Meriter Receives Recognition from Salvation Army

L to R: Tobi Cawthra, Community Relations Manager; Jim Woodward, President and CEO of Meriter Health Services; Chris Ziemba, Development Manager at The Salvation Army

Meriter is pleased to receive recognition from the Salvation Army for its involvement in the Red Kettle campaign. Meriter staff participated by ringing bells at several locations.

The Salvation Army has been an excellent partner to Meriter in the development of the Helping Educate and Link the Homeless program, developed by Meriter hospitalist and current Chief-of-Staff, Dr. Cate Ranheim. The Salvation Army also is the home base for another non-profit organization supported by Meriter, the Madison Dental Initiative. The Madison Dental Initiative provides free dental care to those who are homeless or at risk of homelessness.

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The Truth about Colonoscopies

By: Dr. Gary Griglione, Gastroenterology

Each year, March is recognized as Colon Cancer Awareness Month. Colon cancer is the third most common cancer in the United States and the second leading cause of cancer-related death that affects both men and women, behind lung cancer. But it doesn’t have to be this way; educating the public about the importance of screening for the disease can save lives.

The purpose of a colonoscopy is to ensure you’re healthy and stay healthy. Talk with your doctor today to learn more about colonoscopies and find out whether one is right for you.

Below are a few things you need to know about colonoscopies.

1. Colonoscopies can PREVENT colon cancer.
Colonoscopies allow a physician to examine the inside of your large intestine (colon). We’re looking for small growths of tissue on the wall of your colon, called polyps. Most of these polyps are precancerous in nature and, when left to grow, will turn into cancer. Finding these polyps during a colonoscopy allows us to remove them before they can become cancerous.

2. Colonoscopies can DETECT colon cancer while it’s still in an early stage.
Polyps left to grow develop into cancer over time. Individuals most often do not experience any symptoms until the cancer is large. Unfortunately by that time, the cancer may not be curable. Some common symptoms of colon cancer include blood in or on the stool, stomach pain, alteration in bowel habits, aches or cramps that do not go away, and unexplained weight loss. If you have colon cancer, a colonoscopy is the best way to find it in an early stage, making it easier to remove and hopefully cure.

3. You should schedule a colonoscopy if you are age 50 or older, or at an increased risk for the disease.
Although the disease can occur at any age, the majority of individuals diagnosed are over the age of 50. A healthy adult should first get screened soon after his or her 50th birthday and approximately every 10 years after that, until the age of 75. Some individuals may need a colonoscopy at a younger age or more frequently (every 3-5 years), including those with certain gastrointestinal conditions, those with a family history of colon cancer or polyps, or those who were found to have polyps on prior colonoscopy. The disease affects men and women equally.

4. They’re just not that bad.
Colonoscopies save lives. Still, many people avoid them for as long as possible – or entirely. I can promise you, most of my patients tell me that their colonoscopy wasn’t that big of a deal.

  • The day before the procedure, you will need to completely empty your colon. Historically, that involved drinking practically gallons of sometimes rotten-egg-tasting fluids. This is not the case anymore. In fact, at Meriter, standard procedure involves mixing flavorless Miralax into a low-volume (approximately half the amount used in the past) clear liquid of your choice, like Gatorade or fruit juice.
  • The actual procedure takes typically 30 minutes or less. Many people sleep through their exam and have no memory of the actual test at all.
  • When you’re done with the procedure, you will likely feel a little sleepy, groggy or confused. After a friend or family member drives you home, you will spend the rest of your day relaxing.
  • Even following a polyp removal and biopsy, you should feel only minor discomfort after the exam. Because we insufflate air into your colon to allow us to see during the exam, many people experience some slight cramping due to residual gas. This generally lasts just a few hours.
  • The great news is if no abnormal growths or polyps are found, you will not need another colonoscopy for 10 years.

The purpose of a colonoscopy is to ensure you’re healthy and stay healthy. There is a lot of hype, but the procedure isn’t nearly as bad as many might have heard or expect. I encourage you to talk with your doctor to learn more about colonoscopies and find out whether one is right for you.

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Best Tips for Flying with Your Children

Make sure that each child has an activity bag for the flight. It can include items such as books, washable markers, a blank composition notebook and a favorite stuffed animal.

By: Dr. Kristin Millin, Pediatrics

Wisconsin in the winter makes all of us question why we have chosen to live in the Midwest.  My survival tool is to think about vacations in warmer climates.  I love to fly in an airplane, but flying in an airplane with small children brings on other emotions.  I have learned over the years that there are several survival skills that help when flying with children.

Make sure that each child has an activity bag for the flight.  I always pack washable markers, a blank composition notebook, 1-2 books, a favorite small stuffed animal, and not infrequently scotch tape or painters tape.  Kids love tape and even if they stick the tape all over the seat in front of them, it won’t stain and it is easily removable.  We always check into the airline we are traveling with 24 hours earlier from our home computer as well as print our boarding passes from home.  This saves time waiting in the check-in line and if you are not checking luggage, you just have to go through security.  Make sure to follow the Transportation Security Advisor guidelines on what you can and cannot bring for carry- on items (see website below).  There is quite a lot of variability on what is required by the TSA so checking ahead can save having your child’s favorite bug catcher thrown away as you start your vacation (happened to my son 2 years ago).

You can bring a stroller all the way to the gate of your airplane and in busy airports is it much safer to keep your child restrained at least part of the time.  We also bring our own water bottles and after we have gone through security with the empty bottles, we can fill them at the water fountains (many airports, including Chicago O’Hare, have stations to fill water bottles for free).

As one last tip, although airlines will allow families with small children to board first, I recommend waiting to board the plane.  As soon as a toddler has to stay in a small space, havoc begins.

I love to travel and spend   time with my family.  Making some small changes to keep us mentally and physically healthier during our travel experience is even better.

Websites to check out for traveling with children:
http://www.cdc.gov
http://www.tsa.gov/traveler-information/traveling-children
http://www.travelforkids.com
http://www.parenting.com/gallery/50-ways-entertain-kids-plane

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Allergy and Pediatrics Groups Achieve Best in the Nation

We are proud to announce that our patients have rated the Allergy and Meriter DeForest-Windsor clinic pediatrics groups Best in the Nation (on National Research Corporation’s Fourth Quarter 2013 Survey) for being able to get an appointment as soon as they needed and getting answers to their medical questions the same day. We thank our patients for their loyalty!

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Celebrate Healthy Baby Month

March is Healthy Baby Month. Our staff works tirelessly to ensure every baby born in Meriter Hospital receives personalized attention and support. Each year at Meriter, we care for over 400 babies in our newborn intensive care unit. If a child is born premature, we offer programs to help families to be successful.

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.

Once your baby is ready to head home, Meriter offers compassionate, knowledgeable pediatricians and family medicine physicians who focus on your family’s needs – and schedule. To find the perfect doctor for your little one, visit meriterdoctormatch.com

Meriter is there for your family every step of the way.

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March 7 was Dress in Blue Day

On Friday, March 7, in honor of Colon Cancer Awareness Month, Meriter’s doctors, nurses and staff showed up to work dressed in blue to raise awareness and encourage discussion about the importance of screening for colon cancer. View the photos.

Colon cancer is the second-leading cause of cancer related death for both men and women in America. Through screening, colon cancer is one of the most preventable diseases.

The Colon Cancer Alliance launched the National Dress in Blue Day in 2009 to bring attention to the importance of screening for colon cancer.  Beginning at age 50 (or earlier if you have a family history or are at a higher risk), talk to your doctor about getting screened for colon cancer. The most effective screening is a colonoscopy

To make a donation toward life-saving research, prevention education and patient support services, visit Colon Cancer Alliance. Support Meriter’s Digestive Health Center by donating through the Meriter Foundation.

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How to Set Exercise Goals for Success

You don’t have to run a 5K every day just be active, a brisk walk would do the trick.

By: Lisa Sanborn, Lead Exercise Physiologist

Are you already frustrated and discouraged that you have not kept up with your New Year’s Resolution to exercise more or lose weight? Most likely you probably set too grand of a goal and gave up because it wasn’t attainable and you didn’t see results.

When setting goals for exercise and a healthier lifestyle you should set attainable goals. Making the decision to exercise more, lose weight, or lead a healthier lifestyle is applauded; Exercise provides significant benefits for both mind and body. And with that, comes time. Don’t be discouraged that you aren’t seeing change overnight. It’s important to make both long-term and short-term goals. By setting small goals with rewards along the way, you’ll have more success achieving your ultimate goal. This helps keep you on task and decreases potential frustration and discouragement.

The American College of Sports Medicine recommends 30 minutes of physical activity most, if not all, days of the week. However, if you are just starting an exercise program this might be too much to achieve. You don’t have to run a 5k every day just be active, when a brisk walk would do the trick. When starting an exercise program; you should start with 30 minutes each day, 3 days per week and gradually build up as you are physically able. Also, start with a type of exercise that is easy for you, such as walking. Exercise should not feel hard or hurt your body.

If doing 30 minutes at a time is too hard, break that up into 2 bouts of 15 minutes. Once this gets easier, start by adding more time to your workout, then eventually add another day each week. As the exercise starts to feel easy, start increasing your intensity. Our bodies adapt to exercise, so we need to continue challenging it over time.

For your first month, set a goal of exercising 3 days per week. Once you achieve that goal, reward yourself with a new pair of shoes, a massage, a pedicure or something else to pamper yourself. If you miss a day, or a few days, don’t get discouraged just start over the next day or the next week. Set a new goal each month, a small goal leading up to the ultimate goal. The best thing is to make time for yourself to achieve your goals. Find a friend or exercise buddy that has similar goals because this can help you stay honest and you’ll motivate each other to keep your goals.

Keep in mind that change doesn’t happen overnight. You are making a lasting lifestyle change for a healthier you!

Meriter Women’s HeartCare offers a comprehensive cardiovascular program designed especially for women by women. To learn more, call 608.417.6447 or visit meriterheart.com.

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Register to Improve your Golf Game

Has the polar vortex given you the winter blues? Have you been dreaming about this year’s golf season?

If you want to improve your golf game and your health, then join Zac Lefel, Dave Bollig, Adam Malm and Ben Armstrong, physical therapists, and the PGA Pros from Vitense Golfland for this interactive seminar – Training and Injury Prevention for Golfers. We will discuss the fundamentals of a basic golf swing as well as tips and strategies on how to improve your strength and flexibility allowing for a smooth, efficient golf swing. You will also get a chance to put this into practice on the range under the guidance of a PGA professional from the George Vitense Golf Academy, 5501 Schroeder Rd, Madison, WI 53711.

Date: Saturday, March 22
Time: 8:00-11:00 am
Location: George Vitense Golf Academy, 5501 Schroeder Rd, Madison, WI 53711
Cost: $25

Register for this class today!

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12 Tips from Meriter Women’s HeartCare

  1. Know your numbers. High cholesterol, high blood sugar and high blood pressure are major risk

    Making small life changes with the help of Meriter Women's HeartCare can drastically improve your heart health.

    factors for heart disease. Optimal total cholesterol should be under 200, fasting blood sugar under 100 and blood pressure under 120/80.

  2. Stop smoking cigarettes. Get counseling, nicotine replacement or drug therapy (if needed) and find a group program to help you stop. Check out Meriter’s Smoking Cessation Program.
  3. Pay attention to signs and symptoms of heart disease. Report any chest pressure/discomfort (including back, neck, jaw) along with shortness of breath, fatigue, nausea or stomach upset at rest or with activity to your health care provider. If these symptoms are severe, call 9-1-1.
  4. Avoid the “all-or-nothing” mindset. Instead, try the “something is better than nothing” approach. So, if you can’t fit in your 30-minute workout routine, take a 10 minute walk instead. Remind yourself that even small changes can lead to significant improvements in health.
  5. Simply pay attention. Most of us operate on autopilot a lot of the time. To make yourself more aware, find an inexpensive, brightly colored bracelet, even a rubber band will suffice. Each time you catch sight of your new accessory, ask yourself if there is something that you could do to positively influence your health.
  6. Get a pedometer. These gadgets are a great way to get an objective measure of your physical activity. Start recording your total daily steps to get a sense of your baseline activity level. Figure out what you need to increase your total number steps each day. Competition, even with yourself, is a great motivator!
  7. Consume a more plant-based diet. Continue to enjoy the healthy and delicious Mediterranean diet by filling up 2/3 of your plate with vegetables, fruits, legumes and whole grains. Incorporate more meatless meals, starting with one meal each week and gradually increasing from there.
  8. Choose liquids over solids. Replace solid fats, such as butter and cheese, with heart healthy fats, such as nuts, seeds and oils. Limit fat portions due to high caloric content. An example of this would be to add 1 Tbsp. of nuts to a salad or drizzling 1 tsp. of olive oil over your vegetables.
  9. Practice portion control. Small changes over time really add up. Some suggestions include: switching to a smaller plate at meals, taking ½ your meal home when dining out at restaurants or leave a few bites of food on your plate at meals.
  10. Exercise. Regular exercise can help you lose or maintain weight and can reduce your risk of heart disease. Strive for 30 minutes of exercise most days of the week. You can do the 30 minutes all at once, or break it up into 10 or 15 minute increments. Walking, bicycling, swimming and other activities that increase your heart rate are best.
  11. Move more, Sit less. Find ways to build activity into your day. Instead of the elevator, take the stairs. Get up from your desk every hour or so, and try standing while you are on the phone or working on the computer. Park farther away. Keep a set of small weights next to your favorite chair and pump iron while you watch TV.
  12. Breathe. There is a relationship between your emotions, high stress and heart disease. Ever notice that when you are angry or upset you breathe faster and less deep? Simply slowing your breathing down can calm you down.

To get started on your path to wellness, contact Meriter Women’s HeartCare – a comprehensive heart program designed for women, by women. Call 608.417.6447 to schedule a heart health risk assessment or visit meriterheart.com.

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Understanding the Risk Factors for Heart Disease in Women

If you have a blood relative with heart disease, your risk significantly increases. The more you know about your family health history, the more you can do to protect yourself.

By: Dr. Melissa Grimm, General Internal Medicine

Cardiovascular disease is the leading cause of death among U.S. women.  In fact, for women the average lifetime risk for some type of cardiovascular disease is high, approaching 1 in 2 women. But what can we do to prevent cardiovascular disease and how do we know if we are at high risk?

The presence of any one or more of these risk factors constitutes a high risk of future cardiovascular events such as a heart attack or a stroke:

  1. History of coronary heart disease, such as a previous heart attack or stent placement or history of coronary bypass surgery
  2. History of cerebrovascular disease, such as a previous stroke or TIA (mini-stroke)
  3. Peripheral artery disease, which may cause pain in the legs with walking due to lack of blood flow through the arteries
  4. Abdominal aortic aneurysm
  5. Diabetes mellitus, type 1 or type 2
  6. End stage kidney disease
  7. 10-year risk of cardiovascular disease  ≥ 7.5%, based on other risk factors such as blood pressure, cholesterol, and smoking status

If you have any of the above, controlling other risk factors is known to decrease future risk.  Therefore, keeping blood pressure and cholesterol under control using medication and lifestyle modifications is very important.  Smoking cessation is extremely beneficial. Also, daily aspirin therapy (either a baby aspirin or full dose aspirin) should be used unless it is not tolerated due to a history of gastrointestinal bleeding.

If you do not have any of the above, you still may have a high lifetime risk of cardiovascular disease.  This is dependent on the number of other risk factors that are present and they tend to have a cumulative effect.  These include:

  1. High blood pressure: Defined as BP ≥120/80, or if being treated for blood pressure with medication. Even a slightly high level doubles the risk of heart disease.
  2. High cholesterol, or being treated for cholesterol. About one-third of American women have high enough cholesterol to pose a serious heart disease risk.
  3. Cigarette smoking: Almost as many women smokers die from heart disease as from lung disease.
  4. Sedentary lifestyle
  5. Poor diet
  6. Poor exercise capacity on treadmill testing
  7. Obesity: At 20% or more over ideal weight, particularly in abdomen, the risk of heart disease increases.
  8. Family history: if you have a blood relative with heart disease (men < 55 years old or women <65 years old), your risk significantly increases. The more you know about your family health history, the more you can do to protect yourself.
  9. Metabolic syndrom
  10. Inflammatory arthritis: Such as lupus or rheumatoid arthritis
  11. History of pregnancy complications of preeclampsia, gestational diabetes or pregnancy-induced hypertension

How these risk factors are approached can make a difference in the success of improving your health.  Knowing which of these risk factors can be modified by lifestyle changes and to what extent is important. Work with your provider and health care team to guide you as lifestyle modifications are always important, but may not always be enough.

In regards to lifestyle changes, it is often problematic when people try to make “all-or-nothing” changes searching for a “perfect” solution to eliminate their risk of disease.  This can become overwhelming and can be a set-up for failure.

It can be more helpful to think of making changes as a lifelong process, setting small reasonable goals that are easily accomplished and can be maintained.  These changes become habits and can be motivating to make further changes.

Meriter offers many different wellness options to guide individuals in making healthy lifestyle changes. This includes our Women’s HeartCare Program which provides the multidisciplinary guidance of a nutritionist, exercise physiologist, health psychologist and physician to support women to better heart health. Meriter also offers a very successful Smoking Cessation Program and interdisciplinary Diabetes Care Team among many other resources. For more information, visit meriter.com/wellness.

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Ten Tips for a Heart-Healthy Diet

Try using olive oil as the principal fat, replacing other fats and oils (including butter and margarine).

By: Susan Brueggemann, Registered Dietitian

The Mediterranean Diet was based on the dietary traditions of Crete, Greece and southern Italy circa 1960 when the rates of chronic disease among populations were among the lowest in the world and adult life expectancy was among the highest even though medical services were limited.

As time passed by, this eating pattern was thought of as the “poor” diet for the people of the southern Mediterranean region.  By default, this population resisted all the modernization of foods in most industrialized countries which led to an increased consumption of more meat and processed convenience foods.

Research has shown that the Mediterranean Diet reduces the risk of heart disease.  It has also been shown to reduce blood pressure and “bad” LDL cholesterol as well.

The Mediterranean Diet is plant-based. It favors olive oil loaded with heart healthy unsaturated fats while limiting saturated and trans fats. The Dietary Guidelines for Americans also recommends the Mediterranean Diet as an eating plan that can help promote health and prevent disease.

One major difference between the Mediterranean Diet and other diets is  the frequency and amounts of foods are very non-specific, which is intentional.  The reason for this is dietary variation is considered ideal; encouraging individuals to eating a variety of healthy foods.

Other vital elements of the Mediterranean pyramid that are different from most food pyramids include incorporating daily exercise and emphasizing the importance of sharing meals with others.

As with any diet, portion control is still important. Excess calories, even from the healthiest foods, can result in weight gain.

One final note is that even though olive oil and nuts are heart healthy, they are also high calorie.  Limit portions to control calories; no more than ¼ cup of unsalted or lightly salted nuts and 1-2 tablespoons of olive oil daily.

Ten Tenants of the Mediterranean Diet Guidelines:

  1. An abundance of food from plant sources, including fruits and vegetables, potatoes, whole grains, beans, nuts and seeds.
  2. Emphasis on a variety of minimally processed and, wherever possible, seasonally fresh and locally grown foods.
  3. Olive oil as the principal fat, replacing other fats and oils (including butter and margarine).
  4. Total fat ranging from less than 25-35 percent of energy, with saturated fat no more than 7 to 8 percent of calories or 16 grams on a 2000 calorie diet.
  5. Daily consumption of low to moderate amounts of cheese and yogurt (low-fat and non-fat versions are preferable).
  6. Twice-weekly consumption of low to moderate amounts of fish and poultry (recent research suggests that fish be somewhat favored over poultry); up to 7 eggs per week (including those used in cooking and baking).
  7. Fresh fruit as the typical daily dessert; sweets with a significant amount of sugar (often as honey) and saturated fat consumed not more than a few times per week.
  8. Red meat a few times per month (recent research suggests that if red meat is eaten, its consumption should be limited to a maximum of 12 to 16 ounces per month; where the flavor is acceptable, lean versions such as the loin and round cuts are preferable.
  9. Regular physical activity at a level which promotes a healthy weight, fitness and well-being.
  10. Moderate consumption of wine, normally with meals; about one to two glasses per day for men and one glass per day for women. From a contemporary public health perspective, wine should be considered optional and avoided when consumption would put the individual or others at risk.

We invite you to attend ladies night out on Feb. 20. The event features Mediterranean cuisine and wine paired with inspiring discussions about keeping yourself heart healthy. Visit meriterheart.com to register.

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How to Protect Yourself from Stress

Feeling stressed? Manage it by using deep breathing techniques to redirect your attention and take a few, slow deep breaths.

By: Gretchen Diem, PhD; Women’s HeartCare

These days stress is almost a fact of life. It creeps into our lives in a variety of ways from angst-inducing news about natural disasters and economic woes to daily stressors like looming deadlines and icy roads.

The effects of stress may go beyond what you think.  Even though you might feel that you are dealing with your stress, it can still wreak havoc on your body.  Stress triggers a cascade of stress hormones that produce physiological changes in almost every organ system including your heart and blood vessels, immune system, lungs, digestive system, sensory organs and brain.

We’ve all experienced it —  a stressful incident that can make the heart pound and breathing quicken. Our muscles tense, our stomachs churn and beads of sweat appear.  These changes occur automatically in response to stress.  It is estimated that our stress response is triggered 50 to 100 times per day. Over time, prolonged and repeated activation of the stress has been shown to adversely affect our health, both physical and emotional. Many well-respected studies link stress to heart disease, the number one cause of death of both men and women in the United States.

You may not be able to avoid stressful situations, but you can counteract the damaging effects of stress by calling upon your body’s unique potential for self-healing. The first step is recognizing the connection between your mind and your body. You can learn how to use your mind to elicit the exact opposite physiological response to the stress response — a calm, relaxed state called the relaxation response.

Harvard cardiologist, Dr. Herbert Benson, was the first to scientifically document that the relaxation response can reduce central nervous system activity by lowering blood pressure, decreasing muscle tension and lowering respiratory rate in addition to other beneficial physiological changes.  The relaxation response is not difficult to invoke.  It can be done anytime or anywhere by simply focusing your attention on the breath and slowing it down, breathing in for a count of 5 or 6 and breathing out for a count of 5 or 6.  Do this for as long as you have the time to do it.  Believe it or not, it does not take long for it to work and your physiology will start to shift in beneficial ways in just a matter of seconds.

So, if you believe the experts who estimate that your body is going to get revved up 50-100 times per day, then go ahead and turn on your relaxation response 50-100 times per day (by focusing on your breath and slowing it down) to buffer against the negative physiological effects of stress. No one will even know that you’re doing it!

Deep breathing as a stress management technique is not new, but perhaps you can now better redirect your attention and reduce stress by taking a few slow, deep breaths.  It’s pretty easy and it might just protect your heart and improve your health.  If you are interested in experiencing other ways to elicit the relaxation response, check out the recorded relaxation exercises at  www.meriter.com.

Come enjoy a four-course Mediterranean dinner to learn about women and heart disease on February 20 at 6 p.m. Click here to learn more!

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Welcome Dr. Craig Dopf to Meriter Deming Way

The Meriter Medical Group would like to welcome Craig Dopf, MD to Meriter Deming Way located at 2275 Deming Way, Suite 220, Middleton, WI 53562. We are pleased to offer spine services through the Meriter Medical Group.

Dr. Dopf prides himself on not leaving an exam room until all of his patients’ questions are answered. He uses common language when explaining diagnosis and treatment options, and takes minimally invasive approaches to surgery whenever possible. He finds the best outcomes come from having a relationship of mutual respect with patients who are willing to do what is necessary to reduce their pain. Having experienced broken bones and back pain in the past, Dr. Dopf believes he has some ability to relate to his patients’ pain and problems. He also understands how important family support is for the healing process.

Dr. Dopf works with patients of varying ages experiencing disabling pain and numbness or weakness in their neck, arm(s), back or leg(s). He treats the following spinal conditions: adult degenerative spine conditions, cervical thoracic and lumbar spine disorders, disk herniations, spinal stenosis, spinal fractures and spondylolisthesis.

During his free time, Dr. Dopf enjoys spending time with his wife and five children. He enjoys a multitude of leisure activities including snow and water skiing, fishing, hunting, motorcycling, hiking, photography and attending concerts. For the last five years, he has also volunteered in Haiti performing surgeries with the Community Health Initiative-Haiti.

Please join Meriter in welcoming Dr. Dopf!

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Seven Indoor Activities to Try With Your Kids

Looking for indoor activities to try with your kids? Have a dance party! Kids love music, and it is always fun to get a groove on with Mom and Dad.

By: Dr. Carleen Hanson, Meriter Monona

February is American Heart Month, and while many people think of heart disease as an adult medical issue, it’s important to remember that having a healthy heart starts in childhood. I try to remind my young patients that their heart is a muscle, and just like the other muscles in their body it needs exercise to be strong. However, this time of year, it can be a challenge to keep kids active. I know my own children love to play outside in the snow, but this winter has been particularly brutal. There have been lots of days that even the hardiest kids (and their parents) haven’t wanted to venture out for even 10 minutes.

So what can you do if you’re stuck inside? There are plenty of options – sometimes it takes a little creativity. Remember, it’s always more fun if mom or dad join in too, so be a good sport and get your heart rate up as well. Also, while it’s recommended that kids get a minimum of 60 minutes of physical activity per day, it doesn’t need to be all at once. Break it up and do 10-20 minutes at a time. It all adds up and sometimes it’s helpful to actually keep track. Kids love charts and accomplishments, so feel free to make a sticker chart for being active.

Here are some ideas to get you started:

  • Have a dance party. Kids love music and it’s always fun (and often funny) to get a groove on with mom and dad. Pull out some of your old favorites for dancing to change it up a little.
  • Follow the leader. Explore the whole house and mix it up. Add in some exercises in between those funny walks and use those stairs if you have them. Be sure to take turns with who gets to be the leader.
  • Balloons. There are so many fun things to do with balloons and they are safer, and less likely to damage anything, than balls for indoors. Play the “keep the balloon up” game and try to prevent the balloon from hitting the floor. Add extra balloons to make it more challenging. Write mini-challenges, such as “Do 30 jumping jacks” or “Run up and down the stairs 5 times,” on little slips of paper and slide them into the balloon before you blow it up. Let your kids pick a balloon to pop and then they have to do what’s inside.
  • Scavenger Hunts. These are my kids’ all-time favorite indoor activity. You can adjust your clues to be more challenging for older kids and feel free to add in some “exercise” clues (Run in place for 60 seconds, then …). The American Heart Association has a fun “Healthy Challenge Scavenger Hunt” on their website if you’re looking for inspiration.
  • Hot Spot stations. Set up stations in a larger open area for your kids to rotate through every 30-60 seconds. Have instructions at each station telling them what to do such as run in place, sit-ups, dance, jumping jacks, hula hoop, etc. You can use old milk jugs filled with some water for weights if wanted. For older kids, encourage them to keep track of repetitions and aim to improve.
  • Use your garage. If you have a garage, leave the cars parked outside for a few hours and use the open space for activity. Use empty boxes to set up goals for a mini soccer game or try to throw balls into the boxes for points. You can use chalk to make hopscotch or even blow bubbles for your kids to run around and pop.
  • Ask your kid for ideas. Sometimes, they have the best ideas for fun and are more likely to want to participate if it’s something they helped with. Try to keep an open mind and as long as it’s safe, give it a try.
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Dr. Dana Johnson: Plenty of Ways to Stay Active This Winter

 

The best way for children to be physically active is through play, and this is often best done outdoors.

Originally published on January 22, 2014 in the Wisconsin State Journal. Dr. Dana Johnson is a pediatrician practicing at the Meriter McKee clinic.

Dear Dr. Johnson: My children are starting to get cabin fever. Do you have suggestions on how to address this?

Dear Reader: Children and adults of all ages benefit from physical activity no matter the time of the year. Lack of physical activity can be especially evident in young children, who tend to become more rambunctious and display more behavior problems when physical activity is limited.

While I find it easier in the warmer months to stay active myself and keep my son active, for our overall physical and mental health, it is important to get regular physical activity year round. Many adults will do this by going to the gym. While some gyms offer fun classes for kids, most children would not and shouldn’t get their exercise on a treadmill.

The best way for children to be physically active is through play, and this is often best done outdoors. While there have been a few days recently where it was not safe for anyone to be outside for more than a few minutes, most days it is a good idea for children to play outside as long as they are appropriately dressed. Dressing in layers with waterproof snow gear including a coat, snow pants, hat, gloves and boots should keep them warm and dry. With snow on the ground, children can have fun building forts and snowmen — and don’t forget about sledding. The walk up the hill burns energy, and the ride down is just plain fun.

While I am not a huge proponent of video games, on the days that it is too cold to venture outside, or for additional activity, video games that require physical activity can be used. There are also several indoor play and gymnastic facilities around town that allow children to burn off energy indoors. The Madison with Kids website has a good list of many of them at http://madisonwithkids.com/open-play.

We are also fortunate to have many other opportunities for outdoor activities for the whole family. My family has enjoyed trying several new winter activities in recent years. Having grown up in the south, cold weather activities were not common. We have taken advantage of the Madison Parks cross-country ski trails. They offer ski and ice skating equipment rental at some of the parks for a nominal fee. We have also ventured onto the Elver Park ice rink. I need quite a bit of practice at both, but we had fun as a family spending the day outdoors. There are also several downhill ski places nearby.

Here are some other resources and events that your family might enjoy.

Madison Parks: Ice skating, sledding, cross-country skiing. www.cityofmadison.com/parks
Shoe the Zoo: Snowshoe lessons with 50 percent of the fee benefitting the zoo, Jan. 25 and Feb. 9. http://www.vilaszoo.org (click on “Events”)

Read more: http://host.madison.com/news/local/ask/dr-johnson/dr-dana-johnson-plenty-of-ways-to-stay-active-this/article_2785434d-ab3a-56d8-9da2-d132f71be51c.html#ixzz2rKrJf11Q

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Stop by Polar Dash Today

Yes the weather outside might be frightful but Polar Dash will be delightful!

Most of the outdoor activities have been moved inside due to the cold and windy weather. But children can still fun around one snowy course pulling a sled before going inside to warm up. Stop by for this FREE event from 10 am to noon today!

Join us for a fun-filled morning at Polar Dash!
• Race around a snowy course pulling a stuffed bear in a sled
• Enjoy outdoor hula hooping and bean bag toss
• Warm up inside with treats
• Visit the Bear Clinic: Bring your favorite bear (or stuffed animal) from home for a head-to-toe check-up by Meriter doctors.
• Compete in fun games inside!

Polar Dash is free and open to the public. Bring a friend!
Recommended for Kids 12 and under. All are welcome.

Date: January 25
Time: 10 am to noon
Location: Meriter Monona, 6408 Copps Avenue
Cost: FREE

Download the registration form

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Five Foods to Consume, Limit for a Healthier You

Be sure to eat before going grocery shopping because going on an empty stomach will leave you more likely to buy on impulse.

By: Gena Van Kirk, Registered Dietitian/Diabetes Educator

Have you ever gone on a diet in hopes of losing weight, only to go off the diet a short time later? Did you wonder, “Why didn’t this work for me?” Most diets only modify behaviors temporarily which often leads to short-term success and long-term disappointment.

Let’s take a closer look at the word diet. It can be defined in two very separate ways. Definition one, my favorite, is the usual food and drink of a person or animal. That doesn’t sound so bad, does it? The second definition is the one we often think of first, a regulated selection or restriction of food for a specified outcome such as weight loss or other medical reasons. Sounds a little less appealing, doesn’t it?

My challenge to you is to break the “diet” mentality that we have become accustomed to and replace it with a nutrition consciousness that works for life. You can feel better, have abundant energy from morning to night, and look healthier. You may need to take a second look at your eating habits, but with your newfound knowledge about nutrition you should never have to diet again!

Are you ready? Here we go! By following the health conscious guidelines listed below in your everyday food intake, it can happen.

Foods to Include:
It is recommended that you make half of your grains “whole grains”
Examples include: oatmeal, barley, brown rice, whole grain pasta, whole wheat and corn
Lean Meats
Examples include: chicken or turkey without the skin, round or loin cuts of beef and pork, and fish high in omega 3 fats (salmon, lake trout, mackerel, and herring)
Include a large variety of deeply colored fruits and vegetables
Examples include: spinach, carrots, peaches and berries
Enjoy frozen vegetables and fruit, and shop for seasonal produce. Fruits and veggies are less expensive during their peak growing times. Grow a garden! Not only will you save on vegetables like cucumbers and tomatoes, but you’ll stay active with this new hobby. A few ways to eat more fruit include adding it to your cereal, your salads or even your dinner.
Sneak in more veggies by adding a tomato on your sandwich, peppers on your pizza or extra veggies in your pasta sauce. Keep precut or canned/frozen veggies ready for quick snacks.
Heart-healthy fats and oils
Examples include: olive oil, canola oil, nuts and tub margarines
Eat low-fat or fat-free dairy.
Switching to skim milk or fat free yogurt is another simple way to decrease calories.

Foods to Limit:
Sweets and added sugars
Examples include: table sugar, sucrose, glucose, fructose, maltose, dextrose, corn syrups, high- fructose corn syrup, concentrated fruit juice, honey, soda, fruit drinks, candy, cake and jellies
Foods high in sodium
Examples include: many canned and processed food items, pickled or smoked food items
Saturated fats
Examples include: butter, whole milk, 2% milk and cheese, fatty meats and hydrogenated oils
Alcohol
Females should limit to one drink/day; males limit to two drinks/day

Other suggestions:
-Bring a healthy lunch and snacks to eat throughout the day because this will help you stick to healthy food options.
-Keep a bottle of water handy to drink throughout the day to stay hydrated.
-Eat in more frequently. Many restaurants come with extra large portions, and options at fast food restaurants are typically higher in fat, salt and sugar.
-Eat before you go shopping. Going to the grocery store on an empty stomach will leave you more likely to buy on impulse.
-Make your own pre-packaged snacks by buying a large container of raisins, unsalted nuts or popcorn (low salt and fat) and separating them into individual portions yourself.
-Plan your meals each week. By planning ahead, you can check the nutrition facts of a meal before you decide to make it and create a detailed grocery list for easy shopping. Planning also helps avoid impulse shopping.
-Make some substitutes. Look through your cabinets or fridge and pick three foods you eat every day. Write down the nutritional content. Then, the next time you’re at the store, find lower calorie substitutes for just those 3 items.

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Dr. Dana Johnson: Ways to Help Keep Baby Healthy

Originally published on January 8, 2014 in the Wisconsin State Journal. Dr. Dana Johnson is a pediatrician practicing at the Meriter McKee clinic.

Dear Dr. Johnson: I just had a baby and am concerned about her getting sick. What can I do to prevent illness? 

Dear Reader: Congratulations on your new baby. Having a baby during cold and flu season does increase concerns about her getting sick. Young infants have a developing immune system that puts them at high risk of complications even due to common illnesses. 

While it’s not always possible to prevent illness, you can try your best to keep your baby healthy. As always, the best way to prevent the spread of infection is through good hand washing. It is best to do this with soap and water for at least 20 seconds (two rounds of singing “Happy Birthday”). 

If soap and water are not available, alcohol-based hand sanitizer can be used. The hands should be coated front and back, between the fingers and under fingernails with soap or hand sanitizer. It is important even for people with no signs of illness to cleanse their hands, as we often are contagious before we develop symptoms from an illness. 

As long as there isn’t a medical reason to avoid it, I recommend that everyone get their flu vaccination. For those in close contact with infants, it is especially important. Infants cannot get the flu vaccine until they are 6 months old, so we protect them by making sure those around them are less likely to get the flu and, therefore, less likely to spread it. 

It is also recommended that those in close contact with children under age 12 months make sure they have had their pertussis (whooping cough) booster vaccine. 

The next step is to avoid being around anyone who is sick. Most people are good about not coming to visit or coming near your baby when they have an illness, but it’s still good to be aware. 

I make the assumption that this time of year all toddlers have some virus, whether visibly sick or not. If the young child is someone you want to be able to see your baby and touch them (sibling, cousin, etc.) and they don’t have signs of being sick, then help them to wash their hands well before coming into contact with your baby. 

Also encourage them to touch the baby on her head or feet, avoiding the face and the hands. If germs are spread to the face and hands by touching or kissing, they are more likely to make it to the baby’s mouth, nose or eyes and result in the baby getting sick. 

Avoid crowded places where you would be in close contact with many other people. If you decide to attend a party or get-together, it can be beneficial to “wear your baby,” for example, in a sling. This decreases the chances that others will ask to touch or hold your baby. 

If the baby is breast feeding, it is a good idea for the mother to continue breast feeding even if she gets sick, as long as she is physically able. Some of the mother’s antibodies to the illness can pass through the breast milk and provide the baby some protection. 

If your newborn has signs of illness, it is best to be seen or at least discuss it with the baby’s doctor. If your baby has a temperature above 100.4, she should be seen immediately. 

Read more: http://host.madison.com/news/local/ask/dr-johnson/dr-dana-johnson-ways-to-help-keep-baby-healthy/article_3a0c2811-5813-5f3a-8839-1ddff024ba0c.html#ixzz2qJQ2OnZl 

  

 

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Are You Familiar With the Changes in Pap Smear Screening?

If you feel confused about the new pap smear recommendations, talk with your healthcare provider, who can help you create a comfortable plan for screening that is right for you.

By: Marta Staple, APNP

Have you noticed that your doctor or health care provider has stopped saying the word “annual” before the words “pap smear?” Big changes in pap smear screening have occurred in the last 2 years, and the change is from annual pap smears to pap smears every three to five years.

For those of us who have grown accustomed to the pap smear as an expected part of the annual health maintenance exam, it can be a confusing change. Conversely, many women dislike this portion of their annual physical exam and are happy to have fewer pap smears in their lifetime. Both of these reactions to the change are common. Knowing what is right for your health arises from a good understanding of the change in screening recommendations and a conversation with your healthcare provider about how these guidelines apply to you as an individual.

A pap smear is a screening test for cervical cancer, which is a common disease for women worldwide and a leading cause of death for women worldwide. Cervical cancer is caused by small group of high risk types of Human Papilloma Virus (HPV), which is a sexually transmitted disease. In the past, pap smears were recommended to begin within 3 years of the onset of sexual activity, and pap smears would continue annually until age 65 or 70.This pap smear screening schedule reduced the frequency of cervical cancer by 50% in the last 30 years.

New research data shows that a pap smear done every 3 years for women between the ages of 21 and 30 (regardless of onset of sexual activity), and every 5 years with additional high risk HPV testing in women over the age of 30 is as effective as yearly screening to reduce the rate of cancer deaths, but has the additional benefit of reducing the harm of false positive tests. False positive pap smears lead to unnecessary biopsy and treatment procedures that can cause problems in pregnancy later, like preterm labor and low-birth-weight infants. Less frequent pap smears lead to fewer health risks, but it maintains the same degree of disease protection.

A growing number of young women have been vaccinated against HPV infection through the Gardisil vaccine. This vaccine has been shown to reduce the rate of HPV infection in the vaccinated recipients. It protects against 2 types of high risk HPV infection, but it does not protect against all forms of high risk HPV infection. This means that women who have been vaccinated are still at risk for cervical cancer. The new pap smear screening guidelines apply to these women.

Of course, there are still circumstances when a pap smear is recommended more often than every 3-5 years, and those circumstances include a history of moderate or severe cervical dysplasia or pre-cancerous changes, HIV or other forms of immune compromise, unexplained abnormal pap smears, or unusual symptoms.

If you feel confused about these new recommendations, talk with your healthcare provider, who can help you create a comfortable plan for screening that is right for you.

For more information on preventing cervical cancer, watch Marta’s WKOW interview that aired on January 11.

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Meriter Health Services Officially Joins UnityPoint Health

Meriter, Physicians Plus Positioned for Strong Future through Affiliation

MADISON, Wis. (January 3, 2014) — Meriter Health Services is pleased to announce it has officially affiliated with UnityPoint Health, a nationally recognized, integrated health system headquartered in West Des Moines, IA. This agreement became effective on January 1, 2014.

“This is a great day for our patients, members, employers, the regional healthcare system and the local economy,” said Meriter President and CEO Jim Woodward. “We’ve been serving patients in the greater Madison area for more than 100 years and with UnityPoint Health we’re looking forward to an even greater next 100 years.”

An affiliation agreement was signed in October and has now received all the necessary regulatory approvals. The affiliation will allow Meriter to advance its commitment to high-quality, local patient care through shared best practices with UnityPoint Health’s award-winning providers. Meriter will also gain the value of being part of a larger system, helping to lower the overall cost of care.

“We are thrilled to officially welcome Meriter to the UnityPoint Health family. Meriter is a perfect fit for our network of patient-focused, community-minded health systems; dedicated to providing high-quality, lower-cost healthcare throughout the Midwest,” said Bill Leaver, President and CEO of UnityPoint Health. “Through Physicians Plus Insurance Corporation, we’ll have the added benefit of an HMO in our system, which will only enhance our ability to provide truly coordinated care.”

UnityPoint Health now has an indirect ownership interest, through Meriter, in Physicians Plus and intends to purchase the stock of Physicians Plus from Meriter later this month.

Meriter patients and Physicians Plus members will continue to see their doctors and receive care locally, just as before. Meriter and UnityPoint Health hope to build upon current relationships with local health organizations.

Media Note: UnityPoint Health President and CEO Bill Leaver, Meriter President and CEO Jim Woodward will be available to speak to the media on Wednesday, January 8. More details will be made available next week.

About Meriter Health Services
Meriter Health Services is a nationally recognized health system comprised of Meriter Medical Group, offering primary and specialty care; Meriter Hospital, a nonprofit 448 bed community hospital; and Physicians Plus Insurance Corporation. Meriter is a 2013 recipient of the National Research Corporations’ coveted Innovative Best Practice award, Top Rated Adult Doctors award and Top Rated Pediatric Doctors award. Meriter provides a comprehensive array of patient-focused inpatient and outpatient services to meet the health needs of Dane County. For more information, visit meriter.com.

About UnityPoint Health
UnityPoint Health is one of the nation’s most integrated health systems. Its physician-led team of professionals communicates clearly and effectively to address a patient’s health care in the most appropriate setting: whether that is a clinic, a hospital or services provided within the home. Through relationships with more than 280 physician clinics, 31 hospitals in metropolitan and rural communities and home care services throughout its 8 regions, UnityPoint Health provides care throughout Iowa and Central and Western Illinois.

UnityPoint Health entities employ more than 24,000 employees, working toward innovative advancements to deliver the Best Outcome for Every Patient Every Time. Each year, through more than 4 million patient visits, UnityPoint Health, UnityPoint Clinic and UnityPoint at Home provide a full range of coordinated care to patients and families. With annual revenues of $2.8 billion, UnityPoint Health is the nation’s 13th largest nonprofit health system and the fourth largest nondenominational health system in America. UnityPoint Health provides community benefit programs and services to improve the health of people in its communities.

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Protein Shakes Featured on WISC-TV

Chocolate Espresso Protein Shake

1 portion

 1 scoop            Chocolate or Vanilla Protein Powder (go to local health food store to find which one fits your needs the best)

6-8 ounces       Water, Almond Milk, Kefir, Skim Milk or any other liquid source you would like

2 shots             Espresso

 1)   Put all ingredients into a blender and blend for 30 seconds, if adding ice, may be a bit longer.

Kefir is great because it is full of probiotics and will give the shake more of a creamy consistency, close to yogurt.  Vanilla almond milk is safe for gluten free, lactose free individuals and also gives great flavor and consistency.

Chocolate Fruit Protein Shake

1 portion

 1 scoop            Chocolate or Vanilla Protein Powder (go to local health food store to find which one fits your needs the best)

6-8 ounces       Water, Almond Milk, Kefir, Skim Milk or any other liquid source you would like

½ cup              Fresh blueberries, strawberries or any other berry you would like. Can use fresh or frozen

½ each             Banana

 1)   Put all ingredients into a blender and blend for 30 seconds, if adding ice, may be a bit longer.

Kefir is great because it is full of probiotics and will give the shake more of a creamy consistency, close to yogurt.  Vanilla almond milk is safe for gluten free, lactose free individuals and also gives great flavor and consistency.

Use any fruit you would like to make this.

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Five Common Allergy Myths

Gluten allergies don’t really exist, and wheat protein is actually responsible for most true allergic reactions.

By: Dr. Katherine A. Gonzaga, Allergy/Immunology

Allergies can affect people at any age. Unfortunately, there are a lot of common myths and misconceptions about allergies due to a great deal of false information in the media and on the Internet. Some of these misconceptions can be damaging to your health if vaccinations are skipped and/or extreme dietary avoidances are taken. Take a look at the common allergy myths listed below to separate fact from fiction.

1. Egg Allergy and the Flu Vaccine: People who are allergic to eggs may think they need to skip the seasonal flu vaccine because the vaccine is often grown in hen eggs. However, recent research has shown that the flu vaccine does not contain a significant amount of egg protein, and it is very safe to vaccinate people with egg allergy. This research has been consistent in over 20 well conducted clinical trials since 2009.  The Centers for Disease Control still recommends that egg allergic patients seek guidance from their allergist, and it’s not uncommon for patients with egg allergy to be monitored for 30 minutes after vaccination.

2. Gluten Allergy: Many people self-label as having gluten allergy and avoid gluten without any medical indication. However, “gluten allergies” don’t really exist. It’s actually wheat protein that is responsible for most true allergic reactions. This allergy is very different from Celiac Disease (an autoimmune response to gluten) and gluten intolerance so talk to your doctor about your symptoms before making drastic diet changes. 

3. Shellfish Allergy and Contrast Media: There’s a common misconception that people with shellfish allergies are at an increased risk for allergic reactions to the iodine that is sometimes used as a radiocontrast agent during CT scans for better imaging. This notion is false. People with shellfish allergy react to a specific protein found in shellfish. This protein is not present in radiocontrast agents. Therefore, if you have a shellfish allergy, you can most likely safely get radiocontrast medical procedures, unless you have a separate allergy to them.

4. Highly Allergic Foods Should Be Avoided Until Kids are 12 Months or Older: It is commonly thought that highly allergic foods like nuts and fish shouldn’t be given to children until after 12 months of age. These recommendations were made to parents based on guidelines issued in 2000 by the American Academy of Pediatrics. However, the organization changed its guidelines in 2008 due to lack of evidence. It now states children can eat these foods as early as 6 months, as long as they pose no choking hazard. New evidence emerging shows that early introduction of highly allergenic foods may even promote tolerance. However, it’s important to note that the new guidelines may not apply to children in families with a strong history of food allergies. These children should be referred to an allergist for food allergy testing and guidance prior to introduction.

5. Hypoallergenic Dogs and Cats: Sorry, pet allergy sufferers – there is no such thing as a truly hypoallergenic dog or cat. This is largely because pet allergies are due to a protein in pet skin (dander), saliva or urine. It’s typically not the fur of the pet that triggers allergies.  Therefore, even hairless breeds have some allergen exposure that can lead to symptoms. However, each animal is different and some breeds are less bothersome for allergy sufferers than others. See an allergist to get pet allergy testing and begin treatment before you get a pet to help ease symptoms.

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Dr. Dana Johnson: Enjoy Safer, Happier Holidays

Originally published on December 25, 2013, in the Wisconsin State Journal. Dr. Johnson is a pediatrician practicing at the Meriter McKee clinic.

Dear Dr. Johnson: How do I allow my child and myself to enjoy the holiday season more completely?

Dear Reader: Planning ahead and realizing that the holiday hustle and bustle can affect your child is the first step. The holidays should be a fun and exciting time for everyone, especially young children. As hard as it may be, children will handle all the excitement best if they are kept on a somewhat normal schedule.

Children appreciate consistency, so even when sleeping somewhere other than your home, it is best to follow typical nap times and bedtimes as well as pre-nap and bedtime routines. Sleep deprivation can cause a child to sleep more poorly, which further exacerbates the sleep deprivation.

While most adults can make up for late bedtimes by sleeping in later, many young children will not do this. There are children who will wake up about the same time every day no matter what time they fell asleep. If you will be at a party beyond your child’s bedtime, consider hiring a babysitter or talking with the host ahead of time to determine if there is a place your child can safely be placed to sleep.

It is difficult for adults to avoid all the delicious food temptations of the holiday season, and it is even harder for children. Before all the sweets and goodies are made available, offer your child a nutritious, well-balanced snack or meal. This may mean feeding them before going to a party or bringing healthy options with you. If they are already full, the temptation of sweets will be less.

Remember moderation is best. Combine sweets with healthy foods. Don’t leave the sweets sitting out within reach, as it is much easier for adults and children to nibble and consume numerous calories. Many of the holiday treats also can be choking hazards for young children.

Safety can be an issue during the holidays more than other times of the year. Unless the family you are visiting has young children, their home is unlikely child-proofed.

Most holiday decorations are not designed with the safety of small children in mind, as they often are breakable and have small pieces. Other hazards include decorative stocking hooks on a fireplace mantle (children can pull on the stocking, causing the heavy hook to land on them); Christmas trees (children can pull the tree on top of themselves, and real trees can become a fire hazard if they become overly dry); and lights (check for frayed wires or loose connections that could spark a fire).

Also, be especially aware of fireplaces, as many young children are burned by the glass on gas fireplaces each year.

It’s not just decorations that can pose hazards — the actual gifts can as well. Make sure toys are age-appropriate. Children under age 3 should not have toys with small parts, as these can pose a choking hazard. Keep older children’s toys and gifts that may have small parts or are breakable out of reach of younger children.

Some electronic toys and other gifts require button batteries, and many toys also have magnets. Either of these can be hazardous if swallowed. A healthcare provider should be called immediately in such cases (or even suspected cases).
If your child will be getting a bike, skateboard, scooter, skis, snowboard, etc., make sure he or she has a well-fitting helmet. If car travel is in your holiday plans, make sure children are secured in age-appropriate car seats or booster seats. Make sure the car is in good maintenance, keep the gas gauge above half a tank and have a winter emergency kit in the car.

Overall, be patient with your young child this holiday season. Schedules change, children are often around many people they don’t regularly see, and on top of it all, there is the added excitement of the season. Allowing them a little leeway is in order, although unacceptable behavior should still be corrected.

Have a wonderful and safe holiday season!

Read more: http://host.madison.com/news/local/ask/dr-johnson/dr-dana-johnson-enjoy-safer-happier-holidays/article_f0623636-284d-53cd-b40d-b8c556161fe4.html#ixzz2ogm6qFiI

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Healthy Weight and a Healthy Pregnancy

By: April Eddy, RN, CNS, CDE (APNP), Diabetes Clinical Nurse Specialist for Perinatal Services

Healthy weight can reduce the risk for multiple issues for a women’s health in general, but did you know how your weight can affect the chances of having a healthy pregnancy and baby?

Body Mass Index is a number calculated by comparing height and weight. A normal BMI is 20-25, overweight BMI 25-30, and obesity starts at a BMI of 30. Describing weight in this manner helps healthcare providers address the severity and likelihood of complications resulting from excess weight. It can also help direct goals for weight loss, as often times a weight loss reducing BMI by 1 point can greatly reduce risk for that condition. A BMI of 27 has been associated with an increased risk for type 2 diabetes. We know that a weight loss of 7% can greatly lower diabetes risk, so losing 14 pounds if you weigh 200 pounds can greatly lower risk of developing diabetes.

Women whose weight puts them in the obese category are more at risk for many issues during pregnancy including infertility, miscarriage, birth defects, twin pregnancies, gestational diabetes, gestational high blood pressure, urinary tract infections, complicated labor and deliveries, and c-section delivery with difficulty wound healing. These women are also at increased risk for certain conditions prior pregnancy including type 2 diabetes, high blood pressure and sleep apnea that can further complicate a pregnancy.

Women can also have problems with excess weight gain and retain more weight after giving birth. Women who are overweight and women who are obese do not need to gain as much weight during pregnancy. The Institute of Medicine provides guidelines for weight gain during pregnancy.

Unfortunately, most women do not receive guidance on this topic. It can be difficult for patients and providers to have these conversations. Sometimes women are never aware of pregnancy weight related risks and available resources to help them reduce risk.

There are many programs available to help people with healthy eating and weight loss. Avoid “diets” and fads and find out about healthy eating for you. Take advantage of area programs through your community or work. Ask to see a dietitian or if you have diabetes, a diabetes educator. All area HMO’s have these providers available and all of them also have healthy programs to assist participants with healthy eating and exercise. Many communities offer low cost programs through the local YMCA, city recreation departments, schools and churches. Not for you, work on setting up an individual plan.

Remember to always set goals that measure behavior and are simple, easy to measure progress. A goal of “I will exercise more” is probably not the best…a better goal may be “I will walk 30 minutes a day 4 times per week.” Find support to help you achieve your goal, this may be a spouse or friend who watches your child so you can exercise, or someone who will exercise with you and encourage you to go on those days you would like to skip. Losing weight is not easy but remember the rewards are great and any weight loss is a success.

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Dr. Dana Johnson: Holiday Gift Ideas

Originally published on December 18, 2013, in the Wisconsin State Journal. Dr. Johnson is a pediatrician practicing at the Meriter McKee clinic.

Dear Dr. Johnson: Do you have suggestions on the best gifts for children this holiday season?

Dear Reader: It is the time of year that many children are compiling their list for Santa. As parents, we want to make sure their holiday wishes are met but some gift options are definitely better than others.

For children of any age, gifts that require children to use their own imaginations can be very educational. Especially for young children, I recommend limiting toys that have a single defined use or way to play with them (many electronic toys). Something as simple as blocks can be more educational and entertaining: they can be used to make a fort for other toys; they can be stacked into a tower; they can make a road for toy cars; and many other possibilities. For children under 2, sometimes the box and wrapping can be as or more entertaining than the toy inside.

Screen time is not recommended for children under age 2 so tablets, movies, etc are not appropriate for this age group. Also avoid toys with small parts that could be choking hazards for small children.

Some children can become overwhelmed by the number of toys they receive during the holiday season. Once the gifts are opened, leave a few out for your child to play with and put the rest in a closet. Pulling out one of these “new” toys can provide needed entertainment on a cold, snowy January day.

For many older children, electronic devices may be high on their wish list. While these can be educational and entertaining, their use still needs to be limited. For children over the age of 2, all screen time (TV, video games, computers, etc.) should be limited to a total of 2 hours or less per day. How the device is used and what games are played also need to be monitored. So if Santa will be delivering a new video game system or iPod, be ready to set limits on use from the beginning. If the ground rules are set and enforced from the beginning, hopefully there will be fewer battles regarding use later. Sometimes Santa will even provide these rules along with the gift.

Help to set your child’s expectations as they are preparing their lists. If the list to Santa becomes quite long or expensive, explain to young children that Santa may not be able to bring them everything as he has to bring toys to all little girls and boys. For teenagers, you can discuss more the cost of gifts and narrowing the list based what they want the most.

The holiday season can also be a great time to teach children the joy of giving. Taking the opportunity to volunteer or purchasing gifts for those less fortunate can be a valuable learning experience to teach children the value of sharing time and treasure with others.

I hope you have a wonderful holiday season!

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-holiday-gift-ideas/article_d314cece-9ee2-5583-a3ba-f9002066dfdd.html#ixzz2nxjpTjqk

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