or less commonly, by airborne spread. The incubation period is generally 8-12 days from exposure to onset of symptoms. People can spread the disease from 4 days before to 4 days after the appearance of the rash.

What Happens When You Get the Measles?
For most people, having the measles virus usually means a fever greater than 101oF, cough, runny nose and red sensitive eyes. White spots may appear on the inside of the mouth a few days before a rash, which begins on the face and eventually spreads to the rest of the body.

Additional Complications for Some People
Complications include ear infection, pneumonia, croup, and diarrhea. One of every 1,000 cases results in acute encephalitis which can lead to permanent brain damage.

How to Protect Your Baby
Follow these steps to protect your baby and those who are unable to get vaccinated (people with lowered immune systems, receiving chemotherapy, etc.):

First, consult your baby’s care provider. If your baby is 12 months or beyond, the MMR vaccine can be given, with a second vaccine given between 4-6 years. If there is an outbreak in your community, the second dose can be given 28 days after the first for greater protection.

  • If your baby is 6-12 months and you will be traveling out of the country, your baby’s provider may recommend the MMR vaccination now. Your baby would then receive the regularly scheduled MMR between 12 -15 months and again between 4-6 years.
  • If your baby is less than 6 months, he or she may have some passive immunity to the measles if mom was vaccinated or had the measles herself. This passive immunity lasts for several weeks or months after birth. Breast-fed babies continue to receive antibodies through breast milk that help keep them protected from diseases that affect the intestinal system, but not the measles.

How Do You Treat the Measles?
There is no specific antiviral treatment for the measles. If you think your baby may have been exposed to the measles, contact his or her care provider for specific recommendations.

What Are the Risks Associated with Getting the MMR Vaccine?
A very small number of those vaccinated may develop a fever and/or rash. Even with these complications, people are not contagious.

There is no evidence that any of the components of the vaccine cause any long-term side effects. Click here to read more about the extensive research done on the vaccine schedule by the Independent Institute of Medicine.

Visit the Centers for Disease Control and Prevention for more information on vaccines in general.

Are you looking for a new primary care physician for your child? Meet our physicians today.

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How to Prevent Colon Cancer

Colon cancer is the third-most-common cancer in the United States, but the good news is it’s preventable. Learn how you can reduce your risk and prevent colon cancer.

By: Dr. Gary Griglione, Board-certified Gastroenterologist

What is Colon Cancer?
Before discussing how to prevent it, we should begin with what colon cancer is. The colon is also called the large intestine and begins at the end of the small intestine. The first part, located in the right lower abdomen, is called the cecum. The colon then curves up the right side, across the top under the ribs, winds down along the left side of the belly, and eventually ends as the rectum. The terms ‘colon cancer’ and ‘colorectal cancer’ are used to describe cancer of any part of the colon.

We grow small lumps of tissue in our colon, called polyps, just as we grow skin tags on our skin. There are two types of polyps: ones that are benign and do not turn into cancer and those that are precancerous. It is the precancerous polyps that, over time, develop into cancer.

Preventing Colon Cancer
Colon cancer is the third-most-common cancer in the United States, but the good news is it’s preventable! Here is a list of ways you can prevent colon cancer:

1. Get Screened

If you learn only one thing from this article, I hope it’s this: Colonoscopies can prevent colon cancer. If you wait until you experience signs and symptoms of colon cancer, it means you already have the disease, and it may be advanced and difficult to cure. During a colonoscopy, your doctor can easily find and remove precancerous polyps before they have the chance to turn into cancer.

Yes, it’s a short list, but colonoscopy screening is truly the only way to prevent colon cancer.

Understanding your personal risk factors can help to determine when you should begin colonoscopy screenings, consequently reducing your risk for developing colon cancer.

5 Ways You Can Reduce Your Risk for Colon Cancer

1. Let your doctor know if you have a family history of colon polyps or cancer. Cancer in close relatives, such as parents, brothers and sisters is most concerning, but cancer in distant relatives is also important to note. If multiple close relatives have a history of colon cancer, your risk is increased. It’s also important to find out how old relatives were when they were diagnosed.
2. Talk to your doctor if you have an inflammatory bowel disease called ulcerative colitis or Crohn’s disease. These conditions damage the colon over the years and increase your risk of developing colon cancer.
3. More than 90 percent of people with colon cancer are diagnosed after age 50. Even if you don’t have risk factors such as a family history of colon polyps or cancer, it’s important to start getting colonoscopy screenings around your 50th birthday.
4. Talk to your doctor if you have a personal history of polyps or cancer because your risk for future colon polyps or cancer is greater. Women with a history of cancer of the ovaries, uterus or breast are at a slightly higher risk of developing colon cancer.
5. Maintain an overall healthy lifestyle. Further research is needed to better understand exactly how diet and lifestyle affect the likelihood of developing of colon cancer. To support good health, eat a variety of fruits, vegetables and whole grains to ensure you get adequate fiber, vitamins and nutrients. Limit your consumption of red meat and animal fats.

Inactivity and obesity have been linked to a higher risk of colon cancer—and countless other conditions and diseases. Strive to get at least 30 minutes of moderate to vigorous exercise at least five days a week.

If you drink, stick to the recommended one drink per day for women and two drinks per day for men. Smokers may also be at increased risk of developing polyps and colon cancer.

Signs and Symptoms You Should Have Checked
Preventative colonoscopy screenings are essential—before any symptoms arise. If you experience any of the following signs or symptoms at any age, talk to your doctor.

  • A change in your bowel habits that lasts for more than 2 weeks, including diarrhea or constipation or a change in the consistency of your stool
  • Rectal bleeding or blood in your stool
  • Persistent abdominal discomfort, such as cramps, gas or pain
  • A feeling that your bowel never empties completely
  • Weakness or fatigue
  • Unexplained weight loss

These symptoms can be caused by a multitude of conditions other than colon cancer, but it is important to accurately diagnose the cause. Of great concern is the fact that one of the most common “symptoms” of colon cancer is no symptoms at all.

Because it’s so important, I’ll repeat this one final time: Colonoscopies can prevent colon cancer. Protect your health and schedule your screening if you’re due for a colonoscopy.

Learn more about Meriter Digestive Health and what to expect during a colonoscopy.

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Fire Up the Grill! Healthy Marinade Ideas

By: Michelle Miller, Dietitian

Herb and Garlic Veggie Marinade

Servings: about 2-4 servings


  • ½ cup olive oil            
  • ½ cup lemon juice
  • ¼ cup water                                                                           
  • ¼ cup Dijon mustard
  • 2 TBSP pure maple syrup
  • 2 TBSP minced garlic
  • 1 TBSP fresh or dried basil
  • Salt/pepper to taste                                       


  1. Whisk all ingredients together in a bowl and pour into a gallon Ziploc bag and add vegetables*.  Let marinate for 2 hours or up to 4 hours.

*Suggested Vegetables:  Mushrooms, peppers, onions, tomatoes, zucchini.

Soy Marinaded Chicken Breast

Servings: about 2-4 servings


  • 3 TBSP low sodium soy sauce
  • 2 TBSP extra virgin olive oil
  • 2 TBSP Fresh or dried thyme                                                      
  • 1 TBSP minced garlic
  • 2-4 boneless, skinless chicken breasts                                   
  • Black pepper to taste                                                                    


  1. Whisk all ingredients together in a bowl and pour into a gallon Ziploc bag and add chicken breasts.  Let marinate for 4 hours or up to 24 hours.

Try Michelle’s others recipes at the Meriter Hospital Bistro, located in the main hospital lobby!

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If You Could Prevent Colorectal Cancer Would You?

Colorectal cancer is the third most common cancer diagnosed in the United States. Do you know how to reduce your risk? Get screened today and learn more about Meriter’s Digestive Health Center.

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New Technology to Relieve Chronic Tendon Pain

We are very pleased to announce a new ultrasound guided technology to relieve your chronic tendon pain. When you try to run, swing a golf club, climb the stairs or just take a step – do you feel pain? Has the pain been there for months or even years? Most likely it’s tendonitis also known as tennis elbow, jumper’s knee, Achilles pain or plantar fasciitis.

You have probably tried many ways to feel better such as physical therapy, cortisone injections, medication or taking time off to rest. They may have provided temporary relief but your pain always comes back. If the constant pain is keeping you from doing what you love, we now have a solution.

It’s a new ultrasound guided technology from Tenex Health. It’s a minimally invasive outpatient treatment to remove only the painful tendon tissue without damaging the healthy tissue. It uses only a local anesthetic and there are no stitches or sutures required with a shorter recovery time. You can now return to the activities you love.

Call (608) 417-8500 to schedule an appointment with Dr. Beth Weinman, Sport Medicine Physician, at the Meriter Orthopedic Clinic and see if this new technology will help relieve your chronic tendon pain.

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How to Choose a Contraception

Choosing the right birth control option for you can be confusing. Request an appointment to discuss your options with your physician today!

By: Marta Staple, APNP

Choosing the right contraception can be a confusing task, and many women feel overwhelmed with choices while many others feel that there are not enough options.

Contraception is the intentional or deliberate prevention of pregnancy, and while men have access to condoms use and permanent sterilization with vasectomy, the majority of contraceptive options are designed to affect a woman’s fertility. There are hormonal and non-hormonal options, reversible and irreversible options, and short acting and long acting options. Of all of these options that women have for contraceptive methods, the long acting reversible methods are considered the safest and most effective.

Long acting reversible contraception (LARC) include intrauterine devices (IUDs) and the implant Nexplanon. Both methods are highly effective in preventing pregnancy, last for several years, and are easy to use. Both are reversible—if the user wants to become
pregnant or wants to stop using them, they can be removed at any time. They work better
than pills, the patch, the ring and the shot because they cannot be forgotten, interfered with, or taken late. But even better, they don’t have the same risks as birth control pills, like blood clots, migraine headaches, hypertension (high blood pressure) and elevated cholesterol!

There are 3 IUD options on the market, and they include the Mirena, Skyla and ParaGard
IUD. The Mirena and Skyla IUD contain a small amount of locally acting progesterone. After your health care provider inserts the IUD into the uterus through the vagina, it begins to release progesterone into the lining of the uterus, which can make the period shorter, and light, but can also cause some spotting. The ParaGard IUD is a completely hormone free option, works just as well as the progesteronecontaining IUDs, and lasts for up to 10 years. The Nexplanon implant is a small device that is inserted under the skin of upper inner arm and releases progesterone over 3 years. Periods tend to be shorter and lighter, but some spotting can occur.

Request an appointment today to ask your physician any questions about your birth control options.

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Sign up for Finding Fitness After 40

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 – UnityPoint Health, in-conjunction with Harbor Athletic club, is excited to offer a new exercise program opportunity for the community.  Introduction to Exercise 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 class will provide a combination of lecture and guided exercise instruction and all participants will receive a FREE 1 month membership to Harbor Athletic Club for the duration of the class. Space is limited, so sign up today and get started on the path to health and happiness.  

Date:  Every Thursday from April 16 through May 7 (4 weeks)
Time:  6:00 to 7:30 PM
Location:  The class will meet each night at the Meriter – UnityPoint Health Therapy Clinic at 2521 Allen Blvd., 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 parking spaces
Cost:  $35

What to Wear: The class will include components of active exercise each night so please where loose, comfortable close and athletic shoes.

Register today!

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Meriter Hospital Named One of the Nation’s 100 Top Hospitals

This Week Meriter Hospital was named one of the nation’s 100 Top Hospitals® by Truven Health Analytics,TM a leading provider of data-driven analytics and solutions to improve the cost and quality of health care.

“I could not be more proud of our dedicated team of clinicians and caregivers who truly make the patient the point of everything we do,” said Arthur Nizza, DSW, President and CEO of Meriter – UnityPoint Health. “Providing this level of care and quality is our top priority, and we’ll continue to work to exceed the highest of expectations.”

The Truven Health 100 Top Hospitals® study identifies hospitals and leadership teams that provide the highest level of value to their communities, based on a national balanced scorecard. The 100 Top Hospitals balanced scorecard measures overall organizational performance across 11 key analytic measures including patient care, operational efficiency and financial stability. The study has been conducted annually since 1993.

“For more than 100 years, Meriter Hospital has continually met the health care needs of south central Wisconsin with award-winning results,” said Geoffrey Priest, MD, Chief Medical Officer of Meriter – UnityPoint Health. “This is the third time we’ve received this honor in just the last five years, and it’s a true testament to the quality of care we provide each day.”

Meriter Hospital offers a wide-ranging scope of medical and surgical services, including leading edge heart and vascular care; the busiest Birthing Center in Wisconsin; patient-focused Emergency Services and a full array of orthopedic and general surgical services.
To conduct the 100 Top Hospitals study, Truven Health researchers evaluated close to 3,000 short-term, acute-care, nonfederal hospitals. Risk-adjusted methodologies were used to analyze public information — Medicare cost reports, Medicare Provider Analysis and Review (MEDPAR) data, and core measures and patient satisfaction data from the Centers for Medicare & Medicaid Services (CMS) Hospital Compare reports. Hospitals do not apply, and winners do not pay to market this honor.

Meriter’s UnityPoint Health affiliate St. Luke’s Hospital in Cedar Rapids, IA also received the accolade.

The winning hospitals were announced in the March 2, 2015, edition of Modern Healthcare magazine.

“This year’s 100 Top Hospitals represent the highest national standards in hospital care and management today. They set the benchmarks for peers around the country to follow — consistently delivering outstanding quality of care, satisfaction and community value at a reasonable cost,” said Jean Chenoweth, senior vice president for performance improvement and the 100 Top Hospitals program at Truven Health Analytics. “The majority of the 2015 award winners have produced year-to-year performance improvement, as well. This speaks to the consistent focus on excellence by the entire organization and the men and women who serve patients.”

The study shows that if all hospitals in the U.S. performed at the level of this year’s winners:

  • 126,471 additional lives could be saved
  • 108,926 additional patients could be complication-free
  • $1.8 billion in inpatient costs could be saved
  • The average patient stay would decrease by half a day
  • Episode-of-illness expense would be 2 percent lower than the peer average

More information on this study and other 100 Top Hospitals research is available at

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Meriter-UnityPoint Health Receives STAR Awards

Congratulations to Newborn Intensive Care Unit (NICU) and Plastic Surgery for achieving NRC Best!

Our Newborn Intensive Care Unit (NICU) achieved NRC’s Best in the Nation for keeping the unit quiet at night.

Our Plastic Surgery Clinic achieved NRC’s Best in the Nation for our patient’s being able to get an appointment as soon as they needed.

Thank you to all of our STAR employees for their dedication to extraordinary customer service!

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Celebrate Athletic Training Month

March is National Athletic Training Month. In the last few years, the presence of athletic trainers in the Meriter Medical Group has grown significantly. There are currently 7 athletic trainers working within Meriter Medical Group in Orthopedics, Orthopedic Trauma, and Sports Medicine.

The athletic trainers fill a special role within these care teams as a Physician Extender.  They help move patients more effectively and efficiently through the appointment, evaluation, and treatment process.  Athletic trainers are nationally certified and state licensed health care professionals who collaborate with physicians. Athletic trainers are highly skilled in performance of musculoskeletal examination, surgical education, and rehabilitation. In addition, athletic trainers provide value to a practice through skills in triage, taking patient histories, providing instruction on exercise prescriptions, and general patient education. They also provide preventative services and emergency care. To become a certified athletic trainer, a student must graduate with bachelors or master’s degree from an accredited professional athletic training education program and pass a comprehensive test administered by the Board of Certification. Once certified, they must meet ongoing continuing education requirements in order to remain certified.  Athletic trainers must also work under the direction of a physician and within their state practice act.

Meet Meriter’s athletic trainers

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A Look Into a Woman’s Heart

There are several differences between a man and woman’s heart, and cardiovascular disease as the leading cause of death among women. Our Women’s HeartCare team is here to help the women you love take care of themselves. Learn more today.

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Eating Right for Your Workout

Make sure you hydrate before, during and after your workouts! Try to drink about 12-20 oz of water before and during your workout.

By: Samantha Schmaelzle, Dietetic Intern

Do you know what to eat before and after your workout? Have you ever been so sore the day after weight lifting that you can hardly move and refuse to go back to the gym? Do you feel like you’ve tried a whole gamut of products to improve your workout or recovery, but you haven’t found the right one? Have you been confused and bombarded by all of those “protein-packed” products on the shelves? You aren’t alone! There is a lot out there to confuse and overwhelm you, but it doesn’t have to be complicated. Learn how to fuel your workout and recharge afterwards.

Let’s start with what happens in your body during a workout. Watch this great video that shows you where your energy comes from when you exercise. First, you need to know where these four energy sources are coming from:

  1. Muscle Glycogen: This is stored fuel from sugar (carbohydrate) to use when you first start exercising.
  2. Blood Glucose (aka Blood Sugar): These sugars come from the carbohydrate-rich food in your blood stream for immediate use or storage.
  3. Plasma Free Fatty Acids: This is stored fat that has been broken down to be used for energy.
  4. Muscle Triglycerides: This is fat stored in your muscle that is mobilized and used during prolonged exercise.

Before your workout, it is important to make sure you have enough “fuel” for your body. The most important food component for pre-workout fuel is carbohydrate. Carbohydrates are broken down into sugars in our body and released into the blood stream as blood glucose for our body to use as energy or to store for future use (muscle glycogen). As you saw from the video, muscle glycogen is used in the beginning of your workout. Blood glucose is then used later in the workout. The plasma free fatty acids (coming from the conversion of fat to energy) and muscle triglycerides (fat stored in your muscle) are used throughout the workout and at a higher rate with prolonged exercise. This is why working out is always a great part of a weight loss plan or everyday exercise because as you continue your workout, you begin to use more of the fat that is stored in your body.

Pre-Workout Snacks
What should you be eating? No matter when you workout it is important to eat something, even if you work out first thing in the morning. So, here’s your goal… eat  a piece of fruit or anything else from the list below. A piece of fruit is the perfect fuel for your workout because it has the carbohydrates and the fiber you need to sustain your entire workout. It will also help keep your blood sugar from dipping too low which can result in a crash and burn. When choosing a snack before you workout think complex carbohydrates: whole grains, fruits, and a little protein and fiber to slow the release of the carbohydrate throughout your workout.

Here are a few examples:

  • Oatmeal with nuts and fruit
  • Turkey Wrap
  • Apple and almonds
  • Salad with a piece of whole wheat bread or baguette
  • Half a bagel with cream cheese or peanut butter
  • One cup iced coffee and 1 scoop chocolate whey protein
  • Fruit and Nut Bar
  • Plain or nonfat Greek yogurt with granola
  • Fruit smoothie with yogurt and milk
  • Whole wheat toast with peanut butter or jam and sliced banana
  • Oatmeal with almond butter and fresh berries
  • One apple and a handful of almonds or almond butter
  • Fruit salad
  • Hearty salad
  • Trail Mix
  • String cheese and whole grain crackers

These are great snacks to have an hour or two before your workout. If you don’t have time because you are an early morning workout kind of person, have a smaller portion of these snacks available to you 15-30 minutes before you hit the gym. If you had a big breakfast or lunch, try working out about 3-4 hours afterwards and maybe enjoy a small snack right before you hop on the treadmill.

During your workout, you probably don’t need anything besides water unless you are an endurance athlete or working out for longer than an hour. If this is you, make sure you are getting some quick-acting carbohydrates and some electrolytes as well. Some ideas could be a small piece of fruit, salted pretzels, 4 oz of Gatorade or electrolyte drinks, or coconut water. All of these should be accompanied by water!

Post-Workout Snacks
After your workout, your body will be depleted of muscle glycogen, and your muscles will be ready to start repairing themselves to make your stronger. You should think about eating a 50-50 balance of protein and carbohydrates about 20-30 minutes post-workout. The carbohydrates will help you replenish your muscle glycogen stores, and consuming protein gives your muscles the building blocks they need to repair quickly. Here are some examples of quick fix items that will help you to get back to the gym the day after a heavy lifting.

  • 8 oz fat free chocolate milk
  • 6 oz low fat Greek yogurt
  • Stick of string cheese with a few whole-grain crackers
  • Tuna salad on a rice cake
  • Banana with peanut butter
  • Hardboiled egg and toast
  • Orange and almonds
  • Omelet with vegetables and a bowl of fresh fruit
  • 8 oz non-fat or low-fat chocolate milk
  • Pita with hummus, turkey, cucumber and peppers
  • Grilled chicken and mixed vegetables
  • Salmon and sweet potato
  • Tuna salad on one slice of whole wheat bread or whole grain crackers
  • Fruit and cottage cheese
  • Banana and a glass of milk
  • Cereal and milk
  • Quinoa, vegetables and chicken

Oh… and don’t forget water! Make sure you hydrate before, during and after your workouts! Try to drink about 12-20 oz of water before and little sips during your workout, and you should double that amount after your workouts. Symptoms of dehydration include flushed skin, premature fatigue, increased body temperature, faster breathing and pulse rate, increased perception of effort, decreased exercise capacity, dizziness, weakness, and labored breathing.

Any of this sound like one of your recent workouts? You were probably dehydrated. Drinking water is extremely important! Make sure you are replacing the lost fluids from sweat and breathing.

As for all of the overly-processed protein bars and other snacks — they are fine for a quick fix in a pinch. If you decided to eat a protein bar, try to look for items that have about 15-20 g protein and less than 20g carbohydrate. However, it’s better to get your nutrients from whole foods when you can.

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Epigenetics: Empowering You to Make Positive Lifestyle Changes

A new concept in the medical community known as “epigenetics” suggests that you may have more control over your genetic legacy than you think.

By: Dr. Gretchen Diem, Healthy Psychology

Did you know that your genes may not fully determine your health destiny? A new concept in the medical community known as “epigenetics” suggests that you may have more control over your genetic legacy than you think. Until recently it was believed you were stuck with the genes you were born with and that much of what went on in terms of health, susceptibility to diseases, and longevity were hard-wired into your genetic code.

It’s now known, however, that your genes can get turned on and off, and that they can be expressed to greater or lesser degrees, as a result of your lifestyle habits. In other words, what you put on your plate, how much you move your body, whether you smoke, what and how much you drink, the degree of stress in your life and your attitude can actually change the instructions held in your DNA. So, even if your genes indicate a history of family illness (i.e., heart disease, diabetes, cancer, dementia, etc.) you can make lifestyle choices and health-related behavior changes that can keep a gene from being turned on and expressed as a disease.

Take cancer as an example, healthy lifestyle habits positively affect genes that help fight cancer, while others help turn off genes that promote cancer development, according to a study, which is in the June 2008 issue of the Proceedings of the National Academy of Sciences. Another study conducted here at the University of Wisconsin, published in the Journal of Psychoneuroendocrinology, found that mindfulness practice can lead to epigenetic alterations of the human genome as well. “Our genes are quite dynamic in their expression and these results suggest that the calmness of our mind can actually have a potential influence on their expression,” said Dr. Richard Davidson one of the lead researchers. These findings are very encouraging. They counter the doomsday thinking we so often hear people saying; “It’s all in my genes, there’s nothing I can do.”

The advice to quit smoking, eat more fruits and vegetables, move your body more, get restorative sleep, and cultivate a more positive outlook is not new or novel. We have known for a long time that it can reduce the chance of declining health. It’s just that now the concept of epigenetics tells us that your lifestyle changes can change the expression of hundreds of your genes, and not just your genes but also the genes of several future generations.

So what will you do to minimize your risk of cancer, high blood pressure, heart disease, diabetes or other illnesses that may be part of your family history and genetic predisposition? Pause for a moment to think about what you want for your body and your mind. Each and every day, you make hundreds of decisions and choices that can determine your health in the months and years ahead. The potential health benefits are endless.

We at Meriter understand that changing health habits is not always easy. If you would like to help with learning new tools for making sustainable behavior changes, consider joining one of our lifestyle intervention programs so that you can lead a long and healthy life.

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Benefits of the Mediterranean Diet

Heart Month is the perfect time to find new ways to show your heart some love.  If you’re looking for a heart-healthy lifestyle, the Mediterranean diet might be right for you. Research has shown that the traditional Mediterranean diet reduces the risk of heart disease, as well as numerous other diseases.

A traditional Mediterranean diet promotes enjoying lots of fresh fruits and vegetables, nuts, fish and olive oil, coupled with daily physical activity—among other components of the traditional cooking style of countries bordering the Mediterranean Sea. Many people who switch to this style of eating say they’ll never eat any other way.

The Basics of the Mediterranean Diet

Eat Your Fruits, Vegetables and Whole Grains – Every meal should be based around a variety of plant foods—fresh and whole are best. 

Switch the Type of Meat Your Eat – Lean protein, like fish and poultry, should be a part of your meals at least twice a week. Limit your consumption of red meats and pork to no more than a few times each month. Particularly try to avoid sausage, bacon and other high-fat, high-salt, processed meats.

Choose Low-Fat Dairy – Pick up skim milk, fat-free yogurt and low-fat cheese. Limit your consumption of ice cream and high-fat coffee creamers.

Go Nuts when Snacking – Great for a quick snack, nuts and seeds provide fiber, protein and healthy fats. Beware: although nuts are packed full of vitamins and nutrients, they are also high in calories!

Pass the Butter – Replace butter and margarine with healthy fats, like olive or canola oil.

Pass the Salt – Add flavor to your foods with herbs and spices instead of salt.

Limit Sugar – Be conscious of the amount of sugar your may unintentionally be consuming every day; juices, sodas, sweet snacks and desserts—even savory foods like pasta sauces, chicken nuggets and french fries—are full of sugar.

Lifestyle Changes – The Mediterranean diet emphasizes the importance of being physically active and enjoying meals with family and friends.

By following the recommendations outlined in the pyramid, you and your loved ones can take daily action to live heart healthy!

Learn more about Meriter’s nationally recognized Heart & Vascular center.

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Heart Healthy Tips for Kids

A healthy diet is one of the best ways to prevent heart disease. Kids should have a diet that is full of fruits, vegetables, whole grains, poultry, fish, and nuts.

By: Dr. Kathryn Cahill, Pediatrician

As a child, February was one of my favorite months. After coming down from Christmas, the month of January was cold and dragged on. I eagerly anticipated February and all its heart-themed activities. As a mom, I’ve seen the same excitement in my children as they craft intricate mailboxes for Valentine cards, cut paper hearts, and make heart-shaped sugar cookies. This excitement sets the stage for our children to be a captive audience in learning more about their hearts. As parents, the month of February is the perfect opportunity to help our kiddos learn more about their bodies and show their hearts a little love.

Not coincidentally, the month of February is also American Heart month. Cardiovascular disease (CVD)—including heart disease, stroke, and high blood pressure—is the number one killer of women and men in the United States. It is also one of the biggest reasons for disability, keeping parents from working and enjoying family activities. During this month, we encourage parents to “know their numbers” (cholesterol, blood pressure, blood sugar and weight) and look for opportunities to improve their family’s heart health.

The Basics of Heart Health
Heart disease is complicated, but the basics of it are simple – we’re worried about arteriosclerosis (hardening of the walls of the blood vessels). At rest and with sleep, blood circulates slowly through the body carrying oxygen and nutrients. With exercise or activity, the heart pumps harder to carry blood more quickly through the body. Because of this, blood vessel walls need to be strong and stretchy to accommodate the different amounts of blood flowing through them. If the blood vessels aren’t pliable, it makes everything else work harder and disease develops.

One cause of arteriosclerosis is called atherosclerosis. Atherosclerosis is caused by the development of plaques in the blood vessels. These plaques (like the gunk that clogs pipes) thicken the walls of the vessels and make them stiffer, resulting in blood flowing less easily through the vessel. Research has shown that development of these plaques starts at a very young age. So, while we focus a lot in adults on modifying their risk factors for heart disease, the problem actually started when we were all kids. The good news is that we can do something now to help our kids have healthier hearts when they are our age.

Keeping Kids Healthy
So, what can you do to modify your kids’ risks for heart disease? Start early! A healthy diet and exercise are the best way to prevent heart disease. Kids should have a diet that is full of fruits, vegetables, whole grains, poultry, fish and nuts. Limit juice to less than 4 ounces daily. Avoid too much red meat and cut out sugar-sweetened beverages. Limiting processed foods (stuff that comes in packages) also helps cut back on foods that increase the risk for heart disease. All kids should get at least 60 minutes of physical activity daily. Limit screen time to less than 2 hours daily – this includes TV, video games, and tablet time. Match every minute of screen time with a minute of healthy, vigorous activity. Avoid smoke exposure for your kids. Finally, know your family’s history – genetics play a big role in heart disease. Talk with your kids’ pediatrician about their risk factors and come up with a plan to change them.

February is a great month for families to reflect on their health goals. As pediatricians and parents, our goal is to be the ultimate preventive cardiologists. We need to help each other recognize risk factors for developing heart disease, not just in the parents, but also in our kids. By encouraging families to live heart-healthy lives from an early age, we hope to spread the love and prevent children from developing heart disease.

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