Giving Circle Grants Announcement

The Giving Circle of Fort Memorial Hospital Foundation is pleased to announce the grants that were awarded from funds raised during its 2013 program year. The grants totaling $14,550 were awarded to three health and wellness initiatives at Fort HealthCare.

A grant for $6,500 was awarded to support the services of Dr. David Rutledge at the Rock River Free Clinic. Fort HealthCare’s commitment to Dr. Rutledge’s service on a full-time basis has allowed the clinic to nearly triple the number of children and families being served in the past year. The Rock River Free Clinic provides preventative care and treatment for at risk and vulnerable children and families who live in Jefferson County.

A grant for $6,500 was awarded to the Community Health & Wellness initiatives of Fort HealthCare in collaboration with the Healthiest Community Coalitions in Jefferson and Walworth Counties. These coalitions improve the health of their local communities through activities and education that fit local interests and needs. Coalitions in Cambridge, Fort Atkinson, Jefferson, Johnson Creek, Lake Mills, and Whitewater are planning activities for the coming year.

A grant for $1,550 was awarded to the Pediatric Wellness Team at Fort HealthCare to combat childhood obesity. Funds will be used to expand opportunities for children and families seeking to incorporate healthier eating and fitness habits into their everyday lifestyle. Programs such as Movin’ & Losin’, Railyard Obstacle Course, and Camp 911 continue to grow due to increased interest from local families.

The Giving Circle invites women who are interested in improving the health and well-being of our community to become members in 2014. A series of four lunches is held each year to educate members about healthcare issues important to the Fort HealthCare service area. Members are asked to contribute a minimum of $100 to participate. At the end of the program year, the membership awards grants to Fort HealthCare to support the healthcare needs of children and families in our community.

If you are interested to learn more about the Giving Circle, you are welcome to contact the Foundation office at (920) 568-5404 or email at foundation@forthc.com.

Cold: Friend or Foe?

grandparents talking to granddaughterMost of us are ready to say goodbye to the ice, snow, and cold.  Icy conditions can contribute to a slip hazard.  When that happens to you, it’s easy to want to stay inside until the Spring thaw.  But inactivity can be equally harmful.  If you or someone you know would like to overcome a fear of falling, the Wisconsin Institute of Healthy Aging offers a variety of instruction to increase your strength and balance.  “Stepping On” is a 7-week course that meets once per week; class members learn from each other as well as from an array of guest experts related to balance, home environment, footwear, vision, and more.  This year I will be teaching “Stepping On” during the summer so that participants will be able to approach the cooler weather with confidence; if you are interested in taking the class locally you will find it at FortHealthCare.com/Classes and in the monthly Health365eNewsletter published by Fort Health Care.  I encourage you to browse the Wisconsin Institute of Healthy Aging webpage to explore the variety of classes available in the counties throughout the state:   http://wihealthyaging.org/.  From the homepage you can click on the “Find a Program” tab to learn more about criteria for each course, or “Find a Workshop” to see the scheduled classes.   You owe it to yourself to stay as active as possible during all four seasons.

When an injury does occur from a fall or other activity, you may consider cold helpful.  Ice is a common component of conservative care, RICE: rest, ice, compression, and elevation.   Whereas sore or tight muscles can benefit from heat, ice can help provide pain relief and minimize swelling from physical strain.  This is especially beneficial in the first 24-48 hours after injury.  You may benefit from using ice longer than that, especially if you have had a more severe injury or surgery; your healthcare provider will let you know after making sure that it is “just a strain.”  When an injury occurs to the fingers, wrists, or hands, a bag of frozen peas can work well to mold around the injured area.  Alternatively, at The Center for Hand Care, we recommend an ice pack recipe you can keep ready in your freezer.  In a secure Ziploc bag, combine 1 part rubbing alcohol with 2 parts water.  Place this mixture inside of another Ziploc bag to prevent leaks.  This will become a gel consistency within a day.  Use a protective cloth between your skin and the ice pack, and keep it on up to 10 minutes (or as soon as area feels numb).   If you are using the ice pack on a larger body area, it may take up to 20 minutes before the area feels numb.  Use ice with caution if you have poor circulation, a previous cold injury, or arthritis.  See, cold can be useful!

Tags: , , , ,

My New Year’s “Health” Resolution

“I will take better care of my diabetes.” Diabetes is a scary diagnosis because it is about more than just blood sugars. It is a disease that affects your blood vessels, and it can lead to a stroke or heart attack. Other than heart disease, diabetes is a disease that affects the eyes, kidneys, nerves and other small blood vessels. The “complications” of diabetes are really complications of uncontrolled blood sugars.

Once a person has diabetes, he or she has to watch lipids (cholesterol numbers) and blood pressure, as well as blood sugars. Medications, lifestyle and diet all affect diabetes, and managing these are the core of diabetes care. One of the tests that help us see how well diabetes is controlled is the A1C test. It is also called hemoglobin A1c ( HbA1c), or glycated hemoglobin test. The HbA1c test shows the average blood sugar levels for the past two to three months. It measures how much of the hemoglobin (red blood cells) is glycated (coated in sugar).

“Statistically, we know people who attend diabetes self-management training (DSMT) and go to yearly DSMT follow-up education manage their diabetes better,” reports Rhonda Perdelwitz, RN, BSN and Certified Diabetes Educator at Fort Atkinson Hospital. “The American Diabetes Association suggests having an A1c of 7% or less is optimal blood sugar control and you can improve, reduce or eliminate complications of diabetes.”

If your A1c test has not been done for 4 to 6 months, ask your doctor to have this test done. This blood test does not have to be done fasting. If the results are 7.0 or higher, ask your doctor to refer you for diabetes education to the nurse and dietitian.

Diabetes education is covered by some insurance plans. Because each insurance plan is different it is recommended that you call your insurance company and inquire on if diabetes self-management training is a paid benefit. If you have Medicare, diabetes education is a preventative program Medicare covers. Medicare pays for 10 hours of diabetes class education the first year of a new diabetes diagnosis and for 2 hours every year after initial diagnosis. To meet the Medicare requirements for DSMT education the patient must have a referral from the doctor. Go to www.medicare.gov to see what kind of coverage the plan you are on has.

So when you think “I am going to take better care of my Diabetes” it may simply mean asking your doctor for a referral to diabetes education.

Tags: , ,

What Causes Kidney Stones?

This is maybe the most common question I get. The answer is far from straight forward and usually a combination of patient-specific factors.

Kidney stones form when, if the urine chemistry is just right, substances combine, crystallize, and then those crystals bind together to form stones.

There are many different types of stones: Calcium Oxalate, Uric Acid, Calcium Phosphate, Magnesium Ammonium Phosphate, and Cystiene stones make up the majority of stone types. About 80-85% of stones are calcium based but it is a common misconception that these calcium-based stones are caused by too much dietary calcium (milk, cheese, yogurt, etc.). Usually it is a problem with the way your body handles the calcium. Abstaining from dietary calcium in these circumstances can do more harm than good.

When looking at ways to prevent stones, I focus on common dietary factors that can increase risk. High sodium intake is probably the biggest contribution to stone risk. Excessive sodium from canned foods, processed meats, restaurants, prepared boxed or frozen meals…all contributes to increased stone risk. I try to get my patients to A) recognize where the sodium in their diet is coming from (rarely just the salt-shaker) and B)keep their sodium intake to <2500mg/day.

Sodium is a big culprit, but chronic dehydration is probably the other most common problem. Stone formers should drink no less than 64oz/day of water, ideally with up to 4oz of lemon juice. Lemon juice is high in citrate which is a potent stone inhibitor. Excessive protein consumption can also lead to a more acidic urine, predisposing to certain types of stones.

If a patient has had more than one stone, or if they are young with a strong family history, I usually recommend blood and 24 hour urine testing for a custom stone prevention workup.

If you or a friend/loved one have lived with recurrent stones and haven’t been evaluated for prevention, give us a call.

Tags: , , ,

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.

Tags: , , , , ,

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

Tags: , , ,

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

Tags: , , , ,

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.

Tags: , , ,