Be Smart in the Summer Sun

Summer is a fun and eventful season. Whether you are working in the yard or golfing, watching your child’s sporting events, or relaxing by the pool – the sun is affecting your skin. The sun’s ultraviolet (UV) rays can damage your skin in as little as 15 minutes. To protect yourself and your family, follow these recommendations:

1. Always use sunscreen. Even on partly cloudy or days with cooler temps, you need sunscreen. Apply a thick layer of sunscreen with at least SPF 15 on all parts of exposed skin before going outside. Have a family member or friend help cover those hard-to-reach areas like your back and shoulders. And don’t forget the smaller areas, like the ears and feet if you are wearing sandals.

Sunscreens contain chemicals that protect skin from UV rays. They work by absorbing, reflecting, or scattering sunlight. The SPF number (Sun Protection Factor) is the effective rate at which they block UV rays. Higher numbers indicate more protection.

All sunscreens do not contain the same ingredients, so if you have a bad reaction to one, try a different product or call your doctor for recommendations on alternatives.

Sunscreen does wear off. It is important to reapply if you are in the sun for more than two hours and after swimming, sweating, or toweling off.

Also, did you know that sunscreen expires? So before applying sunscreen from the bathroom cupboard, make sure the product has not expired. Sunscreen without an expiration date has a shelf life of no more than three years, but its shelf life is shorter if it has been exposed to high temperatures.

Finally, some makeup products and lip balms do contain some of the same chemicals used in sunscreens. However, if they do not advertise an SPF level of at least 15, you will need more protection.

2. Don’t forget to protect your eyes. Our sight needs protection from the sun too. Wearing sunglasses is the best way to protect our sight from harmful UV rays. This reduces the risk of cataracts and shields the tender skin around our eyes as well. Most sunglasses sold in stores block both UVA and UVB rays, which is the best protection. Wrap-around sunglasses are even better because they block UV rays from sneaking in through the sides.

3. Cover up. Although it is not a replacement for sunscreen, covering your skin with clothing can help protect against UV rays when needed. Wearing long-sleeved shirts and long pants or skirts that have darker colors can help. However, a typical t-shirt has an SPF rating lower than 15, so use clothing in addition to sunscreen. Clothing made from tightly woven fabric offers better protection. Be especially mindful near the water, as a wet t-shirt offers much less UV protection than a dry one.

4. Cover your head, too. A brimmed hat is a great way to shade your face, ears, and the back of your neck. Again, hats made of tightly woven fabrics work the best. Avoid hats made from straw as they may have holes that let through UV rays. Baseball caps are great too, but be sure to wear sunscreen on your neck and ears to help shield those areas.

5. When in doubt, find some shade. Even if you have sunscreen on, the body sometimes needs a break from the sun. Simply finding some shade under a tree or umbrella is an easy solution when searching for relief. In addition to reducing the risk of skin damage and skin cancer, shade can also help to cool the body down in hot temperatures.

If you have questions on sunscreen products, need more information on what might be best for your skin type, or have concerns about any spots on your skin, please contact our Department of Dermatology by calling 563-584-4425.



Computers and Your Eyes

On average, more than 50% of the work force now uses a computer on the job—and nearly 60 million people experience vision problems as a result. Their condition is called Computer Vision Syndrome (CVS); there are a million new cases each year.

CVS may include:

  • eye irritation, such as dry eye; red, itchy, burning, or watery eyes
  • fatigue, including heaviness of the eyelids or forehead
  • difficulty focusing the eyes
  • headaches, neck, shoulder, or backaches, muscle spasms

Anyone who spends two or more hours a day working on a computer is at risk for developing CVS. The reason is simple: human vision is not suited for staring at a computer screen. Computer images are made up of tiny dots, known as pixels. Since your eyes cannot focus on them, you must constantly refocus to keep images sharp, causing repetitive stress on the eyes.

Tips to reduce computer eyestrain:

Get a comprehensive eye exam.
This is the most important thing you can do to prevent or treat computer vision problems. An eye doctor can accurately diagnose your computer vision problem and determine your correct computer working distance and may prescribe computer eyeglasses that will allow you to work comfortably.  Not everyone who works on a computer or has eyestrain will need computer glasses.

Use proper lighting and minimize glare.
Eyestrain is often caused by excessively bright light coming in from outside and excessively bright light inside.  Eliminate exterior light by closing drapes, shades, or blinds. Reduce interior lighting by using fewer light bulbs or lower intensity bulbs.  Reflections, fingerprints, and dust on the computer screen itself can also cause eyestrain.  You may want to install an anti-glare screen on your monitor, and if possible, position your monitor so that windows are to the side instead of in front or back.  An anti-reflective coating and/or light tint on any glasses that you use at the computer may also help.  Adjusting the brightness, color and contrast on your computer screen may also reduce eyestrain.

Blink more often.
Blinking is very important when working at a computer — it re-wets your eyes to avoid dryness and irritation. When working at a computer, people blink less frequently — about five times less than normally, according to studies. Tears coating the eye evaporate more rapidly during long non-blinking phases and cause dry eyes. Office buildings may have excessively dry environments that also reduce tearing.

For significant problems, ask your eye doctor about artificial tears that you can use during the day. By the way, don’t confuse lubricating drops with the drops that only “get the red out.” The latter can indeed make your eyes look better with vasoconstrictors that reduce the size of the blood vessels in your eyes, but they are decongestants and may worsen dryness and irritation with chronic use.

Also try this exercise: Every 30 minutes blink 10 times by closing your eyes as if falling asleep (very slowly). This will help re-wet your eyes.

Exercise and stretch your eyes – 20/20/20 Rule
Look away from your computer screen every 20 minutes, and focus for 20 seconds on a distant object outside or down the hallway at least 20 feet away. Another exercise to readjust your focusing is to look far away at an object for 10 seconds and then near for 10 seconds, rocking your focusing back and forth between near and far. Do this 10 times. Both of these exercises will help you prevent strained near vision and stretch your focusing muscles.

Take frequent breaks from close eye work.
According to the National Institute of Occupational Safety and Health (NIOSH), full-time computer users should take a 10-minute break from computer work every hour to reduce eyestrain problems.  Part-time users should take frequent breaks after sitting in front of their display for more than a hour.

Modify your work station.
If you need to look back and forth between a printed page and your computer screen, this can cause eyestrain. Place written pages on a copy stand adjacent to the monitor. Properly light the copy stand; you may want to use a desk lamp, but make sure it doesn’t shine into your eyes or onto the computer screen. Adjust your work station and chair to the correct height. Purchase ergonomic furniture to insure proper screen locations and posture.

Exercise even when sitting.
Anyone in a sedentary job, especially those using computers, should stand up, move about, or exercise their arms, legs, back, neck, and shoulders frequently. NIOSH recommends several sitting, stretching, and joint rotating exercises for computer users.  See the HR OHN for more information.

By the Medical Associates Clinic Ophthalmology Team

The Department of Ophthalmology provides total eye care to the tri-state area. Medical and surgical treatment for glaucoma, cataracts, crossed-eyes, age related macular degeneration, macular holes, retinal detachments, as well as other diseases of the eye are offered. Recent advancements in detection and diagnosis of eye disease are utilized in the Clinic. Complete routine examinations of adults and children are available as well. Call 563-584-4415 to schedule an appointment.

Daycare and In-Home Child Care:  How to Choose

Finding the right child care while you are at work is crucial for your child, but also for your own peace of mind. There is no need to be desperate or to just settle.

The first step in finding child care is to decide what you need and want in a caregiver. Take notes. What qualities do you find ideal: Are you comfortable with someone older or younger? What about a professional baby-sitter? Should she have children of her own? What kind of person would fit with your baby? If your baby is quiet, consider someone who will stimulate him and encourage play. If you have an active, restless baby, perhaps your sitter should be more soothing. Consider also what kind of person would complement you and your family’s personalities. These are personal choices, not a matter of right or wrong, good or bad.

There are many ways to arrange baby-sitting or child care.

  • Someone may care for your child in your own home such as a relative, nanny, or babysitter.
  • Someone may care for your child in their home—an in-home daycare.
  • Your child may be cared for in a center designed and staffed especially for the care of children—a daycare center.

Checklist for judging a daycare home or center

  • Does the person caring for the children really care about your child as an individual?
  • Is there at least one person to care for each 4 to 5 children at all times of the day (including the daycare owner’s children)?
  • Does the caregiver treat each child as his or her own, talking to the child while bathing or changing the diaper, holding the child while feeding, “teaching,” and paying attention to each child’s temperament and development?
  • Is the home or center safe, healthful, and clean? Is there room for children’s play and care, fresh air, and is it free of safety and accident hazards?
  • Are your suggestions for the care of your child welcomed and listened to?
  • Do the caregivers and children seem happy, alert, and enjoying themselves?
  • Are you welcome to visit at any time, with or without telling in advance that you are coming?
  • Will they tell you about any accidents your child may have had, or any contagious disease in the group?
  • Will appropriate snacks and meals be given?
  • What happens if your child gets ill or hurt?
  • Is there a telephone which the caregiver can use to reach you or to call for help in an emergency? Is there a first-aid kit?
  • Does the caregiver know CPR (cardiopulmonary resuscitation)?
  • Is the outdoor play area safe? Does it have adequate, safe, sturdy equipment?
  • Are there fire extinguishers, smoke and carbon monoxide detectors available?
  • Are there adequate toilet facilities? Are diaper changing and hand washing areas separate from food areas?

Home care

Parents may choose to have their child (or children) cared for in their home by a grandparent, friend, neighbor, or baby-sitter. The quality of this type of care depends on the choice of the caregiver. The optimal choice is someone who shares the same positive and supportive values toward childrearing as the parents, and who is consistent in the care of the child. Some advantages of home care include the close, personal relationship that can be established between caregiver and child, the convenience, the familiarity of the setting, and the mother’s control over what takes place in her absence. It can also be economical if care is provided for more than one child, or includes other services.

Home daycare

A daycare home can range from a licensed, supervised home to an informal agreement between friends at one home. The caregiver may be related or unrelated, trained or untrained. The number of children, fixed by regulation in many states, may extend to 6 in a family day care home. Optimally, this type of care has many advantages including flexible hours, relative economy, and a situation that provides new experiences and people. You may have less to say about how such a person takes care of your child, so you must choose very carefully and visit frequently to be sure that your baby is getting the kind of care you want.

Daycare centers

The daycare center is another alternative for child care. Children at these centers are usually grouped according to age, and the teachers are sometimes younger than those who provide daycare in their homes. Centers have the advantages of being set up as an ongoing business, open to public inspection, and easily monitored by parents. They offer an environment that frequently is rich in materials and equipment, they may have some staff trained in child development, and they usually offer educational opportunities for the children. However, they can have less flexible hours, usually are unable to care for sick children, and may be more expensive than alternative child care. As with homes offering daycare, centers vary greatly in their quality. Parents should evaluate disciplinary techniques, frequency of turnover of caregivers, and educational opportunities at the center.

Parents who are concerned that an infant may be exposed to five or six caregivers a day at a center will want to know if each infant is assigned a primary caregiver, with others secondary. The infant needs a primary caregiver at the center with whom to form a special relationship.

Word of mouth can also provide information about child care quality, but parents need to be advised that selection of the best place for their child should be made only after they have observed a variety of settings and feel comfortable with a particular daycare home or center.


The Department of Pediatrics provides professional services and consultation for patients 18 years of age and younger, including newborns, infants, young children, and adolescents.

To schedule an appointment, please call:
Pediatrics East
1000 Langworthy St. Dubuque
(563) 584-3440
Pediatrics West
1500 Associates Dr., Dubuque
(563) 584-4440

7 Recommendations for a Heart Healthy 2017

AMA President Andrew W. Gurman, MD, recently said, “This is the perfect time of year for all of us to reflect on our personal health goals and resolve to make healthy lifestyle choices in the coming year.” It is important, as Dr. Gurman said, for people to understand “where they can make the most impactful, long-lasting improvements in their health.” Here are seven ideas to keep your heart health on track for 2017.

1. Limit your consumption of beverages with added sugars. Avoid sports drinks and soda which have over 100 calories of added sugar per container. Try drinking water, coffee, unsweetened tea or other calorie-free drinks instead. When you do drink beverages with sugar, go for milk or all-fruit juices.

2. Know your risk for Type 2 Diabetes. Take a self-screening test now to determine your risk at Eating healthier, exercising regularly and losing between 5 and 7 percent of your body weight can help prevent diabetes.

3. Be more physically active. Adults between ages 18 and 65 need at least 30 minutes of moderate-intensity aerobic physical activity five days a week, such as walking briskly, bicycling slowly or gardening. Or if you prefer a more intense workout, like running or tennis, 20 minutes of vigorous-intensity aerobic physical activity three days a week is recommended.

4. Avoid processed food and added sodium. Be mindful of sodium counts in packaged foods such as meat, poultry, seafood, pasta, dressings, sauces, soups or gravies. Opt for fresh, frozen or canned foods without any added sauces or seasonings when possible, then try other fresh herbs and spices for flavor.

5. If you drink alcohol, do so in moderation. For women over age 21, that means up to one drink a day, and two drinks daily for men over the age of 21, as defined by the U.S. Dietary Guidelines for Americans.

6. Talk with your doctor about tobacco use and quit. Your physician will help you drop the tobacco habit for good with evidence-based, FDA-approved cessation aids.

7. Declare your home and car smoke free to eliminate exposure to secondhand smoke.


By the Medical Associates Clinic Heart Team
The Department of Cardiology provides a wide range of services including initial evaluation and management of all types of cardiac and peripheral vascular diseases. The Department of Cardiovascular & Thoracic Surgery provides multiple types of surgical treatment of diseases related to the heart, coronary arteries, major blood vessels, chest, lungs, and esophagus. This department serves as consultants to primary physicians, but will accept self-referrals by patients.