Mesh: That sounds bad, right?

I’m sure many readers have seen or heard the commercials featuring law firms that do not have many very nice things to say about “mesh”.

So what is mesh and what should I do about it?

“Mesh” often refers to a web-like sheet of a kind of plastic, polypropylene, that has been used medically for various reasons for many years. This mesh is woven into various shapes and sizes. It is used for large blood vessel reconstruction, hernia repair (umbilical, inguinal, ventral, etc.), incontinence and pelvic organ prolapse.

The controversy surrounding mesh focuses on mesh products that were placed vaginally for pelvic organ prolapse. Prolapse is a condition where the bladder, bowel, or uterus is literally falling out of the vagina, usually causing a prominent bulge. These prolapse-fixing products are often large sheets of oddly-shaped mesh meant to reinforce weakened vaginal tissues. If used properly, they helped many women with their prolapse problems. If used improperly and in the wrong patients, the mesh could erode into structures nearby such as the bladder, the ureter, vagina, or bowel. Usually this requries an additional surgical procedure to remove the mesh. This need for re-operation due to mesh complications led the the Food and Drug Administration (FDA) to issue a “Safety Communication” regarding vaginal mesh for pelvic organ prolapse.

Once again, the mesh “controversy” is regarding mesh used for pelvic organ prolapse. The small pieces of mesh desiged to treat female incontinence are not implicated as problematic and still remain an excellent option for treating stress incontinence. This is a type of incontinence that is often best treated with surgery as no medications are effective. Pelvic exercises (kegels) are often tried first but some women remain bothered by the incontinence and surgery is the next step.

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Are You Troubled by Pain, Numbness or Tingling in Your Hands?

Carpal tunnel syndrome (CTS) is a problem that affects the wrist and hand. The carpal tunnel is a narrow space inside the wrist that is surrounded by bone and ligament. This space lets certain tendons and a major nerve pass from the forearm into the hand. With CTS, the tendon sheaths may thicken and enlarge. This reduces the amount of space inside the carpal tunnel. As a result, the median nerve may be compressed.

Tingling and numbness are the most common symptoms of CTS. Some people also have hand pain or even a weakened grip. At first, symptoms may wake you up at night. Later, they may also occur during your daily routines. Your symptoms may become more severe over time.

The most common symptoms for carpal tunnel syndrome include:

  • Weakness when gripping objects with the hand(s)
  • Pain and/or numbness in the hand(s)
  • “Pins and needles” feeling in the fingers
  • Swollen feeling in the fingers
  • Burning or tingling in the fingers, especially the thumb and the index and middle fingers
  • Pain and/or numbness that is worse at night, interrupting sleep

Treatment may include:

  • Splinting of the hand (to help prevent wrist movement and decrease the compression of the nerves inside the tunnel)
  • Oral or injected (into the carpal tunnel space) anti-inflammatory medications (to reduce the swelling)
  • Surgery (to relieve compression on the nerves in the carpal tunnel)
  • Changing position of a computer keyboard, or other ergonomic changes

Surgery is not always a recommended course of action. I have been very excited about the feedback we receive from patients regarding the outcomes for carpal tunnel surgery. Not only are most patients achieving relief of numbness, tingling, and pain, but with our rapid mobilization program they are experiencing a quicker return to function with minimal down time. Care is coordinated with a Certified Hand Therapist, and our Hand Care Center is set up to provide easy communication.

Carpal Tunnel release is one of the most common surgical procedures. If you are experiencing any discomfort in your hands or wrists, I would encourage you to talk to your doctor or give us a call.

www.FortHealthCare.com/HandCare

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It’s Holiday Cookie Baking Time!

It is the time of year when we dust off the rolling pins, and mix up some cookie dough to roll and cut out cookies. How are your hands feeling while doing this task? Any joint pain? Any hand stiffness? Your friends at the Fort HealthCare Center for Hand Care in Fort Atkinson offer some tips:

 1. Pace your activity. All that gripping and pinching can take its toll on hand joints. Try working for 20 minutes, then rest for 20 minutes. Repeat.
2. Delegate! Have some friends or relatives come over and make it a baking day. My daughters and I are going to have one this Saturday. It’s a lot of fun and you can get the younger ones involved and save your hands.
3. Try wool or cotton gloves at night. Sometimes a glove on the hand at night can help provide neutral warmth that can help hands feel less stiff in the morning.
4. Use your appliances instead of hand mixing. But, if you do hand mix, hold the spoon like a dagger to avoid awkward joint postures in your larger knuckles.
5. When sitting or standing while decorating the cookies, avoid awkward reaching. Keep your supplies at waist level, within easy reach. Watch your posture and avoid sitting or standing for prolonged periods. Get up and walk a bit and then get back at it.
6. Use utensils with wider handles for easier gripping.

Hope your holidays are happy and healthy!

I know where every good bathroom is between here and Sauk City.

If you find yourself emptying your bladder before you leave the house, only to have to stop three times between here and Madison, you have an overactive bladder.  “Overactive Bladder” is a term we use to describe a strong, frequent, bothersome urge to go to the bathroom.  It is very, very common but it is NOT necessarily a “normal” part of aging.  Sometimes the urge is so great folks have trouble making it to the bathroom fast enough.  That’s called Urge Incontinence and it is at the far end of the wide spectrum of overactive bladder symptoms.

It is really important to bring up these symptoms to your doctor.  The symptoms of having to urinate often and urgently could represent a bladder infection.  If you have any blood in your urine associated with these symptoms you should be seen by your doctor right away.  Cancers can develop in the bladder and sometimes the only symptom is the constant urge of having to void. 

Ruling out something dangerous is usually as simple as an office-based urine test.  Once you have ruled out an infection or other trouble, there are many different reasons to look into about why your life revolves around where the next bathroom might be.

You see, the bladder is meant to have a pretty boring existence.  Ninety-nine percent of the day, the bladder should be spending its time filling with urine.  That’s it, just hanging out.  It’s supposed to wait until it is full before giving your brain the signal that “it’s time to go”.  At that point, you should have plenty of time to get the bathroom without having an accident.  Even if you’re 80 years old, you should have plenty of time to get to the bathroom without having an accident.  You might say “Well, I’ve always been rushing to the bathroom”.  If that’s the case, then we really should talk.  Bad habits can seriously affect bladder function and with early intervention, we can prevent permanent bladder damage.

A lot of different things can interfere with normal bladder function:  volume of fluid intake, type of liquid (Coffee caffeinated/decaf), bathroom posture, bowel function (especially constipation), nerve damage from prior pelvic surgery, other neurologic conditions like Parkinson’s Disease…the list goes on.  Although treatment sometimes requires a medication, some patients do really well with some simple exercises and behavioral modifications.

Fort HealthCare Urology Associates

What is Low Testosterone (Low T)?

We’ve all been bombarded by the ads on TV of sad middle-aged men that are tired.  Tired and they can’t get erections and have a decreased libido (sex drive).  Then there’s a promise of a virtual “fountain of youth” in the form of a daily gel applied to the underarm, groin, or shoulders…sometimes all three.  Sad man turns into happy, newly moustached, fully-restored man that can now throw a football again.

Low Testosterone is not a new medical diagnosis, but there just so happens to be four relatively new brands of testosterone gel, all vying for your (or your insurance company’s) dollars, hence the deluge of direct-to-consumer advertisements. 

It’s important to remember that Low Testosterone is a lab value.  If your testosterone is found to be abnormally low and you have symptoms, you could be a candidate for testosterone replacement therapy.  Amazingly, over 25 percent of men prescribed testosterone replacement have not had their blood testosterone levels checked! 

The symptoms of low testosterone include decreased libido, erectile dysfunction, difficulty recovering from exercise, decreased muscle mass, and decreased energy or “get up and go”.  As you can see, many of the symptoms of low testosterone overlap with other unrelated conditions. 

If you’re meeting with your primary care physician for an annual physical, do not assume that testosterone will part of the normal panel of labs.  This is a separate, specific test done only in situations of men that are symptomatic.  If you do have your lab work done, make sure to have your T checked within three hours of waking.  This guarantees an accurate reading when your T is at its highest (there’s a scientific explanation for morning wood!)  Usually there are follow up labs to determine if there is any other correctable cause to the low testosterone.

There are several potentially harmful side effects to testosterone replacement therapy.  These may include fueling the growth of prostate cancer, worsening urinary symptoms related to enlarged prostate, and potentially an increased risk of cardiovascular disease.  The effects of treating large populations of men with testosterone has not been extensively studied.  In addition to the physiological side effects, testosterone gel is usually pretty expensive, so keep that in mind if you’re considering therapy. 

As much as there is controversy to diagnosing and treating men with low testosterone (for good reason) some men truly benefit from carefully directed therapy.

Fort HealthCare Urology Associates

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Healthy Eating – A Key Ingredient to Preventing Type 2 Diabetes

November is Diabetes Awareness Month!

You’ve heard it countless times before – eat healthy.  Here is one more reason to follow that advice.  Science has proven that if you lose a small amount of weight by eating healthier and being physically active 30 minutes a day, five days per week, you can prevent or delay type 2 diabetes.

The National Diabetes Education Program, sponsored by the National Institutes of Health (NIH) and The Centers for Disease Control and Prevention (CDC), has developed educational materials for many audiences and in several languages as part of the Small Steps. Big Rewards Prevent type 2 Diabetes campaign. Although there are lots of diet choices and weight-loss plans available, taking small steps to reduce fat and caloric intake and becoming more physically active is most likely to lead to successful weight loss—and helps to keep the weight off as well.

Why is preventing type 2 diabetes so important?
Diabetes is a condition where the body cannot process glucose, one of the fundamental things our body needs to have energy. If undiagnosed or not managed properly, diabetes can be very dangerous. When your body doesn’t make or use insulin properly, it can’t covert glucose into energy in order for your body to function. All this extra glucose builds up in your blood stream, depriving your body of the energy it needs. This results in high blood sugar levels.

Prolonged periods of high blood sugar can lead to a lot of problems. If left untreated, diabetes can lead to:

  • Kidney disease
  • Nervous system disease
  • Amputation
  • Eye problems or blindness
  • Skin problems
  • Heart disease
  • Peripheral Artery Disease
  • High blood pressure
  • Dental problems
  • Stroke
  • Death

Here are some tips for eating healthier and getting you on the road to diabetes prevention:

  • Eat a variety of fruits and vegetables.  A serving is one medium- sized fruit; ¼ cup of dried fruit; 1 cup leafy vegetables; ½ cup raw, cooked, frozen or canned fruits or vegetables.  Buy a new fruit or vegetable during each shopping trip.  Try eating at least one serving of a fruit and vegetable at each meal.
  • Choose water instead of regular sodas or fruit drinks.
  • Instead of fried chicken, try it grilled or baked. Instead of French fries or potato chips, slice a few potatoes, sprinkle them with a little oil, salt, and pepper, and bake them in the oven.
  • Curb your craving for dessert or a sweet snack by eating a piece of fruit.
  • Instead of salty, fat-filled snacks, eat crunchy veggies with low or reduced fat dip.  

You can prevent or delay the onset of type 2 diabetes through a healthy lifestyle. Change your diet, increase your level of physical activity, maintain a healthy weight…with these positive steps, you can stay healthier longer and reduce your risk of diabetes.

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You Are What You Eat!

Eating healthy is an important part of a healthy lifestyle and is something that should be taught to children at a young age. The following are some general guidelines for helping your child eat healthy. It is important to discuss your child’s diet with your child’s health care provider before making any dietary changes or placing your child on a diet.

  • Eat three meals a day, with healthy snacks.
  • Increase fiber in the diet and decrease the use of salt.
  • Drink water. Try to avoid drinks and juices that are high in sugar.
  • Children under the age of 2 need fats in their diet to help with the growth of their nervous system. Do not place these children on a low fat diet without talking with your child’s health care provider.
  • Eat balanced meals.
  • When cooking for your child, try to bake or broil instead of frying.
  • Decrease your child’s sugar intake.
  • Eat fruit or vegetables for a snack.
  • Decrease the use of butter and heavy gravies.
  • Eat more lean chicken, fish, and beans for protein

Making healthy food choices
MyPlate.gov
The Choose My Plate icon is a guideline to help you and your child eat a healthy diet. My Plate can help you and your child eat a variety of foods while encouraging the right amount of calories and fat.

The USDA and the U.S. Department of Health and Human Services have prepared the plate to guide parents in selecting foods for children age 2 and older.

The My Plate icon is divided into five food group categories, emphasizing the nutritional intake of the following:

  • Grains. Foods that are made from wheat, rice, oats, cornmeal, barley, or another cereal grain are grain products. Examples include whole wheat, brown rice, and oatmeal.
  • Vegetables. Vary your vegetables. Choose a variety of colorful vegetables, including dark green, red, and orange vegetables, legumes (peas and beans), and starchy vegetables.
  • Fruits. Any fruit or 100 percent fruit juice counts as part of the fruit group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut up, or pureed.
  • Dairy. Milk products and many foods made from milk are considered part of this food group. Focus on fat-free or low-fat products, as well as those that are high in calcium.
  • Protein. Go lean on protein. Choose low-fat or lean meats and poultry. Vary your protein routine—choose more fish, nuts, seeds, peas, and beans.

Oils are not a food group, yet some, such as nut oils, contain essential nutrients and can be included in the diet. Animal fats are solid fats and should be avoided.

Exercise and everyday physical activity should also be included with a healthy dietary plan. For more information, visit FortHealthCare.com/HealthyKids.

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Knowing Matters

One in eight women either currently has or will develop breast cancer in her lifetime.

If detected early, the five-year survival rate for breast cancer exceeds 96 percent. Mammograms are among the best early detection methods, yet 13 million U.S. women 40 years of age or older have never had a mammogram. The National Cancer Institute and U.S. Department of Health and Human Services recommend that women in their forties and older have mammograms every one to two years. A complete early detection plan also includes regular clinical breast examinations by a trained medical professional. In addition, monthly breast self-exams are strongly suggested.

At Fort HealthCare, we use the best available imaging technology referred to as “full-field digital mammography.” This offers greater power to detect subtle breast tissue changes ultimately enhancing the ability to detect breast cancer early.

Because early detection is so critical, we partner with the UW Health Radiology department for reading and interpretive services. That means that radiologists, specializing in breast health, will review your mammogram. You get the same care and service you would get at a larger facility while staying close to home. And, your results can follow you electronically at UW Health and Meriter facilities.

FREE MAMMOGRAMS FOR UN- OR UNDER-INSURED WOMEN
The Wisconsin Well Woman Program (WWWP) provides preventive health screening services to women with little or no health insurance coverage. Women aged 45 – 64 (with some funding for ages 35 – 44) who meet income requirements, can be enrolled in WWWP for breast and cervical screenings. For women in this category, age 40 – 49, Fort Memorial Hospital Foundation Vouchers are available to use for a free mammogram. For more information on WWWP or Fort Memorial Hospital Foundation Vouchers, please contact the Jefferson County Health Department at (920) 674-7193.

STATE-OF-THE-ART CARE
FHC Pink Ribbon FacilityFort Memorial Hospital is a Pink Ribbon facility, recognized as providing excellence in breast health paired with exceptional commitment and support to the women of our community.

When something is found during these routine screenings, it can be a confusing and scary time. To help ease stress, provide knowledgeable guidance, support, and education to women in all stages of breast care, we have created our new Healing Breast Care Center.

SAVE THE DATE for the Fort HealthCare Healing Breast Care Center Open House at Fort Memorial Hospital on Tuesday, October 29th from 3-6 p.m. Email promo@forthc.com if you would like an invitation sent to you!

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Meatless Mondays

FHC Meatless MondaysWell, another month down-hard to believe. For many individuals and families this is the last week of summer before school is back in session, and the calendar is starting to become scary with all of the activities, meetings and plans. (On a positive note, September means football is starting back up!) It’s easy to lean toward making poor nutritional choices when the schedule gets crazy and convenience takes priority. Perhaps this school year new goals for tackling new health regimes can be made for you and your family!

Growing up, I broke the mold with diet and nutrition and stopped eating meat when I was in first grade. My family is very “meat and potatoes” and did everything they could think of to get me to eat meat. However, I spent dinnertime picking out every minute piece of hamburger and chicken out of my dinner because I hated the taste and texture. Bless my parents’ hearts for trying, but I was a lost cause becoming a carnivore.

There was always a separate meal for me growing up and my mom went above and beyond to make sure I had enough protein sources and was always introducing new foods such as quinoa and TVP (textured vegetable protein) to ensure I had enough to eat. Dad always made sure there was enough celery in the fridge. As the years went on and as I started high school, more and more meals with the family were vegetarian and I could count on at least one meal a week where everything was “safe” from meat. This brought our family together, and encouraged a healthier day during the week.

Now, I won’t go on a rant about converting everyone reading this into a vegetarian, as it may not be a good fit for everyone. But, a well-balanced vegetarian diet tends to be lower in cholesterol, certain fats and calories and can offer numerous health benefits. Even just replacing the meat in one meal a week can kick-start healthier habits.

Meatless Mondays is a concept I have heard about in magazines and from other families and individuals adapting their lives on a quest for a healthier lifestyle. Once a week, (Mondays in this example) one meal is made entirely sans meat. It’s an easy way to branch out and to make an adjustment during the week that is health conscious and a great way to try new foods. Many vegetarian recipes that are available simply omit meat and/or add vegetables and have all the flavors of the original dish. Examples of this would be spaghetti with sauce and vegetables, chili with extra beans, and tacos with vegetables and guacamole.

If the thought of one vegetarian meal a week scares you, adding vegetables or fruit to each meal may be a better starting point. Start with one day a week adding a fruit, or a vegetable and work your way up to most meals of the week. There are so many options available, and a variety of ways to season and cook them that can jive up the flavors and make it an easy transition for day to day usage. Branching out and trying new foods can be a fun and rewarding experience, especially when you find fruits and vegetables that are winners in your family.

As a resounding theme this month, farmers markets and stands are a great place to peruse and pick up vegetables, fruit and other products during the week that can be incorporated into meal planning. The produce is almost always fresher straight from the farm than in the supermarket, and many times you can taste the difference-making eating vegetables a little more fun and palatable. Make it a goal to start small and continue to make changes that will benefit your body today and in the future!

A healthy snack—when your munchkins have the munchies!

You can hardly watch the news without seeing an ad for a new food product masqueraded as a “healthy,” “all natural,” snack.  More often than not, there is nothing natural or healthy about those foods.  With childhood obesity rates skyrocketing, it’s important to teach your kids how to make healthy choices, and what better way than to let them make nutritious snacks that are easy and delicious!

The first step is setting aside a low cabinet or low refrigerator shelf where kids can access food to make snacks on their own.  As school and sports begin to once again crowd your family’s schedule, you could also make some simple homemade granola bars or trail mix for a convenient, on-the-go snack for your busy bees. 

Here are some great, easy recipes for kids to make on their own.  

  1.  Vegetables and Dip – Keep washed and prepared veggies in a low drawer in your refrigerator with small containers of low-fat dip.

Shopping List: baby carrots, cherry tomatoes, cucumbers, broccoli, cauliflower, bell peppers, sugar snap peas, ranch dip

  1. Fruit and Cheese Kabobs – These are a great snack that will keep the younger kids busy while they hone in on their fine motor skills.  Keep bowls of cut up fruit and cheese cubes so the kids only have to thread them on the kabob. 

Shopping List: Pineapple, apples (dip in orange juice so they don’t brown), strawberries, grapes, cheese cubes, wooden kabob sticks

  1. Yogurt Parfaits – Save money and calories by making your own sweet treat!  Plain yogurt sweetened with fresh fruit and sprinkled with some granola is a colorful, tasty treat that is healthy as well. 

Shopping List: plain yogurt, granola, fruit, frozen or fresh berries

  1. Ants on a Log – Celery sticks filled peanut butter and raisins are a good source of protein.  Peanut butter can get messy for younger children, so you may consider putting peanut butter in an icing bag (a plastic bag with the corner snipped).  They can pipe the peanut butter right on to the celery without making a mess.

Shopping List: celery sticks, peanut butter, raisins

  1. Cinnamon or Peanut Butter Toast – Learning to use the toaster is a great cooking lesson for your child.  Whole grain bread with peanut butter or lightly buttered with cinnamon sugar is a great snack that easily introduces children to the kitchen. 

Shopping List: bread, peanut butter, cinnamon and sugar

  1. Microwave Pizza – Older kids can use pita bread, sauce, cheese, and toppings to make a healthy microwave pizza themselves.  You may consider trying it yourself ahead of time to see how long it takes to melt the cheese.  You could even post a chart with the cooking times for some of their favorite snacks so they have it for future reference. 

Shopping List: pita bread, pizza sauce, pizza cheese, pizza toppings

Letting your kids make their own snacks and encouraging them to help cook dinners is a great way for them to learn healthy habits and portion sizes while spending quality time together as a family.  Here are some other fun ways to involve your kids in the kitchen!

Need some help getting started? Our Let’s Do This web portal offers endless opportunities to learn about family wellness, nutrition and medical conditions. Fort HealthCare can also give you the help and motivation you need to make healthy family choices with the NEW Movin’ and Losin’ class. This class, held every Tuesday at 6:30 p.m. from September 17 to October 22, is designed for families with children ages 8 – 15 years old who are looking for ways to incorporate healthier eating and fitness habits into their everyday lifestyle. Each week, one of our Pediatric Nurse Practitioners and Occupational Therapists will cover a different topic related to diet and exercise, including a family activity utilizing Fort HealthCare’s new Railyard fitness equipment. Space is limited! Register online today or call Andrea Billinghurst at (920) 568-5244 to reserve your spot!

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