Author Archives: Medical Associates

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

Know the Signs of Heat-Related Illness

As the weather heats up, it’s very important to take precautionary steps against the heat, but also to know the signs of heat-related illness should a problem arise.

First, always wear appropriate clothing. Choose lightweight, light-colored, loose-fitting clothing. It’s also important to stay hydrated. Drink more fluids, regardless of how active you are. Don’t wait until you’re thirsty to drink. Alcoholic drinks are not recommended – these actually cause you to lose more body fluid. Taking a cool shower or bath is also a great way to cool off.

Next, stay cool indoors with air-conditioning on particularly hot days. If your home does not have air conditioning, go to the shopping mall or public library—even a few hours spent in air conditioning can help your body stay cooler when you go back into the heat. It’s also smart to use your stove and oven less to maintain a cooler temperature in your home.

When you do go outside, try to limit your outdoor activity to when it’s coolest, like morning and evening hours. Rest often in shady areas. This gives your body a chance to recover. Also remember to pace yourself. If you’re not accustomed to working or exercising in a hot environment, start slowly and pick up the pace gradually. If exertion in the heat makes your heart pound and leaves you gasping for breath, STOP. Get into a cool area or into the shade, and rest, especially if you become lightheaded, confused, weak, or faint.

Finally, remember to wear sunscreen. Sunburn affects your body’s ability to cool down and can make you dehydrated. If you must go outdoors, protect yourself from the sun by wearing a wide-brimmed hat, sunglasses, and by putting on sunscreen of SPF 15 or higher 30 minutes prior to going out.

If a problem should arise, it’s important to know the signs of heat-related illness and take action right away. If you or someone near you is exhibiting any of the following symptoms, take the appropriate action listed.

Heat Stroke

Heat stroke is the most serious heat-related illness. It occurs when the body becomes unable to control its temperature: the body’s temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. Heat stroke can cause death or permanent disability if emergency treatment is not given. Symptoms include: confusion, altered mental status, slurred speech, loss of consciousness (coma), hot, dry skin or profuse sweating, seizures, very high body temperature.

Treatment:

  • Call 911 for emergency care.
  • Move to a shaded, cool area and remove outer clothing.
  • Cool quickly with cold water – wet the skin, place cold, wet cloths on the skin, or soak clothing with cool water.
  • Circulate the air around to speed cooling.

Heat Exhaustion

Heat exhaustion is the body’s response to an excessive loss of the water and salt, usually through excessive sweating. Most people prone to heat exhaustion are those that are elderly, have high blood pressure, and those working in a hot environment. Symptoms include: headache, nausea, dizziness, weakness, irritability, thirst, heavy sweating, elevated body temperature, decreased urine output.

Treatment:

  • Go to a clinic or emergency room for medical evaluation and treatment.
  • If medical care is unavailable, call 911.
  • Remove from hot area and drink liquids.
  • Remove unnecessary clothing, including shoes and socks.
  • Cool with compresses or have the person wash head, face, and neck with cold water.
  • Encourage frequent sips of cool water.

Heat Syncope

Heat syncope is a fainting (syncope) episode or dizziness that usually occurs with prolonged standing or sudden rising from a sitting or lying position. Factors that may contribute to heat syncope include dehydration and lack of acclimatization. Symptoms include: fainting (short duration), dizziness, light-headedness during prolonged standing or suddenly rising from a sitting or lying position.

Treatment:

  • Sit or lie down in a cool place.
  • Slowly drink water, clear juice, or a sports drink.

Heat Cramps

Heat cramps usually affect people who sweat a lot during strenuous activity. This sweating depletes the body’s salt and moisture levels. Low salt levels in muscles causes painful cramps. Heat cramps may also be a symptom of heat exhaustion. Symptoms include: muscle cramps, pain, or spasms in the abdomen, arms, or legs.

Treatment:

  • Drink water and have a snack and/or sports drink (with electrolytes) every 15 to 20 minutes.
  • Avoid salt tablets.
  • Get medical help if the person has heart problems, is on a low sodium diet, or if cramps do not subside within 1 hour.

Heat Rash

Heat rash is a skin irritation caused by excessive sweating during hot, humid weather. Symptoms include: red cluster of pimples or small blisters. Usually appears on the neck, upper chest, groin, under the breasts, and in elbow creases.

Treatment:

  • When possible, a cooler, less humid environment is the best treatment.
  • Keep rash area dry.
  • Powder may be applied to increase comfort.
  • Ointments and creams should not be used.

 

Are you unsure if you or someone near you needs help? The 24 Hour Help Nurse for Patients and Members of Medical Associates is available to assist you 24 hours a day, 7 days a week. They provide a staff of professional, registered nurses available by the telephone.

Do you need advice on a medical symptom, question, or problem? Do you have questions pertaining to a medication? Do you need help determining whether your symptoms require immediate medical attention? The Patient Services – Help Nurses can assist patients and members of Medical Associates with all of these and more. Call (563) 556-4357 or 800-325-7442

 

Source: www.cdc.gov

Keep Yourself Safe this Summer: Prevent Lyme Disease

Lyme disease is spread by the bite of an infected tick. In the United States, an estimated 300,000 infections occur each year. If you camp, hike, work, or play in wooded or grassy places, you could be bitten by an infected tick.

Protect Yourself from Tick Bites

Know where to expect ticks. Blacklegged ticks (the ticks that cause Lyme disease) live in moist and humid environments, particularly in and near wooded or grassy areas. You may get a tick on you during outdoor activities around your home or when walking through leaves and bushes. To avoid ticks, walk in the center of trails and avoid walking through tall bushes or other vegetation.

Repel ticks on skin and clothing. Use repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours. Parents should apply this product to their children, avoiding hands, eyes, and mouth. Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks and tents with products containing 0.5% permethrin. It remains protective through several washings.

Perform Daily Tick Checks

Check your body for ticks after being outdoors, even in your own yard. Search your entire body for ticks when you return from an area that may have ticks. Take special care to check these parts of your body and your child’s body for ticks:

  • Under the arms
  • In and around the ears
  • Inside the belly button
  • Back of the knees
  • In and around all head and body hair
  • Between the legs
  • Around the waist

Check clothes and pets carefully and remove any ticks. Place clothes into a dryer on high heat to kill ticks.

Removing Ticks

Remove an attached tick with fine-tipped tweezers. If a tick is attached to your skin for less than 24 hours, your chance of getting Lyme disease is extremely small; however, other diseases may be transmitted more quickly. Over the next few weeks, watch for signs or symptoms of Lyme disease such as rash or fever. See a healthcare provider if you have symptoms.

Be Alert for Fever or Rash

Even if you don’t remember being bitten by a tick, an unexpected summer fever or odd rash may be the first signs of Lyme disease, particularly if you’ve been in tick habitat. See your healthcare provider if you have symptoms.

Prevent Ticks on Animals

Prevent family pets from bringing ticks into the home by limiting their access to tick-infested areas and by using veterinarian-prescribed tick collars or spot-on treatment.

Create Tick-safe Zones in Your Yard

Remove leaves and clear tall grasses and brush around your home. Tick control chemicals are available for homeowners to use, or hire a professional pest control expert. Discourage deer, as they are the main food source of adult ticks. Keep deer away from your home by removing plants that attract deer and by constructing barriers to discourage deer from entering your yard.

 

KEY FACTS ABOUT TICKS

  •  Symptoms of Lyme disease begin 3-30 days after a tick bite; average 7 days.
  •  Of people who get Lyme disease, 70-80% develop a rash, called an erythema migrans.
  •  The ticks that transmit Lyme disease can sometimes cause other diseases, too.
  •  Only blacklegged ticks transmit the bacteria that cause Lyme disease.

Source: lyme