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V.I.A. Health System

Thursday, December 18, 2014

Avoiding Winter Weight Gain

Winter can be a tricky time for maintaining a healthy weight. Besides the holiday food glut, cravings for comfort foods and less daylight combine to undermine our healthy eating and exercise efforts. Our nutrition expert offers some practical tips to eat healthy and stay active.

Last winter was a doozy. Multiple snowstorms and single-digit temperatures were rough. If you gained weight over the long winter months, you weren't alone.

"Gaining weight during the winter months is a common phenomenon," says Audrey Fleck, MS, RDN, LDN, CFSP
 of Doylestown Hospital Nutrition Therapy and Counseling. "There are many factors contributing to winter weight gain."

Audrey answers some questions about winter weight gain and offers tips for staying out of trouble.

Does the winter have an effect on people’s diets?

I think it depends on the individual person, but warm foods as well as those known to comfort us can do just that – warm us up and comfort us. People can usually always find a reason to eat if they want to and an impending snowstorm can be a reason to stock up on foods that are often considered "junk" or comforting. One may reason that these foods might make it more "fun to be snowed in." In my experience, some people calm anxieties with food as well. Here's an example, I ran into someone I knew in Wegmans supermarket last year right before a snowstorm. She was stocking up on chips and ingredients to make sour cream and onion dip because of the storm!

Why do people crave carbs and other "comfort foods" in the winter?

In my experience, people crave carbs and "comfort foods" throughout the entire year. Because sugar can change our brain chemistry and increase serotonin levels (the hormones that make you feel good), more often than not once people are exposed to foods high in refined sugar, they crave more because of the "feel good" effect on the brain. Starting at Halloween and up to the New Year, people are exposed to more sugar than they previously were months before. To the right person, this exposure can trigger out-of -control binges on sugar and processed foods that may continue on throughout the rest of winter.

Does the shortened amount of daylight contribute to weight gain?

Definitely! Shorter days mean less sunlight. Insufficient exposure to sunlight has been associated with decreased serotonin levels, carbohydrate cravings, and sleep disturbance. All of these factors are associated with weight gain. Also, with less daylight, there is less time to fit a daily walk or hike in.

What are some strategies for fighting winter weight gain and a staying active even when it's 4 degrees outside?

  • Choose warming, healthy foods! If you are making food at home, it is always healthier than if you were to dine out or buy pre-prepared foods. Make a homemade soup or chili once a week.
  • Focus on grounding and root foods during this season such as grass-fed beef, chicken, wild caught fish, eggs, sweet potatoes, turnips, and winter squash.
  • Choose seasonal produce like dark leafy greens (spinach and kale), broccoli, cauliflower, and Brussels sprouts.
  • Mindful eating can be the single most effective thing you can do to prevent weight gain around the holidays. Mindful eating brings non-judgmental awareness to the act of eating. For example, if someone at work brings a platter of cookies to share, instead of mindlessly having one because it’s in sight, you may try to decide first if you are truly hungry.
  • Indoor exercises are aplenty! If you usually walk for exercise, you may consider joining a 6- or 12-week program at a gym, where you may not necessarily have to be a member. Dumbbells and exercise bands, as well as body weight exercises, are effective and can be done from your home. To get cardiovascular exercise, look into DVDs or sometimes you can find free exercises On Demand from your cable provider.

About Nutrition Counseling of Doylestown Hospital

Nutrition Counseling of Doylestown Hospital offers personalized nutrition plans for those with a current medical condition or those interested in preventive health and weight loss. Visit Nutrition Counseling of Doylestown Hospital for more information.

Wednesday, December 17, 2014

Avoid Knee Pain this Winter

Winter sports are fun, but can take a toll on your knees. Follow these tips to keep knees healthy and pain-free.

Sledding, skiing, snowshoeing . . . they're all fun, but as we get older winter sports activities can cause pain in aging knees. Much of it is caused by arthritis, which is inflammation of one or more of your joints. Osteoarthritis is the most common form of arthritis in the knees.

Osteoarthritis most often occurs in people age 50 and over due to the wear and tear of daily living and physical activity. Pain, swelling, and stiffness are the main symptoms of arthritis. Any joint in the body can be affected by osteoarthritis, but it is particularly common in the knee.

These tips for maintaining strong, healthy knees can help you survive winter sports and be ready for more action in the spring -- and throughout the year.

Maintain a healthy weight

The more overweight you are, the more pressure you put on your joints. Every extra pound exerts four pounds of pressure on your knees. So, to your knees, being 10 pounds overweight is like carrying 40 extra pounds. Joints like your knees support much of your body weight. A healthy weight decreases pressure on your joints and decreases the risk of developing osteoarthritis in the first place.

Stay active

Exercise and being physically fit not only help you maintain a healthy weight, they're also good for the joints. If you already have achy knees, try activities that are gentle on your joints, like swimming in a nice warm indoor pool during the winter months. Gentle yoga, walking and floor exercises can also be joint-friendly activities to help keep your knees in shape for the occasional intense activity like skiing.

Exercise also builds muscles around the knees, like the quadriceps and hamstrings, to help the joint function properly. Unused muscles, like in the case of couch potatoes, stiffen more easily than muscles that move.

Remember to stretch or warm up before exercising to prevent injury, and also stretch or cool down post-exercise.

Ice, ice, baby

Try icing your knees for 15 minutes after exercise or activities if you tend to get sore. Icing your joints can help reduce swelling.

Don't overdo it

Certain exercises or activities might be a bit much for your joints to handle at first, especially if you haven't been active for a while. Take it slow to prevent injury and pain. You shouldn't feel serious pain after exercise or recreational activity.

Professional athletes train for their sports. Think twice before hitting the slopes if you've been hitting the couch instead of the gym.

About the Orthopedic Institute of Doylestown Hospital

The Orthopedic Institute of Doylestown Hospital is a collaborative program between the hospital and our affiliated orthopedic doctors, orthopedic surgeons and orthopedic rehabilitation specialists. The Institute offers a full range of advanced medical services to treat problems of the bones, joints and muscles.

For health tips and information, connect with us on Facebook or Twitter.

Thursday, December 11, 2014

Still Time to Get Flu Vaccine

Don't let recent media reports dissuade you. The flu vaccine is still the best protection against the flu, and it's not too late to get vaccinated.

Still haven't gotten your flu shot?

Discouraged by reports that the Centers for Disease Control and Prevention (CDC) says this year's vaccine might not be totally effective?

Don't be.

"Flu season is just beginning and it is not too late to get vaccinated. Vaccination is still our best defense against influenza," says Vera Cessna BSN, RN, CIC, director of Infection Prevention at Doylestown Hospital.

The CDC has stated that about half of the flu viruses analyzed are "drift variants: viruses with antigenic or genetic changes that make them different from that season's vaccine virus."

The flu vaccine is still a good idea. "Even in seasons where the circulating flu strain has drifted the vaccination may lead to milder symptoms or protect against other strains that occur later in the season," notes Vera.

The CDC recommends that everyone 6 months of age and older get vaccinated each year for the flu. To highlight the importance of vaccination, the CDC established National Influenza Vaccination Week, which is this week (Dec. 7-13).

Flu activity usually peaks in the U.S. between December and February. The flu season in general is considered as early as October and can run as late as May.

Remember, you cannot get the flu from the flu vaccine.

Once you do get vaccinated, it takes about two weeks for the body's immune response to fully kick in. "So if you haven't gotten the vaccine, go and get it so you can be well and stay well for the upcoming holidays," says Krista Doline, BS, MT (ASCP), CIC, who works along with Vera in Infection Prevention at Doylestown Hospital.

"Vaccination still offers protection and may reduce the likelihood of severe outcomes such as hospitalization and death. If not for you, get it to protect your family and loved ones," says Krista.

She adds, "Make an appointment with your family doctor or your child's pediatrician today. Call or visit your local pharmacy, which may be offering flu shots that can be covered by your insurance. If you don't see a regular doctor, you can get a flu vaccine somewhere else, like a health department, urgent care clinic, and often your school, college health center, or work. It might just save your life."

Want to learn more? Visit flu.gov for information about symptoms, where to get a vaccine locally, tips for caring for a loved one with the flu, and more.

Tuesday, December 9, 2014

Toy Safety Tips for Parents

'Tis the season for toy shopping. When you shop, stop and think about the safety of toys first to ensure fun later.

Every year, thousands of children across the country go to the ER for treatment of injuries caused by toys. Robert Linkeheimer, DO, FACOEP, medical director of the Doylestown Hospital Emergency Department, shares the following tips for toy safety.

Avoid small parts for small children.

Young children are just as likely to taste a toy as play with it. Small balls and toy parts can cause choking.

"If the child is under three, there is a good chance he or she is going to stick something in their mouth and swallow it," says Dr. Linkenheimer.

Anything that gets caught in the airway is a big problem and requires medical attention. Chronic coughing, pneumonia and gasping for air are all symptoms that something is stuck where it's not supposed to be.

Children occasionally swallow coins as well as toy parts. Often these coins travel through the digestive system and reappear in the child's poop. "Anything the size of a quarter or smaller should pass through the child's system," advises Dr. Linkenheimer.

Kids also tend to stick stuff in their ears. This could become a problem if the object punctures the eardrum. If the object doesn't come out on its own, seek medical attention.

Be wary of button batteries.

Pay special attention to electronic toys with button batteries.

"They're a problem," Dr. Linkenheimer says. "If they child swallows the battery, it can get lodged in the child's esophagus and eventually burn through the esophagus."

If swallowed, these small batteries need to be retrieved by a medical

Make sure toys are age appropriate.

Keep toys for older children away from curious younger siblings. Besides having small parts, some of these toys are just not meant for young children. For example, a scooter and other riding toys could be dangerous for a toddler to try.

A helmet and safety pads are recommended at all times, even for the older set. It's a good idea that protective gear be part of a gift of sports equipment (face guard with new batting helmet, eye goggles with basketball, etc.).

Also, be careful with toys containing magnets. Building and play sets with small magnets pose a choking threat to young children, and should be kept away from them.

About Emergency and Trauma Care for Pediatrics

Care at Doylestown Hospital's Emergency Department is available anytime, day or night. This service is especially helpful if a child has an immediate and serious need for care after the pediatrician's office hours have ended.

If your child needs to be admitted for inpatient treatment, The Della Penna Pediatric Center of Doylestown Hospital provides overnight, inpatient care to all ages, including infants, children and adolescents. This secure unit, designed for a child's needs, is staffed by board-certified physicians and nurses experienced in caring for the special needs of children.

Watch a video to learn more about pediatric services at Doylestown Hospital.

Thursday, December 4, 2014

"Health Matters" Takes on Tobacco and Smoking

The newest episode of Health Matters with Doylestown Hospital offers an eye-opening look at the dangers of smoking and tobacco use. The CBTV show includes a list of free resources for stopping smoking.

Ever seen the lung of a smoker up close?

It’s not pretty.

The latest episode of "Health Matters with Doylestown Hospital" on CBTV, Chris Anderson, Director of Respiratory Therapy, offers up the lobe of a smoker diagnosed with emphysema and a cancerous tumor. The lung is black.

That's the tar, which never leaves the lung, says James McClurken, MD, Doylestown Hospital cardiothoracic surgeon, adding "the lungs of non-smokers are baby pink."

The blackened lung is a visual reminder of the dangers of smoking, which is the leading cause of preventable death worldwide. Cigarette smoking is the number one risk factor for lung cancer. In the United States, cigarette smoking is linked to about 85% of lung cancers.

Dr. McClurken notes that lung cancer that is caught early can be treatable. Doylestown Hospital offers low-dose CT screening for appropriate patients who meet criteria and are at high risk for lung cancer.

Lung Cancer Statistics

In Pennsylvania, 21.4% of adults (2.1 million) smoke; the national rate is 18.1%. Nearly 19% of high school students (about 125,000) smoke in Pennsylvania; the national rate is 15.7%.

On the national level, cigarette smoking is responsible for more than 480,000 deaths per year in the United States, including about 41,000 deaths resulting from secondhand smoke exposure. On average, smokers die 10 years earlier than nonsmokers.

In this episode of Health Matters on CBTV, Dr. McClurken explains how smoking accelerates the aging process in people both inside and out, including developing wrinkles in the skin at a younger age.

Another number to consider is your potential salary. Health Matters moderator Sheri Putnam raises the point that an increasing number of companies and organizations are not hiring users of tobacco. Doylestown Hospital announced its decision not to hire tobacco users in July. The Doylestown Hospital campus, as well as all other Bucks County hospitals, have been tobacco free for several years.

Watch Video: "Health Matters" Takes on Tobacco and Smoking

E-cigarettes and Vaping

There is a new form of tobacco usage that is gaining popularity, especially among young people; the use of electronic cigarettes (e-cigarettes) or "vaping." "Vape," the 2014 Word of the Year according to the Oxford Dictionary, is defined  as to " inhale and exhale the vapour produced by an electronic cigarette or similar device".

The Centers for Disease Control and Prevention (CDC) recently announced that e-cigarette use has tripled among teenagers in just two years. The recent report also indicates that among all high school students, 4.5 percent reported using e-cigarettes within the last 30 days and 1.1 percent of middle school students reported using e-cigarettes in the last 30 days.

As usage among teens and middle school students is growing, vapor shops or parlors are also popping up all over the country, including locally.

Chris Anderson and Dr. McClurken both agree that while there needs to be more research on the effects of vaping, the use of tobacco is addictive and is not good for overall health.

It’s Never Too Late to Quit

Dr. McClurken reminds Health Matters viewers that quitting smoking and other tobacco use is always a good idea. Stopping smoking reduces the risk of lung and other forms of cancer, the risk of cardiovascular disease and stroke, as well as chronic obstructive pulmonary disease (COPD) -- one of the leading causes of death in the United States.

At the end of Health Matters, viewers can see a list of free smoking cessation resources both locally, statewide and national.

Health Matters with Doylestown Hospital airs regularly on CBTV. View the schedule online.

The Cancer Institute of Doylestown Hospital

To ensure patients receive the most comprehensive care available, the Cancer Institute of Doylestown Hospital's Lung Cancer Program brings together top doctors from several disciplines to collaborate on personalized treatment plans for patients. This multidisciplinary approach includes experts from medical oncology, radiation oncology, surgery, pulmonary medicine and other specialties who meet regularly to collaborate on personalized treatment plans for each lung cancer patient. Learn more about the Cancer Institute of Doylestown Hospital's Lung Cancer Program or to find a physician call 215-345-2121.

Wednesday, December 3, 2014

Nurses Teach and Learn from Native Americans

Guest blogger Kim Mikula, RN, BSN, CEN, of Doylestown Hospital's Emergency Department, shares her experiences as part of an exchange program with Native Americans in New Mexico.

Editor's Note: Doylestown Hospital welcomed a group of Native American nursing students from the University of New Mexico (Gallup) in March. Several nurses from Doylestown Hospital traveled to New Mexico to complete the exchange in September. Kim Mikula was one of them.

Read the previous blog, Expanding Horizons One Nurse at a Time, about the nurse exchange.

The plans began in the spring of 2013. Americans for Native Americans (ANA) found a tremendous need for health screenings in the Native American elementary schools on the Navajo reservation in New Mexico.

Many Native American families will not subscribe to Western medicine. Without any school nurses and "medical care" being provided by non-medical personnel, the children are in need of screenings. These help identify deficiencies that may affect their academic progress as well as their overall health. The teachers also benefit from health screenings so they can adapt their classrooms to the needs of the children.

On September 7, 2014, after one and a half years of planning and fundraising, the first group of Doylestown Hospital nurses left for New Mexico. The group included Cherie Mee (ANA board member) and Emergency Department nurses Dottie Prior and Kim Mikula. We arrived one day early to see the area and learn some of the culture. Cherie was on the scouting trip in 2013 so she was our area expert.

Our first site was a to visit Window Rock, the site of the Code Talkers Memorial, and a 3-hour tour Canyon de Chelly (Shay). Our tour guide gave us an amazing education on Native American customs and traditions. We learned that a strong sense of patriotism is a long-standing part of that custom.

We spent the next three days at Baca/Dlo'Ay Azhi Community School, grades K-6th. Of the 349 students, we were able to complete 230 health screenings (the rest lacked permission slips). The health screenings consisted of height, weight, vision, hearing, and color blindness for all students as well as a partial scoliosis screening for grades 5 and 6.

We had the help of nine student nurses on the first day and eight student nurses on the third day from the University of New Mexico, Gallup. They were supervised by our Navajo contact and ANA board member Michele Kellywood-Yazzie, nursing professor at University of New Mexico, Gallup. We also trained 13 staff members on how to use the equipment so that one day they can be independent in completing the health screenings.

On our last day we were also able to visit an Acoma tribe village on the top of a mesa. It has no running water or electricity. Some of the families have generators but they are only allowed to run them for short periods of time and only on certain days of the year.

Overall, it was an unforgettable experience. We are grateful for the opportunity to serve, train, and learn about this culture that is so different from our own and yet such an integral part of our country's history. ANA looks forward to going back and expanding our goal to reach more children in more schools next year.

--Kim Mikula RN, BSN, CEN

Wednesday, November 26, 2014

Grateful for Her Heart Attack

You might wonder why Edie Weinstein is actually thankful for the health issues – including a heart attack – she's had this year. Until she explains why.

To say Edie Weinstein had a busy schedule would be an understatement. For so many years, days consisted of working a 12-hour shift at her addictions counseling job, followed by several hours of writing at home, and maybe five hours of sleep.

"My friends and family warned me I couldn't keep up with this pace," says Edie, a freelance journalist and former magazine publisher who also hosts a radio show.

Edie thought she was a healthy 55-year-old. She ate a vegetarian diet and worked out at the gym. It turns out that diet of mostly prepared foods was high in cholesterol and sodium. And the workouts were just another facet of a lifestyle marked by constant movement, frenetic drive and overwhelming pressure. She also has a family history of heart disease.

Her body couldn't take it any more.

A day she'll never forget

It was June 12, 2014 and Edie was driving home from the gym when the jaw tightness and pain set in, followed by profuse sweat and a pain that outstripped heartburn. When she got to the Doylestown Hospital Emergency Department, Edie calmly told the nurse behind the desk, "I think I'm having a heart attack."

Within minutes she was taken upstairs to The Heart Institute where interventional cardiologist Joseph McGarvey, Jr. opened her blocked artery with a stent he had threaded through her wrist, called radial artery stenting. Edie emerged from the heart attack with no damage to her heart muscle, but her life would never be the same.

"I realized I was sleepwalking through a lot of my life. This was a huge wake up call for me," Edie says.

The first order of business was to take a week and a half off – no work, no working out, no attending to worries. "One of the hardest things to do was rest," says Edie, determined to become a "recovering workaholic."

Edie started doing Cardiac Rehabilitation at Doylestown Hospital. The professionally supervised exercise and education program helps patients increase their function and reduce chances of another cardiac event.

The staff at cardiac rehab encouraged and motivated Edie all along the way. "I call them my cheerleaders," says Edie.

She now participates in the Phase Three program at Cornerstone Fitness in Warrington, having learned how to exercise safely and effectively without overdoing it.

"I wasn't going to let this heart attack go to waste."

Edie had asthma as a kid and grew up always having to prove she could do anything. That drive carried into her adult life, which saw this licensed social worker take on speaking commitments and more and more writing assignments. She is also an interfaith minister who officiates weddings. Edie grew accustomed to taking care of others, often at her own expense.

"I was always saying ‘yes' to people when I really wanted to say ‘no'," she points out.

In addition to her heart attack this year, Edie has survived a case of shingles, a breast cancer scare, kidney stones and an exhausted adrenal system.

She took a hard look at her life.

"One of the things I want people to know is that as much as you think you're invincible, you're really not. Your body needs rest."

Edie now takes naps. She has scaled back her work and social schedules. She is determined to enjoy life by reveling in the simple things one day at a time and by having fun. In recent months she has dyed her hair purple and danced on stage at a Chubby Checker concert. The result? Blissful enjoyment.

The power of positivity

"A positive attitude is everything. I don't know how people who don't have one get through this," Edie says.

"I do my best to be grateful for everything." Topping Edie's list is her family and friends. Followed by resilience. "I'm not a victim," she says. "I'd rather be resilient and thrive."

Having a sense of humor helps. Edie is also grateful for creativity, the gift of writing and touching others' lives. She wants to spread the word about her experience and about women and heart disease, and the importance of slowing down.

"Now I look back at my old schedule and wonder how I did that for so many years."

This Thanksgiving and indeed, every day, Edie looks forward to what lies ahead with a sense of positivity and purpose.

"I have so much to be grateful for. I'm grateful for life."

About the Heart Institute of Doylestown Hospital

The Heart Institute of Doylestown Hospital is your resource for advanced cardiac care right in your community. We offer the latest minimally invasive treatment options for arrhythmia, valve disease, heart failure and coronary artery disease. Visit the Heart Institute of Doylestown Hospital for more helpful tips and information on treatment options.

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