What is Pelvic Health and how can I Benefit From it?

The term Pelvic Health refers to treatment for men and women of all ages who experience symptoms affecting bladder, bowel, and/or sexual function due to pelvic floor muscles that may be tight, weak, or spastic.

At the bottom of your pelvis, there is a group of muscles that work to control and coordinate bladder and bowel function, aid in sexual function, and provide stability to the pelvic girdle and your core. This group of muscles is called the pelvic floor. Your pelvic floor can become affected during or after pregnancy/delivery, after surgery, due to other injury/trauma, or due to lifestyle factors or disease processes, especially those involving the bladder, bowel, or reproductive systems.

You may benefit from pelvic floor physical therapy, if you have answer “yes” to any of these questions:

  • Do you have an increased frequency of urination?
  • Do you experience leakage or loss of control of urine, stool, or gas?
  • Do you have difficulty emptying your bladder or bowels?
  • Are you constipated or need to strain with bowel movements?
  • Do you have pain with bowel movements?
  • Do you experience pain during or after intercourse?
  • Are there any changes in sexual function?
  • Do you have pain with gynecological exams or tampon use?
  • Are your periods painful?
  • Do you have worsening pain or feelings of instability during pregnancy or after delivery?
  • Do you have pain in the abdomen, hip, low back, or tailbone?

Are you living with any of these conditions? While they are common, these symptoms are not normal and you do not have to endure them each day.

How can Physical Therapy Help?

Pelvic floor physical therapy assesses the pelvic floor muscles, and other closely related structures, looking for reproduction of symptoms, restrictions, tightness, or weakness. From this assessment, an individualized treatment plan will be created to address your specific needs. The source of your symptoms will be targeted to improve quality of life. Pelvic floor physical therapy may also assist in many phases of healthcare from preventative measures, conservative management of a diagnosis, post-operative care, or post-injury/symptom onset.

If you are experiencing symptoms of pelvic floor dysfunction, you may be a candidate for pelvic floor physical therapy. Contact your primary care provider and receive an appointment referral or contact the Physical Therapy Department at Medical Associates directly at 563-584-4465.

At age 65, are you Better off on an Employer Plan or Medicare?

Whether or not you continue to work after age 65, you can still get Medicare. Most people should enroll in Medicare Part A when they become eligible, even if they are covered under an employer sponsored plan. Medicare Part A (hospital) covers institutional care in hospitals and skilled nursing facilities, as well as certain care given by home health agencies and care provided by hospices. Part A is free for most people. Medicare Part B (medical) covers most medically necessary doctors’ services, preventive care, durable medical equipment, hospital outpatient services, laboratory tests, x-rays, mental health care, and some home health and ambulance services. Part B has a monthly premium that may change each year (currently it is $134.00 a month). Part B premiums may be higher for some people if their yearly income is above a certain amount as reported on their tax returns.

If you are Medicare eligible, it may be helpful to perform an analysis to determine if it would be more cost effective to drop your group plan and take Medicare (Part A and B), along with a Medicare supplement or cost plan, and a Medicare prescription Plan (Part D). Although you can remain on your employer group health plan, it might just make better financial sense for you to be on Medicare.

Here are some things to consider when deciding if you should stay on your employer group health plan or enroll in Medicare.

  1. Average out-of-pocket costs. These include the premiums deducted from your paycheck and the member liability you pay when incurring medical or prescription drug claims.
  2. Max out-of-pocket costs. While your current medical needs may not be requiring them to pay much out of pocket, all plans have a maximum out-of-pocket cost which you could be facing in future years in the event your medical needs change.
  3. Effects on dependents covered under their plan. If you choose to elect Medicare instead of our employer group health plan, you will no longer be able to cover your spouse or dependent children, if applicable.
  4. Tax effects. While your employer group health plan premiums are pre-tax, premiums you pay for Medicare are not.
  5. Benefits Medicare does not cover. Some employer group health plans may cover additional benefits that Medicare does not cover, like eyeglasses.

To learn more about our top-rated plan, click here for a schedule of our monthly Medicare meetings, where a plan representative will be available to present you with plan information and applications. Walk-ins are welcome at our Dubuque office, located at 1605 Associates Dr., Monday through Friday, 8:00 a.m. to 5:00 p.m.

 

Y0045_MAHP_892 CMS Accepted 08272017

Living with Diabetes: What Can I Eat?

Grains and Starchy Vegetables

If you are going to eat grains, choose whole grains. Whole grains are high in fiber. Foods high in fiber take longer to digest and therefore affect your blood glucose more slowly (i.e. whole wheat bread, prunes and other vegetables). Reading food labels can help you with making the best choice.

What is a Whole Grain?

A whole grain is the entire grain—which includes the bran, germ and endosperm (starchy part). “Refined” flours like white and enriched wheat flour include only part of the grain. They are missing many of the nutrients found in whole wheat flour. Examples of whole grain wheat products include 100% whole wheat bread, pasta, tortillas, and crackers. For cereals, pick those with at least 3 grams of fiber per serving and less than 6 grams of sugar.

Best Choices of Starchy Vegetables

Starchy vegetables are great sources of vitamins, minerals and fiber. The best choices do not have added fats, sugar or sodium. Try a variety such as parsnip, plantain, potato, pumpkin, acorn squash, butternut squash, green peas, and corn.

Best Choices of Dried Beans, Legumes, Peas and Lentils

Try to include dried beans into several meals per week. They are a great source of protein and are loaded with fiber, vitamins and minerals. Examples include dried beans (such as black, lima, and pinto), lentils, dried peas (such as black-eyed and split), fat-free refried beans, and vegetarian baked beans.

What you need to know about Cholesterol

LDL (Bad) Cholesterol

LDL cholesterol is called “bad” cholesterol. Think of it as less desirable or even lousy cholesterol, because it contributes to fatty buildups in arteries (atherosclerosis). Plaque buildup narrows arteries and raise the risk for heart attack, stroke and peripheral artery disease.

HDL (Good) Cholesterol

HDL cholesterol is “good” cholesterol. Think of it as the “healthy” cholesterol, so higher levels are better. HDL acts as a scavenger, carrying LDL cholesterol away from the arteries and back to the liver, where it can be broken down and passed from the body.

A healthy HDL cholesterol level may protect against heart attack and stroke. Low levels of HDL cholesterol increases the risk of heart disease. HDL cholesterol does not completely eliminate LDL cholesterol. Only 1/4 to 1/3 of blood cholesterol is carried by HDL.

Triglycerides

Triglycerides are the most common type of fat in the body; they store excess energy from your diet. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol is linked with fatty buildups in artery walls. This increases the risk of heart attack and stroke.

 

 

The Medical Associates Department of Internal Medicine provides a Fellowship-trained Endocrinologist, who specializes in diabetes, thyroid disease, and osteoporosis. The staff also includes two certified diabetes educators with board certifications in advanced diabetes management. They see patients for diabetes education appointments and medication. Call 563-584-3310 to schedule an appointment.

Source: www.diabetes.org

Tips to Help with Common Menopausal Symptoms

Menopause is the time in a woman’s life when her period stops. It usually occurs naturally, most often between the ages of 40-58. The average age is 51. Menopause happens because the woman’s ovaries stop producing the hormones estrogen and progesterone. A woman has reached menopause when she has not had a period for one year.

Changes and symptoms can start several years earlier. This transition phase is called perimenopause and may last for 4 to 8 years. Each woman’s experience of menopause is different. Many women report no physical changes during perimenopause except irregular menstrual periods that stop when menopause is reached. Other women experience many combinations of the following symptoms:

• A change in periods – shorter or longer, lighter or heavier, with more or less time in between
• Hot flashes and/or night sweats
• Trouble sleeping
• Vaginal dryness
• Mood swings
• Trouble focusing
• Less hair on head, more on face

How severe these body changes are varies from woman to woman, but for the most part these changes are perfectly natural and normal. Below are some simple suggestions you can do to try and relieve common menopausal symptoms.

Hot Flashes and Night Sweats
Hot flashes are the most common menopause-related discomfort. They involve a sudden wave of heat or warmth often accompanied by sweating, reddening of the skin, and rapid heartbeat. They usually last 1 to 5 minutes. Hot flashes frequently are followed by a cold chill. Night sweats are hot flashes at night that interfere with sleep. If hot flashes and/or night sweats are interfering with your daily activities, don’t hesitate to seek relief. There are some easy and practical steps you can try:

• Sleeping in a cool room
• Dressing in layers, which can be removed at the start of a hot flash
• Drinking cold water or juice when you feel a hot flash coming on
• Using sheets and clothing that let your skin “breathe”
• Not smoking

You can also try to keep a written record of what you were doing just before the hot flash started. This might reveal some triggers for your hot flashes which you could then try to avoid. Exercise can improve your quality of life and may help with hot flashes. It will also help reduce your risk of heart disease and osteoporosis. Another technique of deep breathing, known as relaxation breathing, may also help reduce hot flashes.

Relaxation Breathing
Deep breathing, relaxation breathing, and paced respiration all refer to a method used to reduce stress. It involves breathing in (inhaling) deeply and breathing out (exhaling) at an even pace. Do this for several minutes while in a comfortable position. Slowly breathe in through your nose. With a hand on your stomach right below your ribs, you should first feel your stomach push your hand out, and then your chest should fill. Slowly exhale through your mouth, first letting your lungs empty and then feeling your stomach sink back. You can do this almost anywhere and several times during the day, whenever you feel stressed. You can also try this if you feel a hot flash beginning or if you need to relax before falling asleep.

Sleep Problems
Because different things can cause sleep problems, the solutions vary. If night sweats are disrupting your sleep, treating them could help you sleep better. If you find yourself getting up to go to the bathroom, try limiting fluids shortly before bedtime unless you need a cool drink to handle a hot flash. If you aren’t sure what is keeping you from getting to sleep or causing you to wake during the night or early in the morning, there are still some things you can do to get a good night’s sleep:

• Be physically active most days of the week but not within 3 hours of bedtime.
• Go to bed and get up at the same time every day, even on weekends, and avoid naps, if possible, in the late afternoon and evening.
• Have a bedtime routine that you follow each night—read a book or magazine, take a bath, etc.
• Make sure your bedroom and bed are comfortable for sleeping, and only use the bedroom for sleeping and sexual activity.
• Don’t eat a large meal close to bedtime, and stay away from caffeine later in the day.
• After turning off the light, give yourself about 15 minutes to fall asleep. If you don’t go to sleep, get out of bed, and only go back when you feel sleepy.
• Try relaxation breathing.

Vaginal Dryness
The drop in estrogen around menopause leads to vaginal atrophy (the drying and thinning of vaginal tissues) in many women. It can cause a feeling of vaginal tightness during sex along with pain, burning, or soreness. Over-the-counter water-based vaginal lubricants and moisturizers are effective in relieving pain during intercourse. For women with more severe vaginal atrophy and related pain, speak to your primary care provider about treatment options.

What about hormones for symptoms of menopause?
Some symptoms may require medical treatment. Hormone Replacement Therapy (HRT) uses hormones to ease the symptoms of menopause or to prevent osteoporosis. This type of treatment comes in a variety of types and doses such as pills, creams, or skin patches. The FDA recommends that HRT be used at the lowest dose that relieves symptoms for the shortest time needed. If you are not able to take hormones, other management options may be available.

Talk to your primary care provider about how to best manage menopause. Make sure the doctor knows your medical history and your family’s medical history. This includes whether you are at risk for heart disease, osteoporosis, or breast cancer. Then work with them to find the best treatment option for you.

 

The Department of Obstetrics/Gynecology & Infertility is concerned with diagnosis and treatment of diseases, problems, or pathology affecting the female reproductive system. Additionally, the department deals with wellness of the female population. Our board certified physicians provide complete obstetrical and gynecology care. Professional infertility services include routine evaluation of infertile couples, diagnosis of infertility problems and treatment such as induction of ovulation and artificial insemination. Call 563-584-4435 to schedule an appointment.

 

Sources:
National Institute on Aging
The North American Menopause Society