Healthy Choices Count

As a parent, there is nothing more important than the health of your child. The best thing you can do for your child’s health is to help them form healthy habits. The 5-2-1-0 program sets clear goals to help parents achieve this. 5-2-1-0 stands for 5 or more fruits and vegetables, 2 hours or less of screen time, 1 hour or more of physical activity, and 0 sugary drinks (more water). Those four numbers may be catchy and easy to remember, but any parent knows that achieving those tasks with their children is easier said than done. We’ve compiled some facts and tips for each task to try and help your family strive for a 5-2-1-0 lifestyle.

Eat at least 5 servings of fruits and vegetables per day.

First of all, a serving or fruits or vegetables is about the size of a tennis ball. And while fresh fruits and veggies are a great perk of warmer weather, there’s no reason not to have fruits and vegetables year-round. Frozen and canned produce are good choices, too. Did you know that frozen or canned produce is just as good for you? It’s true. Their nutrients are preserved in the canning and freezing process. However, not all are alike. Choose fruit packed in their natural juice, not in syrup. Choose canned vegetables that are salt-free. You can season them later if you like. Or if unsalted isn’t available, just be sure to rinse them before preparing.

Frozen or canned fruits and vegetables are also great because they cost less than fresh produce, are always in season, and provide lots of options for the picky eaters in your home. Plus, they come pre-washed and often pre-cut, so throw them on the table as a side dish for any meal. Vegetables can also easily be added into chili, soups or stews, pasta, or casseroles. Fruits can be added to smoothies, yogurt, fruit salad, or cereal.

Spend 2 hours or less of recreational time on screens each day.

Screen time includes time spent on TVs, computers, gaming consoles, tablets, and smartphones. It’s important to limit the use of ALL screens. How do you do this when screens seem to rule the day? First, set some basic limits. Some examples of rules are: no TV or computer until your homework (or a certain household chore) is done or no screens during meals. By setting these types of rules as a family, and adhering to them yourself, you’ll be setting a great example for your kids. Some more direct tactics might be trying a timer, and eliminating the TV or computer from the room where your child sleeps.

When you are trying to avoid screens with your kids, it’s important to provide other engaging activities for them to do. Puzzles, books, magazines, or board and card games are great alternatives to TVs, video games, or smart phones. They are also easy activities to do together with your child. Other ideas are to draw pictures, turn on some music and dance, go for walks, play ball, or go your town library or museum. All are engaging activities that will help them reduce their daily screen time.

Get at least 1 hour of physical activity every day.

Physical activity is not only healthy for your kids, it is also free and can be quite fun. What counts as physical activity? Well, there are different types: moderate physical activity can be described as doing any activity that makes you breathe hard, like fast walking, hiking, or dancing; vigorous physical exercise involves activities that make you sweat, like running, aerobics, or playing basketball. Physical activity makes you and your kiddos feel good. It is healthy for your heart and lungs, plus it makes you stronger and more flexible.

The best tip to ensuring your kids get the physical activity they need is to simply schedule an activity for the family each day. Some easy things you can do with your family are: taking a walk or bike ride together, playing with your pet in the yard, playing a game of tag, dancing, or jumping rope. There are also a few things you can just incorporate into your daily life, like taking the stairs instead of the elevator and parking at the far end of the parking lot. You can also choose toys and games that promote physical activity. If you are nervous to start, know that making gradual changes to increase your activity level are okay.

Aim for zero sugary drinks each day. Substitute water instead.

The best drinks for young children – and for kids of all ages – are water and milk. Water is essential for good health and milk is loaded with important nutrients, especially calcium. The alternatives like juice, pop, and sports drinks simply have too much sugar! Even 100% juice has a significant amount of sugar. (100% orange juice as 22 grams of sugar per 8 ounce glass.) You can help curb your child’s sugar intake by limiting their drink choices at home. Promote water and milk as the drinks of choice by also trying to drink them while around your children. You can also liven water up with fresh lemon, lime, or orange wedges for some natural flavor.

Another important thing you can do is to simply educate yourself on what exactly is in the drinks we see on grocery and convenience store shelves today. Sports drinks are flavored with sugar and market their minerals and electrolytes. But most people don’t need them! They are only recommended when you are doing intense physical activity for at least an hour or longer. They are not for everyday drinking or even to quench your thirst after routine physical activity. Energy drinks such as Monster, Red Bull, Rockstar, etc., contain caffeine, sugar, and other vitamins and minerals. But again, most people get these nutrients from our food and do not need them. These drinks are not the same as sports drinks and are never recommended for children.


Raising healthy and happy children is a long-term goal. It’s a love and commitment for which every parent strives. We hope this article gives you a few ideas and tips to help you kick-start your ambition. Remember to set goals that are attainable. Start small and work to extend your goals over time. All efforts will be beneficial for your family. If you need help or more ideas, ask your pediatrician at your next visit. You can also visit the Iowa Healthiest State Initiative website for more information and tips.


Karen Hospodar Scott, MD, PhD
Pediatrics Department
(563) 584-3440



The Department of Pediatrics provides care for patients 18 years of age and younger, including newborns, infants, young children, and adolescents. This department offers services including diagnosis and treatment of infectious disease, chronic illness, and physical problems associated with children, including well child services such as growth and development counseling, periodic check-ups and dietary assistance to maintain good health. Special problems including weight control, anorexia nervosa, bulimia, and others, are also treated. Call 563-584-3440 (East Campus) or 563-584-4440 (West Campus) to schedule an appointment.

A New Option for Knee and Hip Replacements: Robotic-Assisted Joint Replacement

Modern joint replacement surgeries are some of the most successful and common surgeries that can improve a patient’s quality of life. Medications, exercise and injections may limit joint pain for a period of time. However, for many patients, a knee or hip joint replacement is needed for long-term pain relief.

Knee or hip joint replacement surgery may be considered when the joint pain limits everyday activities such as walking, standing for long periods, or stiffness that limits your ability to lift or move your leg.  The MAKOTM robotic-assisted joint replacement surgery is an evolution in the technology of how knee and hip replacements are done.

This technique provides a personalized surgical plan based on each person’s unique anatomy. With the robotic-assisted procedure, a 3D model of a patient’s knee or hip is made to specifically match the individuality of each patient. This allows for the surgeon to prepare a very specific and precise plan for each patient, using implants to help ensure a long track record of success.

What to expect with robotic assisted surgery:

  • A 3-D model of your joint is made and used to personalize your surgery.
  • The surgical plan is made well before your surgery based on a CT scan of your joint. It is important to understand that the surgery is performed by the surgeon, who guides the robotic arm during surgery to precisely align and position the new joint.
  • A customized treatment plan helps to get you back to your active lifestyle as quickly and safely as possible.

Robotic-assisted surgery aligns well with the principles of minimally invasive techniques which can make for smaller incisions, less injury to surrounding tissues, and often a more rapid recovery.

Each person’s body is unique, and the joint replacement surgery should be, too. Robotic-assisted hip and knee replacement surgeries offer the most innovative and personalized technology for our community.

Dr. Brian Silvia MD, PhD is a board certified, fellowship trained orthopedic surgeon specializing in joint replacement surgery with Medical Associates Clinic. Currently, Dr. Silvia is the only surgeon in the Tri-State area with experience and expertise in robotic-assisted joint replacement options.

silvia Brian A. Silvia, MD, PhD
Department of Orthopedics
Medical Associates Clinic




Is a vasectomy right for you? Top things to consider

Portrait shot of an attractive, successful and happy middle aged man male arms folded outside wearing a blue sweater

A vasectomy is a safe, outpatient (same day) procedure that makes a man sterile (unable to father a child). It’s the most effective birth control method for men while also being a simple and relatively inexpensive procedure. However it is a major step, and you and your partner should know all the facts and share in the decision. Our Board Certified Surgeons at Medical Associates have put together some key facts and questions to consider when contemplating this form of birth control.

Think it through:
Having a vasectomy should be thought of as a permanent decision. Before you make this choice, be sure it’s what you want. Many men choose it because their families are complete. Others choose it because it is more reliable than other birth control methods. If you choose a vasectomy, you and your partner should be in agreement and you should have no doubts about your decision. A vasectomy will not fix problems you and your partner may be having. And it is not a choice that you should make during times of stress.

Know your facts:
A vasectomy is safe and effective. There are no serious complications associated with vasectomies. Most men feel perfectly normal after surgery, with only minor discomfort. The procedure is far safer than the equivalent operation for women, a tubal ligation. A vasectomy also will not affect your sex drive. Your male hormone levels remain the same. It has no effect on libido or the ability to perform sexually.

The procedure:
Prior to surgery, you will have a consultation with your doctor. A vasectomy is an outpatient procedure and it is done in an exam room in the Surgery Department at the East Campus of Medical Associates. You will be awake for the procedure (which takes around 30-45 minutes) and a local anesthetic is used to numb the area. As with any surgery, there are possible risks and complications. Your doctor will discuss these potential risks with you prior to your surgery during your consultation appointment.

After surgery:
After the procedure, you will need to rest (with minimal movement) for the next several days to recover and may be given a prescription painkiller to take as needed. Again, most men feel perfectly normal after surgery, with only minor discomfort. Although you may feel well, it is strongly advised that you take the time to rest and recover. After three days you should be able to resume normal activities, but with caution. After a vasectomy, some active sperm remain in the semen. You and your partner need to use another form of birth control until lab tests prove you are sterile. This is done at a follow up appointment a couple months after the procedure. You will be asked to provide a sample that will be tested to verify that you are sterile.

To schedule an appointment at Medical Associates, please contact 563-584-3450 to set up a consultation. In most cases, this procedure is covered by your insurance and only requires an office visit co-pay. Please check with your health insurance provider if you are unsure.


1000 Langworthy  |  Dubuque, Iowa 52001  |  563.584.3450


Urinary Incontinence: Common but not Normal

There are some body issues that no one really likes to discuss, even with their doctor. Incontinence (leakage), urinary or fecal, is one of those issues. Incontinence affects both men and women, but did you know that it is two times more likely in females than males? The National Association for Continence (NAFC) says 1 in every 4 women over the age of 35 experiences incontinence. Incontinence is common, but that does not mean it is an inevitable part of aging and it does not mean you can’t find relief.

First, let’s review how the bladder functions: your kidneys filter your blood and remove waste/toxins which creates urine. Little tubes, called ureters, take the urine from the kidneys to your bladder where it is stored. As the bladder fills, it stretches. When it reaches a certain level, a message is sent to the brain telling you it’s time to find a bathroom. When you reach the restroom the brain tells the muscles of the bladder to contract (you can’t control this part, it just happens) and your pelvic floor muscles to relax (you can control this part).. If something interrupts the communication process between the brain and bladder or if the muscles of the pelvic floor are weak (or sometimes even tense), leakage can occur. While you cannot control the contraction of your bladder, you can control your pelvic floor muscles. Strengthening these muscles with a specific type of physical therapy can help.

Incontinence is not only a physical problem, but it can affect your personal life. Every patient is unique, but incontinence is usually a bigger issue than needing to wear a pad or change your clothing. Many sufferers experience impacts on their emotional and psychological well-being. A decrease in social activity is also common. Incontinence has also been associated with a 26% increased risk of falls in the elderly population, as reported by the NAFC. Some can lose their balance when experiencing a sudden need to reach the bathroom quickly.

There are many different types of incontinence and they all mean something slightly different. Knowing the various types can help when trying to communicate the problem to your doctor or physical therapist.

  • Stress Incontinence: loss of urine with physical activity/exertion. Often individuals note this leakage is associated with cough, sneeze, laugh, jump, or exercise.
  • Urge Incontinence: loss of urine that is preceded by a strong and sudden need to empty the bladder. With this type of incontinence, you may notice every time you hear running water or pull into your garage after work you feel the need to urinate and can’t make it to the toilet.
  • Overactive Bladder: with overactive bladder symptoms of urgency, urinating frequently, and not feeling like you empty your bladder all the way tend to coincide and one may or may not have leakage along with these symptoms.
  • Mixed Incontinence: this simple means a combination of any of the above listed types of incontinence; most often a combination of stress and urge incontinence.

No matter the factors contributing to your incontinence, you can find relief. It may be embarrassing to discuss with your doctor, but it is important to speak up. Your physician can rule out larger medical conditions, assess if any of your medications are contributing to the problem, and recommend a form of treatment. Ask your doctor about a referral for pelvic floor physical therapy. Return to your beloved social activities and experience less anxiety over incontinence. Have confidence and take back control!

Gosse_B_2017_ultiproBrittany Gosse, DPT
Department of Physical Therapy
Medical Associates Clinic