Science & Compassion Bloghttps://www.uhhospitals.org/blog/rss-feedScience and Compassion Blogen{7D14A7FE-29DA-42BA-B772-AE2E66D9680A}https://www.uhhospitals.org/blog/articles/2024/03/how-worried-should-you-be-about-measlesShould You Be Worried About Measles?<p>Measles cases are on the rise across the United States. And while the number of cases may sound low, the risk of full-blown outbreaks are significant, says <a href="/doctors/Edwards-Amy-1295916864">Amy Edwards, MD</a>, a pediatric infectious disease specialist at <a href="/rainbow">University Hospitals Rainbow Babies & Children’s Hospital</a>.</p> <p>“One of the things that makes measles particularly difficult to contain is you’re contagious for as many as four to five days before you have symptoms,” says Dr. Edwards. Measles can spread with lightning-quick speed among people who are unvaccinated and lead to severe complications, including death.</p> <h2>What Makes Measles a Threat?</h2> <p>For the vast majority of U.S. adults and children who have been vaccinated, there’s no reason to panic about catching measles. Two doses of the <a href="/health-information/health-and-wellness-library/article/pediatric-diseases-and-conditions-v0/measles-mumps-and-rubella-mmr">MMR</a> (measles, mumps, rubella) vaccine – typically given starting at age one – are 97 percent effective against measles. You’re very unlikely to contract the disease if exposed.</p> <p> </p> <p>Nine out of 10 people exposed to measles who aren’t vaccinated will catch it. Common symptoms include high fever, cough, runny nose, pink eye and a rash over the face and body. A child usually will recover in a couple weeks. But complications are not uncommon. “About 20 percent of unvaccinated children will require some amount of hospitalization before they're able to recover,” she says. “And one in 1,000 unvaccinated children will have long-term disabilities even if they survive. Measles is a very common cause of encephalitis, which is inflammation or swelling of the brain.”</p> <p>Measles can also lead to secondary bacterial infections, which can be fatal, Dr. Edwards says. “Measles overwhelms the immune system,” she says. “Because of this, it's easier to get other serious infections like bacterial pneumonia, which can lead to hospitalization or even death. For some kids, that damage to the immune system is permanent.”</p> <h2>Measles Vaccination Rates Are Declining</h2> <p>Most children receive two doses of MMR vaccine starting at age 1. When 95 percent of the population is vaccinated it provides herd immunity, which protects infants who are too young to be vaccinated and children who can’t tolerate vaccination because of a severely weakened immune system.</p> <p>Vaccination rates have been on the decline since the start of the COVID-19 pandemic. At last count, <a href="https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/maintain-vaccination-coverage-level-2-doses-mmr-vaccine-children-kindergarten-iid-04">93 percent</a> of kindergartners were vaccinated with 2 doses of the MMR vaccine in 2021-22. That’s down from 94.7 percent in 2018-19. Schools across the country also are loosening vaccine requirements.</p> <p>Before the first vaccination program started in the 1960’s, an estimated 3 to 4 million people got the measles every year in the United States. In 2000, measles was <a href="https://www.cdc.gov/measles/elimination.html">declared eliminated</a> in the United States, thanks to vaccines. However, an increasing number of children have not been vaccinated.</p> <p>The growing number of children at risk is alarming, says Dr. Edwards. “Measles requires a very high vaccination rate to keep outbreaks under control because it’s so contagious. Any increase in cases is a massive red flag when it comes to a virus that is this contagious and this deadly.”</p> <p>“It’s all of our responsibility to make sure that our children are vaccinated to protect everybody else. That is the basis of herd immunity,” says Dr. Edwards. “We've dropped below that threshold and there are regions of the country where the uptake is much, much lower. So, we are basically just waiting for an outbreak that will harm children.”</p> <h3>Related Links</h3> <p>University Hospitals Rainbow Babies & Children’s has the region’s largest coordinated network of pediatric primary care providers, committed to delivering the very best care to children of all ages, including routine immunizations. <a href="/rainbow/services/pediatrics">Find a UH Rainbow pediatric practice near you.</a></p>Wed, 13 Mar 2024 20:00:00 -0400{D5E83480-FCDB-4A8F-89F5-970930657288}https://www.uhhospitals.org/blog/articles/2024/03/man-undergoes-surgery-after-colonoscopy-detects-cancerMan Undergoes Surgery After Colonoscopy Detects Cancer<p>Don’t put off that colonoscopy.</p> <p>Dana Saunders Sr., 61, speaks from experience. He had surgery at 58 after a colonoscopy found a tumor.</p> <p>He’d had a colonoscopy before, and a few polyps were removed. He was told to return in five years, but time flew. Nine years had passed before his primary care physician found blood in Dana’s stool and advised a <a href="/services/Digestive-health-services/Conditions-and-treatments/small-and-large-intestine/colonoscopy">colonoscopy</a>.</p> <p>Dana had several risk factors for <a href="/services/cancer-services/gastrointestinal-cancer/colorectal-cancer">colon cancer</a>. His mother was diagnosed with Stage 4 colon cancer in her 70s. He also smoked for 20 years earlier in his life, and enjoyed his share of barbeque and fried foods. Dana also is African American, which makes his risk of colon cancer 20 percent higher than that of White Americans.</p> <p>Current guidelines advise colonoscopies starting at age 45 for most adults. Anyone with parents or siblings who have had colon cancer or advanced, large polyps should start routine colonoscopies at age 40. And any abnormal symptoms, like unexplained rectal bleeding, is reason to ask your primary care physician about colon cancer screening.</p> <p>“The screening is the most important preventive measure you can do,” Dana says. “You can eat right but you still have to get checked.”</p> <p>Since his cancer diagnosis, Dana eliminated meat and dairy from his diet, adopting a plant-based regimen. He also exercises five to six days each week. He’s grateful his cancer only required a surgical resection with <a href="/doctors/Charles-Ronald-1447427661">Ron Charles, MD</a>, and he did not need chemotherapy or radiation therapy.</p> <p>“I feel great, like I’m only 50 years old,” says Dana. “It’s a wake-up call.”</p> <p>According to the World Health Organization, colorectal cancer is the third most commonly diagnosed cancer in the world. Screening for colorectal cancer can identify pre-cancerous lesions and detect asymptomatic early-stage cancers that have a greater chance of being cured. Screening has been shown to decrease risk of dying from colorectal cancer.</p> <h3>Related Links</h3> <p>To learn more about colonoscopies and to schedule yours today, go to <a href="/services/Digestive-health-services/Conditions-and-treatments/small-and-large-intestine/colonoscopy">www.uhhospitals.org/colonoscopy</a>.</p>Sun, 10 Mar 2024 20:00:00 -0400{EAE39818-BEE3-4571-8D5D-8B3DEDE497CE}https://www.uhhospitals.org/blog/articles/2024/03/retired-truck-driver-chooses-groundbreaking-cancer-care-at-uhRetired Truck Driver Chooses Groundbreaking Cancer Care at UH<p>Brian Weary feared he was given a death sentence when a colonoscopy revealed inoperable <a href="/services/cancer-services/gastrointestinal-cancer/colorectal-cancer">colorectal cancer</a>.</p> <p>Instead, the 69-year-old retired truck driver received the revolutionary immunotherapy Keytruda that effectively erased his cancer.</p> <p>Approximately 20 percent of colon cancer patients harbor a specific genomic signature known as microsatellite instability-high (MSI-H), which makes them especially receptive to <a href="/services/cancer-services/gastrointestinal-cancer/colorectal-cancer/treatment/immunotherapy">immunotherapy</a>. Immunotherapy activates a person’s immune system to identify and destroy cancer cells. Over the course of six treatments, Brian found the world’s most “unbelievable” cancer care team.</p> <img class="UH-Inline-Image-Small" alt="Brian Weary receives Keytruda immunotherapy" src="/-/media/Images/Blog/Weary-Brian.jpg?la=en&hash=EAA7661247397F1D775659782C16B88E2F5A7333" /> <p>After the immunotherapy concluded, they searched extensively to ensure he was clear. The cancer was gone.</p> <p>“A lot of people don't realize that some colon cancers can be put in complete remission and potentially be cured without surgery or radiation or chemotherapy,” said <a href="/doctors/Chakrabarti-Sakti-1538260104">Sakti Chakrabarti, MD</a>.</p> <p>Brian went to UH Seidman Cancer Center on main campus every three weeks for a 45-minute infusion. This opportunity, offered by Dr. Chakrabarti, was Brian’s redemption.</p> <p>“I was really lucky,” reflected Brian. “What a doctor. That man is a saint, as far as I’m concerned. You couldn’t ask for a more caring doctor. He would call just to check on me. He’s just a super guy.”</p> <p>Brian drives past numerous hospitals on his way to downtown Cleveland from Doylestown in Wayne County. But he would not go anywhere else.</p> <p>“I will always go to University Hospitals,” Brian said. “I’ve never gone to a hospital where I’ve had the quality of treatment that I’ve had at University Hospitals. Everybody is there for your best interest.”</p> <h3>Related Links</h3> <p>Learn more about <a href="/services/cancer-services/gastrointestinal-cancer/colorectal-cancer/treatment/immunotherapy">Keytruda immunotherapy for colorectal cancer</a>.</p>Thu, 07 Mar 2024 19:00:00 -0500{BAE9E7FB-FA5D-4BC3-BA02-7A0DDC14DBDA}https://www.uhhospitals.org/blog/articles/2024/03/can-ozempic-treat-other-diseases-tooCan Ozempic Treat Other Common Diseases Too?<p>Ozempic and similar medications have received widespread attention for the treatment of diabetes and weight loss. There’s also growing research that it may help treat heart disease, sleep apnea, kidney disease, polycystic ovary syndrome (PCOS), substance use disorder and other conditions.</p> <p>“Despite the promise, it’s best to take a cautiously optimistic view because research is in the early stages,” says <a href="/doctors/Khaitan-Leena-1255358115">Leena Khaitan, MD</a>, Director of <a href="/services/Digestive-health-services/Conditions-and-treatments/weight-loss-management/surgical-weight-loss-bariatric">University Hospitals Bariatric Surgery Program</a>. “There is still much to be learned about these drugs, how they work and the long-term effects.”</p> <p>Dr. Khaitan answers other common questions about the potential of Ozempic and similar drugs for treating other conditions.</p> <h2>Q. Ozempic, Wegovy and other GLP-1 drugs have grown in popularity. What should consumers know about them?</h2> <p><strong>A.</strong> Drugs in the Ozempic family are known as glucagon-like peptide 1 (GLP-1) agonists, which help lower blood sugar and promote weight loss.</p> <p>These medicines are very effective for the right patients. What gets transmitted in media and advertising is that all you have to do is give yourself a shot once a week and the medicine does everything. It’s important for people to realize there is no sustainable weight loss program if diet and exercise aren’t at the core of it. To maintain results long-term, you have to eat well, with lots of protein and vegetables and minimal fast food, fried food and processed foods.</p> <p>If you do that with GLP-1 medicines, it can be extremely effective. People have lost 20, 30, even 50 pounds using these medicines. We should remember one of the most effective and durable treatments for this amount of weight loss or more is weight loss surgery. Yet it’s only chosen by 1 percent of people who qualify.</p> <h2>Q. What about Ozempic and similar drugs for other conditions?</h2> <p><strong>A.</strong> With these medicines, were seeing reduction of cardiac events, sleep apnea, hypertension, and other beneficial effects beyond weight loss and stabilizing blood sugar.</p> <p>The question is: Is that a direct effect of the medicines or because of the weight loss? I think they go together. With bariatric surgery, we see many positive health effects. I think it’s the same for these medications. Researchers are trying to tease out why these effects happen.</p> <p>Obesity is an underlying factor for so many health issues. With obesity, there is more inflammation in the body, which affects other disease processes. Hormonal changes that affect health are also associated with weight gain. For example, polycystic ovary syndrome (PCOS) is related to high testosterone levels, which tend to decline with weight loss.</p> <p>There is a lot for us to understand here, but I think the underlying theme is obesity. The medications do have promise, but it may not be the medication itself, but rather their effect on weight loss that reduces other health conditions.</p> <h2>Q. Any words of caution?</h2> <p><strong>A.</strong> These medications are being prescribed to a lot of people. I am concerned about long-term effects.</p> <p>People need to educate themselves and talk to their providers about potential side effects. Particularly severe <a href="https://jamanetwork.com/journals/jama/fullarticle/2810542">GI-related issues</a>, such as gastroparesis (delayed gastric emptying). For most people, gastroparesis goes away. But studies coming out are showing persistent gastroparesis in about 4 percent of patients. That’s a miserable condition to have.</p> <p>Also, just like with any weight-loss method, it may work great when you’re doing it, but when you stop doing it, there’s a good chance you will gain back the weight if you haven’t adopted healthy lifestyle changes.</p> <p>We have no research on the long-term effects of these medications. Some people remain on what we call a maintenance dose. But it’s expensive, it may not be covered by your insurance and supply is poor because of high demand.</p> <p>It’s also true that people have different obesity profiles. What works for one person may not work for another. These medications are not the answer to everyone’s prayer for weight loss. Patients should evaluate all methods of weight loss, including diet and exercise (core of everything), medications and surgery. Then determine which is the best for them.</p> <h3>Related Links</h3> <p>Our team of weight loss doctors and surgeons, medical weight loss specialists, nutrition experts and other clinical support staff provide a wide range of <a href="/services/Digestive-health-services/Conditions-and-treatments/weight-loss-management">weight loss solutions</a> – and help you find the right one for your personal weight loss goals.</p>Thu, 07 Mar 2024 08:00:00 -0500{52F1B034-C8B1-4536-9FD1-A75554BC88C9}https://www.uhhospitals.org/blog/articles/2024/03/is-allulose-the-perfect-sweetenerIs Allulose the Perfect Sweetener?<p>If you’ve been wishing for a better tasting low-calorie sweetener, allulose might be the answer. This recently FDA-approved sugar substitute boasts a lot of positives. But before adding it to your coffee, it’s important to get the whole picture.</p> <p>“Allulose is a new option in the list of safe alternatives to sugar,” says University Hospitals registered dietitian <a href="/doctors/Traxler-Elizabeth-1659966711">Elizabeth Traxler, MS, RDN, LD</a>. “Like many sugar substitutes, allulose is low calorie and doesn’t raise insulin or blood sugar levels, so it can be helpful for weight management and diabetes. The thing that sets allulose apart is it has a texture and flavor similar to table sugar and it doesn’t seem to give the strong aftertaste that is often associated with most low-calorie sugar substitutes.”</p> <h2>What is Allulose?</h2> <p>Allulose is a sugar found naturally in raisins, figs, maple syrup, molasses and wheat. Allulose is commercially produced by heating the sugar molecule fructose and changing its chemical form. The resulting sweetener is available granulated like sugar or in liquid form. You can find it online, but you won’t find it on most store shelves or in many low-calorie foods or beverages – at least not yet.</p> <h2>Allulose and the Body</h2> <p>The body responds to allulose differently than it does to table sugar. Allulose is quickly absorbed and excreted, but isn’t metabolized by the body. Because it isn’t metabolized, allulose doesn’t increase insulin or blood sugar levels, isn’t stored as fat and won’t promote weight gain like sugar does.</p> <h2>The “Sweet” News about Allulose</h2> <p><strong>Sweet and tasty.</strong> Allulose is about 70 percent as sweet as sugar and tastes a lot like sugar, with little or no aftertaste. That means you can truly enjoy it as a sugar substitute, including for baking.</p> <p><strong>Low calorie.</strong> Allulose has about one-tenth of the calories in sugar. It contains approximately 1.6 calories per teaspoon compared to 16 calories in 1 teaspoon of sugar.</p> <p><strong>Safe.</strong> Allulose has received the “Generally Recognized as Safe” approval from the Food and Drug Administration (FDA).</p> <p><strong>No tooth decay.</strong> Unlike sugar, and like some other sugar substitutes, allulose isn’t metabolized in the mouth, so it doesn’t contribute to tooth decay.</p> <p><strong>Doesn’t raise insulin and blood sugar levels.</strong> Allulose doesn’t raise insulin or blood sugar levels, which makes it an appropriate choice for individuals with diabetes. But the benefits may go far beyond that.</p> <p>“A few studies have shown that if a certain amount of allulose is consumed with other carbohydrates, there may be a lower blood sugar spike than what is typical for that food on its own. And studies conducted with rats demonstrated that allulose may enhance the body’s sensitivity to insulin, which is important for blood sugar regulation,” says Traxler.</p> <h2>The Drawbacks of Allulose</h2> <p><strong>Side effects.</strong> At this point, there aren’t many human studies to show how much allulose may be harmful. While not many side effects have been identified, it’s possible that when consumed in higher amounts, allulose may cause GI upset due to its poor absorption. In addition, some research shows that allulose may promote the growth of certain bacteria associated with poor effects on gut health. In either case, allulose could cause GI symptoms of discomfort, gas or bloating similar to those with other sugar substitutes. Moderation is always the key.</p> <p><strong>Price.</strong> The product is new, has to be commercially produced and has a lot of positive qualities that put it in high demand. That all adds up to a high price. Compared to other sweeteners, allulose is the most expensive. Allulose is almost five times the price of table sugar, more than twice the price of Sweet’N Low, and about 30 percent more expensive than Truvia and Equal.</p> <p>“If you can afford the cost, allulose has a lot in the plus column. It provides another safe option for adding sweetness without sugar or calories. It may be especially appealing due to its potential to support weight loss and blood sugar management. However, like any other sugar substitute available, we should consume it in moderation as more research is needed to assess its health impact over time,” says Traxler.</p> <h3>Related Links</h3> <p>University Hospitals has a team of <a href="/services/clinical-nutrition-services">clinical dietitians</a> with the expertise to provide counseling and personalized eating plans for anyone looking to enhance their health, meet nutritional goals or lose weight safely and effectively.</p>Wed, 06 Mar 2024 08:00:00 -0500{E41F510B-9779-426C-A991-FD6CCB603C3C}https://www.uhhospitals.org/blog/articles/2024/03/inherited-eye-diseases-the-importance-of-early-diagnosisInherited Eye Diseases: The Importance of Early Diagnosis<p>Many eye diseases tend to run in families. In fact, recent studies have identified more than 350 eye diseases with a hereditary link.</p> <p>“Most eye diseases have a genetic component,” says University Hospitals ophthalmologist <a href="/doctors/Kurup-Shree-1437103389">Shree Kurup, MD</a>, and ophthalmology resident Robin Su, MD, PhD. “But other factors also contribute to eye disease and vision loss. Thanks to accelerating advances in genetic studies, we have more hope than ever before for treating eye disease. However, like any health concern, early diagnosis is critical to successful treatment.”</p> <h2>Causes of Eye Disease</h2> <p>Genetic mutations can affect any part of the eye: the cornea, pupil, lens, retina or optic nerve. In addition to family history, a variety of other factors can contribute to <a href="/services/ophthalmology">eye disease</a>. These include age, diet, overall health, and environmental exposures such as smoking, ultraviolet light, and certain chemicals and drugs that cause degenerative changes in the eye.</p> <ul> <li><strong>Glaucoma</strong>, a disease which is driven largely by genes, can be worsened by smoking.</li> <li><strong>Age-related macular degeneration, AMD</strong>, has a mix of causes. It is associated with age, genetics, diet, smoking, and other health issues such as obesity and cholesterol levels.</li> <li><strong>Nearsightedness (myopia)</strong> is on the rise in children younger than 15. While the condition tends to run in families, Dr. Kurup and Dr. Su believe the recent increase is related to how much time children are spending on screens and reading in low light.</li> </ul> <h2>Symptoms of Hereditary Eye Disease</h2> <p>Some hereditary eye diseases progress slowly, while others appear at a very young age. Many result in vision reduction. Diseases that involve the retina, cornea or optic nerve can lead to significant vision loss.</p> <p>Common eye diseases include color blindness, macular degeneration, glaucoma and Fuch’s (corneal) dystrophy. Although a large number of hereditary eye diseases and conditions have been identified, many of them remain rare.</p> <h2>When to Get Screened for Hereditary Eye Disease</h2> <p>A doctor should examine and track young children for proper eye health, development and vision. Every year, children should be checked for vision changes. In addition, early ophthalmology care is vital if you have health issues such as diabetes or high blood pressure that increase the risk for eye disease.</p> <p>At all ages, from teens to senior adults, monitor for changes in vision:</p> <ul> <li>Dark spots</li> <li>Poor focus or blurriness</li> <li>Cloudiness</li> <li>Flashes of light</li> <li>Floaters or wavy lines</li> <li>Difficulty adjusting to different amounts of light</li> <li>Pain</li> </ul> <p>“You should be able to have clear 20/20 vision, with corrective lenses if necessary, and have the same quality of vision you experienced previously,” says Dr. Kurup and Dr. Su. “If your vision changes and you don’t see 20/20 even with corrective lenses, you need to see an ophthalmologist.”</p> <h2>The Value of Early Diagnosis</h2> <p>A wide range of vision tests are available to diagnose eye diseases. Based on your symptoms, genetic testing may be recommended. For many conditions including glaucoma and AMD, eyedrops, ointments, medications, injections or surgery can treat or slow the progression of eye disease, especially in early stages.</p> <p>“For example, in the early stages of Fuch’s disease, eyedrops or ointments can be used relieve symptoms like blurry vision. However, treatment at advanced stages requires a surgery with a corneal transplant. In certain forms of macular degeneration, injections may actually improve vision. We want to treat eye disease before too much damage is done,” Dr. Kurup and Dr. Su explain.</p> <p>“If you have inherited eye disease, there are new medications, stem cell and gene therapy, and other approaches still emerging. But don’t wait. An early diagnosis and treatment always offers a better outcome.”</p> <h3>Related Links</h3> <p>The University Hospitals Eye Institute is ranked among the best in the country, conducting innovative research and applying the most advanced techniques and treatment in ophthalmological care. <a href="/services/ophthalmology">Learn more.</a></p>Mon, 04 Mar 2024 08:00:00 -0500{58122DB2-EBC7-4404-AA73-90E6ED4D4ACF}https://www.uhhospitals.org/blog/articles/2024/02/what-your-tongue-can-reveal-about-your-healthWhat Your Tongue Can Reveal About Your Health<p>Long before the advent of modern medicine, healthcare providers relied primarily on their senses to evaluate patients. Diagnoses were often made by simply looking at and listening to the patient. In Traditional Chinese Medicine (TCM), observation of the tongue in particular was – and still is – an especially useful diagnostic tool. So, what can your tongue tell you about your health? </p> <h2>Look and Learn: A Visual Exam of the Tongue</h2> <p>“The tongue can provide vital clues about your overall health and be an early indicator of certain diseases or deficiencies,” says <a href="/doctors/Wolf-Jacob-1639506710">Jacob Wolf, ND, LAc</a>, a naturopathic doctor at <a href="/services/integrative-health-network">University Hospitals Connor Whole Health</a>. “Healthcare providers including TCM practitioners examine and take note of the color, size and texture of the tongue to assist them in making a diagnosis. We also look for any unusual coatings on the tongue,” adds Dr. Wolf.</p> <p>The following characteristics of the tongue are considered during the visual exam: </p> <ul> <li><strong>Color.</strong> Healthy tongues can range in color from pale pink to reddish-pink. Extreme variations from the normal color palette may be an early warning sign of certain diseases, vitamin deficiencies or infections. For example, a bright red tongue might indicate an infection or conditions like anxiety or insomnia, a tongue with a bluish tint could suggest poor circulation, and a very pale tongue can be a sign of nutrient deficiency. </li> <li><strong>Size. </strong> Although there is no standard size for a tongue, it should rest comfortably in your mouth. If the tongue is enlarged and swollen, this can be an indicator of allergies, digestive disturbances or blood sugar issues like diabetes. </li> <li><strong>Texture. </strong> Tiny bumps called papillae cover the surface of the tongue, giving it a rough texture. A very smooth tongue surface may indicate a condition called atrophic glossitis in which some or all of the papillae are missing. If any new lesions, masses, discolorations or irregular patches are noted on the tongue’s surface, they may be signs of a bacterial or fungal infection, an immune deficiency or even a pre-cancerous condition. </li> <li><strong>Coating. </strong> Tongue coating is complex because it can change based on diet. However, coating discolorations and their location on the tongue are noted and considered in the diagnostic process. </li> </ul> <p>The information from a visual exam of the tongue can help your healthcare provider determine which body systems are dysfunctional or out of balance and help to guide treatment. “If you are being cared for by an acupuncturist, the clues provided by the tongue’s appearance can help us choose the appropriate acupuncture points and guide the selection of an herbal formula if indicated,” says <a href="/doctors/Kaiser-Christine-1972674075">Christine Kaiser, LAc, DACM</a>, clinical manager of acupuncture at University Hospitals Connor Whole Health.</p> <h2>Tips to Keep Your Tongue Healthy</h2> <ul> <li><strong>Practice good oral hygiene. </strong> Brush your teeth and tongue at least twice a day. Consider using a tongue scraper.</li> <li><strong>Stay hydrated. </strong> Drinking plenty of water is important for your tongue and your overall health. </li> <li><strong>Don’t smoke. </strong> Smoking is a leading cause of oral cancers including cancers of the tongue. </li> <li><strong>Eat a healthy diet. </strong> A tongue-healthy diet includes probiotics like yogurt, leafy greens, brightly colored fruits, and vegetables and iron-rich foods like spinach and shellfish. </li> <li><strong>Get regular dental checkups. </strong> In addition to caring for your teeth, dentists routinely examine the entire mouth and tongue for signs of disease. </li> </ul> <h3>Related Links:</h3> <p>At <a href="/services/integrative-health-network">UH Connor Whole Health</a>, we take the whole person into account, addressing the full range of physical, emotional, mental, social, spiritual and environmental influences that affect an individual’s health. Our diagnostic and therapeutic healthcare services include acupuncture, massage therapy, chiropractic and lifestyle medicine consultations.</p>Thu, 29 Feb 2024 08:00:00 -0500{E9DE1B2A-8E8D-42DC-BB00-C02627FA3468}https://www.uhhospitals.org/blog/articles/2024/02/how-to-tell-if-your-child-has-appendicitisHow to Tell If Your Child Has Appendicitis<p>Abdominal pain is a common complaint in children, and most of the time the cause isn’t serious. However, when the pain is increasingly intense and accompanied by vomiting or other symptoms, it could be a sign of appendicitis – which requires urgent medical attention. </p> <p>Appendicitis – or when the appendix becomes inflamed or infected – is actually fairly common in children, and is one of the top reasons for emergency abdominal surgery in children, explains University Hospitals Rainbow Babies & Children’s pediatric surgeon and director of pediatric trauma <a href="/doctors/Dingeldein-Michael-1114184272">Michael Dingeldein, MD</a>. </p> <p>The appendix is a small structure attached to the end of the colon, and it doesn’t serve any known purpose in humans. The opening of the appendix is small, making it prone to getting blocked. When this happens, the appendix becomes swollen and infection can develop. This becomes especially dangerous when the appendix ruptures or bursts, causing the infection to spread to the belly. </p> <p>Appendicitis can affect children of all ages, though it is less common in children under the age of 3 and rarely affects children under 1 years old. It most commonly occurs in children ages 5 – 10. </p> <h2>Signs to Look For</h2> <p>Because belly pain is a vague symptom with many potential causes, it can be tricky for parents to determine whether their child’s abdominal pain is a sign of appendicitis or something else. Appendicitis usually starts out as a vague discomfort around the belly button, which then migrates to the lower right side of the belly. The pain may be accompanied by nausea, vomiting, diarrhea, or a fever. </p> <p>Parents should also be on the lookout for behavioral signs that something is amiss, especially in younger children who may not be able to communicate their symptoms effectively. This can include signs such as irritability or having no interest in eating, not even their favorite foods. </p> <p> “I’ll often ask patients what their favorite food is and if they want to eat it right now,” says Dr. Dingeldein. “If they answer no, that’s a good indication that something is wrong.” </p> <p>Appendicitis pain often gets worse with movement or activity, due to inflammation of the abdominal cavity’s lining (peritoneum). So another thing parents can try is the “jump test”. As the name suggests, this involves having the child try to jump. If jumping makes the pain worse, it could be a sign that the peritoneum is inflamed, which may indicate appendicitis. </p> <h2>When to Seek Care </h2> <p>If your child displays any of these symptoms, it warrants an urgent trip to their pediatrician, says Dr. Dingeldein. </p> <p>Your child’s doctor will be able to take a medical history and perform a physical exam. While appendicitis can often be diagnosed with history and exam alone, your child may also undergo additional tests such as: </p> <ul> <li>Blood work</li> <li>Ultrasound</li> <li>Computed tomography (CT) scan </li> </ul> <h2>Surgery and Recovery</h2> <p>If your child is diagnosed with appendicitis, the first step will be to put them on antibiotics to stop the infection from getting worse. Surgery to remove the appendix will usually be scheduled within 6 – 12 hours. </p> <p> “It’s incredibly rare that there is a need for an immediate emergency surgery,” says Dr. Dingeldein. </p> <p>In some cases, your child’s doctor can attempt to treat appendicitis with antibiotics alone. However, there’s a chance of recurrence within the next 10 years, so most parents opt for the surgical removal of the appendix, or an appendectomy. This minimally invasive laparoscopic surgery uses tiny incisions in the abdomen to remove the appendix. In uncomplicated cases in which the appendix hasn’t ruptured, the patient may be able to return home the same day and can return to school and sports within a couple of weeks. However, if the problem isn’t caught quickly enough and the infection has spread, it may require a longer hospital stay. </p> <p> “This is why it’s so important to recognize those early signs and seek medical care if you suspect appendicitis,” says Dr. Dingeldein. “The earlier we catch it, the easier it is to treat it and get your child healthy again.”</p> <h3>Related Links</h3> <p>If your child is suffering from abdominal pain, the UH <a href="/rainbow/services/pediatric-gastroenterology">pediatric digestive health team</a> can help identify and treat the specific cause. If it’s a condition that requires surgery, such as appendicitis, the experienced <a href="/rainbow/services/pediatric-surgery">pediatric surgery team</a> can provide expert surgical care, 24/7.</p>Wed, 28 Feb 2024 08:00:00 -0500{7F9EC7A5-1DDC-425B-B9B3-EC1B7D2716EA}https://www.uhhospitals.org/blog/articles/2024/02/screenings-help-identify-kids-at-risk-for-suicidal-behaviorScreenings Help Identify Kids at Risk for Suicidal Behavior<p>A recent analysis found that mental health-related hospital stays among children in the U.S. increased by more than 25 percent between 2009 and 2019. Over 60 percent of those hospitalizations involved suicidal behavior – an increase from around 30 percent in 2009. Mental health hospitalizations also increased significantly in the 11 – 14 age group. </p> <p>This alarming trend is being seen in hospitals across the country, including here in Ohio, says University Hospitals Chief of Pediatric Emergency Medicine, <a href="/doctors/Macias-Charles-1902986300">Charles Macias, MD, MPH</a>. He says the key to helping decrease hospitalizations is identifying mental health problems in children early and getting them the help they need – before a crisis situation develops. </p> <h2>What’s Driving the Increase?</h2> <p>Emergency departments across the country are seeing a steady increase in visits for all types of <a href="/rainbow/services/pediatric-developmental-and-behavioral-issues">behavioral health issues</a>, including suicidal ideation and suicide attempts. Suicide has become the second leading cause of death among adolescents, after car accidents. </p> <p>The root source of the problem is complex, but systemic barriers to care are a big part of what’s driving the increase in mental health hospitalizations, says Dr. Macias. Long wait times to see mental health providers, problems with insurance coverage, and other access issues mean the emergency room is often where parents go when they have nowhere else to turn. </p> <p>Growing social media use among children and teens has also been cited as a contributor to mental and behavioral health issues. Although the analysis cited above didn’t include data past 2019, the COVID-19 pandemic and the isolationism it spurred may have played a role in the trend continuing, says Dr. Macias. </p> <h2>Who’s at Risk?</h2> <p>There are a number of factors that could put a child at risk for a mental health crisis or suicide attempt. These include underlying anxiety, depression or behavioral health disorders, bullying, past suicide attempts, and drug or alcohol use. Children may also be influenced by other suicide deaths or attempts, especially when it involves a peer or family member. They can be more at risk if they have experienced other trauma in their lives, such as a death in the family or violence. </p> <h2>Identifying At-Risk Children</h2> <p>Screening to identify children who are at risk for suicidal behavior is a key tool in getting them access to appropriate mental healthcare before an emergency situation occurs. Dr. Macias notes that the barriers to care that many parents encounter make early identification all the more important for the well-being of at-risk kids. </p> <p> “Emergency room visits can’t be the solution,” he says. “We need to go upstream to catch depression early, before it escalates to suicidal ideation.” </p> <p>The ASQ suicide risk screening tool involves a series of yes-or-no questions to help gauge a child’s immediate and long-term risk for suicidal behavior. The questionnaire can be administered by the child’s primary care provider during well child or sick visits, or by other qualified health providers. Dr. Macias says the screening tool is well tested and is proven to be effective at identifying children at risk for suicidal behavior. </p> <p>If a child is determined to be at risk, their provider can refer them for a further mental health evaluation and connect families with resources to address their child’s mental health needs, such as access to a licensed therapist or pediatric psychiatrist. </p> <h2>How Parents Can Help a Struggling Child</h2> <p>Parents who are concerned about whether their child is at risk should be on the lookout for new behaviors or personality changes. These can include: </p> <ul> <li>Becoming increasingly isolated or withdrawn</li> <li>Not socializing well at school</li> <li>New or escalating impulsivity or aggression</li> </ul> <p>It’s important to keep the lines of communication open with your child and not be afraid to bring up their mental health struggles, says Dr. Macias. It’s okay to ask your child directly if they’ve ever had suicidal thoughts and let them know that it’s okay to talk to you about it. </p> <p>Don’t wait until a child has severe symptoms before seeking help, advises Dr. Macias. Contact your child’s pediatrician at the first signs of at-risk behavior. They will be able to connect you with the resources your child needs to stay safe. </p> <h3>Related Links</h3> <p>If you suspect your child is struggling with mental health issues, even if they don’t acknowledge it, you may want to consider having them evaluated by their pediatrician or a pediatric behavioral health professional. The <a href="/rainbow/services/pediatric-developmental-and-behavioral-issues">pediatric behavioral health team</a> at UH Rainbow offers a full range of behavioral health screening and treatment services to help children and families.</p> <p>If you need immediate support, call or text the National Suicide Prevention Lifeline at <a href="tel:988">988</a> to be connected with someone who can help. </p>Tue, 27 Feb 2024 08:00:00 -0500{F36D63A8-81A0-4AF5-9615-0800DE8DAFA1}https://www.uhhospitals.org/blog/articles/2024/02/how-safe-is-marijuana-for-medicinal-purposesHow Safe Is Marijuana for Medicinal Purposes?<p>With the legalization of marijuana in many states, more people are turning to the remedy for relief from health conditions like pain and insomnia. But like all therapies, the potential benefits come with side effects. <a href="https://www.uhhospitals.org/services/integrative-health-network/meet-the-team/acupuncturists/jacob-wolf-nd-lac-dipl-om">Jacob Wolf, ND, LAc</a>, a naturopathic doctor at <a href="/services/integrative-health-network">University Hospitals Connor Whole Health</a>, explains more.</p> <h2>How Does Medicinal Marijuana Work?</h2> <p>Medical marijuana has been used to help manage nausea and vomiting in cancer patients, chronic pain and multiple sclerosis (MS). Other promising uses that require more research include glaucoma, irritable bowel syndrome, inflammatory bowel disease and epilepsy; and improving appetite in patients with cancer, HIV and other severe illnesses.</p> <p>Medical marijuana and recreational marijuana sold at dispensaries are derived from the same source: the cannabis plant. Cannabis contains naturally occurring compounds called cannabinoids. The cannabinoid responsible for the medicinal benefits and euphoria associated with marijuana is tetrahydrocannabinol (THC).</p> <p><strong>Pain Relief</strong></p> <p>When marijuana is taken, THC enters the bloodstream to travel throughout the body. Some cells in the brain and other organs have specialized proteins on their surfaces called cannabinoid receptors. THC binds to these receptors, causing physical and mental effects. One result is reduced inflammation, which may account for the pain relief and muscle relaxation that many people experience when using marijuana.</p> <p>The sedative powers of THC may also contribute to marijuana’s ability to relieve pain. People with acute or chronic pain are often anxious about their pain, which can intensify it, leading to a vicious cycle. Feelings of relaxation from marijuana may indirectly ease pain by lessening the anxiety that accompanies it.</p> <p><strong>Nausea Relief</strong></p> <p>While marijuana’s effectiveness at reducing nausea is not fully understood, it likely involves THC’s activation of another cannabinoid receptor that regulates a person’s awareness of how their body feels. THC may dull the sensation of nausea.</p> <h2>Common Delivery Methods for THC</h2> <p>“There’s no difference in quality between medical and recreational marijuana purchased from a licensed dispensary,” says Dr. Wolf. “The THC concentration is similar for both.”</p> <p>Common forms of marijuana sold in licensed dispensaries include:</p> <ul> <li><strong>Smoking</strong>: Cannabis flowers can be smoked in a variety of forms, including joints and pipes.</li> <li><strong>Vaping</strong>: Cannabis flowers and concentrates can be vaporized with devices that heat the product to release vapors that are inhaled.</li> <li><strong>Edibles:</strong> Edibles are food and beverages infused with cannabis. These may include gummies, candies, baked goods and a variety of canned beverages.</li> <li><strong>Tinctures, sprays and capsules:</strong> Tinctures are marijuana extracts that are taken under the tongue with a dropper. THC can also be taken with oral sprays or capsules.</li> <li><strong>Topicals</strong>: Balms or lotions are applied directly to the skin to target pain on specific body parts. Unlike other formulas, they do not circulate through the body and have psychological effects.</li> </ul> <p>Marijuana affects every person in a different way and it also varies depending on the delivery method. “Vaping and smoking have the quickest onset of effects, usually within minutes,” says Dr. Wolf, “But those methods have a higher risk of causing respiratory and cardiovascular health issues.”</p> <p>Edibles and tinctures have a slower onset of effects, sometimes one to three hours from the time of consumption, but are safer for the lungs than smoking or vaping.</p> <p>However, Dr. Wolf warns that new users may be unaware of the lag time between ingesting THC and the onset of effects, which may lead to taking additional doses that cause unwanted side effects, including anxiety, dry mouth or eyes, and increased heart rate.</p> <h2>Tips to Stay Safe</h2> <p>Dr. Wolf advises anyone using THC for the first time to start slowly. Depending on the person, finding the right THC dose and delivery method may take some trial and error to determine.</p> <p>Here are some additional tips:</p> <ul> <li>Start with a low-THC product or one that has THC and CBD, which is another compound derived from the cannabis plant that can help balance the effects of THC on the body. Starting with a THC dose under five milligrams is a good idea.</li> <li>Never take additional doses when first trying THC until you understand the timing of how your body processes it. Start with partial doses. For example, 1/4 or 1/2 of a gummy may be a good starting point depending on the potency.</li> <li>Look for a good dispensary that can help you find products that are more moderate in THC and meet your health goals.</li> <li>Some research shows that it may be helpful to have CBD on hand to minimize any negative effects if too much THC is consumed. A tincture is often best.</li> </ul> <p>All forms of cannabis have potential risks, including a higher rate of cardiovascular effects; slower reaction time and drowsiness; and anxiety and paranoia, especially at higher doses. As with any medication, each person should consider the risks and benefits and discuss it with their doctor beforehand.</p> <p><strong>Related Links:</strong></p> <p>At <a href="/services/integrative-health-network">UH Connor Whole Health</a>, we take the whole person into account, addressing the full range of physical, emotional, mental, social, spiritual and environmental influences that affect an individual’s health. This includes exploring diet and nutritional needs.</p>Mon, 26 Feb 2024 08:00:00 -0500{7CEC7F9A-E09F-4E44-B7E2-C1972BEF0DBE}https://www.uhhospitals.org/blog/articles/2024/02/how-to-manage-your-kids-screen-time-and-social-media-useHow to Manage Your Kids’ Screen Time and Social Media Use<p>Today, more than 50% of kids touch their first screen while still wearing diapers. A reported 95% of teens have access to smartphones and social media. But how much screen time should children be exposed to?</p> <p>To help parents navigate this question, <a href="/doctors/Batt-Courtney-1962846543">Courtney Batt, MD</a>, an adolescent medicine expert at University Hospitals Rainbow Babies & Children’s, shares the latest guidelines from the American Academy of Pediatrics (AAP).</p> <h2>For Infants and Toddlers</h2> <p>Kids younger than age 2 have trouble understanding what they see on screens. What’s more, when toddlers watch TV or a tablet, it reduces chatter with other people that’s critical to brain development. Infants and young toddlers need hands-on exploration and social interaction to develop thinking, language, social and emotional skills.</p> <p>That said, a total ban isn’t necessary. Instead, limit media use and only allow your children to use screens with an adult to talk with them and to help them apply what they learn. Video calls with family and parents are a good example of appropriate media use for this age group.</p> <p>High-quality, educational programming can be introduced around ages 18 to 24 months, the AAP says. And up to age 5, these shows should be limited to one hour per day. Parents should watch alongside their children to help them understand what they see.</p> <h2>For School-Age Children</h2> <p>Once kids are a bit older, educational TV and apps can help them learn, provided you choose wisely.</p> <p>Still, kids at this age should spend time offline. Unstructured play and social interactions are important for creativity and learning. Make a point to allow unplugged, unstructured playtime each day.</p> <p>In addition, keep devices out of children’s bedrooms at night and stop all screen time at least an hour before bed. Discourage kids from watching TV or using other media while completing homework.</p> <h2>For Teens</h2> <p>“Allowing adolescents to use social media can help them develop healthy habits, expose them to new ideas and information on current events, and give them access to support groups and communities,” says Dr. Batt. “However, it’s important for parents to monitor this use and recognize that screen time and social media can be detrimental for teenagers, as well.”</p> <p>More than a third of teens say they use social media almost constantly. From Instagram and TikTok to Discord and Twitch, here’s how parents can help teens keep their social media usage healthy and safe.</p> <h3>Do:</h3> <ol> <li><strong>Allow them to create healthy online relationships.</strong><br /> “Many teens benefit from the support and companionship that comes from interacting online with peers who are similar to them—especially if they’re anxious or lonely,” says Dr. Batt.</li> <li><strong>Watch for problematic social media use.</strong><br /> Signs include being unable to stop using devices and lying to retain access to platforms. Problematic use has been linked to sleep problems and attention deficits.</li> <li><strong>Limit use.</strong><br /> “Social media shouldn’t interfere with sleep, school or physical activity,” Dr. Batt says. “Parents should set time limits for teens—and for themselves, so they can provide a good example.”</li> </ol> <h3>Don’t:</h3> <ol> <li><strong>Let younger kids use social media unsupervised.</strong><br /> Parents should review and discuss the social media use of kids younger than age 15. And you should stay up to date on the newest platforms teens might be using.</li> <li><strong>Allow interaction with harmful content.</strong><br /> This includes content around self-harm or risky behaviors, as well as behavior like discrimination and bullying. Create profiles for yourself and “friend” your child or ask teens to show you what they do online. That way, you’ll know what’s happening in their virtual world.</li> <li><strong>Permit social media for comparison.</strong><br /> It can be unhealthy to compare yourself to other social media users—especially as it relates to appearance and engagement, such as number of likes or comments. Take action if you see signs of it in your child’s online or offline behavior.</li> </ol> <h2>At All Ages</h2> <p>Setting smart limits on media usage can prevent harms, from obesity to troubled sleep to problems at school and home.</p> <p>One way to do it: Create a family media use plan. Together, draft a document that lays down basic rules. Consider:</p> <ul> <li>No screens in bedrooms.</li> <li>Unplugged family mealtimes.</li> <li>A “media curfew” at least an hour before bedtime.</li> <li>Sticking to age-appropriate content, as determined by movie, game and TV ratings.</li> </ul> <p>Model proper media use yourself. For instance, put your phone away during family dinners. Skip the news and violent TV programs in favor of those that foster education, kindness and creativity.</p> <h3>Related Links</h3> <p>The team at the UH Rainbow combines state-of-the-art clinical care and research to diagnose and treat children and adolescents with developmental and behavioral issues. <a href="/rainbow/services/pediatric-developmental-and-behavioral-issues">Learn more.</a></p>Fri, 23 Feb 2024 08:00:00 -0500{B31B83E2-AEA7-4A05-B2AA-0811BD0B37C7}https://www.uhhospitals.org/blog/articles/2024/02/living-your-best-life-after-menopauseLiving Your Best Life After Menopause<p class="UH-Lead">Listen to the most recent episode here:</p> <iframe title="Living Your Best Life After Menopause" allowtransparency="true" height="150" width="100%" style="border: none; min-width: min(100%, 430px);height:150px;" scrolling="no" data-name="pb-iframe-player" src="https://www.podbean.com/player-v2/?i=vd2n8-1587e4d-pb&from=pb6admin&share=1&download=1&rtl=0&fonts=Arial&skin=9&font-color=&logo_link=podcast_page&btn-skin=1b1b1b" loading="lazy"></iframe> <p><strong>Subscribe: </strong><a href="https://podcasts.apple.com/us/podcast/healthy-uh-podcast/id1472782476">Apple Podcasts</a> | <a href="https://podcasts.google.com/u/1/feed/aHR0cHM6Ly9mZWVkLnBvZGJlYW4uY29tL3VuaXZlcnNpdHlob3NwaXRhbHMvZmVlZC54bWw?sa=X&ved=0CAIQ4aUDahcKEwi4_-jtuqPsAhUAAAAAHQAAAAAQBw">Google Podcasts</a> | <a href="https://www.stitcher.com/podcast/healthyuh-podcast">Stitcher</a> | <a href="https://open.spotify.com/show/41zIrk1mwWSQnawaAjVzmX">Spotify</a></p> <p><em>From common concerns about weight gain to changes in bone health and sexuality, OB/GYN, <a href="/doctors/Lasch-Susan-1760407092">Susan Lasch, MD</a>, shares how to live your healthiest life after menopause. This insightful discussion covers the latest research and provides actionable strategies to thrive in this new chapter of life.</em></p> <hr /> <p><strong>Macie Jepson</strong><br /> You know, here’s the thing about growing older. You feel like you’re still in your 20s until you wake up one day and clearly you’re not, and your body feels older than you really are. Yet somehow we don’t see this coming. Now, Pete, today I want to talk about living well, and I mean really living after menopause. So, this is for your wife. This is for your co-host. This is for your mom, every woman and every person who loves a woman out there who gets discouraged by aging.</p> <p><strong>Pete Kenworthy</strong><br /> Right. You mentioned my wife, and she used to be an avid runner, but now she’s shifted to walking, doing some workouts at home, and I would think that’s still pretty good when it comes to exercising at 52 years old. But what about all that other stuff after menopause, right? Your body changes. Is there anything you can do about that? And what about mental decline? Can you slow that down? Hi, I am Pete Kenworthy.</p> <p><strong>Macie Jepson</strong><br /> And I’m Macie Jepson, and this is <em>The Science of Health</em>. Today, we’re going to break down the myth that women have to just accept the signs and the consequences of aging. Joining us today is obstetrician gynecologist, Dr. Susan Lasch of University Hospitals Cleveland. Thanks for being here. </p> <p><strong>Susan Lasch, MD</strong><br /> Thank you for having me.</p> <p><strong>Macie Jepson</strong><br /> So, life expectancy for women in this country is darn near 80 years old. That is a lot of living past menopause, which occurs on average at about 51 in the US. In your practice, what are you seeing in your older patients physically and emotionally as they approach or go through menopause?</p> <p><strong>Susan Lasch, MD</strong><br /> I would say the number one thing that women come to me talking about is gaining weight. Every single woman when she starts to go through the menopausal transition, complains about weight gain. How can this happen? Nothing has changed. I’m eating the same. The second thing that women complain about when they start to go through the changes that lead to menopause is decrease in sex drive. Every single woman will ask, is this normal? What’s going on? I’ve never noticed this before.</p> <p><strong>Macie Jepson</strong><br /> And before we go too deep into this, are there solutions to this or is it something we just have to accept?</p> <p><strong>Susan Lasch, MD</strong><br /> There are always solutions to weight gain, and the simplest one is changing your diet. And it’s hard to accept that you need to change your diet again in your lifetime, but you will need to change your diet if you intend to maintain your weight going through the menopausal transition.</p> <p><strong>Pete Kenworthy</strong><br /> How does where you are physically at menopause play a role in that path forward? Is it too late to turn things around significantly enough to impact quality of life down the road? So, once you’re at that point physically when you start menopause, is it too late? Should you have done something sooner or are there things you can still do physically moving forward through menopause and beyond? Does that make sense?</p> <p><strong>Susan Lasch, MD</strong><br /> Sure. That’s a great question. Well, probably one of the most important things for getting ready to address that part of your life is being a regular exerciser. It’s recommended 30 minutes most days of the week, and a lot of us don’t maintain that recommendation, so that’s a really important thing for most women to have going for them into their 40s. And becoming familiar with a diet that works for them is also very helpful, something to help them maintain their weight.</p> <p><strong>Pete Kenworthy</strong><br /> Anything specific from a diet standpoint that women should be paying attention to? Or is it this simple eat right and exercise? Right? I mean, is it that simple? Are the things to avoid are the things specifically for women that they should or shouldn’t be eating as they age?</p> <p><strong>Susan Lasch, MD</strong><br /> There’s no specific thing that women shouldn’t be eating as they age. It is just getting a healthy diet that works for you, whether that’s the Dash diet, the Mediterranean diet, a whole food diet, something like that. It is recommended to eat fish for all of us in moderation, low mercury fish so that’s an important part of all of our diets, but there’s no bad food that everyone should avoid, most things in moderation, but obviously avoiding sugary foods is very helpful.</p> <p><strong>Macie Jepson</strong><br /> And important, you said Dash diet, which is for your heart, and we’re going to get into some of the medical side effects of menopause. And so changes to our bodies in the years around menopause may actually raise your risk of certain health problems at low levels of estrogen affecting our bodies as well. Let’s dig into that just a little bit. Let’s talk about heart disease first. Does menopause increase our chances of that?</p> <p><strong>Susan Lasch, MD</strong><br /> So going through menopause does seem to increase your risk of heart disease, but there are a lot of things that we can do to decrease that: healthy weight, regular exercise and seeing your doctor for recommendations on other health conditions like high blood pressure, elevated lipids.</p> <p><strong>Macie Jepson</strong><br /> What about osteoporosis?</p> <p><strong>Susan Lasch, MD</strong><br /> Osteoporosis is sort of the big bad wolf of menopause just waiting there to get you. Your bone density does decrease after menopause. That’s a big, big change for us, although it starts to decrease throughout our lifetime starting after adolescence. Some of the things that can help decrease the risk of osteoporosis are regular exercise, although it’s sort of a modest risk, but having strong muscles can help maintain your bones, keep your bones strong, and then it’s also recommended to have a bone mineral density test at age 65 unless you have other risk factors.</p> <p><strong>Pete Kenworthy</strong><br /> And this is, you talk about the bone density issues for women that start immediately after adolescence, right? Is there nothing, is that just a thing with women, there’s nothing you can do to keep that better, keep it as good as it was when you were an adolescent? It’s just one of those things. Or is there a magic pill? Is that the daily exercise? Is that calcium supplements? I don’t know. I’m just kind of spit-balling here. Is it just one of those facts?</p> <p><strong>Susan Lasch, MD</strong><br /> Well, calcium plus vitamin D may slightly decrease your risk of fractures. The jury is still a little bit out on that, so getting enough calcium in your diet seems to be helpful, but how much supplementation with calcium is a little bit unclear, but having vitamin D supplementation in your diet may also help if you don’t get enough through light exposure or the foods that have vitamin D in them. There is probably nothing to totally reduce osteoporosis, but there are kinds of exercise that are more helpful for osteoporosis than no exercise at all. Specifically weightbearing exercise such as walking, Tai Chi, yoga can decrease the risk of fractures to the femoral neck, and progressive resistance exercises, that’s exercises using bands or weights also decrease risk of fracture to the femoral neck. And then weightbearing exercise and other resistance exercise can decrease risk to the spine of fractures.</p> <p><strong>Macie Jepson</strong><br /> When you say weightbearing, you mean…?</p> <p><strong>Susan Lasch, MD</strong><br /> Weightbearing is anything where you’re using your weight to get around, walking, even riding a bike, Tai Chi, yoga, things where you’re standing and just holding your weight.</p> <p><strong>Macie Jepson</strong><br /> I’m hearing from you that maybe the most important thing is that you’re keeping your body fit and strong so that you can avoid those falls down. If you have a strong core, you’ve got some muscles in your legs and your arms, you might avoid an accident that could lead to a fracture because the osteoporosis is there, right?</p> <p><strong>Susan Lasch, MD</strong><br /> Well, if you already have osteoporosis, you should be careful initiating an exercise program if you don’t already have one going, because it can be associated with risk of falls, which can increase your risk of fracture. So, for women who already have osteoporosis, starting with basic walking and using the resources available to them, such as a Silver Sneakers program or a trainer or gym that has specific programs for seniors would be advised.</p> <p><strong>Macie Jepson</strong><br /> So, we need to ease into it if we’re not accustomed to working out. So, I guess that begs the question, is it ever too late to actually become active?</p> <p><strong>Susan Lasch, MD</strong><br /> It’s never too late to become active, but if you have not been active previously, you should probably consult your doctor to make sure you’re healthy enough to begin activity. And then if you’re doing things beyond just walking, you should probably check with a senior program before you start weight exercises or resistance exercises.</p> <p><strong>Macie Jepson</strong><br /> We’re throwing those words around a lot. So, I guess I’d want you to get specific. Do you have three top activities that you like to suggest to your patients?</p> <p><strong>Susan Lasch, MD</strong><br /> Top activities that I suggest to my patients are walking, walking and doing something involving some kind of weights. For most of us, walking is very accessible. Most of us live in a place where we can walk. We can walk almost all year round if we just put a coat and hat on and we’re pretty much good to go. Most of the time the roads are not too slick or the sidewalks too slick to walk outside, so walking outside is a great way to get that exercise, get to have a regular habit, and being outdoors is also a mood lifter, which a lot of us need, especially in these cloudy days of winter.</p> <p><strong>Pete Kenworthy</strong><br /> Kind of reminds me of an article I read a long time ago about these hundred-year-old athletes, and each of them when asked how they were able to still be athletic at a hundred was each of them almost said to a T, the secret has never stop moving, right?</p> <p><strong>Susan Lasch, MD</strong><br /> Right. Secret is never stop moving. And if you’re walking now and you feel like you could start doing more, then there’s nothing wrong with increasing your activity. Just go slow. Maybe consult a trainer in that area.</p> <p><strong>Macie Jepson</strong><br /> Ten thousand steps, though, isn’t necessary. Is it? When you say walking, how much?</p> <p><strong>Pete Kenworthy</strong><br /> Well, 30 minutes, right?</p> <p><strong>Susan Lasch, MD</strong><br /> Thirty minutes most days of the week. Yeah. A lot of us talk about taking stairs as a way that we get our exercise, but to go up a flight of stairs only takes about 10 seconds. So, for most of us, that’s not going to cut it unless we do a lot of stairs.</p> <p><strong>Pete Kenworthy</strong><br /> So, we talked a little bit about diet, controlling heart disease, blood pressure, those kinds of things, but when women need additional help, I mean, we see lots of supplements marketed toward women, right? Are they worth it? Do they work? Are they worthwhile?</p> <p><strong>Susan Lasch, MD</strong><br /> No. Most supplements are not worth it. If there was a supplement that was like a secret hack for losing weight, it would be the most popular item on the market, and it’s clearly not. So, really, it’s about using your diet. Lots of vegetables is always a good way to start, seeing a dietician, if you need additional resources, talking to your doctor. Sometimes there are medications that may help, too. There’s no secret sauce for a healthy diet.</p> <p><strong>Pete Kenworthy</strong><br /> I have a note here to myself that says multivitamins can be marketed like you talked about, like vitamin D or B12 or less iron. But I also have a note here that says, unless you have a poor appetite or conditions keep you from eating a healthy diet, you probably don’t need them. Is that it?</p> <p><strong>Susan Lasch, MD</strong><br /> That seems to be the truth, right? There is not a lot of evidence in favor of vitamins for those who have a healthy diet. Right.</p> <p><strong>Macie Jepson</strong><br /> So, we’re all looking at social media, a lot of us are and see promises out there, and what do you tell them?</p> <p><strong>Susan Lasch, MD</strong><br /> There is always going to be some change in our mental cognition as we get older. There isn’t any way around it, and it affects each person in their own way. One of the things that women talk about frequently when they start to go through the menopause transition is trouble finding names, and that’s probably one of the most common things that we notice initially.</p> <p><strong>Pete Kenworthy</strong><br /> So, post menopause, when something doesn’t feel right for a woman, how do they know if it’s just a result of those hormonal changes versus something else they should be concerned about? Right? It’s probably easy to say, oh, that’s just because I went through menopause, that’s why I’m feeling this way. Right? But it’s not necessarily true.</p> <p><strong>Susan Lasch, MD</strong><br /> You should probably see your doctor if there’s changes that you’re noticing that you’re attributing to menopause. They may or may not be, but it’s something to discuss with your doctor.</p> <p><strong>Pete Kenworthy</strong><br /> Are there common things your patients will say to you like, oh, I’m sure this has to do with me just going through menopause, and it’s heart failure. I went pretty extreme there, but…</p> <p><strong>Macie Jepson</strong><br /> Or an inability to sleep, not giving good sleep anymore. Do you just write that off or could there be another issue? That’s when you send them to the sleep specialist to answer those questions.</p> <p><strong>Susan Lasch, MD</strong><br /> I mean, there are definitely a lot of sleep disturbances that come with menopause, mostly like waking up in the night and feeling like you’re wide awake and trouble going back to sleep. A lot of times if you’re having trouble falling asleep, it might be a mood disorder that is inhibiting that, but again, that’s something to talk to your doctor about.</p> <p><strong>Pete Kenworthy</strong><br /> What do you tell your patients about hormone replacement?</p> <p><strong>Susan Lasch, MD</strong><br /> I tell my patients that there are risks and benefits to hormone replacement and for some people it’s the right choice of medication for the things that they’re experiencing.</p> <p><strong>Pete Kenworthy</strong><br /> What is it? Give me an explanation for that woman out there who doesn’t even know what it’s for.</p> <p><strong>Susan Lasch, MD</strong><br /> Hormone therapy is best used for treatment of hot flashes and night sweats. That’s where it’s most effective. It may have some improvement in sleep. It may have some improvement in mood disorders if they’re related to the menopausal transition. There are risks, but there are benefits. It also decreases the risk of osteoporotic fractures, too, so it has some benefit in that regard.</p> <p><strong>Pete Kenworthy</strong><br /> What are the risks?</p> <p><strong>Susan Lasch, MD</strong><br /> Most of the risks that we have associated with hormone therapy are from the Women’s Health Initiative study, and it showed increased risk of stroke, thromboembolic events, heart disease and breast cancer. Some of those risks are probably lower than they were shown to be in that study as that was an older population, not women around the menopausal transition, which is when most women seek out hormone therapy. And we’ve also changed the way we give hormone therapy using more topical estrogens such as a patch and different progestins that may have less of a negative effect on breast cancer and heart disease.</p> <p><strong>Macie Jepson</strong><br /> If you have a predisposition to or family history of breast cancer and you don’t want to do hormones, do we just have to accept that we’re not going to sleep well or that we’re going to have hot flashes or are there any natural ways to approach this?</p> <p><strong>Susan Lasch, MD</strong><br /> There are other medications that you can use for hot flashes and night sweats. Antidepressants can be helpful in this regard. Some of the neuromodulators like gabapentin can be helpful. There is also a newer medication that works in the neurotransmitter area that may reduce hot flashes. As far as sleep disturbances, we do not have great medications that will help women not wake up in the night. We have more medications that help women fall asleep at night, which doesn’t seem to be as much of a menopausal problem. So, it is hard to address that early morning awakening that a lot of women experience in menopause. Some women feel better on hormone therapy, but not everyone.</p> <p><strong>Macie Jepson</strong><br /> I want to follow up because you mentioned antidepressants, so it made me start thinking about what women are going through emotionally at this time, and while that might not be your level of expertise, you’re certainly seeing them and you’re probably the first visit where they start talking about. Some women praise menopause and say, my cycle’s over, I don’t have to deal with that anymore. Other women see it kind of as a, I don’t want to say, death seems like a strong word, but it’s an end to a time in your life. Do you deal with that with your patients? What emotionally are you seeing?</p> <p><strong>Susan Lasch, MD</strong><br /> Like you said, both sides, both sides of the coin. Definitely. Some women are glad to find out that they don’t or are glad to know that they don’t have to worry about pregnancy any longer and that there are not more feminine hygiene products in their lifetime as far as changing and ruining their clothes. But other women feel like that loss of their, they might feel like they have a loss of their femininity or their womanliness if they’re not having cycles anymore and starting to see the changes that come in their body with menopause.</p> <p><strong>Macie Jepson</strong><br /> How do you talk them through that?</p> <p><strong>Susan Lasch, MD</strong><br /> In my practice, I just try to help women embrace the new you. This is you. This is who you are, and you’ve gone through a lot to get to this point and this is who you are until you’re not with us anymore. So, there’s not a lot of value in mourning the loss of those things. It’s more about just embracing what’s ahead of you.</p> <p><strong>Pete Kenworthy</strong><br /> That’s great advice.</p> <p><strong>Macie Jepson</strong><br /> But here’s the thing. When I think about aging, I want to look and feel like that beaming, graying active woman that we see in all of those commercials that honestly what she’s doing, I would fear I’d break a hip. I mean, she’s playing tennis. I want to take trips. I never want to slow down. What would you say is the secret to that kind of life?</p> <p><strong>Susan Lasch, MD</strong><br /> Healthy diet and exercise.</p> <p><strong>Macie Jepson</strong><br /> Oh, it’s always that. Nice.</p> <p><strong>Pete Kenworthy</strong><br /> That’s it, though. But that starts well before menopause, right?</p> <p><strong>Susan Lasch, MD</strong><br /> It can.</p> <p><strong>Pete Kenworthy</strong><br /> You can’t just decide after menopause to completely shift your diet if you weren’t doing well before that?</p> <p><strong>Susan Lasch, MD</strong><br /> Sure, you can.</p> <p><strong>Pete Kenworthy</strong><br /> You can?</p> <p><strong>Susan Lasch, MD</strong><br /> Yeah, sure. If it’s a big shift, see a dietician and work through it. If it’s a big shift in your activity, go to a gym that has specialization in senior programs and get into it. You’ll see older people running marathons, at CrossFit, doing gymnastics, hiking, climbing, doing all those things. It may have been something they’ve been doing their whole life, but it may be something totally new.</p> <p><strong>Pete Kenworthy</strong><br /> Yeah.</p> <p><strong>Macie Jepson</strong><br /> Sounds like the key to that success is it starts with your frame of mind.</p> <p><strong>Susan Lasch, MD</strong><br /> That’s a great way to look at it. Yeah. Obviously, your mind is very powerful for controlling your body.</p> <p><strong>Pete Kenworthy</strong><br /> If we could tie a bow on this whole conversation and you had advice for, well, probably three different women coming to you, right? I know I’m about to go into menopause or I’m in menopause or I’m coming out of menopause, what’s the takeaway?</p> <p><strong>Susan Lasch, MD</strong><br /> My advice for women starting to go through the change in menopause, I guess is be familiar with the changes that are coming, and healthy diet and exercise is probably the way to get through menopause the best way and continue for hopefully a long and healthy life.</p> <p><strong>Pete Kenworthy</strong><br /> You said be familiar with it. What do you mean?</p> <p><strong>Susan Lasch, MD</strong><br /> The changes that most women experience with menopause: weight gain changes in their menstrual cycle, sometimes mood changes, more premenstrual syndrome. They may notice decreasing their libido also.</p> <p><strong>Pete Kenworthy</strong><br /> It’s all normal.</p> <p><strong>Susan Lasch, MD</strong><br /> It’s all normal. It’s all normal. Every woman experiences those things.</p> <p><strong>Pete Kenworthy</strong><br /> Yeah, I mean, and it’s frustrating, but it’s normal.</p> <p><strong>Susan Lasch, MD</strong><br /> Correct.</p> <p><strong>Pete Kenworthy</strong><br /> Right.</p> <p><strong>Macie Jepson</strong><br /> Wait a minute. We didn’t talk about libido. And I mean, come on. That’s important. And you said that that’s what women come in and they’re concerned about.</p> <p><strong>Susan Lasch, MD</strong><br /> Libido is important, and being aware that there is a natural change is probably one of the most important things. It’s not necessarily something wrong; it’s just something natural. It’s just something to talk to your partner about. Maybe you never had to talk to your partner about the changes that you notice in your libido, but it’s okay to be honest and be truthful. And figuring out a way to work through that together can be sexy, can be great.</p> <p><strong>Macie Jepson</strong><br /> Any medications out there for that?</p> <p><strong>Susan Lasch, MD</strong><br /> There are some medications for problems with libido that are very mildly effective.</p> <p><strong>Pete Kenworthy</strong><br /> Yeah. But there’s other things that go along with that, right? Cause like dryness or pain or those kinds of things, and those are treatable.</p> <p><strong>Susan Lasch, MD</strong><br /> There are a lot of different ways to manage dryness and pain with sex. Definitely. That’s definitely something to talk to your doctor about.</p> <p><strong>Pete Kenworthy</strong><br /> And there are medications for that.</p> <p><strong>Susan Lasch, MD</strong><br /> There are medications, and there’s a lot of over the counter things, too.</p> <p><strong>Pete Kenworthy</strong><br /> Yeah.</p> <p><strong>Macie Jepson</strong><br /> I feel like there are some warning signs that your body is telling you, this is coming. What would they be?</p> <p><strong>Susan Lasch, MD</strong><br /> Some women might notice that their periods get a little shorter but heavier, but still coming monthly. The interval might become slightly shorter before it starts to extend, and then you might start to skip menstrual cycles. But if you have questions about how often you should be bleeding or the bleeding seems out of the ordinary, you should definitely contact your doctor because that could be a warning sign for something serious.</p> <p><strong>Macie Jepson</strong><br /> And to be clear, if your cycle resurfaces in month 11, you are starting over, right?</p> <p><strong>Susan Lasch, MD</strong><br /> You are starting over, but that’s a good topic to discuss with your doctor, too.</p> <p><strong>Pete Kenworthy</strong><br /> Dr. Susan Lasch from University Hospitals in Cleveland, thank you so much for joining us today.</p> <p><strong>Susan Lasch, MD</strong><br /> Thank you for having me.</p>Thu, 22 Feb 2024 19:00:00 -0500{A8ABCE67-D5CD-40EF-BA58-EC4A04755BD4}https://www.uhhospitals.org/blog/articles/2024/02/food-allergies-how-to-help-your-child-stay-safeFood Allergies: How to Help Your Child Stay Safe<p>Food allergies can affect children of all ages – from infants to young adults – with mild, severe or even life-threatening reactions. If your child has a <a href="/rainbow/services/pediatric-allergy-and-immunology/conditions-and-treatments/food-allergies-in-children">food allergy</a>, how can you ensure they’re safe when they’re not at home?</p> <h2>What is a Food Allergy?</h2> <p>A food allergy is different than food intolerance. A food allergy is an immune system response to a food. “Unfortunately, many types of food reactions are mistakenly considered allergic,” explains University Hospitals Rainbow Babies & Children’s pediatric allergy and immunology specialist <a href="/doctors/RudaWessell-Kathryn-1922329820">Kathryn Ruda Wessell, DO</a>.</p> <p>“But some of these aren’t caused by an immune system response. Lactose intolerance to cow's milk is a good example of a food reaction that is not a food allergy. Symptoms like bloating, nausea and diarrhea aren’t allergic, but rather are due to a lack of enough lactase enzyme in the digestive tract to effectively break down the lactose sugar in milk.”</p> <h2>Two Types of Food Allergies</h2> <p>Food allergies are broken down into two main types based on the immune system’s response: Immunoglobulin E (IgE) and non-IgE food allergies.</p> <ul> <li><strong>IgE food allergies.</strong> The immune system sends antibodies into the bloodstream, which causes the release of histamine and other substances. Histamine causes symptoms such as coughing, wheezing and hives. Reactions occur quickly – from minutes to a few hours after ingesting the food. IgE food allergies can trigger anaphylaxis, a life-threatening emergency that causes difficulty breathing.</li> <li><strong>Non-IgE food allergies.</strong> The immune system responds with other reactions, not antibodies. Symptoms are delayed and can take hours to appear. They may include eczema and other rashes, and intestinal distress such as vomiting and diarrhea.</li> </ul> <h2>Common Food Allergies</h2> <p>Nine foods account for 90 percent of food allergy reactions:</p> <ul> <li>Milk</li> <li>Egg</li> <li>Peanut</li> <li>Tree nuts</li> <li>Wheat</li> <li>Soy</li> <li>Fish</li> <li>Shellfish</li> <li>Sesame</li> </ul> <p>The two most common IgE food allergies in children are cow's milk and eggs. Most patients who have an IgE allergy to cow's milk can’t tolerate milk from goats or other mammals either. Fortunately, milk and egg allergies also the most common food allergies that children can outgrow.</p> <p>The most common foods that trigger non-IgE food allergies are cow’s milk and soy proteins in infants. Wheat is a common cause of non-IgE food allergyies in older children.</p> <h2>Diagnosing and Testing for Food Allergies</h2> <ul> <li><strong>Clinical history and exam.</strong> Diagnosing food allergies begins with the child’s and family’s health history and physical exam. The best indicator of an IgE food allergy is a description of symptoms or reactions to the food.</li> <li><strong>Skin prick testing</strong> is performed in the office to see if scratching the skin with an allergen causes a hive reaction on the skin where the skin is scratched.</li> <li><strong>Blood testing</strong> measures the IgE antibody level that a patient makes to an allergen.</li> <li><strong>Food challenge test.</strong> “Typically both skin prick and blood tests are performed to diagnose food allergies,” says Dr. Ruda Wessell. “But the gold standard to diagnose an IgE food allergy is an in-office, provider-guided food challenge. The patient consumes a small amount of the food in age-appropriate amounts under close observation to assess symptoms, with access to medications to treat an allergic reaction if it occurs.”</li> </ul> <h2>Treating Food Allergies</h2> <p>Antihistamines are safe and effective for mild food allergy reactions and can be purchased over the counter, without a prescription.</p> <p>If an allergic reaction occurs quickly and worsens after using an antihistamine or causes a variety of symptoms, epinephrine is the most effective medication to prevent it from progressing. Also known as an EpiPen, it’s the best treatment for anaphylaxis, a serious and life-threatening condition. For any severe allergic reaction, use epinephrine, then call 9-1-1 and/or go to the emergency department immediately.</p> <p>Non-IgE food allergies do not occur quickly and are not usually life-threatening. The best treatment is to simply avoid the food.</p> <h2>Keeping Kids Safe</h2> <p>Parents can help kids with food allergies stay safe when they’re not at home by teaching them to follow these recommendations:</p> <ul> <li>Avoid the foods you are allergic to as much as possible.</li> <li>Read every label every time for the ingredients. Ask a parent or teacher if you need help or if you aren’t sure about what you’re being served.</li> <li>Watch for menu information or signage about allergens at restaurants.</li> <li>If you’re unsure of what is in the food product, don’t eat it.</li> <li>Have your epinephrine device with you everywhere, at all times: at school, at work, going to a friend’s house, playing sports, on vacation, etc.</li> </ul> <h2>Two Rules for the Road</h2> <p>“There are no tests that can predict the severity of a food allergy reaction,” says Dr. Ruda Wessell. “Testing simply provides information on the probability of an IgE food reaction. And a previous reaction to a food does not predict a future reaction to the food. Based on this fact, we encourage every food allergic patient to carry an epinephrine device to be prepared no matter what the future reaction may be.”</p> <p>“You can live a happy and normal life with food allergies, especially if you follow the two most important recommendations: read every ingredient list and have access to your epinephrine device at all times. Children with food allergies don’t have to feel isolated or embarrassed by their food allergy. They can safely participate in normal daily activities. I view my patients and myself as a team, and together we can determine the best practices to keep them comfortable and safe with their food avoidance strategies.”</p> <h3>Related Links</h3> <p>The experts at University Hospitals Rainbow Babies & Children’s Pediatric Allergy and Immunology Division provide exceptional care for the full spectrum of food allergies. <a href="/rainbow/services/pediatric-allergy-and-immunology/conditions-and-treatments/food-allergies-in-children">Learn more.</a></p>Wed, 21 Feb 2024 08:00:00 -0500{FBB9B3FE-2F1A-4F6E-90FC-047E2DF45A8E}https://www.uhhospitals.org/blog/articles/2024/02/ecpr-proves-lifesaving-for-52-year-old-cardiac-arrest-survivorECPR Proves Lifesaving for 52-Year-Old Cardiac Arrest Survivor<p>In the early morning hours of November 12, 2023, Aletah Whitman was awakened by what felt like an explosion in her left leg. She tried to stand, but lost consciousness. Aletah came to and managed to call <a href="tel:911">9-1-1</a>.</p> <p>“I was going in and out of consciousness, but I felt like my job was to get myself to the hospital. I knew I called 911, and they came, so I was just trying to stay calm,” she said.</p> <p>Emergency responders broke down her door and rushed her to University Hospitals Cleveland Medical Center where the 52-year-old suffered a cardiac arrest.</p> <p>In the U.S., 436,000 people die every year from cardiac arrest. People who experience a cardiac arrest outside of a hospital setting have only about a 10-percent chance of survival. Globally, cardiac arrest claims more lives than colorectal cancer, breast cancer, prostate cancer, influenza, pneumonia, auto accidents, HIV, firearms and house fires combined.</p> <p>Every passing second is critical during a cardiac arrest. Even if you’re lucky enough to get to the hospital, your organs – most importantly your brain – are losing oxygen as the emergency team assesses your situation and works to address it. Often, by the time they address and sometimes even fix your cause, it’s too late for your brain, because it has lost neurological function due to lack of oxygen.</p> <p>That’s where extracorporeal cardiopulmonary resuscitation (ECPR) comes in. ECPR is a method of cardiopulmonary resuscitation (CPR) that passes the patient's blood through a machine in a process to oxygenate the blood supply.</p> <p>ECPR uses an ECMO machine (extracorporeal membrane oxygenation), which is a form of life support for people with life-threatening illness that affects the function of their heart or lungs. ECMO keeps blood moving through the body, supporting oxygenation of the brain and other organs. The device has been around for decades, but has not been used in this specific way until more recently.</p> <p>Research published in <em>The Lancet</em> in November of 2020 was the first, community-wide ECMO-facilitated resuscitation program in the U.S. The research showed that 43 percent of patients in their program had functionally favorable survival rates at hospital discharge and at three months after discharge, significant compared to the 10 percent on average who survive a cardiac arrest in general.</p> <p>“We’re early adopters of ECPR here at University Hospitals,” said cardiothoracic surgeon <a href="/doctors/AbuOmar-Yasir-1346872181">Yasir Abu-Omar, MD</a>, who launched ECPR at <a href="/services/heart-and-vascular-services">UH Harrington Heart & Vascular Institute</a> in 2020 and continues to lead the program. He is also Surgical Director of the Advanced Heart Failure & Transplant Center, and the Russ and Connie Lincoln Chair in Cardiovascular Innovation at UH Harrington Heart & Vascular Institute. “The study out of Minneapolis showed we could save lives with this program, so we began building it right away.”</p> <p>To ensure a successful program, UH Harrington Heart & Vascular Institute created a system with coordination and collaboration from different experts and disciplines, such as emergency medicine, cardiothoracic surgery, interventional cardiology and critical care.</p> <p>When UH Harrington Heart & Vascular Institute started its ECPR program, it was the only ECPR program active in Ohio and the first in Northeast Ohio (another system had a program that closed around 2020). As of January 2024, UH is the only ECPR program in Northeast Ohio and has a 66-percent neuro intact survival rate, which exceeds national averages.</p> <p>“These patients are dead,” said <a href="/doctors/McCloskey-Colin-1316200520">Colin McCloskey, MD</a>, a specialist in anesthesiology, critical care and emergency medicine at UH Cleveland Medical Center. “Usually when we use ECMO, we’re using it on a patient to keep them alive. But with our ECPR program, we’re using ECMO on a patient that has died to keep them alive while we work to treat them.”</p> <p>By the time Aletah Whitman was brought to UH Cleveland Medical Center, the ECPR program had been in place for about three years. In the emergency department, personnel suspected a massive pulmonary embolism (PE).</p> <p>“When Aletah came in, staff in the ED immediately identified her as a candidate for the ECPR program and our team, led by Dr. Abu-Omar, was mobilized,” said Dr. McCloskey. “She was cannulated and placed on ECMO to keep her alive while staff investigated her condition further.”</p> <p>A massive PE was confirmed through a CT scan, and Aletah was transported to the cardiac catheterization lab, where she received a pulmonary embolectomy to remove the blood clots in her lungs.</p> <p>“If we had not mobilized our ECPR team and placed Aletah on ECMO, she would not be here,” said Dr. Abu-Omar. “We could have cleared the clots in her lungs, but not quickly enough to keep her neurologic function intact unless we placed her on ECMO.”</p> <p>Aletah spent four days on ECMO in the cardiothoracic intensive care unit before she regained consciousness and was removed from ECMO.</p> <p>“I slept through the exciting bits,” she said. “My family and friends faced the fears. They revealed the seriousness of it in the days following and the odds that were shared with them. They eventually told me they thought they were coming to the hospital to say goodbye.”</p> <p>She was discharged to a rehab facility and eventually returned home. Less than two months after her cardiac arrest she returned to work on light duty.</p> <p>“So many things had to be in place for this to go right,” she said. “I know I’m so fortunate. I just wanted to get back to the life I had. I’m so grateful to UH for the amazing care.”</p> <p>“The statistics for cardiac arrest are grim. Every life we can save is a win,” said Dr. McCloskey. “We’re thrilled to have started this program and positively impacted patients like Aletah and their families.”</p>Mon, 19 Feb 2024 19:00:00 -0500{2DE15670-3DD7-4B96-AE18-476B6E04B727}https://www.uhhospitals.org/blog/articles/2024/02/zero-proof-why-more-people-are-choosing-low-or-no-alcohol-drinksZero Proof: Why More People Are Choosing Low or No-Alcohol Drinks<p>In previous generations, alcohol was widely accepted as the go-to beverage for adults looking to relieve stress, unwind and relax. In the past twenty years, however, there has been a noticeable decline in alcohol consumption, particularly among young adults, many of whom are opting for no- or low-alcoholic drinks instead of traditional wine, beer or liquor. </p> <h2>A Shifting Mindset about Alcohol</h2> <p>The top five reasons given by young people who have chosen to eliminate or significantly reduce the amount of alcohol they consume include: </p> <ol> <li><strong>Health & Wellness.</strong> Young adults today tend to be more focused on physical fitness than previous generations. They choose healthier foods, exercise more and strive for moderation in how they live their life, including their drinking habits. </li> <li><strong>Fear of Negative Effects. </strong> Avoiding the negative physical effects of drinking, whether a hangover or fear of alcoholism, is a powerful motivator for many. The fear of losing control in social situations and the potential for unflattering images to be posted on social media is also a factor. </li> <li><strong>Drinking is Expensive. </strong> Financial concerns are another common reason for cutting back. Whether drinking at a bar or at home, alcoholic beverages are pricey and can take a big bite out of one’s disposable income. </li> <li><strong>Weight Management. </strong> Alcohol contains a lot of empty calories and over-indulging can lead to weight gain, poor food choices or both. </li> <li><strong>Reduce Risk of Disease. </strong> Science has proven that alcoholic beverages are toxic to the body and can contribute to a wide range of serious health problems, including liver disease, heart disease and cancer. </li> </ol> <p>Another less widely known health benefit of shifting to a low- or no-alcohol lifestyle, is better sleep. Although many people believe that they fall asleep more easily after a few drinks, alcohol actually disrupts the REM stage of sleep which is crucial for restful, restorative slumber.</p> <h2>Fewer Barriers to a No- or Low-Alcohol Lifestyle</h2> <p>Most brands have noticed this cultural shift, so there is now an abundance of non-alcoholic beers, wines and spirits available that are both flavorful and satisfying. In addition, sober bars are gaining popularity and opting for no- or low-alcohol beverages is becoming more socially acceptable. </p> <p>Examples of non-alcoholic options include: </p> <ul> <li><strong>Non-Alcoholic and Low Alcohol Beer. </strong> A regular beer contains 5-6 percent alcohol, light beers have slightly less and some craft beers can contain up to 10 percent alcohol. Low- and non-alcoholic beers may contain 0.05 - 0.5 percent alcohol, even those labeled alcohol-free or 0.0% alcohol. </li> <li><strong>Alcohol-Free Spirits. </strong> Non-alcoholic spirits like gin, vodka, whisky and tequila are now widely available. Although the majority of the alcohol is removed through distillation, these spirits may still contain up to 0.5 percent alcohol. </li> <li><strong>Non-Alcoholic Wine. </strong> There are plenty of red, white and pink non-alcoholic wines available. However, like the beer and spirit options, they can contain up to 0.5 percent alcohol. </li> </ul> <p>Choosing low or no-alcohol beverages is a great way to significantly lower your alcohol intake. However, if you are trying to avoid alcohol completely, low and non-alcoholic beverages may not be suitable. Because they typically contain trace amounts of alcohol, they may be triggering for people in recovery for alcohol addiction. </p> <h2>Adaptogenic Drinks: A Healthy Alternative to Alcohol?</h2> <p>Another option that is rapidly gaining popularity are premade beverages that contain adaptogens. These herbal and plant-based ingredients have been used for centuries in Eastern medicine to help manage anxiety, stress, fatigue and depression. Examples of adaptogenic ingredients include: </p> <ul> <li><strong>Ginseng.</strong> Derived from the root of the ginseng plant, ginseng may offer health benefits like improved brain health, enhanced immune function, better blood sugar control and increased energy.</li> <li><strong>Hemp seeds. </strong> The small brown seeds of the hemp plant are rich in protein, fiber and healthy fatty acids. Although the hemp plant is a member of the cannabis family, hemp-derived products do not contain enough THC to create the “high” traditionally associated with marijuana. Benefits of hemp seeds may include improved brain, heart and skin health. </li> <li><strong>Tumeric. </strong> A common spice that is proclaimed to help regulate cortisol levels, manage stress and reduce inflammation. </li> <li><strong>CBD. </strong> Cannabidiol or CBD is the main compound in cannabis that does not create mind-altering effects. It may be useful in reducing anxiety in some people. </li> <li><strong>Ashwagandha. </strong> Derived from an evergreen shrub that grows in Africa and Asia, ashwagandha has been found to help lower stress and anxiety. </li> <li><strong>Lion's Mane Mushroom. </strong> Named for its resemblance to a lion’s mane, some studies suggest that extracts from this mushroom may promote nerve growth and boost cognitive functions. </li> <li><strong>L-Theanine. </strong> An amino acid found naturally in tea leaves that may be helpful in relieving stress, improving mood and promoting relaxation. </li> </ul> <p>Adaptogenic beverages may contain one or more of the ingredients listed above and are available in a variety of forms including sparkling waters, flavored teas and coffees. Many can also be purchased as powdered additives.</p> <h2>Are Adaptogenic Beverages Safe?</h2> <p>Although adaptogens are naturally occurring substances, they aren’t necessarily risk-free. Some have the potential to interact negatively with certain prescription medications, so it’s important to check with your doctor before trying any adaptogenic beverage or supplement. Pregnant women should also talk to their doctor before use.</p> <p>Because they’re not regulated by the FDA, adaptogens aren’t proven to provide the health benefits they claim and some people may actually experience negative side effects like headaches. And, as with alcohol, they can be expensive and high in calories – if weight gain is a concern, intake should still be moderate.</p> <h3>Related Links: </h3> <p>For those considering a no- or low-alcohol lifestyle to improve their health, University Hospitals recommends talking to a <a href="/services/primary-care">primary care</a> provider or <a href="/services/clinical-nutrition-services">nutrition specialist</a> for assistance in supporting this positive change. If alcohol addiction is a concern, we also offer comprehensive <a href="/services/addiction-services">addiction treatment</a> services.</p>Mon, 19 Feb 2024 08:00:00 -0500{C1FB349E-6218-4D76-8A56-7405CBBE606B}https://www.uhhospitals.org/blog/articles/2024/02/senior-treasures-30-years-with-her-primary-care-physicianSenior Treasures 30 Years with Her Primary Care Physician<p>For one-third of her 90 years, Helen Bishop has entrusted her healthcare to one primary care physician.</p> <p>The Portage County resident knows the value of a doctor who has seen her through decades, notes subtle changes, anticipates her needs, and urges her to get her regular screenings. <a href="/doctors/Jastrzemski-Edward-1962577726">Edward Jastrzemski, MD</a>, even managed to persuade her to go for screenings she didn’t think she needed – like the mammogram that caught breast cancer 25 years ago.</p> <p>“He’s always been really great for me,” says the polka-dancing senior, who drives 20 minutes to see the internal medicine specialist in his Kent office. “It’s worth a little drive. I can just talk to him and he doesn’t rush me. He takes the time.”</p> <p>Dr. Jastrzemski, known by his patients as Dr. J, has been a practicing internal medicine physician for nearly 35 years, mostly in Kent. He is among University Hospitals’ more than 400 primary care providers across 100 locations. Dr. Jastrzemski joined University Hospitals when Robinson Memorial Hospital became UH Portage Medical Center, and he enjoys practicing relationship-based care.</p> <p>“Some of my patients have been seeing me for over 30 years,” says Dr. Jastrzemski. “It is important for patients to establish primary care with a provider they trust so that they can build a relationship. It is important for the provider to know the patient’s health history in detail and to know the patient’s relationships with family and community, so that we can offer the best options to them.”</p> <p>Trust built between patients and primary care providers allows them to speak candidly. These bonds can prove beneficial over time, especially when important healthcare decisions must be made. If trust doesn’t exist, notes Dr. Jastrzemski, health concerns could go unaddressed or advice go unheeded.</p> <p>Helen initially declined a mammogram order, but Dr. Jastrzemski urged her to get the screening that caught cancer early. She had surgery and recovered well.</p> <p>“I always felt if he hadn’t done that, who knows what would’ve happened?” Helen says.</p> <p>And when her mother died at 93, her doctor showed compassion and concern, which she deeply appreciated.</p> <p>“Trust allows the patient to speak about health and personal matters that have a significant bearing on chronic conditions, both physical and mental,” Dr. Jastrzemski added. “Trust between patient and provider is important, so that both parties are able to speak candidly about ongoing issues. Providers benefit from knowing as much about the patient as possible, so that decisions about healthcare may be made honestly with the patient’s best interests at the forefront.</p> <p>“Managing patient care long term is a blessing for me,” said Dr. Jastrzemski.</p> <h3>Related Links</h3> <p>University Hospitals has a vast network of primary care providers at convenient locations across the region. With online scheduling, next-day appointments, and accepting most major insurance plans, UH is dedicated to your health. To find a physician near you, go to <a href="/services/primary-care">UHhospitals.org/PrimaryCare</a>.</p>Sun, 18 Feb 2024 19:00:00 -0500{A28D3AFC-0339-4479-8191-2ED6F1E6F387}https://www.uhhospitals.org/blog/articles/2024/02/how-to-help-your-child-thrive-after-cancerHow to Help Your Child Thrive After Cancer<p>A child who has conquered cancer has much to look forward to. But as a parent, you know challenges still lie ahead.</p> <p>“Regular follow-up care after treatment ends is crucial to helping your child thrive,” says <a href="https://www.uhhospitals.org/doctors/Hackney-Lisa-1821250291">Lisa Hackney, MD</a>, Director of the <a href="/rainbow/services/pediatric-cancer-and-blood-disorders/patient-resources/life-after-cancer-survivorship-clinic">Pediatric Oncology Survivorship Program at University Hospitals</a>.</p> <h2>Long-Term Strategies for Parents</h2> <p>Children often face long-term complications as a result of cancer or the treatments they received. These problems may affect many facets of their lives and their bodies, including their growth, reproductive and sexual development, and lung and heart health. Some children may develop learning difficulties or emotional problems. Childhood cancer survivors are also more likely to develop cancer later in life.</p> <p>Here are some strategies parents can utilize to help their child thrive:</p> <p><strong>Develop and follow a long-term plan.</strong> Even though cancer-free, your child will need follow-up care throughout life to look for any recurrent or new cancer, as well as side effects or complications from treatment. “It’s important to find a provider who is trained in the late effects of <a href="/rainbow/services/pediatric-cancer-and-blood-disorders">childhood cancer</a> to maintain long-term health,” says Dr. Hackney. “The follow up is different for each patient and depends on the type of cancer and treatment, overall health status, genetic factors and other health habits.”</p> <p><strong>Keep careful medical records.</strong> Be sure to note details of the diagnosis, treatments, side effects and any complications. Provide copies to any new healthcare providers your child visits while growing into adulthood. This medical history is invaluable to understand any future health issues. Ideally, the hospitals that treats your child will provide this at the conclusion of treatment.</p> <p><strong>Start good habits early.</strong> Keep your child robust by encouraging a healthy lifestyle. Teach the importance of avoiding smoking, eating a balanced and nutritious diet, and getting plenty of regular exercise.</p> <p><strong>Keep your child emotionally fit.</strong> You know the emotional toll your child’s illness took on you and your child. Nurture emotional well-being by encouraging your child to talk about their feelings. See whether your child is comfortable speaking with a counselor to deal with depression, stress, anxiety or fear of the illness returning. Support groups can also help young cancer survivors cope with emotional effects.</p> <p>Parents of cancer survivors understand what a precious gift life is. Use that information to make each day a healthy one for your child to thrive.</p> <h3>Related Links</h3> <p>At UH Rainbow Babies & Children’s, we offer each child the best cancer care that extends into young adulthood and beyond. <a href="/rainbow/services/pediatric-cancer-and-blood-disorders/patient-resources/life-after-cancer-survivorship-clinic">Learn more.</a></p>Fri, 16 Feb 2024 08:00:00 -0500{07F82851-A259-4155-BF4E-BB1FADF3CDDA}https://www.uhhospitals.org/blog/articles/2024/02/dads-play-an-important-role-in-pregnancy-and-beyondDads Play an Important Role in Pregnancy & Beyond<p>When it comes to pregnancy and birth, we often focus on mother and baby. But fathers play a vital role, too. They can contribute much more than just another set of hands to change a diaper.</p> <p>“When fathers are actively involved during and after pregnancy, it can significantly improve the child’s wellbeing,” says <a href="/doctors/Vagi-Lisa-1275284721">Lisa Vagi, CNM</a>, a certified midwife at University Hospitals “For example, babies with involved dads have greater physical and mental health. Throughout life, they tend to be more social, have higher self-esteem, do better in school and have fewer behavioral problems.”</p> <p>Dads, here’s how you can give your baby the best start.</p> <h2>Connect Early</h2> <p>All dads can forge a powerful bond with their little ones. The key is to connect from the beginning:</p> <ul> <li>Talk to your unborn baby. Sing, tell jokes or read stories. Your infant will recognize your voice from the moment of birth.</li> <li>Hold your baby skin-to-skin as much as possible. Cuddle them to your chest so they can hear your heartbeat.</li> <li>Participate in one-on-one time by giving baby a bath or feeding with a bottle, if possible. Not only does it give mom a break, but it can also help you grow closer.</li> </ul> <h2>Focus on Quality Time</h2> <p>Concerned that work takes you away from your child? What happens if you don’t live in the same household? Not to worry. “When it comes to time, quality is more important than quantity,” says Vagi. To make the most of moments together:</p> <ul> <li>Put away your phone and give full attention to your baby.</li> <li>Become an expert on your infant. What makes them laugh? Do they have a favorite song you can sing?</li> <li>As your baby grows, create a special daily ritual with them, such as reading a bedtime story every night. (Video calls work, too!)</li> </ul> <h2>Offer Support</h2> <p>Dads can also be a strong emotional support to moms:</p> <ul> <li>Attend prenatal and postnatal visits with your partner.</li> <li>Take walks together. It can give you time to connect.</li> <li>Keep tabs on your partner’s emotional well-being, as well as your own. Welcoming a new member to the family is a major transition. Having someone to talk to and finding a support group can help.</li> </ul> <h3>Related Links</h3> <p>University Hospitals offers comprehensive care for women in every stage of life, from well woman visits to diagnosis and treatment for the full spectrum of gynecologic and women’s health conditions. <a href="/services/obgyn-womens-health">Learn more.</a></p>Wed, 14 Feb 2024 08:00:00 -0500{4B1EAA6E-C02A-4441-B322-A9DE9888CB52}https://www.uhhospitals.org/blog/articles/2024/02/arrested-four-times“Arrested” Four Times<p class="UH-Lead">51-year-old patient writes book to thank interventional cardiologist and team who saved his life</p> <p>Korey Loughry of Kent was halfway home when an intense burning began boring through the center of his chest. But it couldn’t be a heart attack, right? He was only 51, the youngest of eight children with no family history among them.</p> <p>He kept trying to talk himself out of it. But somewhere, in his heart of hearts, he thought he might die that day. He fired off a text to his family, telling them he loved them. He pushed home, laid on the floor, took his blood pressure, Googled heart attack symptoms and then, finally, called 911.</p> <p>The first cardiac arrest occurred in the Kent ambulance en route to <a href="/locations/uh-portage-medical-center">University Hospitals Portage Medical Center</a>. Korey was sitting up, noting the landmarks whizzing by the windows and consciously calculating how soon they’d arrive at the hospital. Then his heart when into V-tach, an arrhythmia in which the heart is beating too fast to refill and finally, the uncontrollable quivering known as V-fib.</p> <p>“I remember thinking, ‘I can’t wait to get to the hospital. Hopefully they can fix what’s going on,’” Korey recalled.</p> <p>Korey arrested four times that day – another time upon arrival in UH Portage’s Emergency Department and twice on the cardiac cath lab table in UH Portage’s Harrington Heart & Vascular Institute. Interventional cardiologist <a href="/doctors/Mayuga-Myttle-1780830950">Myttle Mayuga, MD</a>, later interviewed by Fox 8 about Korey’s remarkable story, saved him to see his 52nd birthday. She placed two stents in him that day and unblocked his left anterior descending artery.</p> <p>Known as the widowmaker, a blockage of the left anterior descending artery often equates with sudden death.</p> <p>Korey published his sobering story in a book titled <em>I Was Arrested: A Candid Memoir of One Cardiac Arrest Survivor</em>. In addition to Dr. Mayuga, he thanks his many caregivers, including Gretchen, Brittany, Marc, Nicole and Rachel. He even sought out the medics who brought him to the hospital and obtained his 911 recording, which he found surreal to hear.</p> <p>In the book, Korey details his journey through cardiac rehabilitation, losing 40 pounds, adopting a heart-healthy diet, and expanding his support network beyond his beloved wife, Molly, and two adult children who are in the military. He also addresses his decision to seek counseling to help him process having died and been revived.</p> <p>“There was a driving need to write this book to process everything and to thank these people who literally saved my life,” Korey said. In his book, Korey notes: “I’m seeing how really true it is that we inevitably bring the whole of who we are – struggles as well as strengths – to each new season that we face.”</p> <h3>Related Links</h3> <ul> <li><a href="/services/heart-and-vascular-services">Heart & Vascular Services</a></li> </ul>Mon, 12 Feb 2024 19:00:00 -0500{55F92FB1-5F58-4821-9085-15714CE9A03F}https://www.uhhospitals.org/blog/articles/2024/02/telemedicine-convenient-and-immediate-accessTelemedicine: Convenient and Immediate Access (When Appropriate)<p class="UH-Lead">Listen to the most recent episode here:</p> <iframe title="Telemedicine: Convenient and Immediate Access (When Appropriate)" allowtransparency="true" height="150" width="100%" style="border: none; min-width: min(100%, 430px);height:150px;" scrolling="no" data-name="pb-iframe-player" src="https://www.podbean.com/player-v2/?i=g7kbn-156773e-pb&from=pb6admin&share=1&download=1&rtl=0&fonts=Arial&skin=9&font-color=auto&logo_link=podcast_page&btn-skin=1b1b1b" loading="lazy"></iframe> <p><strong>Subscribe: </strong><a href="https://podcasts.apple.com/us/podcast/healthy-uh-podcast/id1472782476">Apple Podcasts</a> | <a href="https://podcasts.google.com/u/1/feed/aHR0cHM6Ly9mZWVkLnBvZGJlYW4uY29tL3VuaXZlcnNpdHlob3NwaXRhbHMvZmVlZC54bWw?sa=X&ved=0CAIQ4aUDahcKEwi4_-jtuqPsAhUAAAAAHQAAAAAQBw">Google Podcasts</a> | <a href="https://www.stitcher.com/podcast/healthyuh-podcast">Stitcher</a> | <a href="https://open.spotify.com/show/41zIrk1mwWSQnawaAjVzmX">Spotify</a></p> <p><em>Telemedicine exploded during the pandemic and has held steady as a convenient way for people to get the care they need without leaving the house. <a href="/doctors/Zack-Brian-1023223781">Brian Zack, MD</a>, explains how telemedicine helps more patients get essential care and why it isn’t just here to stay, but may become the preferred way to see your doctor.</em></p> <hr /> <p><strong>Pete Kenworthy</strong><br /> It feels like Telehealth, telemedicine, virtual care, whatever you want to call it, has exploded in the last five years or so, right? Especially during COVID. At first it was an insurance issue, right? There was a struggle to get insurance companies to cover the cost like it was an in-person visit, but we’re past that now and it seems like there’s great value in it for people.</p> <p><strong>Macie Jepson</strong><br /> Well, we didn’t grow up with it. That is for sure, but it is here to stay, Pete. The questions that people struggle with are similar to when to see a primary care doctor, when to go to an urgent care? I asked myself that just recently. When you should head on to the emergency room and really can you get prescriptions filled actually through a virtual visit? Hi everybody. I’m Macie Jepson.</p> <p><strong>Pete Kenworthy</strong><br /> And I’m Pete Kenworthy, and this is <em>The Science of Health</em>. And joining us today is Dr. Brian Zack, Medical Director for Telehealth at University Hospitals in Cleveland. Thanks for being with us.</p> <p><strong>Brian Zack, MD</strong><br /> It’s my pleasure. Thank you for having me.</p> <p><strong>Pete Kenworthy</strong><br /> Can you start with a high-level explanation of virtual care for those who may be unfamiliar with it? It’s actually been done, and I was surprised myself. It’s actually been done successfully since the 1960s.</p> <p><strong>Brian Zack, MD</strong><br /> That’s correct. The actual first documented telehealth visit was in 1959 in the University of Nebraska as part of medical education, and within five years they were doing crosstown consults to the hospital from various sites.</p> <p><strong>Pete Kenworthy</strong><br /> Things have changed quite a bit in the last 80 years or last 60 years, right?</p> <p><strong>Brian Zack, MD</strong><br /> Sixty years, absolutely. But certainly it has exploded. As you said, the first, I would say 50 years was a slow growth that was based on technology, based on interest from both patients and providers and acceptance. But certainly the pandemic made this part of our commonplace, everyday healthcare. To answer your question about all the different names that we apply to it, virtual care, as most people refer to it, is a connection between a patient and a provider at two different sites via an audio/video connection. So usually that refers to both a video screen with an image, and, of course, the discussion that goes in the audio. There are people who do phone visits as well, telephone only, and we have other forms in the digital portfolio of visits that we can do over email, text and et cetera.</p> <p><strong>Macie Jepson</strong><br /> We like to break down myths here, and one might be that really these services are only for people who can’t get into see a physician or they live in a rural area and that’s who you’re servicing. Is that true?</p> <p><strong>Brian Zack, MD</strong><br /> No. And I think that’s a really common myth. In fact, I think it was based in some fact to your earlier point about insurance coverage prior to the pandemic, the only insurances that paid prior to the pandemic on a regular basis was Medicare for rural patients, and they had to be very strict criteria to make it eligible, so much so that most providers didn’t even understand those rules and therefore didn’t participate. But as the pandemic hit and in the first months of the pandemic, over 70% of our visits in this system were performed virtually for a few months. That includes primary care, specialty care and urgent care. So most patients were being seen virtually while we figured out what was safe and what was unsafe as the healthcare system, the Federal Government, led by making these reimbursable. And while we don’t want to always associate money with our health, it was that paradigm shift that allowed healthcare systems and physicians to embrace this technology as a safe part of their practice.</p> <p>And now it is a part of our permanent model. The most important thing to address is that it’s not just for people who can’t get in. It’s an access initiative to allow people to not have to leave work, not have to leave school, whose physician might be across town if it’s a specialist and they want to see them from their home. The most important thing here is, and this is something I try to say over and over again the more I talk about telehealth and virtual care, is we should not both as patients, but also as providers and healthcare professionals, we should not be thinking of telehealth or virtual care as a binary choice between in-person visits and virtual visits. You’re not making a choice, one or the other. It’s a new tool. Don’t think of it as the visit. Think of it as a stethoscope or as an otoscope we use to look at your ears.</p> <p>It’s a tool that your providers can use to manage your personal healthcare needs. And so what I mean by that is it’s great for triage. Do I need to go, to your question earlier, about when do I go to the ER versus urgent care versus my primary care doctor’s office versus a virtual visit? The answer is it could be used to triage and help you make that decision before you commit to all night in the emergency room. It can be used to follow up on a visit that you may have not otherwise done. And we’ve actually shown some evidence and we being healthcare system that people who do a follow-up visit virtually after leaving the hospital or emergency room because they couldn’t get in with their specialist or primary care doctor are less likely to be readmitted because we’ve addressed any in-between needs that occurred since their discharge. So it is a new part of the healthcare system. It’s not an either/or.</p> <p><strong>Pete Kenworthy</strong><br /> Yeah. That was the next myth on our list here is that virtual care is only for urgent care.</p> <p><strong>Brian Zack, MD</strong><br /> Absolutely not. And I think, though, the biggest impact that virtual care has had now and will continue to have in the future is that it is now being used to manage chronic care, to manage how patients flow through the system. One great example will be a patient who was admitted to the hospital for congestive heart failure, one of our most common reasons for admission. When they’re discharged, they’re told to follow up with their primary care doctor and their cardiologist. When we get them in with a member of that care team within three to seven days for a virtual check-in, there are certain questions for congestive heart failure that they ask, like, has your weight gone up? Are you having difficulty with movement or going up and downstairs that would indicate you’re getting worse again? These virtual quick touch-bases that don’t involve an all day trip to the doctor are preventing people from having to be readmitted, are helping care teams pivot and readjust a treatment plan prior to their need to be seen in the office. So it’s a part of that journey.</p> <p><strong>Pete Kenworthy</strong><br /> So you’re actually differentiating between two different things here. There’s scheduled virtual care where you make a scheduled appointment with your doctor, and then there’s on demand virtual care where, oh my gosh, my throat hurts, or I see this rash on me. Those are two different things, but it’s the same vehicle that gets those answers.</p> <p><strong>Brian Zack, MD</strong><br /> I’m so glad you asked. That’s a really phenomenal question. So yes. Actually, the majority of virtual visits, and not by a little bit, the vast majority of virtual visits that are our system, and I would venture to say most systems are currently seeing, are in the scheduled category. Any physician who has a clinic, an outpatient clinic, can see patients either in person as we’re all used to the traditional visit or can do a virtual visit. And here at UH, an example, every single department does virtual visits, some more than others, but every single one does. So people, for example’s primary care, which was over 70% virtual during the pandemic has settled into somewhere between eight and 13% depending on the provider are still virtual. Our behavioral health departments, so we’re talking about psychiatry, psychology, counseling, are still over 80% virtual. And that is after the pandemic because it was great for access. And in the mental health space…we talked about congestive heart failure as an example as a follow-up… in the behavioral health space, more people are seeking care because the stigma of going to a provider in person for mental health is decreased. You can do it from the comfort and safety of your home, and actual compliance with treatment regimens is better because they have more resources to check in. If they’re having a side effect, they have the ability to get a quick check-in as opposed to just saying, I don’t like this, I’m just going to stop.</p> <p><strong>Macie Jepson</strong><br /> This is what confuses me. How can you give me an exam for a sore throat or an ear infection or maybe an eye infection without seeing me? I feel like this is one of the misconceptions…oh, I’ve got to go in, I’ve got a sore throat. True or false?</p> <p><strong>Brian Zack, MD</strong><br /> It’s both. So the answer is, of course, there are visits and complaints and medical issues that are absolutely not appropriate for virtual care, and so it’s important that as health systems build infrastructure in terms of their digital portals of entry…that’s the fancy way of saying their webpage, where patients go to find way in or their patient care apps on their smartphones…it’s really important to speak to the patient to help them navigate that. A lot of systems are actually creating apps that are about what are your symptoms and what’s the best site of care for you? But where I’m going for is there’s so much part of the physical exam that can still be done on video, and it’s really important that all patients know that here at UH, and I’m sure with every system who provides this type of care, we expect our providers to keep to the same standards of clinical care and quality metrics as they do for an in-person visit.</p> <p>So if the clinical guideline, I’ll use strep throat, a very common complaint. Strep throat should not be diagnosed virtually because there are so many different causes of a sore throat, and really the only way to know is with a swab, but that doesn’t mean we can’t meet halfway. And there are clinics that are associated with virtual visits where after the virtual visit, we send the patient a list of multiple sites they can go to on their own time to get swabbed, and the treatment team will follow up with an antibiotic if appropriate. Traumas like a fall or a car accident, of course, not appropriate for virtual. Breathing issues, chest pain, not appropriate for virtual. Those patients should go to the ER or to whoever they can be seen as quick as possible. But you mentioned eye infections. If the patient is seen virtually, and I do this from my office, if the patient’s seen virtually, we know as physicians and other providers that there are certain red flags that say this needs to be examined, but if the answers are no, we can actually do that virtually with the expectation of if this doesn’t improve or if you get A, B and C, other symptoms, come into the office.</p> <p>And this is, pivoting back to the really important point of it’s not about the one visit yes or no. It’s about that continuum and that journey. This was a way to start treatment and if it gets worse, you need to come see me. And patients are very compliant with that. They understand that we’re giving them a convenience in not having to leave work or come in. They can do it from home and we can really start their healthcare journey for this issue virtually. And if it needs to be a follow-up in person, they can do it at a more convenient time for them.</p> <p><strong>Pete Kenworthy</strong><br /> Okay, so here’s one for you. Virtual care devalues the doctor-patient relationship. It doesn’t feel personal.</p> <p><strong>Brian Zack, MD</strong><br /> I love that question because I couldn’t disagree more. And I love being able to share my thoughts here. In our previous discussion, I mentioned that it’s not the…I keep coming back to it…it’s not the binary visit, it’s the how does this type of tool fit into the need I have right now? And what I have found and most of our providers have agreed with is that it actually enhances the relationship for a couple of very important reasons. First, access. We are breaking down barriers to care. So if I am seeing one of my patients, they just appreciate that I’m getting them in as fast as possible. I already have that relationship with them. This is building on that relationship. It’s a different way for them to get what they need from me and to me to have that pleasure and the privilege of treating them.</p> <p>But the second thing that I like to point out is this is a whole new aspect of how providers like myself can see patients in their own spaces. I’m seeing them in their home environment. I’m seeing them, for a patient with mental healthcare needs, is the room they’re in completely messy and disheveled? Evidence that maybe things aren’t going as well. Are they in a safe place? They feel more comfortable. They feel more private. I mentioned previously the stigma sometimes of going in for care.</p> <p>Another example outside of mental health that I love, that I’m very interested in is obesity management. And so we have a lot of patients… I’m a pediatrician…teens don’t want to talk about their weight. They don’t want to be weighed in the office, but sitting in their bedroom at home, it’s a little safer, and they’re more open to some discussions of healthcare, not their weight, but healthcare. And we can really make a different kind of connection, which I think is much more powerful.</p> <p><strong>Macie Jepson</strong><br /> Let’s talk a little bit more about safety. I think about my parents. My dad pays cash for gas because, oh, he’s not going to put that credit card everywhere. There’s got to be a concern with some patients about healthcare, public record safety, their personal information being out there on the Internet or what have you. What do you say to that?</p> <p><strong>Brian Zack, MD</strong><br /> So there’s two answers. And to the patient, I would say the first step is on you, meaning you should not be doing a virtual visit while walking through the grocery store. You should be making sure you’re in a private place that your personal issues and your private matters are not being overheard by others. So we can’t control that part of it, but you can. The second issue, which I think is what you were getting at, is how do we know what’s over the airwaves, if you will, happening with this visit and this information? So there’s a couple things, and I absolutely want to empower our listeners and our patients to ask these questions no matter where they live and no matter who their provider is. All health systems should be using and are required to use secure networks and secure platforms under the HIPAA guidelines. So it’s a HIPAA compliant platform. That means security features are in place to prevent other parties from seeing this information. It means that it meets standards of security and privacy set by the government to make sure your information is safe. No one should ever be recording or taping your visit without your consent in full information.</p> <p><strong>Pete Kenworthy</strong><br /> A tough one for people may be when they use virtual care, is that the cost is the same for going in for an in-person visit, right? And some people may think, well, this should cost less. I’m not using their office, I’m not using all their overhead costs, right? Why doesn’t it cost less? It costs the same, right?</p> <p><strong>Brian Zack, MD</strong><br /> So at current state, it costs the same. That may change in the future. Every year we’re finding out more and more about where the governing bodies over billing codes and how these things work, usually led by Medicare, will lead us in this space. But I think the answer you’re looking for is that remember that even though that visit doesn’t need the office, that physician was seeing a patient in person right before they saw you and probably right after they saw you. And their ability to make these options available is dependent upon the staff members at the front desk, the nurses taking care of patients in the back, the rent, everything that goes into maintaining an office. So unless a provider is fully virtual, which almost no one is, this is part of the course of medicine. And more importantly, remember, you’re not just paying for the office space. You’re paying for the trust, expertise and guidance of the physician or healthcare provider in front of you.</p> <p><strong>Macie Jepson</strong><br /> We touched on this, but I want to dig a little bit deeper, and that is when is virtual care a good idea? When do you need to go see someone, whether urgent care, wait for your physician, emergency room?</p> <p><strong>Brian Zack, MD</strong><br /> So I think if it is a non-urgent issue, I think calling your doctor’s office and asking for yourself, is this something we can see virtually or do I need to come in for this visit? And that’s in the scheduled space, just like any other doctor’s appointment. Okay. I think in the on-demand space, which is what a lot of people don’t understand, it’s, you brought up a sore throat or an earache, it’s okay to go to your healthcare system’s website that allows entry into the on-demand virtual spaces, if you’re not sure, and usually they’ll guide you. On our site, it very clearly says ear infections cannot be diagnosed virtually. Sore throats for a strep cannot be diagnosed virtually, but we could see you and start that process. Other things, as I mentioned earlier, certainly are immediate referrals to urgent cares or EDs, which are more risky or high acuity complaints: chest pain, shortness of breath, uncontrolled bleeding, trauma are good examples.</p> <p>As patients get more comfortable with virtual care and as providers get more comfortable, and I think it’s really important for our patients to know that not every provider has the same approach to virtual care. So it is part of that partnership and relationship you have. But if you’re part of an ongoing, regular continuity relationship with a provider, whether they be in the primary care space or a specialty space, and you see them regularly, I think having that conversation, when can we do this virtually versus when can we do this in person, is a really reasonable and now normal conversation. And providers in their own specialties will have no problem saying, when we need to get a weight, when we need to do lab work associated with your visit or other testing, we’ll have you come in. But in the in-betweens, we can do it virtually.</p> <p><strong>Pete Kenworthy</strong><br /> And there are things that people may not be thinking about, right? You can have that continuum of care for chronic problems. You can have it for prescriptions that may be needed to be refilled, things like that.</p> <p><strong>Brian Zack, MD</strong><br /> Correct. Anything I can prescribe in the office at current state, I can prescribe virtually. There are some limitations and they probably are going to get a little tighter on controlled substances, but that makes sense for safety. But in other realms, in terms of any blood pressure, cholesterol, antidepressants, antibiotics, if clinically appropriate, can all be prescribed virtually.</p> <p><strong>Macie Jepson</strong><br /> What stands out to me in what you just said, continuum of care. Important to note, this isn’t meant to be a replacement for your physician.</p> <p><strong>Brian Zack, MD</strong><br /> So this is about your physician. This is about your ability to navigate your health, your personal journey, and how health systems can be a partner and offer you resources. And virtual care is one of those resources. Some data that came out during the pandemic, just to make an example, is when you go see a primary care doctor or a specialty physician for a scheduled clinic visit, and we assume the normal average time of transportation, parking, walking in the building, checking in, waiting for the doctor or a provider, seeing them, checking out and reverse, going home compared to a virtual visit starting at home, the average virtual visit without significant delay was between 22 and 26 minutes. The average time door to door for an in-person visit was over three hours. This is why people take half days off of work for a doctor’s appointment, or they could take their break, go in a private room and do it from work or home. So the ability to access those services is actually reinforcing that continuum of care and not creating barriers.</p> <p><strong>Pete Kenworthy</strong><br /> Let’s tie a bow on this. Anything else? Anything we left out or just kind of a takeaway for people here.</p> <p><strong>Brian Zack, MD</strong><br /> As I think that we’ve said over and over about the value of virtual care in not being its unique, one-time visit, but about the bigger picture and your total health. As patients become more comfortable and more engaged in these options, we actually have changed, and we’re using a term called digital health, which actually means we’re looking at ways technology can be part of this journey beyond the video camera on your computer. We are using text chats to help people follow chronic conditions. We’re allowing patients to use email or e-visits to ask very simple non-complicated questions that don’t require the video. We’re looking at other technology like remote patient monitoring. So if you wear a blood pressure cuff at home or a continuous glucose monitor for diabetes, all of these equipment are now being tied digitally into our electronic medical records as part of your total picture. And we’re making sure that along with virtual visits, all this technology together is allowing our patients to stay healthy at home as opposed to sick at the hospital.</p> <p><strong>Pete Kenworthy</strong><br /> Dr. Brian Zack, Medical Director for Telehealth at University Hospitals in Cleveland, thanks so much for being with us today.</p> <p><strong>Brian Zack, MD</strong><br /> Thank you so much for having me.</p>Mon, 12 Feb 2024 16:00:00 -0500{E1F0215B-6913-4A57-A26C-4FC81FC87F40}https://www.uhhospitals.org/blog/articles/2024/02/more-than-a-lump-8-less-common-signs-of-breast-cancerMore Than a Lump: 8 Less Common Signs of Breast Cancer<p>Most people know the most common sign of <a href="/services/cancer-services/breast-cancer/breast-cancer-in-women">breast cancer</a> is a new lump or mass in the breast. But there are other less common symptoms that can signal the disease and may further evaluation by your doctor.</p> <p><a href="/doctors/Marshall-Holly-1205030574">Holly Marshall, MD</a>, Division Chief of Breast imaging at University Hospitals, shares more.</p> <h2>What to Look For</h2> <p>“There are many kinds of breast cancer that can present in many different ways,” Dr. Marshall says. “Any changes in the breast should be evaluated. If you have any of these signs, you need to come in and not wait for your next <a href="/services/obgyn-womens-health/conditions-and-treatments/breast-health/mammography">mammogram</a>.”</p> <p>Changes that could be signs of breast cancer:</p> <ul> <li>Retracted, inverted or downward-pointing nipple</li> <li>Pucker, indentation or dimpling of the skin</li> <li>Thickening or hardening of the skin and/or breast tissue</li> <li>Nipple discharge, particularly bloody or clear discharge</li> <li>Peeling, scaling or flaking of the nipple</li> <li>Rash or swelling</li> <li>Swollen lymph nodes under the arm or near the collarbone</li> <li>A change in breast size</li> </ul> <p>A rapid increase in size of the breast is a sign that needs to be evaluated because that could indicate an advanced type of breast cancer, Dr. Marshall says.</p> <p>Your primary care doctor may order tests such as an ultrasound or mammogram. Keep in mind, many conditions can cause lumps and other symptoms. Most breast lumps are not cancerous. Two common causes of lumps are benign fibroadenomas and cysts.</p> <h2>The Value of Mammograms</h2> <p>Dr. Marshall says the best way to catch early signs of breast cancer is an annual mammogram starting at age 40 for women at average risk. Mammography can detect cancer that you’re unable to see or feel.</p> <p>“The whole purpose of screening is to detect breast cancer before it’s clinically evident,” Dr. Marshall says. “The goal is to detect breast cancer before you can feel it. The smaller it is, the easier it is to treat and the better the outcome.”</p> <p>Mammograms also look for more than masses. “We’re looking for anything that can be a sign of breast cancer. That includes masses, asymmetries (areas that look different than normal breast tissue), calcifications , abnormal lymph nodes and skin thickening.”</p> <p>“If you are high risk due to family history or other factors, you may want to talk to your doctor about starting mammogram screening earlier than age 40.” Dr. Marshall says.</p> <h3>Related Links</h3> <p>The University Hospitals Breast Health Center provides innovative care to prevent, diagnose and treat benign and malignant breast disease. <a href="/services/obgyn-womens-health/conditions-and-treatments/breast-health">Learn more.</a></p>Mon, 12 Feb 2024 08:00:00 -0500{289EDA8E-1C60-41EB-B70B-977961AE1A6E}https://www.uhhospitals.org/blog/articles/2024/02/why-do-people-have-intrusive-thoughtsWhy Do People Have Intrusive Thoughts?<p>Has an unsettling thought or a disturbing image ever popped into your head, seemingly from out of nowhere? If you answered yes, you are one of six million Americans who have experienced intrusive thoughts.</p> <h2>What Are Intrusive Thoughts?</h2> <p>Intrusive thoughts are unwanted ideas and images that come to mind unexpectedly. These thoughts can be directed towards yourself, your loved ones or people who just happen to be nearby at the moment.</p> <p>Some common examples include:</p> <ul> <li>A parent thinking about hurting their baby or child.</li> <li>A fleeting urge to jump when standing on a bridge or rooftop of a tall building (a phenomenon also known as “the call of the void” or “the high place phenomenon”).</li> <li>Thoughts of running your car off the road or swerving into oncoming traffic.</li> <li>Thoughts about doing something embarrassing; for example, shouting obscenities or doing something inappropriate in public.</li> </ul> <h2>Are Intrusive Thoughts Harmful?</h2> <p>“The short answer is no,” says <a href="https://www.uhhospitals.org/doctors/Chester-Robert-1477030401">Robert Chester, PsyD</a>, a clinical psychologist with University Hospitals Department of Psychiatry. “Although intrusive thoughts can be unsettling, they are not always a sign of mental illness or an indication that you have a hidden desire to follow through with the disturbing or strange thought that arose in your mind.”</p> <p>What’s more, multiple studies have shown that people who have intrusive thoughts are not more likely to act on them.</p> <h2>What Causes Intrusive Thoughts?</h2> <p>Stress is the most common trigger for intrusive thoughts. But even people with normal or low stress levels can experience the occasional intrusive thought. Most intrusive thoughts fall into one of the following categories, which can feel understandably disturbing:</p> <ul> <li>A phobia or deep-seated fear</li> <li>Embarrassing or shameful</li> <li>Immoral or against your values</li> <li>Violent or sexual in nature</li> </ul> <p>So, what prompts a healthy brain to produce ideas that are disturbing – or even at odds with – who you are? Some researchers believe intrusive thoughts are a type of misinterpreted warning signal, a sort of brain hiccup.</p> <p>“Intrusive thoughts may serve to protect us from our deepest fears or potential dangers,” says Dr. Chester. “For example, the sudden urge to step off a bridge causes you to step back. Similarly, the mother who has an intrusive thought about hurting her baby nearly always reacts with feelings of horror because her baby’s well-being is all that matters. Ultimately, intrusive thoughts remind us of the things we value the most in our lives.”</p> <h2>How to Stop Intrusive Thoughts</h2> <p>Here are some tips to help manage intrusive thoughts:</p> <ul> <li><strong>Identify and recognize the intrusive thought</strong>. A thought may be intrusive if:</li> <ul> <li>It’s very different from your usual thoughts.</li> <li>It’s disturbing and bothersome to you, and you want to rid your mind of it.</li> <li>The thought feels difficult to control – intrusive thoughts are typically repetitive and often get “stuck in your head.”</li> </ul> <li><strong>Don’t fight it.</strong> When you have an intrusive thought, try to accept it. As unsettling as they may feel, intrusive thoughts usually go away if you accept them without focusing on them or trying to push them away.</li> <li><strong>Don’t judge yourself</strong>. Remind yourself that having this type of unusual or alarming thought does not mean that something is wrong with you. Thoughts are not the same as behavior.</li> </ul> <h2>When to Seek Help</h2> <p>You should seek the help of a <a href="/services/adult-psychiatry-psychology">mental health professional</a> if your intrusive thoughts are disruptive to your daily life, especially if they interfere with your ability to work or to do things you enjoy. A therapist can help determine if intrusive thoughts are a symptom of a mental health condition, such as obsessive-compulsive disorder (OCD), generalized anxiety disorder, depression or post-traumatic stress disorder (PTSD).</p> <p>Many people learn to manage intrusive thoughts with cognitive behavior therapy (CBT), which helps patients change thought patterns. In addition, selective serotonin reuptake inhibitors (SSRIs) and certain other antidepressant medications can be effective in managing intrusive thoughts.</p> <p>“Psychologists are here to help, not judge,” adds Dr. Chester.  “Please do not be ashamed to share your intrusive thoughts with us. We’ve heard it all.”</p> <p><strong>Related Links</strong></p> <p>Signs and symptoms of mental illness should not be ignored. University Hospitals has a wide network of <a href="/services/primary-care">primary care physicians</a> and <a href="/services/behavioral-health">behavioral health professionals</a> at convenient locations across the region who can diagnose and treat all types of depression, anxiety and other mental health disorders.</p>Thu, 08 Feb 2024 08:00:00 -0500{B7757E6F-EE25-444A-8FD1-5A93BC62F696}https://www.uhhospitals.org/blog/articles/2024/02/an-oasis-for-patients-with-fmdAn Oasis for Patients with FMD<p class="UH-Lead">UH Harrington Heart & Vascular Institute draws patients from around the country for its expertise on rare vascular condition</p> <p>Imagine being told you have a rare health condition for which there is no known cure. Now imagine being told by a doctor that they had absolutely no idea how to help you.</p> <p>Rosie Miklavcic, RN, MPH, the retired Chief Public Health Nurse of Kentucky who was part of the state’s top medical team, was shocked when this happened to her. But Rosie is a woman determined to find answers to health problems, even if it means crossing state lines.</p> <p>Her quest led her to cardiologist and vascular medicine specialist <a href="/doctors/Gornik-Heather-1316030802">Heather Gornik, MD</a>, Director of the Fibromuscular Dysplasia & Arterial Dissection Program at <a href="/services/heart-and-vascular-services">University Hospitals Harrington Heart & Vascular Institute</a>. Dr. Gornik is a leading international expert in the unusual condition known as fibromuscular dysplasia, or FMD. Patients like Rosie have traveled from as far as Hawaii, California, Idaho, Nebraska, Texas and Florida for care at UH Harrington Heart & Vascular Institute.</p> <h2>What Is FMD?</h2> <p>FMD is signified by the abnormal growth of cells in the walls of arteries, generally characterized by a “string of beads” that can cause the vessels to narrow or bulge. There is no known cause or treatment for this condition. Patients must be monitored because these beads can potentially block blood flow to the organs of the body. Areas of the body most commonly affected by FMD are the carotid and vertebral arteries in the neck, as well as the arteries to the kidneys. Many FMD patients have twisted and tortuous arteries and are prone to form aneurysms and dissections.</p> <p>Some patients with FMD suffer from high blood pressure or migraine headaches. Others have no symptoms at all. Rosie, a lifelong runner, was diagnosed when her calcium was noted as elevated on a blood test. During a physical exam, a doctor detected bruit in her neck, which is a whooshing pulsatile sound that can be heard when listening to blood flow in a patient’s carotid arteries. Some patients with FMD can also hear their own bruits or whooshing, a symptom known as a pulsatile tinnitus.</p> <p>“The vascular surgeon knew about FMD, but they weren’t really sure what to do with me,” said Rosie, now 72 and diagnosed in her 60s. “They don’t know what causes it, and there is no cure. I was in shock.”</p> <h2>In the Hands of a Leader</h2> <p>UH Harrington Heart & Vascular Institute has one of the largest dedicated programs for FMD and arterial dissection in the world, says Dr. Gornik, who is a member of the Medical Advisory Board of the Fibromuscular Dysplasia Society of America (FMDSA) and serves on the steering committee of the North American Registry for FMD. The registry now contains about 4,000 patients, and UH follows more than 400 of them.</p> <p>Dr. Gornik noted that no blood test can diagnose FMD. The disease requires an experienced clinician to detect it in arteries on an imaging study such as a special CT or MR angiogram.</p> <p>Some patients, like Rosie, come to UH annually for ultrasounds to monitor their FMD. Thus far, Rosie has not had any serious complications resulting from her diagnosis.</p> <p>“More than half of patients with FMD don’t need a procedure at all, just good medical care and follow-up, as well as aspirin or other medications to prevent clots and medications to lower blood pressure and prevent and treat headaches,” says Dr. Gornik. “Approximately one-third of FMD patients have more serious events such as a coronary artery dissection causing a heart attack, carotid or vertebral artery dissection, or stroke.</p> <p>“We have a terrific multispecialty care team that helps with advanced therapies, when needed, to open blocked kidney arteries and treat aneurysms in the brain, neck and abdomen,” Dr. Gornik added.</p> <h2>A String of Support</h2> <img class="UH-Inline-Image-Small" alt="Rosie Miklavcic hiking with a friend" src="/-/media/Images/Blog/Miklavcic-Rosie.jpg?la=en&hash=7CB8C674F066D4C9B9AF64C582AB93AF1F640C50" /> <p>A mother of three and grandmother of seven, Rosie remains active. However, since her diagnosis, she has eased off rigorous boot camp and heavy weight workouts in favor of more mild strength training and walking.</p> <p>In addition to participating in the quarterly international online FMD support group meetings that Dr. Gornik chairs, Rosie is active in the FMDSA and has started a support group in Kentucky’s capital city. The Frankfort, Kentucky-based group that initially had four members in 2018 now has more than 20 participants.</p> <p>The majority of participants in these support groups, Rosie notes, have symptoms, and many have experienced aneurysms or dissections.</p> <p>Dr. Gornik is an active listener and a thorough clinician who explains things well for patients, Rosie adds.</p> <p>“What sets her apart from other physicians is her positive approach to FMD, which is a complex condition,” Rosie said. “I would not go anywhere else. Traveling 350 miles is well worth it.”</p> <h3>Related Links</h3> <p>Learn more about <a href="/doctors/Gornik-Heather-1316030802">Dr. Gornik</a> and the <a href="/services/heart-and-vascular-services/conditions-and-treatments/vascular-disease/fibromuscular-dysplasia-program">Fibromuscular Dysplasia Program</a> at UH Harrington Heart & Vascular Institute.</p>Tue, 06 Feb 2024 19:00:00 -0500{9FE19B36-5AB3-46D3-9324-258AB898A972}https://www.uhhospitals.org/blog/articles/2024/02/breathe-your-way-to-better-health-and-less-stressBreathe Your Way to Better Health & Less Stress<p>Breathing is an automatic function that seems simple – you breathe in, you breathe out. You don’t have to think about it. But maybe you should. There are multiple benefits that can be gained from purposeful, mindful breathing, including better health and lower stress levels.</p> <h2>Health Benefits of Breathing Exercises</h2> <p>“Certain breathing techniques have been proven to enhance the functioning of the heart and lungs, improve mental wellness, increase energy and concentration, and promote better sleep,” says Robert J. Snyder, MAEd, BSHS, RRT, RCP, a respiratory therapist at University Hospitals.</p> <p>When deep breathing techniques are practiced regularly and correctly, they can provide the following health benefits:</p> <ul> <li><strong>Lower blood pressure and heart rate.</strong> When you take deep, measured breaths, it triggers a relaxation response. Blood vessels open wider, making it easier for the heart to pump blood. </li> <li><strong>Reduce stress and anxiety. </strong> Slow, deliberate breathing sends a message to your brain that everything is okay. This calms the nervous system and reduces levels of stress hormones in the blood. </li> <li><strong>Enhance immune response. </strong> Improved blood flow and less stress hormones help the body clear germs and viruses from the blood more efficiently. </li> <li><strong>Improve muscle function. </strong> The improved blood flow that occurs with relaxation delivers more oxygen and essential nutrients to the muscles so they can function properly. </li> </ul> <h2>Types of Breathing Exercises </h2> <p>Breathing exercises are easy to learn and do. And, unless they are part of a prescribed program to treat specific lung conditions, they don’t require any clinical supervision. </p> <p>Here are some common breathing techniques to help reduce stress and anxiety: </p> <ul> <li><strong>Pursed Lip Breathing. </strong> Inhale deeply through your nose and exhale very slowly through pursed lips, with each exhalation lasting longer than the inhalation. </li> <li><strong>Diaphragmatic (Belly) Breathing. </strong> Place one hand on your chest and the other on your belly. Inhale deeply through your nose so that you can feel the belly expanding while the chest remains still. Then exhale slowly through your mouth. </li> <li><strong>Equal or Sama Vritti Breathing. </strong> Breathe in and out through your nose, while counting the length of your inhale and your exhale. The goal is to make the inhales and exhales last the same length of time. </li> <li><strong>4-7-8 Breathing. </strong> Breathe in for four seconds, hold your breath for seven seconds and then exhale for eight seconds through the mouth. This breathing exercise is known for its calming effects on the body and mind and may help some people fall asleep. </li> <li><strong>Alternate Nostril Breathing. </strong> Use your ring finger to press one nostril closed. Keep your mouth closed and breathe in slowly through the open nostril. Release your finger and press the other nostril closed, while slowly and completely exhaling through the open nostril. </li> <li><strong>One Minute or Box Breath. </strong> While comfortably seated, inhale slowly for 10 seconds, hold for 10 seconds, and then exhale slowly for 10 seconds. You can start with a shorter amount of time or work your way up to longer times, so long as every part of the exercise is the same length. </li> </ul> <p>For optimal results, all of these breathing exercises should be performed for several minutes per session.</p> <h2>Other Tips for Better Breathing</h2> <ul> <li>Maintain adequate indoor air humidity in all seasons so you are not breathing in dry air.</li> <li>Practice good posture to keep the chest cavity open and allow for full lung expansion. </li> <li>Change the air filter on your furnace and air conditioner as recommended. </li> <li>Don’t smoke and avoid secondhand smoke. </li> <li>Avoid environments with excess dust (construction sites, ball fields when windy, BBQ smoke and campfires – if unavoidable, wear a mask over mouth and nose. </li> <li>Use an air purifier to reduce unhealthy particles in the air, including those that may contain germs and viruses. </li> </ul> <h3>Related Links: </h3> <p>University Hospitals offers a supervised <a href="/services/pulmonary-and-sleep-services/conditions-and-treatments/pulmonary-rehabilitation">pulmonary rehabilitation program</a> for patients with chronic lung conditions such as asthma, COPD, and lung cancer. Patients are taught specific breathing exercises to help manage their disease and improve stamina for performing daily activities. </p>Tue, 06 Feb 2024 08:00:00 -0500{DA1B0104-0A47-408F-97DE-EC43413728DB}https://www.uhhospitals.org/blog/articles/2024/02/hcm-patient-returns-to-hiking-the-appalachian-trailHCM Patient Returns to Hiking the Appalachian Trail<p>Stuart O. Smith, Jr., is a retired website director and experienced backpacker. Now in his mid-sixties, Stuart is a former Appalachian Trail thru-hiker and has been section hiking the Appalachian Trail for 10 years in the hope of completing the entire trail a second time. In early 2023, this man, who hiked mountains, suddenly couldn’t walk up two steps without feeling winded.</p> <p>Stuart was diagnosed with <a href="/services/heart-and-vascular-services/conditions-and-treatments/cardiomyopathy/hypertrophic-cardiomyopathy">hypertrophic cardiomyopathy (HCM)</a>, a condition affecting the left ventricle (the main pumping chamber) of the heart. In people with HCM, the walls of the left ventricle become thick and stiff. Over time, the pressures in the heart rise. In Stuart’s case, the thickened heart muscle was also intermittently blocking blood flow out to the body.</p> <p>Symptoms of HCM can include gasping for air, lightheadedness or weakness, and the feeling of a heavy chest or chest pain.</p> <p>People with HCM may need to make lifestyle changes, such as limiting their activity to adjust for their disease. As the disease progresses, it can cause other health problems. People with HCM are at higher risk for developing atrial fibrillation, which can lead to blood clots, stroke and other heart-related complications. HCM may also lead to life-threatening heart failure.</p> <p>“I had to quit hiking, which was devastating,” said Stuart.</p> <p>But soon he regained hope, thanks to his caregivers at <a href="/services/heart-and-vascular-services">University Hospitals Harrington Heart & Vascular Institute</a>. Stuart and his cardiologist, <a href="/doctors/Gorodeski-Eiran-1396729943">Eiran Gorodeski, MD, MPH</a>, developed a plan.</p> <p>“I did a lot of research on my own, as well as discussed options with my doctors,” he said. “I knew that the success rate was high with the option I ultimately chose.”</p> <p>In April of 2023, Stuart underwent open-heart surgery at UH Cleveland Medical Center to address his HCM.</p> <p>“Stuart’s surgery went very well. We performed a procedure known as septal myectomy where a portion of the overgrown and thickened muscle that is causing obstruction was removed. Stuart’s surgery was uneventful, and he made an excellent recovery,” said Stuart’s cardiothoracic surgeon, <a href="/doctors/AbuOmar-Yasir-1346872181">Dr. Yasir Abu-Omar</a>, Surgical Director of the Advanced Heart Failure & Transplant Center, and Russ and Connie Lincoln Chair in Cardiovascular Innovation at UH Harrington Heart & Vascular Institute.</p> <p>“The first day I got home from the hospital, I walked just under a mile. And the second day home from the hospital, I walked just under a mile,” he said.</p> <p>“Many of his symptoms disappeared,” said Dr. Gorodeski. “The trophy on the top was that he was able to go back to hiking, which honestly, I wasn't sure he was ever going to be able to do. We always hope for the best outcome for our patients, but Stuart exceeded our expectations, which is just wonderful.”</p> <p>Just two months after his surgery, Stuart was back to day hiking sections of the Buckeye Trail to rebuild his strength. This led to him being able to take a 54-mile backpacking trip on the Appalachian Trail in Massachusetts just five months after his open-heart surgery.</p> <p>“My endurance returned to how it was previously, like I’d never experienced the surgery or a heart condition,” Stuart said.</p> <p>Today, Stuart has no HCM symptoms. He says his stamina and strength are great. He’s back to normal, living his life to the fullest.</p>Mon, 05 Feb 2024 19:00:00 -0500{6FE82BF6-5590-497C-A71B-E7297A90EE06}https://www.uhhospitals.org/blog/articles/2024/02/how-being-single-can-affect-your-healthHow Being Single Can Affect Your Health<img class="UH-Inline-Image-Large" alt="Infographic: How Being Single Can Affect Your Health" src="/-/media/Images/Blog/Being-Single-infographic.png?la=en&hash=3EFBB17D367437B82F682782F8D1257D02C0947C" />Fri, 02 Feb 2024 08:00:00 -0500{0EB8F4F6-E916-4A58-9774-9306C2ADB091}https://www.uhhospitals.org/blog/articles/2024/01/10-tips-for-supporting-a-child-with-adhd10 Tips for Supporting a Child With ADHD<p>Living with ADHD can be challenging for parents and children alike. By providing the right support to your child with ADHD, you can help them boost their self-esteem and reach their potential. Plus, it can help keep your relationship with them healthy and strong.</p> <p>“Living with <a href="/rainbow/services/pediatric-developmental-and-behavioral-issues/conditions-and-treatments/attention-deficit-hyperactivity-disorder">attention-deficit/hyperactivity disorder, or ADHD</a>, can be difficult for both the person who has the disorder and for those who live with them. When you have a child with ADHD, you can support them and make a positive difference,” says <a href="/doctors/Bothe-Denise-1932389129">Denise Bothe, MD</a>, a developmental behavioral pediatric expert at University Hospitals Rainbow Babies and Children’s.</p> <p>Try these tips:</p> <ol> <li><strong>Learn about ADHD:</strong> Make an effort to research the disorder so you can better understand your child’s behaviors. This can include learning from a knowledgeable therapist or reading trustworthy sources of information, like the <a href="https://www.cdc.gov/ncbddd/adhd/index.html">CDC</a>.</li> <li><strong>It takes a team:</strong> Parents, teachers and healthcare providers should work together to manage ADHD problems. Children with ADHD benefit from behavior guidance to learn self-regulation skills, environmental modifications to improve focus, and sometimes medication management to help with better self-control. Your child may need specially tailored instruction and goals at school.</li> <li><strong>Encourage healthy habits:</strong> Following a healthy lifestyle that includes regular exercise, a healthy diet, and plenty of sleep can help keep ADHD symptoms in check. Help your child avoid processed foods and those that are high in sugar. Schedule time for physical activity. See that they go to sleep and wake up about the same time each day.</li> <li><strong>Stick to a routine:</strong> Following a similar schedule daily can help with organization skills by repeating what is expected each day. Plus, routines help reduce stress for all, which can help a child with ADHD feel less overwhelmed and function better.</li> <li><strong>Communicate clearly:</strong> All children benefit from clear communication, but this is especially important for children with ADHD, who need clear expectations. Keep communications and directions simple, brief and specific.</li> <li><strong>Join a support group:</strong> Talking with people who are in similar situations can help. Try joining a group that helps parents and family members of people with ADHD connect with each other. If that seems like too much, you can also attend therapy geared toward families. CHADD is a great online resource for parents.</li> <li><strong>Encourage tidiness:</strong> Keeping spaces organized can help manage ADHD symptoms and lessen the strain that ADHD can cause in relationships. Encourage your child to reduce clutter and keep items in the same place. Designate a specific place like a basket or table by the front door where they can drop important items. That way, they’ll always know where to find them, and that will cut down on stress – for both of you.</li> <li><strong>Promote organization:</strong> Being organized is a trait that helps life run more smoothly. Write down reminders and appointments or encourage your child to do so. Have them write a daily to-do list. Work with the teachers to come up with strategies for organizing school/homework, with reminders to turn it in for credit. For school, one strategy is a one binder system, where each subject is in a different colored folder in the same binder, and this goes with the child to every class and home to reduce the chances of leaving important work at school or forgetting papers.</li> <li><strong>Help them manage stress:</strong> Teaching deep breathing exercises can help your child learn a skill they can do anywhere to promote relaxation. Lots of exercise also helps get the stress out. Yoga can help your child with concentration and relaxation, while massage can help reduce muscle tension.</li> <li><strong>Take care of yourself:</strong> You cannot take the best care of your child when you are running on empty. Take time out for self-care, whether it’s enjoying a hobby, going for a walk or taking a few quiet minutes to yourself.</li> </ol> <h3>Related Links</h3> <p>The pediatric experts at UH Rainbow address a wide range of child development issues and help families nurture children’s development, build strengths, and address children’s and families’ needs. <a href="/rainbow/services/pediatric-developmental-and-behavioral-issues">Learn more.</a></p>Wed, 31 Jan 2024 08:00:00 -0500{3879AA3E-3DC5-4FA5-8EF7-C7D5D23759C2}https://www.uhhospitals.org/blog/articles/2024/01/high-blood-sugar-makes-chemotherapy-more-effectiveResearch: High Blood Sugar Makes Chemotherapy More Effective<p>Elevated blood sugar generally is not a good thing. But researchers at <a href="/services/cancer-services">University Hospitals Seidman Cancer Center</a> found that high blood sugar helped some cancer patients respond better to chemotherapy drugs.</p> <p>The findings present a potentially new way to treat the cancer, says <a href="/doctors/Winter-Jordan-1003966920">Jordan Winter, MD</a>, Director of Surgical Services at <a href="/services/cancer-services">University Hospitals Seidman Cancer Center</a>. “Our findings reveal an approach that would be relatively low cost and could be easily tested in other patients with cancer.”</p> <h2>A New Strategy for Fighting Cancer</h2> <p><a href="https://www.nature.com/articles/s41467-023-38921-8">The study</a>, published in the science journal Nature Communications, found that <a href="/services/cancer-services/gastrointestinal-cancer/pancreatic-cancer">pancreatic cancer</a> cells were more responsive to chemotherapy when blood sugar was high. They studied the effects in mice and also in a group of patients with metastatic pancreatic cancer.</p> <p>The researchers increased blood sugar levels by adding glucose to drinking water. The chemotherapy worked much better in the mice with high blood sugar, compared to mice with normal blood sugar.</p> <p>“Making tumors more sensitive to chemotherapy by raising blood sugar offers a completely new therapeutic strategy. Our findings reveal an approach that would have relatively low cost and could be easily tested in patients with pancreatic cancer,” says Dr. Winter.</p> <p>“We’re already getting to work designing a trial to treat patients safely with intentionally elevated blood sugars and will determine if this strategy can improve patient outcomes.”</p> <h2>From the Lab to Real Life</h2> <p>Dr. Winter says this simple strategy could potentially reduce the significant cost and time required to develop new therapies for pancreatic cancer. In a clinical setting, doctors could raise the blood sugar levels of cancer patients with an intravenous infusion of a simple sugar, at the same time as chemotherapy infusions.</p> <p>Cancer researchers have sought for decades to find effective new therapies to improve survival rates. In the case of pancreatic cancer, the median survival of patients with disease that has spread is just eight to 11 months, and the five-year survival rate is around 3 percent. About 60,000 new cases of pancreatic cancer are diagnosed annually in the United States.</p> <p>“Our patients need better treatment options urgently,” says Dr. Winter.</p> <h3>Related Links</h3> <p>At <a href="/services/cancer-services">University Hospitals Seidman Cancer Center</a>, our care team provides the most advanced forms of cancer care, from prevention, screening, diagnosis, treatment through survivorship.</p>Tue, 30 Jan 2024 08:00:00 -0500{19130BDE-8F5D-4805-88EA-5738379457AF}https://www.uhhospitals.org/blog/articles/2024/01/food-and-autism-is-your-child-a-picky-eaterFood and Autism: Is Your Child a Picky Eater?<p>Many children are described as picky eaters during different stages of their development. Children with autism spectrum disorder (ASD) are more likely to have significant issues related to food and eating.</p> <p><a href="/doctors/Barry-Christine-1427078302">Christine Barry, PhD</a>, a pediatric neuropsychologist with University Hospitals Rainbow Babies and Children’s, shares strategies to help parents when choosing and preparing food for a child with autism.</p> <h2>How Autism Affects Eating Habits</h2> <p>Common symptoms of <a href="/rainbow/services/pediatric-developmental-and-behavioral-issues/autism">autism</a> include an insistence on sameness, rigidity and sensory issues – all of which can interfere with food choices and eating. Children with ASD often have very restricted diets, with a preference for only a few food items. For example, they tend to be routine-oriented, they may only eat foods on a certain colored plate or in a specific order.</p> <p>In addition, children with ASD often have aversions to certain smells, textures or flavors, which further limits their food choices. These issues make it difficult for parents to ensure their child is eating a well-balanced diet. It can also contribute to a stressful mealtime experience for the entire family.</p> <p>Children with autism are also more prone to <a href="/rainbow/services/pediatric-gastroenterology">gastrointestinal (GI) issues</a>, such as diarrhea or constipation, and may have specific food allergies. If you’re concerned about your child’s limited diet, first discuss options with your pediatrician. A referral to a GI specialist may be a good place to start to rule-out any underlying medical condition contributing to your child’s picky eating.</p> <h2>Ease in New Foods</h2> <p>Children with ASD may avoid certain foods or types of food. Rather than forcing the issue, try taking it step by step:</p> <ul> <li><strong>Look at pictures of new foods in books or magazines.</strong> Bring your child to the supermarket and ask them to help you choose a new food to try together.</li> <li><strong>Prepare the food, but don’t force your child to try it.</strong> Your child could start by just smelling or licking the new food the first time it’s offered. Sometimes getting familiar with new foods in a low-pressure, positive way can help your child expand their diet. You can do this for several days in a row.</li> <li><strong>Try introducing new foods that are similar to something your child already likes.</strong> For example, if they like maple and brown sugar oatmeal, try offering apple and cinnamon oatmeal.</li> <li><strong>Praise your child for every small step.</strong> Give positive feedback as your child makes progress towards tolerating looking at, smelling, licking and tasting new foods.</li> </ul> <h2>Make Mealtimes Comfortable</h2> <p>Most kids with ASD like to keep things predictable. Making mealtimes as routine as possible will help your child feel more comfortable and less stressed about eating. Here are some tips:</p> <ul> <li>Prepare your child in advance of eating with a mealtime story.</li> <li>Try to serve meals at the same time every day.</li> <li>Let your child choose their seat at the table.</li> <li>Include one of your child’s favorite foods at every meal.</li> <li>When dining out, prepare your child as much as possible. Make a reservation so you don’t have to wait and print out the menu ahead of time.</li> <li>Have a “plan B” dish that your child likes in case their favorite food isn’t available.</li> </ul> <h2>Ask for Help</h2> <p>If you’re concerned about your child’s diet or eating habits, ask your provider or a nutritionist for help. You could also consider working with an occupational therapist to develop a feeding program.</p> <p>According to <a href="/doctors/Diekroger-Elizabeth-1477724110">Elizabeth Diekroger, MD</a>, a developmental/behavioral pediatrician with UH Rainbow, “If you are considering any special diets, talk with your child’s healthcare provider first. You may want to work with them or a nutritionist to get started. Sometimes limiting the diet of child that is already restricted can make it challenging to maintain appropriate nutrition.”</p> <h3>Related Links</h3> <p>UH Rainbow offers an annual webinar series designed to improve understanding of the medical, behavioral, social and educational issues related to ASD. Speakers and topics focus on practical interventions and techniques for families with children on the spectrum. <a href="/rainbow/services/pediatric-developmental-and-behavioral-issues/autism">Learn more.</a></p>Mon, 29 Jan 2024 19:00:00 -0500{F2CFB63F-E46D-4F43-AE3F-8122A560DC38}https://www.uhhospitals.org/blog/articles/2024/01/is-joint-pain-worse-in-cold-weatherIs Joint Pain Worse in Cold Weather?<p>People often blame cold weather or an impending storm for their increased joint pain. Are the two connected? And if so, what’s really causing the pain?</p> <p>“It’s true that you can have more symptoms in cold weather, humid climates and when storms approach,” says University Hospitals rheumatologist <a href="/doctors/Kuchynski-Marie-1780764977">Marie Kuchynski, MD</a>. “People who scoff at the idea probably don’t notice weather-related joint pain because their joints are healthy and adjust well to weather changes.”</p> <h2>How Weather May Affect Joints</h2> <p>A number of weather-related factors can affect joint physiology. Depending on your <a href="/services/rheumatology-services">joint health</a> – especially with aging or arthritis or prior trauma – certain weather conditions can increase joint pain and/or stiffness.</p> <p><strong>Cold:</strong> Joints have two structures that enable easy and pain-free movement. Cartilage cushions bone surfaces to reduce wear and synovial fluid lubricates the joint so it moves smoothly. Healthy synovial fluid is the consistency of egg whites. But when the weather gets colder, synovial fluid thickens. This reduces its slipperiness, which increases joint friction during movement and, over time, wears down protective cartilage. More friction results in more pain.</p> <p><strong>Barometric pressure:</strong> When air pressure drops, the joints sense and respond to it. Soft tissues around the joint expand slightly under lower air pressure. The swelling increases pressure on the joint, resulting in stiffness and discomfort or pain during movement.</p> <p><strong>High humidity:</strong> When the barometric pressure drops, rain or snow are also more likely. High humidity can cause soft tissue swelling and bring more discomfort to the joints. This is especially true in colder temperatures.</p> <h2>Other Factors Matter, Too</h2> <p>Additional factors can make people more susceptible to weather-related joint pain:</p> <p><strong>Nerve hypersensitivity:</strong> Joints irritated by injury, inflammation due to arthritis, or surgical joint repair or replacement can make the nerves in that area hypersensitive to weather-related factors. This increases sensations of pain, numbness or burning.</p> <p><strong>Reduced activity:</strong> When it’s cold outside, we tend to be less active. When combined together, the cold temperatures and inactivity allow joints to stiffen. Flexibility suffers and joint pain often increases as a result.</p> <h2>How to Ease Weather-Related Joint Pain</h2> <p>Having a variety of tools in your arsenal can help you prepare for and manage when weather-related joint pain may be in the forecast:</p> <ul> <li><strong>Keep joints warm.</strong> When temperatures drop or conditions are wet, take extra care to keep yourself warm. Wear warm socks and extra layers. Take a bath or hot shower. Use a heating pad when you’re relaxing. All of it will help decrease pain and stiffness.</li> <li><strong>Explore pain relief options.</strong> Talk with your doctor about prescription and over-the-counter medications to help make your pain more manageable. Many people find also relief with arthritis cream or other topical balms.</li> <li><strong>Skip heavy lifting or exertion.</strong> On days that you’re feeling more pain or stiffness, don’t strain your joints by pushing your body too far. Stick to gentle movements and stretching.</li> </ul> <p>Most importantly, be sure to plan range of motion activities into your day, especially on those cold, damp days when going outside for a walk is not possible. “Movement is medicine. It is the one of the best things you can do to keep your joints mobile and pain free, no matter what the weather is,” advises Dr. Kuchynski.</p> <h3>Related Links</h3> <p>The Division of Rheumatology at University Hospitals offer a comprehensive approach to the diagnosis, management and treatment of rheumatic diseases in adults and children. <a href="/services/rheumatology-services">Learn more.</a></p>Fri, 26 Jan 2024 08:00:00 -0500{A695FF16-5801-4767-A49A-6C5BB8DD299D}https://www.uhhospitals.org/blog/articles/2024/01/top-10-nutrition-and-exercise-questions-answeredTop 10 Nutrition & Exercise Questions Answered<p>When it comes to diet and exercise recommendations, there’s a lot of confusion out there. Which foods are good for you and which ones should you avoid? How much exercise do you really need? </p> <p>The truth is, research is always evolving. What’s considered healthy today, might be deemed unhealthy tomorrow. So how can you make the best choices? <a href="/doctors/Wolf-Jacob-1639506710">Dr. Jacob Wolf, ND</a>, a naturopathic doctor at <a href="/services/integrative-health-network">University Hospitals Connor Whole Health</a>, shares the latest research.</p> <h3>COFFEE: GOOD OR BAD? </h3> <p><a href="/blog/articles/2023/04/the-health-benefits-of-coffee">Coffee</a> is considered healthy by the latest research. It’s a great source of antioxidants and studies suggest it lowers the risk of cancer, Parkinson’s disease, Alzheimer’s disease and type 2 diabetes. “You can drink too much coffee, however,” says Dr. Wolf. “Four to five cups is the daily maximum for most people to reap the benefits without the jitters.” For maximum benefit, coffee should be black with no added sweeteners.</p> <h3>8 GLASSES OF WATER A DAY?</h3> <p>The amount of fluid needed varies from person to person and from day to day – there is no magic number for optimal hydration. “Listen to your body,” advises Dr. Wolf. “If you’re thirsty, drink something. If your <a href="/blog/articles/2023/09/what-does-the-color-of-your-urine-mean">urine isn’t clear or very light yellow</a>, you need to hydrate.” Choose beverages without added sugar and increase your fluid intake during periods of intensive activity or exercise, when you’re outside in the heat, and if you’re pregnant or breastfeeding.</p> <h3>FRUITS & VEGETABLES: FRESH OR FROZEN? </h3> <p>Frozen fruits and vegetables are just as nutritious as fresh, maybe even more so since they’re frozen at the peak of freshness. “The big thing you need to watch out for is added salt and sugars,” says Dr. Wolf. “Read the labels and only buy frozen produce that is free of any additives.”</p> <h3>IS ORGANIC PRODUCE BETTER? </h3> <p>Choosing organic produce can reduce the risk of exposure to pesticides and other chemicals, but it comes at a price. Here’s a good rule of thumb: If you eat the whole item (berries, lettuce, apples, grapes, peppers etc.), choose organic. If you’re peeling it before eating (pineapples, bananas, onions, melon), then conventional is probably okay.</p> <h3>IS LOW FAT ALWAYS HEALTHIER?</h3> <p>“Dietary fat is a category that’s changed a lot in recent years. In the 90s, fat was bad. Now we’ve totally changed our tune and fat is good,” says Dr. Wolf. “Although low-fat can be beneficial in some instances such as dairy, we need fat in our daily diet to be healthy.” Good sources include nuts and seeds, avocados, olives and olive oil. Even getting some fat from a piece of grass-fed steak is better than getting the same amount from a cupcake or a donut. </p> <p>“And beware of anything labeled as fat-free,” says Dr. Wolf. “This usually means that a whole bunch of chemicals, sugars and artificial ingredients have been added to make it palatable.”</p> <h3>SUGAR VS. ARTIFICIAL SWEETENERS</h3> <p>Ideally, you shouldn’t be using sweeteners at all. However, it’s generally better to use a small amount of real sugar or honey instead of an artificial, calorie-free sweetener. Recent research shows that artificial sweeteners can raise your insulin levels and increase the risk of developing type 2 diabetes and cardiovascular disease. They can also change the bacteria in the gut, negatively affecting both digestion and bowel movements.</p> <h3>YOU CAN’T GET ENOUGH PROTEIN FROM A PLANT-BASED DIET</h3> <p>False. “Even vegans have <a href="/blog/articles/2023/02/plant-based-nutrition-good-for-you-good-for-the-planet">plenty of options for dietary protein</a>,” says Dr. Wolf. “There are beans, tofu, nuts and seeds – and all fruits and vegetables have a little bit of protein. Vegetarians and pescatarians have even more options to increase their protein intake, with fish, dairy and eggs.” And beware of meat alternatives, which often contain chemicals and other additives, including high sodium and sugar levels. Eating beans or a lean piece of chicken or fish is a much healthier choice.</p> <h3>WILD-CAUGHT VS. FARMED SALMON</h3> <p>Salmon is a good dietary choice in general whether it’s wild or farm-raised. “We used to say that wild-caught is always better than farm-raised,” says Dr. Wolf. “But now, the question is more challenging. With increased pollution in our oceans, there are some concerns about chemicals and microplastics in wild-caught fish, whereas farm-raised fish may contain more healthy fats because their diets can be manipulated. My advice is to find the highest quality salmon available and make it a regular part of your diet.” </p> <h3>BREAKFAST: THE MOST IMPORTANT MEAL OF THE DAY?</h3> <p>“People who are more active earlier in the day will benefit from ‘fueling’ up in the morning. And children should always eat a well-balanced breakfast so they have the energy to focus in school,” says Dr. Wolf. “However, with busy schedules and the rising popularity of <a href="/blog/articles/2023/10/is-intermittent-fasting-safe-and-effective-for-weight-loss">intermittent fasting</a>, breakfast is the meal many adults choose to skip. This is okay if you eat appropriately and get sufficient calories later in the day. It’s always good to avoid late-night eating, as some studies show that digestion slows at night and may signal the body to store more fat,” he adds. </p> <h3>10,000 STEPS A DAY? REALLY?</h3> <p>Similar to fluid intake, the optimal number of steps per day is different for every person. Some newer research suggests that for people under the age of 60, approximately 8,000 steps a day may be sufficient, whereas individuals over 60 should aim for somewhere between 6,000 and 8,000 daily steps. “You should look at it as more than just steps,” says Dr. Wolf. “What’s really important is active time – everyone needs a certain number of minutes spent in moderate or vigorous activity based on their age, which can include a <a href="/blog/articles/2022/05/is-walking-good-enough-exercise">variety of activities</a>.”</p> <h3>Related Links: </h3> <p>At <a href="/services/integrative-health-network">UH Connor Whole Health</a>, we take the whole person into account, addressing the full range of physical, emotional, mental, social, spiritual and environmental influences that affect an individual’s health. This includes exploring diet and nutritional needs.</p>Thu, 25 Jan 2024 08:00:00 -0500{4B544567-19A9-47ED-8374-7C66F7FDF036}https://www.uhhospitals.org/blog/articles/2024/01/treating-the-severe-pelvic-pain-of-endometriosisTreating the Severe Pelvic Pain of Endometriosis<p><a href="/services/obgyn-womens-health/conditions-and-treatments/general-gynecology/conditions-and-treatments/endometriosis">Endometriosis</a> is a condition that affects many women and is one of the most common sources of <a href="/services/obgyn-womens-health/conditions-and-treatments/female-pelvic-health/conditions-and-treatments/chronic-pelvic-pain">pelvic pain</a>. </p> <p>While we don’t know exactly what causes endometriosis or how to prevent it, there are ways to manage the symptoms. The pain from endometriosis can be debilitating, and women no longer need to suffer needlessly with the variety of treatment options available, says University Hospitals OB/GYN <a href="/doctors/Griebel-Lauren-1194188441">Lauren Griebel, MD</a>. </p> <h2>Pain That Interferes With Daily Life</h2> <p>Endometriosis occurs when cells similar to the cells that line the inside of the uterus are found in the pelvis, outside the uterus. Just like the lining of the uterus, this tissue thickens and breaks down with each menstrual cycle. But the tissue has no way to leave the body, so it become trapped. The buildup of endometrial tissue can lead to inflammation, scarring and other issues in and around the reproductive organs. </p> <p>This can cause a variety of symptoms, including very painful periods, pain with sex, and pain with urination and bowel movements. Repeatedly tensing up the pelvic muscles in response to this pain can lead to even more painful muscle spasms that won’t relax on their own. Scar tissue from endometriosis can also make it difficult for some women to get pregnant. </p> <p>Endometriosis affects up to 10 percent of women of childbearing age, and there are likely many more women affected but undiagnosed. For many, endometriosis is a huge source of chronic pain, which can interfere with everyday life. Dr. Griebel says this type of debilitating pain is not normal, and anyone experiencing it should talk to their doctor. </p> <p> “If you are experiencing extreme pelvic and period pain that makes you miss days of school or work, something else is probably going on," she says. </p> <h2>Treating Endometriosis</h2> <p>Surgery is the only way to definitively diagnose endometriosis, though symptoms can be managed without an actual diagnosis. During a diagnostic laparoscopic surgery, the surgeon uses a thin tube and camera inserted through the abdomen to look at the tissue around the uterus. They can then take a sample of any suspicious tissue and perform a biopsy. The biopsy can confirm if the patient has endometriosis. </p> <p>Endometriosis can be managed with medication, surgery or both: </p> <p><strong>Medication.</strong> Medical management focuses on suppressing endometriosis and its symptoms. This is the preferred initial treatment, especially for younger patients. It can slow the growth of endometrial tissue, help prevent the disease from advancing, and make patients feel a lot better, says Dr. Griebel. </p> <p>Medications can include birth control pills and other hormonal contraceptives such as Nuvaring and intrauterine devices (IUDs). Another medication that can be prescribed for endometriosis is Orilissa (elagolix). This medication can decrease the body’s estrogen levels, which can be helpful for relieving endometriosis pain. </p> <p><strong>Surgery.</strong> There are an array of surgeries used to treat endometriosis, depending on the severity and other individual factors. Laser ablation uses heat to destroy the endometrial tissue and may be helpful for patients with milder endometriosis. Surgically removing the endometrial tissue, or excision, is the preferred surgical treatment for most patients and is thought to improve long-term pain control and slow the recurrence of endometriosis. Both surgeries are done laparoscopically, through small incisions in the abdomen. </p> <p>Research indicates that a hysterectomy, or surgery to remove the uterus, is not an effective treatment for endometriosis. Dr. Griebel says it doesn’t prevent reoccurrence, and is not a cure. Hysterectomy also makes pregnancy impossible, so it should not be considered unless the patient is no longer interested in preserving their fertility. </p> <p><strong>Pain management. </strong>In addition to medication and surgery, endometriosis pain can be controlled with pelvic floor therapy and intermittent muscle relaxers. </p> <h2>Infertility and Pregnancy</h2> <p>While some women with endometriosis experience <a href="/services/obgyn-womens-health/conditions-and-treatments/fertility-and-reproductive-health">infertility</a>, others do not have a problem getting pregnant. Scar tissue from endometriosis can block the fallopian tubes and cause inflammation that may make pregnancy more difficult to achieve. Surgery to remove endometrial and scar tissue can help these women increase their chances of getting pregnant. </p> <p>Women with endometriosis can safely carry a pregnancy to term, and endometriosis alone doesn’t put a woman at higher risk for pregnancy complications, though it may make it harder to perform a C-section if needed. Once pregnant, many women find they feel better and have less pain since they’re no longer experiencing menstrual periods. </p> <h3>Related Links</h3> <p>The <a href="/services/obgyn-womens-health">women’s health experts</a> at University Hospitals are experienced in treating the full range of gynecologic conditions and have expertise in both medical management and surgical treatment of <a href="/services/obgyn-womens-health/conditions-and-treatments/general-gynecology/conditions-and-treatments/endometriosis">endometriosis</a> and other causes of <a href="/services/obgyn-womens-health/conditions-and-treatments/female-pelvic-health/conditions-and-treatments/chronic-pelvic-pain">female pelvic pain</a>. </p>Wed, 24 Jan 2024 19:00:00 -0500{DD0755D9-60AD-41BF-8EA5-8144056469D1}https://www.uhhospitals.org/blog/articles/2024/01/the-benefits-of-strength-training-for-young-athletesThe Benefits of Strength Training for Young Athletes<p>More and more children are participating in competitive sports at younger ages, and for the most part, this is a healthy trend. It’s important to recognize, however, that organized sports activities place more demands on growing bodies and, without proper training and supervision, can lead to overuse injuries. “Regardless of their age or ability level, age-appropriate strength training can be performed safely in young athletes,” says <a href="/doctors/WeissKelly-Amanda-1811913254">Amanda Weiss Kelly, MD</a>, pediatric sports medicine specialist at University Hospitals. </p> <h2>A Wide Variety of Health Benefits</h2> <p>Strength training is designed to enhance muscle strength, improve sports performance, increase endurance and reduce the risk of injury. Programs may include the use of free weights, kettlebells, elastic stretch bands or a person’s own body weight to provide the resistance needed to increase strength.</p> <p>Research has demonstrated that supervised, technique-driven strength training programs can reduce the risk of sports-related injuries. In addition, strength training can provide the following health benefits:</p> <ul> <li>Improved blood sugar levels</li> <li>Increased bone density (especially in girls)</li> <li>Enhanced muscle development, coordination and overall strength</li> <li>Improved ability to move functionally in life</li> </ul> <p>“And, for overweight or less active children, strength training is a nice introduction to exercise that can have positive results in a relatively short time. Generally, after just 4-6 weeks of training, children will have more stamina when performing day-to-day tasks such as climbing stairs. This, in turn, can increase their confidence and inspire children to continue their athletic pursuits,” says Dr. Weiss Kelly.</p> <h2>Proper Supervision Is Key to Safety & Success</h2> <p>“The accepted premise is, the younger the child, the more supervision needed for safe, effective strength training,” says Dr. Weiss Kelly. “Ideally, the supervision ratio should be one trainer to one child until age 11. Athletes in the high school age range who have trained consistently and have good technique can typically move to sessions with a 1:15 supervision ratio, and at the college level, 1:20 is usually sufficient.”</p> <p>“In addition to a gradual decrease in supervision levels, the resistance exercises performed in strength training will change with experience level, gradually becoming more demanding. Proper form and technique is always emphasized throughout the progression,” adds Dr. Weiss Kelly. </p> <p>To ensure your child receives the safest, most effective strength training, it’s important to choose a professional program that follows the latest <a href="/services/orthopedic-services/conditions-and-treatments/sports-medicine-services/youth-sports-programs/youth-strength-training/guidelines">youth strength training guidelines</a> set forth by the American Academy of Pediatrics (AAP). In addition, all children should receive clearance from their pediatrician before beginning any new exercise program.</p> <h3>Related Links: </h3> <p><a href="/services/orthopedic-services/conditions-and-treatments/sports-medicine-services">University Hospitals Drusinsky Sports Medicine Institute</a> partners with T3 Performance to offer <a href="/services/orthopedic-services/conditions-and-treatments/sports-medicine-services/youth-sports-programs/youth-strength-training">strength training classes</a> to children and adolescents six years of age and older. The T3 coaches follow all recommended AAP guidelines to provide safe, supervised and age-appropriate training sessions for young athletes. </p> <p> The <a href="/rainbow/services/pediatric-sports-medicine">pediatric sports medicine experts</a> at University Hospitals Rainbow Babies & Children’s are dedicated to treating athletes of any age – from toddlers to adolescents and young adults. </p>Tue, 23 Jan 2024 19:00:00 -0500{4213F1F6-62AA-448C-BD10-1A73812CD77E}https://www.uhhospitals.org/blog/articles/2024/01/how-to-eat-safe-after-a-power-outageHow to Eat Safe After a Power Outage<img class="UH-Inline-Image-Large" alt="Infographic: How to Eat Safe After a Power Outage" src="/-/media/Images/Blog/Power-Outage-Infographic.png?la=en&hash=0905628301B6507EA5701F4BC3BC47C86AE3523E" />Fri, 19 Jan 2024 19:00:00 -0500{BFD527C1-DBEC-436C-BC81-8C2BB7FD7F5D}https://www.uhhospitals.org/blog/articles/2024/01/can-you-drink-too-much-waterCan You Drink Too Much Water?<p>We often hear about the importance of drinking plenty of water. But did you know that drinking too much water can be bad for your health?</p> <p>Drinking excessive amounts of water can overwhelm your kidneys and dilute the sodium content of your blood. The condition is sometimes called water intoxication or hyponatremia. When this happens, water moves into cells – including brain cells – and can cause swelling. Hyponatremia can lead to a host of symptoms, including:</p> <ul> <li>Headache</li> <li>Nausea or vomiting</li> <li>Fatigue</li> <li>Confusion</li> <li>Muscle cramping or weakness</li> </ul> <p>Severe cases can lead to seizures, loss of consciousness or death, though these occurrences are rare. In 2007, hyponatremia caused the death of a radio show contestant after she took part in a water-drinking contest and reportedly drank nearly two gallons over two hours. More recently, actress Brooke Shields said she had a grand mal seizure caused by drinking too much water.</p> <h2>How Much Water is Enough?</h2> <p>The widespread belief that you should drink eight, 8-ounce glasses of water a day for good health is a myth. There is no scientific research behind it.</p> <p>There’s no standard amount of water you should <a href="/blog/articles/2023/11/how-much-water-do-you-really-need">drink daily</a> – it varies person to person and depends on health conditions and levels of physical activity. The National Academy of Medicine estimates an optimal daily fluid intake is approximately 15 cups for healthy men and 11 cups for women. That includes fluids consumed from foods and beverages. About 20 percent of your daily fluid intake comes from foods.</p> <p>A good rule of thumb for healthy people is to drink according to thirst. Older adults may have a decreased level of thirst and should make it a point to drink water even if they’re not thirsty. <a href="/blog/articles/2023/09/what-does-the-color-of-your-urine-mean">Urine color</a> is another good gauge of hydration: Light yellow is good. Dark yellow indicates dehydration. Also, you may need to drink more than usual if you have vomiting or diarrhea.</p> <h2>How Much Water Is Too Much?</h2> <p>There is no set amount of water that causes water intoxication. The kidneys can process about one liter of fluid per hour, so any amount above that over a number of hours can be risky.</p> <ul> <li>Among healthy people, <a href="/blog/articles/2021/08/water-carbs-and-race-day-eating-what-endurance-athletes-should-know">endurance athletes</a> tend to be at greatest risk for overhydrating.</li> <li>Certain medical conditions such as kidney and liver disorders can contribute to overhydration.</li> <li>Certain drugs such as diuretics, anti-psychotics and ecstasy can increase thirst and lead to overhydration.</li> </ul> <h3>Related Links</h3> <p>University Hospitals has a team of <a href="/services/clinical-nutrition-services">clinical dietitians</a> with the expertise to provide counseling and personalized eating plans for anyone looking to enhance their health, meet nutritional goals or lose weight safely and effectively.</p>Thu, 18 Jan 2024 07:00:00 -0500{E7A53633-E731-4935-9E47-AA0A800D10A4}https://www.uhhospitals.org/blog/articles/2024/01/why-arent-more-older-adults-getting-the-rsv-vaccineWhy Aren’t More Older Adults Getting the RSV Vaccine?<p>The first vaccines to prevent RSV in older adults were approved in 2023. But so far, only a small percentage of adults are taking advantage of it.</p> <p>“Everybody knows about flu and the flu vaccine has been around for a long time,” says <a href="/doctors/Edwards-Amy-1295916864">Amy Edwards, MD</a>, a pediatric infectious disease specialist at <a href="/rainbow">University Hospitals Rainbow Babies & Children’s</a>. “RSV tends to be just as serious an illness as flu for older adults, yet not many people are aware of it.”</p> <p>A <a href="https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciad658/7451197?login=false">recent study</a> found that if older people received the RSV vaccine at the same rate as the flu vaccine, it would cut hospitalizations and deaths by as much as 60 percent the first year. Early data shows that only about 17 percent of people 60 and older have gotten the vaccine this respiratory season. By comparison, about 70 percent of people 65 and older have gotten a flu shot.</p> <h2>What Is RSV?</h2> <p>RSV is a highly transmissible virus that causes infections of the lungs and respiratory tract. RSV season begins in fall, peaks during the winter and ends in the spring. Historically, it’s been known as a virus that primarily affects young children. Improved testing, however, has shown that RSV also causes significant numbers of hospitalizations and deaths in people over age 60.</p> <p>“RSV is something we’ve dealt with in pediatrics since time immemorial, but in the adult world it wasn’t tested for a long time,” she says. “Older people would come in very sick with respiratory illness, but if they tested negative for the flu the illness was just labeled a viral infection.”</p> <p>Adults most vulnerable for serious disease are older with weakened immune systems or chronic heart and lung diseases. “People think it’s a pediatric problem, but people over 60 can end up in the hospital. They can end up in the ICU and they can die from RSV,” Dr. Edwards says.</p> <p>RSV causes an estimated 60,000 to 160,000 hospitalizations and 6,000 to 10,000 deaths per year among U.S. adults 65 and older, according to the Centers for Disease Control and Prevention.</p> <h2>New Vaccines Offer Powerful Protection</h2> <p>The FDA has approved two RSV vaccines, Arexvy and Abrysvo. In clinical trials, Arexvy and Abrysvo were highly effective at preventing severe illness in older adults. Abrysvo was also approved for pregnant women. Research shows the vaccines provide protection for two respiratory seasons, with diminished protection the second year.</p> <p>Dr. Edwards says aside from lack of awareness about RSV and the vaccine, more people have become reluctant to vaccinate themselves and their children because of mistrust fueled by politicization of the COVID-19 vaccines.</p> <p>“It still hasn’t translated out in the community. A lot of people just don’t know what RSV is and they don’t know the impact it’s having on older adults,” Dr. Edwards says.</p> <p>“If everybody got all three of their shots (for RSV, flu, and COVID-19), we’d empty out our hospitals. We have the tools to fundamentally change respiratory viruses in America. We have to do better and protect more people.”</p> <h3>Related Links</h3> <p>The experts at University Hospitals have the expertise to diagnose and treat a wide range of infectious diseases, including viral, bacterial and fungal pneumonia in both adults and children. Learn more about our vast network of <a href="/services/primary-care">primary care providers</a> and <a href="/rainbow/services/pediatrics">pediatricians</a>.</p>Tue, 16 Jan 2024 08:00:00 -0500{B84B87A5-7A81-4563-B114-8B31E7164AB9}https://www.uhhospitals.org/blog/articles/2024/01/coronary-bypass-surgery-patient-celebrates-her-102nd-birthdayCoronary Bypass Surgery Patient Celebrates Her 102nd Birthday<p>Cecilia Zarobila of Cleveland celebrated her 102nd birthday with the physician and medical team who have helped keep her alive and well for so long.</p> <p>Just before she turned 80, Cecilia began experiencing severe shortness of breath. Her cardiologist, <a href="/doctors/Farah-Michel-1780603563">Michel Farah, MD</a>, of <a href="/services/heart-and-vascular-services">University Hospitals Harrington Heart & Vascular Institute</a>, diagnosed her with congestive heart failure. An ultrasound showed a very weak heart, which was not pumping blood throughout her body successfully. A cardiac catheterization revealed that two major coronary arteries were completely blocked and other branches had severe disease.</p> <p>On April 27, 2001, at the age of 79, Cecilia underwent quadruple coronary artery bypass surgery. The next few weeks were touch and go for her. Her chest was kept open for several days to help stabilize her. Cecilia had an abnormal heart rhythm and was on a respirator for 17 days. But with excellent postoperative care, she recovered, and her heart strengthened.</p> <p>“Traditionally, younger patients fare better after bypass surgery, but Cecilia would not be alive today if we hadn’t completed hers at age 79,” said Dr. Farah. “It has been a joy to follow her health for more than two decades and to see her come into my office happy and healthy.”</p> <p>Cecilia turned 102 in December 2023. During her cardiology appointment that month at <a href="/locations/uh-health-center-at-chagrin-highlands">UH Minoff Health Center</a>, Dr. Farah and team surprised Cecilia with a small celebration. Dr. Farah continues to treat Cecilia for hypertension, high cholesterol and aortic valve disease.</p>Sun, 14 Jan 2024 19:00:00 -0500{3BABAD43-F0EB-4C6E-AED5-2386D9FC9A5E}https://www.uhhospitals.org/blog/articles/2024/01/how-expressive-therapies-help-patients-healHow Expressive Therapies Help Patients Heal<p>When the stress of a life-changing diagnosis or the crush of pain or depression hits hard, expressive therapies – art, music and movement – can provide relief, hope and healing.</p> <p>Expressive therapies allow and empower people to express themselves – their concerns, feelings and thoughts – in creative and nonverbal ways. Expressive therapy also uses the arts to restore a sense of self and wholeness. This can be especially helpful for those with challenging health issues such as cancer, stroke, disabilities or a chronic illness.</p> <p>“The expressive therapies – art, music and movement – are truly effective ways to process and manage stress, pain, depression and anxiety, and to promote rest and healing. These non-pharmacological approaches have a clinically significant impact on challenging patient experiences, and may improve both immediate and long-term outcomes,” says University Hospitals board certified music therapist and the Lauren Rich Fine Endowed Director of UH Connor Whole Health’s Expressive Therapies <a href="/services/integrative-health-network/meet-the-team/music-therapists/seneca-block-ma-mt-bc">Seneca Block, PhD(c), MT-BC</a>. “Our research shows that modalities such as music therapy offer, on average, a 20 percent decrease in a patient’s reported pain.”</p> <h2>The Benefits of Expressive Therapies</h2> <p>Expressive therapy’s primary goal is to reduce patient experiences such as depression, anxiety, stress, pain and fatigue. The secondary goal is to provide a way to cope through self-discovery and expression. While helping patients is the focus, family members, caregivers and others can also benefit.</p> <p><strong>Art therapy.</strong> An <a href="/services/integrative-health-network/our-services/art-therapy">art therapist</a> guides each session by demonstrating how to use materials for self-expression, allowing patients to create art with personal meaning. Mediums may vary from abstract or realistic. Color, texture, movement, material, size, shape and other tools help explore feelings and can bring new discoveries, insight and inspiration. Calm scenes or color tones may promote relaxation and relief. Soaring skyscrapers and bold colors or shapes may inspire strength and positivity. Objects or subjects in the artwork may restore fond memories that soothe. As a result, patients find rest, joy, strength and more, bringing hope and healing.</p> <p>Beyond the pursuit of personal expression and insight, patients can also choose to create art for or with their family or caregiver. Sharing the artwork can help family members, caregivers and others understand and connect with the patient.</p> <p><strong>Music therapy.</strong> Music influences a person physically, mentally and emotionally. It can provide comfort, or ease anxiety, lift the spirit or even motivate movement. It can help people recognize and work through difficult feelings and times in life. Music transforms the listener and allows for relief through distraction, joy and interaction. It can relieve depression, boost mood, reduce stress and aid relaxation, which can reduce pain, improve sleep and promote healing.</p> <p>During <a href="/services/integrative-health-network/our-services/music-therapy">music therapy</a>, patients can choose to simply listen to music or actively participate by singing or playing instruments. Patients with severe pain, anxiety and stress often benefit from music-assisted guided imagery, a relaxation technique that focuses on breath, meditation and live music.</p> <p>Beyond its value to the intended individual, when music therapy services offered to one patient are overheard, the positive impact can spread to nearby caregivers and patients. They may listen, hum or sing along and share in its benefits.</p> <h2>What Expressive Therapy Offers</h2> <p><strong>Expert care.</strong> Music and art therapists hold bachelor and graduate degrees in their chosen specialties, complete internships, and are board certified by their national accreditation bodies.</p> <p><strong>Individual and group sessions.</strong> Services are available for individuals and groups, depending on the patient’s circumstances. Group sessions allow patients to share their experiences and learn from each other. Individual sessions provide more privacy for personal exploration.</p> <p><strong>Ongoing stress reduction.</strong> Therapists assist patients in learning new, creative stress-reduction techniques that they can continue to use on their own outside of the therapy. “We see incredible changes through expressive therapies,” says Block. “They are truly an innovative way to use elements as ancient as art, music and dance within the modern healthcare setting in ways that are both clinically effective and comforting.”</p> <h3>Related Links</h3> <p>At <a href="/services/integrative-health-network">UH Connor Whole Health</a>, we take the whole person into account, addressing the full range of physical, emotional, mental, social, spiritual and environmental influences that affect an individual’s health.</p>Sun, 14 Jan 2024 19:00:00 -0500{E4403461-1DC3-4E37-9BDA-3F523CC2043B}https://www.uhhospitals.org/blog/articles/2024/01/the-hero-he-never-metThe Hero He Never Met<p class="UH-Lead">47-year-old with pulmonary fibrosis grateful for the hero he never met following successful double-lung transplant</p> <p>At the age of 47, Ron Ross, an active runner, started experiencing shortness of breath. He was diagnosed with idiopathic pulmonary fibrosis (IPF). IPF has no known cause and leads to scarring and stiffness of the lungs. Early symptoms include chronic dry cough. As the disease progresses, it causes shortness of breath with exertion, which can lead to a decrease in exercise tolerance and promote a more sedentary lifestyle.</p> <p>“It was devastating,” Ron said. “I went from running every day to not being able to walk up the steps in my house.”</p> <p>A sedentary lifestyle didn’t feel like an option for this runner, husband and father of three.</p> <p>But Ron’s condition continued to decline, and soon he began fighting just to stay alive. His oxygen levels dropped so low that he required hospitalization at University Hospitals Cleveland Medical Center. One day in April of 2022, he “crashed” and was placed on a ventilator.</p> <p>"In Ron's case, unfortunately his disease progressed very quickly. However, this is not uncommon with pulmonary fibrosis,” said <a href="/doctors/Kilaru-Silpa-1033378013">Silpa Kilaru, MD</a>, Ron’s pulmonologist and the medical director of the <a href="/services/transplant-services/conditions-and-treatments/lung-transplant">lung transplant program</a> at UH Cleveland Medical Center. “He ended up in our ICU and needed cardiopulmonary support with ECMO, a type of life support for people who have the most severe heart and lung failure. He was placed on the list for lung transplant.”</p> <p>Ron waited only a few days before a pair of lungs that matched became available. He underwent a double-lung transplant at UH Cleveland Medical Center on April 22, 2022. His ordeal was fast and furious – only 22 months from diagnosis to transplant.</p> <p>"That person is the hero I never met,” said Ron. “I really, really from the bottom of my heart thank them so much. I don't think anyone has any idea how grateful a donor recipient is. I know my whole family is thankful for the gift that person decided to give."</p> <p>Ron spent two months in the hospital. He fought through delirium and muscle atrophy. Post-transplant, he participated in physical therapy and pulmonary rehab.</p> <p>It took Ron more than 18 months to get back to almost 100 percent.</p> <p>During the 2023 holiday season, Ron reported he was doing medium-paced walks and was “almost” back to running.</p> <p>He calls Dr. Kilaru a miracle worker.</p> <p>“Ron’s story had a positive outcome because of early intervention,” said Dr. Kilaru. “Whenever patients have any signs of lung disease, particularly pulmonary fibrosis on imaging, they need to pursue evaluation as soon as possible. We’re thrilled Ron is doing well and living life with his family. It is truly an inspirational story and one that showcases Ron’s tenacity and strength to regain his life after transplant.”</p>Sun, 14 Jan 2024 19:00:00 -0500{E0EC39EA-B458-4667-9DB2-4C7AFC4430CD}https://www.uhhospitals.org/blog/articles/2024/01/does-wine-culture-pose-health-risks-to-momsDoes Wine Culture Pose Health Risks to Moms?<p>Wine culture encourages drinking as a way for women to connect and let off steam from the stresses of motherhood. Many women feel pressure to be an ideal parent or caregiver. As the responsibilities of raising a family add up, it’s no wonder many seek relief.</p> <p>But as alcohol consumption continues to rise, some women may be flirting with danger.</p> <h2>Understand the Risks of Alcohol</h2> <p>“The Dietary Guidelines for Americans define moderate drinking as no more than one drink per day for women and two for men,” says <a href="/doctors/HuckinsBarker-Jamie-1861850927">Jamie Huckins-Barker, PhD</a>, clinical health psychologist and women’s behavioral health specialists at University Hospitals “This definition is only for healthy adults; people with some health conditions may have lower recommended limits.”</p> <p>Women whose drinking exceeds one drink per day might face a variety of risks, including:</p> <ul> <li><strong>Breastfeeding.</strong> Alcohol stays in breast milk for at least two to three hours. Over time, it could decrease your milk supply or affect your baby’s sleep and development.</li> <li><strong>Childcare.</strong> Alcohol may impair your judgment and your ability to tend to infants and young children.</li> <li><strong>Youth drinking.</strong> The harms may extend past early childhood. Adults who regularly drink alcohol tend to pass on the habit to their children by modeling the behavior.</li> <li><strong>Your health.</strong> Alcohol contributes to accidents, weight gain and chronic disease. With heavy drinking on the rise, doctors have noted more deaths from alcohol-associated liver disease among people in their 20s and 30s.</li> </ul> <p>For some people, drinking interferes with their work, relationships, or how they think and feel. If you have any of these thoughts about drinking, you may have a problem with alcohol:</p> <ul> <li>You know it’s harmful in some ways, but you look forward to drinking anyway.</li> <li>You feel guilty about drinking.</li> <li>You think you might need to drink less.</li> </ul> <h2>Your Consumption, Your Choice</h2> <p>Many women fear they’ll miss out on socializing and connecting with others if they curtail their drinking. Fortunately, you don’t have to let social pressures dictate your drinking habits. You can:</p> <ul> <li><strong>Set your own limits.</strong> Identify a drink limit before you go out. Keep track of what you drink to stay within it. Tell a friend to help you stay accountable; you don’t have to do it on your own.</li> <li><strong>Identify an alternative.</strong> Non-alcoholic cocktails are increasing in popularity. They are more widely available, taste good and often look just like alcohol-infused versions.</li> <li><strong>Practice your “no.”</strong> You can’t always avoid alcohol-soaked occasions. But you can decide how you’ll refuse boozy offers. A clear and firm “no thanks” usually works.</li> </ul> <h2>Find Other Ways to Unwind</h2> <p>It’s important for all women – especially those caring for others – to prioritize moments of self-care. When you’re struggling, take a deep breath and run through this checklist:</p> <ul> <li><strong>When was the last time you exercised?</strong> Physical activity, even just a couple minutes of it, is a great stress buster.</li> <li><strong>Are you making your mental health a priority?</strong> Schedule time off from caretaking and multi-tasking in your routine, in the form of a hobby, time outdoors, relaxing exercise, journaling or something else that rejuvenates you. These can be short breaks or longer indulgences like a warm bath or night out with friends. What matters is giving yourself the time.</li> <li><strong>Do you need help?</strong> If you try to cut back or quit and can’t, seek help. Whether it’s sadness you can’t shake or a persistent need to drink, talk with your healthcare provider to find the best treatment. Medications and/or behavioral treatments may work for you.</li> </ul> <h3>Related Links</h3> <p>The board-certified psychiatrists and licensed psychologists at University Hospitals specialize in general and family psychiatry. <a href="/services/adult-psychiatry-psychology">Learn more.</a></p>Fri, 12 Jan 2024 08:00:00 -0500{B62729F5-B6AE-4792-9491-F4F569465A80}https://www.uhhospitals.org/blog/articles/2024/01/heart-test-finds-lung-massHeart Test Finds Lung Mass<p class="UH-Lead">Coronary calcium screening offered at no charge by UH can yield important findings</p> <p>When Wendy DiDomenico’s sister had a heart attack at 55, she decided it was time for a <a href="/services/heart-and-vascular-services/conditions-and-treatments/calcium-scoring-program">coronary calcium score</a> to assess her own risk.</p> <p>An avowed believer in preventive medicine, the Medina Country resident isn’t afraid of screenings such as mammograms for breast cancer and colonoscopies to check for colorectal cancer. The coronary calcium score is a simple, low-dose CT scan of the heart, offered at no charge by University Hospitals. </p> <p>Wendy’s test did not show cardiovascular disease that required any medication or treatment. But a spot on Wendy’s lung needed another look.</p> <h2>“Lit up like a Christmas tree”</h2> <p>At her follow-up scan, Wendy said that the spot on her lung “lit up like a Christmas tree.” She saw the providers at UH Parma’s Lung Nodule Clinic, who were able to diagnose it as a carcinoid tumor. This type of slow-growing tumor responds well to surgery, according to thoracic surgeon <a href="/doctors/Towe-Christopher-1750529111">Christopher Towe, MD</a>, who offered her surgical resection. </p> <p>The Lung Nodule clinic monitors and treats these kinds of masses, which are often found incidentally on radiology tests. Many nodules may not require surgery, Dr. Towe notes, but following their growth over time reassures patients that they are not in danger. According to the American Cancer Society, lung carcinoid tumors account for 1 to 2 percent of all <a href="/services/cancer-services/thoracic-and-esophageal-cancer/lung-cancer">lung cancers</a> and are typically slow-growing, although some can metastasize to other areas of the body.</p> <p>A smoker since her teen years, particularly during her years working as a nurse, Wendy also would have been eligible for a lung CT screening, which the American Lung Association recommends for anyone 50 to 77 years old who has a 20-pack-year history (defined as one pack of cigarettes a day for 20 years or two packs a day for 10 years), or who has quit smoking in the past 15 years. These low-dose CT scans of the lungs can catch cancer before it starts manifesting symptoms in patients.</p> <p>“Lung cancer screening is an invaluable tool to identify early lung cancers in patients with significant tobacco exposure history,” says Dr. Towe, who also offers CT screening to individuals beyond the screening guidelines with significant tobacco exposure history, since cancer risk increases with age. As this screening modality is endorsed by the US Preventive Health Task Force, it is typically covered by insurance.</p> <p>“University Hospitals has been embracing this screening modality given its substantial health benefits,” Dr. Towe says. “My experience with patients is that they see incredible value in the test, as it feels like a great way to inform them of what is happening ‘on the inside.’ Many of my patients feel a sense of guilt or regret from long-term tobacco use, and use lung cancer screening to help motivate them for positive lifestyle modifications such as tobacco cessation.”</p> <h2>Innovation in lung surgeries</h2> <p>UH is not only innovative in tracking and treating these tumors. Wendy received a minimally invasive surgery to remove the tumor from her lung. She was discharged the day after her operation. Specialists like Dr. Towe have published studies on this approach to expedited post-operative care. </p> <p>In articles such as “Early Discharge After Lung Resection Is Safe: 10-Year Experience” published in the <em>Journal of Thoracic Disease</em>, and others in <em>The Annals of Thoracic Surgery</em> and <em>The Journal of Thoracic and Cardiovascular Surgery</em> published over the past five years, UH surgeons have shared their success in discharging patients the day after minimally invasive lung surgery. Dr. Towe reports that UH’s rate of post-op day 1 discharge more than triples the national averages. </p> <p>Lung cancer surgeries were once only performed with a large incision between the ribs called a thoracotomy to reach the lungs. Patients often spent several days in the hospital recovering. Dr. Towe says UH thoracic surgeons transitioned to video-assisted procedures and then to using a surgical robot, which have led to decreased incision size, reduced pain and shorter hospital stays. </p> <p>“In the past, it was common that patients would be in the hospital three to five days, and now many patients are leaving the hospital the first day or two after surgery,” Dr. Towe says. “Our research group at UH has published on the safety and benefits of day 1 discharge, and are leading the way in these super short hospital stays. We believe this innovative approach is associated with fewer complications and a faster return to normal activities. </p> <p>“Many in the thoracic surgery world are reluctant to break with traditional dogmatic approaches of longer stays, but UH has been embracing these innovative strategies to improve patient outcomes.”</p> <h2>Make time for testing</h2> <p>Wendy, only in her late 50s, looks forward to many more years of antiquing, baking, time with her husband and four dogs, and trips to Amish country with friends. Over the next decade, she will make time for an annual CT scan of her lungs.</p> <p>“I’m doing well,” she said. “You’ve got to get your testing done.”</p> <div class="UH-Inline-Callout UH-Inline-Callout-Large"> <div class="UH-Inline-Callout-Content"> <p>UH offers lung cancer screening, as well as extensive cancer-related services through UH Seidman Cancer Center. To learn more, go to <a href="https://UHhospitals.org/lungscreening">UHhospitals.org/lungscreening</a>.</p> </div> </div>Thu, 11 Jan 2024 19:00:00 -0500{723AA853-5EA7-4955-9E29-67EE50DC6BFF}https://www.uhhospitals.org/blog/articles/2024/01/preventing-deep-vein-thrombosis-from-coming-backPreventing Deep Vein Thrombosis from Coming Back<p><a href="/services/heart-and-vascular-services/conditions-and-treatments/vascular-disease/conditions-and-treatments/vein-disorders/conditions-and-treatments/deep-vein-thrombosis">Deep vein thrombosis</a>, or DVT, is a common condition caused by a blood clot in a deep vein, blocking or slowing blood circulation in the body. DVT is a serious condition that thankfully has many effective therapies. However, if you have been diagnosed and treated for DVT, you may be at an increased risk for another blood clot. </p> <p>That’s why it is important to know your risk factors, and stay up-to-date on strategies that can help prevent DVT from recurring, says University Hospitals Director of Vascular Medicine <a href="/doctors/Carman-Teresa-1346354289">Teresa Carman, MD</a>. </p> <h2>DVT Causes and Risk Factors</h2> <p>DVT can occur at any age but is most common in adults over the age of 70. It can develop in any deep vein of the body but is most frequently located in the lower legs, thighs or pelvis. The danger with DVT is if part of the clot breaks off and travels to the lungs. This is called a <a href="/services/pulmonary-and-sleep-services/conditions-and-treatments/pulmonary-embolism">pulmonary embolism</a>, which can be life-threatening. Together, DVT and pulmonary embolism are the third-leading cause of cardiovascular death after heart attack and stroke. </p> <p>There are a number of risk factors and causes of DVT. These include: </p> <ul> <li>Genetic risk for clotting</li> <li>Periods of immobility, such as long flights or bed rest while recovering from an illness or surgery</li> <li>Vessel injury or trauma, including the use of a catheter or pacemaker</li> <li>Hormone therapy or use of hormone contraceptives</li> <li>Pregnancy</li> <li>Smoking</li> <li>Obesity</li> <li>Cancer</li> <li>Immune disorders</li> <li>Inflammation</li> </ul> <h2>How to Prevent DVT from Returning</h2> <p>According to Dr. Carman, the risk for DVT recurrence is quite common. Patients treated for DVT overall have a 40 percent chance of it coming back within 10 years. If the original DVT was caused by a temporary risk factor such as surgery or trauma, it is less likely to recur. But idiopathic DVT (when the cause is unknown) has up to a 50 percent chance of returning. Your doctor should review all your risk factor for recurrence when recommending a treatment plan. </p> <p>Prevention is key. There are a number of strategies that can help reduce your risk of blood clots and DVT recurrence. These include: </p> <p><strong>Medications: </strong>Blood thinners, or anticoagulant medications, may be prescribed by your doctor on either a short- or long-term basis, depending on your risk factors. These are helpful in preventing recurrence as long as you have a low to moderate risk for bleeding, says Dr. Carman. It’s important to have regular visits with your provider while on these medications to monitor and adjust if needed. </p> <p><strong>Compression stockings: </strong>Your provider may also recommend the use of compression stockings to reduce your risk of DVT recurrence. Some data suggests it can be especially helpful in preventing travel-related DVT. Dr. Carman says usually a 20 – 30 millimeters of mercury (mmHG) stocking is recommended, which is prescription-grade compression. If the patient can’t tolerate this level of compression, a 15 – 20 mmHG stocking may be advised instead. </p> <p><strong>Stay active: </strong>Getting physically fit, keeping active and have a weight in the normal range may help reduce your risk. Make sure to talk to your doctor before attempting a new exercise or weight-loss routine. </p> <p><strong>Quit smoking: </strong>Tobacco use is a risk factor for DVT and can also amplify other risk factors such as obesity. Quitting smoking not only reduces your DVT risk, but is also great for your health overall and has numerous other benefits. </p> <p><strong>Travel strategies: </strong>On long flights, make sure to stay hydrated, do foot and ankle mobility exercises and periodically get up and walk. You can wear compression stocking on a flight to help reduce your risk as well. </p> <p> “Given the high likelihood of recurrence, avoiding known DVT triggers is important,” says. Dr. Carman. “This can reduce your overall risk and help avoid complications associated with blood clots and DVT.” </p> <h3>Related Links</h3> <p><a href="/services/heart-and-vascular-services">University Hospitals Harrington Heart & Vascular Institute</a> provides diagnosis and treatment for patients with any condition that affects the body’s blood vessels, including <a href="/services/heart-and-vascular-services/conditions-and-treatments/vascular-disease/conditions-and-treatments/vein-disorders/conditions-and-treatments/deep-vein-thrombosis">deep vein thrombosis</a>. With multiple locations across northern Ohio, our providers offer a complete range of services, from routine examinations and medical treatments to the most advanced surgical interventions and post-treatment follow-up care. </p>Wed, 10 Jan 2024 08:00:00 -0500{D81BDAAF-38E0-4810-AB26-7C1798A85D7B}https://www.uhhospitals.org/blog/articles/2024/01/proper-dental-care-begins-with-baby-teethProper Dental Care Begins With Baby Teeth<p>Healthy teeth are important to your child’s growth and development. They help your child eat and speak properly and smile with confidence.</p> <p><strong>The good news:</strong> Recent stats show that nearly 84% of children in Ohio had a dental visit in the past year.</p> <p><strong>The bad news:</strong> About 23% of U.S. children still get cavities before age 5. In fact, 52% of children 6 to 8 years of age, and 57% of youth 12 to 19 years of age have cavities. The total prevalence of dental cavities in youth 2 to 19 years of age in 2015 to 2017 was 45.8%, according to a recent article.</p> <p>“Primary teeth, also known as baby teeth, hold space for permanent teeth,” explains <a href="/rainbow/find-a-doctor/Kirtland-Kelly-1275535320">Kelly Kirtland, DDS</a>, Chief of <a href="/rainbow/services/pediatric-dental-and-oral-surgery">Pediatric Dentistry</a> at University Hospitals Rainbow Babies & Children’s. “Keeping baby teeth healthy can also save children from the pain of a cavity—and the impact it may have on your child’s ability to learn, focus, and play.”</p> <h2>Care Should Start Before Teeth Develop</h2> <p>Most babies begin teething between 6 months and 12 months of age. But you can protect your child’s oral health from birth.</p> <ul> <li>Don’t put your little one to bed with a bottle of milk, juice, sweetened water, or sugar-laden drinks that can promote tooth decay.</li> <li>Wipe your baby’s gums with a damp washcloth after meals. Once you see teeth come in, brush gently with a soft baby toothbrush and rice-sized amount of fluoride toothpaste.</li> <li>Report any spots and stains on developing teeth to your child’s doctor or dentist.</li> </ul> <p>Also, breastfeeding during your child’s first year may reduce their risk of future tooth decay by 50%.</p> <h2>Maintain a Healthy Mouth Through Childhood</h2> <p>All of your child’s baby teeth should come in by age 3. Follow these tips to keep them intact.</p> <ul> <li>Visit the <a href="/rainbow/services/pediatric-dental-and-oral-surgery">pediatric dentist</a> between ages 6 months and 1 year, or when your child’s first tooth appears. Take them back as often as the dentist recommends—usually once every six months.</li> <li>Feed your child a healthy diet. Think fruits and veggies instead of sugary cookies and candy.</li> <li>Brush teeth twice a day. Use a smear of fluoride toothpaste no larger than a grain of rice until age 3. Then brush with a pea-sized drop of toothpaste. Please supervise brushing until age 8 or 9.</li> <li>Please do not give your child gummy candies or sugary juices.</li> </ul> <h2>Know What to Do in Case of Emergency</h2> <p>Even when you take good care of teeth, emergencies may happen. When they do, visit your child’s dentist as soon as possible. If the dental office is not open, or in serious situations, go to an emergency department.</p> <p>For a cracked tooth, rinse your child’s mouth out with warm water to clean the area. Keep the swelling down by using cold compresses on the face. Then, see a dentist right away. If your child bites their lip or tongue, carefully clean the area with water then apply a cold compress. If there’s a lot of blood or the bleeding won’t stop, visit the dentist or the emergency department.</p> <p>If your child’s tooth is knocked out by a hard fall or something that might have caused a more serious injury, if possible, place the tooth back in the socket. If not, place the tooth in a cup with saliva or milk. Bring the child to the Emergency Room as soon as possible.</p> <h3>Related Links</h3> <p>UH Rainbow Pediatric Dentistry is specially designed just for children and staffed by pediatric dentists, dental residents and staff who are experts in the care of kids. <a href="/rainbow/services/pediatric-dental-and-oral-surgery">Learn more.</a></p>Mon, 08 Jan 2024 19:00:00 -0500{65815F83-7950-4FD8-B23D-D39F2D58566F}https://www.uhhospitals.org/blog/articles/2024/01/oral-cancers-on-the-rise-in-young-peopleOral Cancers on the Rise in Young People<p>Oral cancer is on the rise, with more than 50,000 cases diagnosed in the United States each year. These cancers are most common in men over age 55, with a history of smoking or excessive alcohol consumption. However, diagnoses are increasing in younger people as a result of HPV infection.</p> <p>“The most common HPV-related cancers are those of the genitals and reproductive tract. However, since the early 1970s, there has been a steady increase in cancers of the throat, tongue and tonsils that are linked to HPV,” says <a href="/doctors/Fowler-Nicole-1134398746">Nicole Fowler, MD</a>, otolaryngologist and head & neck surgeon at University Hospitals. “Although the percentage of people who will develop HPV-related oropharyngeal cancer is very small, the upward trend is concerning.” </p> <h2>What Is HPV?</h2> <p>The human papillomavirus (HPV) is a naturally occurring virus. There are almost 200 different strains of HPV, most of which are harmless. However, a small number have been shown to increase the risk of developing cancers of the tongue, tonsils and throat, as well as certain reproductive cancers. </p> <p>Nearly all Americans will have an HPV infection at some point in their lifetime, the vast majority of which are cleared by the immune system without causing any symptoms or awareness. In a small percentage of people the virus survives and, often decades later, may cause cells to develop into cancer. Researchers aren’t sure why the immune system doesn’t always recognize the virus as a threat.</p> <p>The virus spreads through skin-to-skin contact including kissing and sexual contact. HPV infection rarely causes symptoms, so it’s easy to pass from one person to another. </p> <h2>HPV Vaccination</h2> <p>There is no cure for HPV and there are no anti-viral drugs available to treat it. The HPV vaccine blocks the virus and protects against developing an infection that could later lead to cancer. In fact, HPV vaccination can prevent more than 90 percent of cancers caused by HPV from ever developing. </p> <p>“The vaccine is safe and effective. Because it is made using only a single protein from each variant of the virus, it can’t cause HPV infection,” says Dr. Fowler. “Side effects are usually mild and may include fever and redness or swelling at the injection site.” </p> <h2>Who Should Be Vaccinated? And When?</h2> <p>The CDC recommends HPV vaccination at ages 11 and 12, given as two doses 6 to 12 months apart. The vaccine is most effective before any exposure to the virus. Teens and adults who didn’t start or finish the vaccine series should also be vaccinated.</p> <p>Certain adults, up to 45 years old may also benefit from vaccination and should discuss it with their doctor. </p> <h2>Symptoms of Oral Cancer</h2> <p>Symptoms of oral cancer may include a lump or non-healing sore in the mouth or neck; white red or black patches on the tongue or gums; difficult or painful swallowing or chewing; or a persistent cough or hoarseness. </p> <p>These symptoms can be signs of many conditions and don’t necessarily indicate cancer. Check with your doctor or dentist for further evaluation. As with all cancers, early detection of oral cancer offers the best chance for successful treatment and a positive outcome. </p> <h3>Related Links: </h3> <p>The <a href="/services/cancer-services">oncologists</a> and <a href="/services/Ear-Nose-and-Throat-Services">otolaryngologists</a> at University Hospitals offer the most advanced diagnostics and treatment options for cancers of the mouth and throat. Parents are strongly urged to talk to their child’s pediatrician about the benefits of HPV vaccination as one way to lower their risk of HPV-related cancers in adulthood. </p>Fri, 05 Jan 2024 08:00:00 -0500{7D611D76-6AAD-4EBD-B95D-944F8C69ABF6}https://www.uhhospitals.org/blog/articles/2024/01/pots-a-mysterious-but-common-syndromePOTS: A Mysterious But Common Syndrome<img class="UH-Inline-Image-Large" alt="Infographic: POTS: A Mysterious but Common Syndrome. This little-known syndrome affects 1 in 500 people, mostly women ages 15-50. Short for postural orthostatic tachycardia syndrome, POTS can cause racing heart, nausea, dizziness – even fainting – when standing up." src="/-/media/Images/Blog/POTS-Infographic.png?la=en&hash=06F91C23C35DFB971DF290DF9D8EB483EDAEE6B9" />Wed, 03 Jan 2024 19:00:00 -0500{8B022784-1254-4D7A-9778-4FC42D69B873}https://www.uhhospitals.org/blog/articles/2023/11/how-much-water-do-you-really-needHow Much Water Do You Really Need? 14 Health Myths Debunked<p class="UH-Lead">Listen to the most recent episode here:</p> <iframe title="How Much Water Do You Really Need? 14 Health Myths Debunked" allowtransparency="true" height="150" width="100%" style="border: none; min-width: min(100%, 430px);height:150px;" scrolling="no" data-name="pb-iframe-player" src="https://www.podbean.com/player-v2/?i=z3r74-150ed16-pb&from=pb6admin&share=1&download=1&rtl=0&fonts=Arial&skin=9&font-color=auto&logo_link=podcast_page&btn-skin=1b1b1b" loading="lazy"></iframe> <p><strong>Subscribe: </strong><a href="https://podcasts.apple.com/us/podcast/healthy-uh-podcast/id1472782476">Apple Podcasts</a> | <a href="https://podcasts.google.com/u/1/feed/aHR0cHM6Ly9mZWVkLnBvZGJlYW4uY29tL3VuaXZlcnNpdHlob3NwaXRhbHMvZmVlZC54bWw?sa=X&ved=0CAIQ4aUDahcKEwi4_-jtuqPsAhUAAAAAHQAAAAAQBw">Google Podcasts</a> | <a href="https://www.stitcher.com/podcast/healthyuh-podcast">Stitcher</a> | <a href="https://open.spotify.com/show/41zIrk1mwWSQnawaAjVzmX">Spotify</a></p> <p><em>Popular health advice is everywhere. From what to eat to how much to exercise, it can feel overwhelming to make the right choices. Naturopathic doctor, <a href="/doctors/Wolf-Jacob-1639506710">Jacob Wolf, ND</a>, cuts through the noise and shares the evidence behind common health myths.</em></p> <hr /> <p><strong>Pete Kenworthy</strong><br /> I like to say I can’t wait for the study that shows that bacon is good for you, right? I’m obviously not holding my breath, but it seems like there’s a lot of conflicting information out there. Coffee is bad for you. Wait, it actually has health benefits. You can’t get enough protein from plant-based diets. Well, I know I don’t have to worry about that one because I love eating meat, but lots of people who are vegetarian or vegan certainly consider it.</p> <p><strong>Macie Jepson</strong><br /> Hey. Speaking of healthy foods, what about organic food? Just because the label says it’s organic, is it really better for you? Well, we know that it sure costs a lot more. And then there’s the old adage about breakfast being the most important meal of the day. Hope that’s not the case, Pete. I happen to know you skip it. I mean, is that really true? And here’s a big one. Certainly, here in America, 10,000 steps, eight glasses of water every day. Really? Hi everybody, I’m Macie Jepson.</p> <p><strong>Pete Kenworthy</strong><br /> And I’m Pete Kenworthy, and this is <em>The Science of Health</em>. And joining us today is Dr. Jacob Wolf, a naturopathic doctor at <a href="/services/integrative-health-network">University Hospitals Connor Whole Health</a> in Cleveland. Thanks for being with us.</p> <p><strong>Jacob Wolf, ND</strong><br /> Thanks for having me.</p> <p><strong>Pete Kenworthy</strong><br /> So, we want to cover a lot of myths today and the science behind them. We have kinds of foods and drinks and also things that we do because we think we’re supposed to do them to be healthy. So let’s start with food and drinks. First off, coffee, right? Good or bad, or is it that it depends.</p> <p><strong>Jacob Wolf, ND</strong><br /> Coffee is an interesting question. It depends. In most cases nowadays it’s good. The studies change a lot, but coffee is generally seen as a good thing right now. For most people, it’s their primary source of antioxidants for the day. Most people don’t eat nearly enough fruits and vegetables, so taking out coffee is going to be a big hit to them. But there is some research that it helps to decrease cancer risk. It can lower risk of Parkinson’s and Alzheimer’s and can maybe help with Type Two diabetes as well. So I think coffee’s a good thing.</p> <p><strong>Pete Kenworthy</strong><br /> Is there too much coffee though?</p> <p><strong>Jacob Wolf, ND</strong><br /> There’s a too much coffee. So somewhere around four to five cups a day is kind of the maximum. You’re getting around 400 milligrams of caffeine. Most people feel really jittery at that point. You don’t need that much. Tea works well as well, so less caffeine, but has similar benefits as coffee if you don’t like coffee.</p> <p><strong>Macie Jepson</strong><br /> And when it comes to drinking things, of course, everybody’s trying to get enough water. And that would be eight glasses a day or would it be?</p> <p><strong>Jacob Wolf, ND</strong><br /> Yeah, water is another one. It’s an arbitrary number. So we kind of picked eight glasses a day as a standard. Originally it came from some research of all fluid for the day. So that’s not just water, that’s all of your foods, all your fruits and vegetables. Most people don’t need exactly eight glasses of water a day. If you’re feeling thirsty, drink fluids. If your urine is not clear or light yellow, drink fluids, you should be aiming for some amount of water every day or healthy liquids, not soda, not calorie beverages, something that’s good for you.</p> <p><strong>Pete Kenworthy</strong><br /> There’s actually a danger to too much water, right? I mean, we’ve seen stories about people thinking they need to drink lots and lots of water and it actually gets them in physical trouble.</p> <p><strong>Jacob Wolf, ND</strong><br /> Sure, you’re talking about usually gallons and gallons of water at that point. That’s well beyond what most people would need. There’s also a time where you do need more water: if you’re exercising a lot, if it’s hot out, if you’re pregnant, if you’re breastfeeding. So there’s times where you may need way more than eight glasses of water, but that’s a good kind of average.</p> <p><strong>Macie Jepson</strong><br /> Pay attention to your body.</p> <p><strong>Jacob Wolf, ND</strong><br /> Pay attention to your body. Again, if you feel thirsty or your urine is dark yellow, drink fluids. You should hydrate at that point.</p> <p><strong>Pete Kenworthy</strong><br /> What about vegetables? Frozen produce lasts longer, but fresh is better for you. Is that right?</p> <p><strong>Jacob Wolf, ND</strong><br /> Vegetables are vegetables. Frozen vegetables and frozen fruits are perfectly good. They are frozen instantly. They’re at the peak of their freshness, particularly if there are foods that are not in season, it’s a great time to get frozen. It could be more cost effective as well. So I’d rather people eat vegetables and fruits than not eat vegetables and fruits. And they’re equal nutrition either way. The big thing you do need to watch out for is if they’re adding salts and sugars. So if it’s a green that’s frozen, there should be no added salt into it. And you should watch on the packaging.</p> <p><strong>Macie Jepson</strong><br /> We’re kind of running through these quickly, but something that comes to mind for me and Pete, we’ve talked about this. When we were on the air in our former careers as news anchors, literally from week to week or month to month, the headline could change and we could say, coffee is bad for you and everybody’s talking about it. And then a month later, it’s embarrassing almost to a certain point. Nope, nope, hold on, coffee is really good for you. Before we go down the list any further, why do we get such conflicting information?</p> <p><strong>Jacob Wolf, ND</strong><br /> The research is changing all the time. There’s new information coming out all the time. Some initial research is coming maybe from animal studies or from small groups, and then they do larger groups and generalize it to the wider population and find that the information has changed. Research is notoriously challenging. There could be different factors in the research study itself that changed the answer. And sometimes news picks up on a small piece of the headline, but not the bigger story of is it good or bad? And then that finally comes out as well.</p> <p><strong>Macie Jepson</strong><br /> So what about organic foods though? I mean, talk about headlines. But can we just wash that stuff away? And if it says organic, is it really better for you?</p> <p><strong>Jacob Wolf, ND</strong><br /> So organic is a challenging question. So nutritionally organic may not be dramatically better than conventional, but you’re reducing the risk of exposure to excess pesticides, fertilizers, potentially antibiotic resistant bacteria. And so that’s the stuff that we’re really most cautious with with organic foods. There’s an easy way to figure it out which ones you should buy. There’s a list put out by the environmental working group every year: the Dirty Dozen in the Clean 15, which foods are the most clean and which foods have the most residues on them? And that’s a great dividing line of should I buy organic or should I buy conventional? The easiest way to remember it if you don’t have that list is if you eat the whole product, if you eat the whole strawberry or the lettuce, then you should buy organic. If you’re peeling off the outside, then you can usually buy conventional and be okay.</p> <p><strong>Pete Kenworthy</strong><br /> Well, that’s great advice. How about low fat foods? Because it sounds like just by their name, right? Low fat has to be better. It can’t be a myth that low fat foods are better for us. That can’t be a myth, right? They have to be better for us.</p> <p><strong>Jacob Wolf, ND</strong><br /> Low fat and fat is a category that’s changed a lot over the last decade or two. In the 90s, fat was bad. Now we’ve totally changed our tune. Fat is good. There’s important benefits to our health with fat. Low fat can be beneficial sometimes with things like with dairy, with other types of fats. But we need fats in general to live. There are a lot of good fats. Nuts and seeds, avocados, olives or great fats that we need every day. And we’re even changing our tune on saturated fat that we’re looking more at where is the fat coming from versus just fat or not fat. So getting some fat from a healthy piece of grassfed steak is better than getting the same amount of fat from a cupcake or a donut. There’s differences in types of fats.</p> <p><strong>Macie Jepson</strong><br /> And along those lines, I’ve often wondered, especially when you go fat free in a margarine, what’s left? It’s got to be bad for you eventually when you’re processing it down to nothing.</p> <p><strong>Jacob Wolf, ND</strong><br /> Nothing. Yeah. Whenever I see free, whether it’s gluten-free or fat-free, it means that we’re adding in a whole bunch of other chemicals to make it work. So if you’re taking out fat and presenting someone with margarine, which is fat, what’s in there? Now you’ve made it into trans fats. You made it into really exceptionally bad fats that are, we know are harmful to your health. And so making it fat-free a product that should be fat is really bizarre. But fat-free products that don’t have that in are using lots of sugars and artificial things to make it seem like it’s fatty in your mouth and to your taste.</p> <p><strong>Macie Jepson</strong><br /> Did you look at our list? Because we’re talking artificial sweeteners now and sugar. What are your thoughts on that?</p> <p><strong>Jacob Wolf, ND</strong><br /> For overall health, we shouldn’t be using sweeteners at all. Our food should be sweet how they are. Getting fruits are a natural source of sweeteners. Honey is a great natural source of sweetener, but we shouldn’t be adding sugar to things in general. As far as artificial sweeteners, there’s some new research showing that artificial sweeteners can worsen the risk of Type Two diabetes. It’s not adding sugar in the body, but it’s raising your insulin levels and kind of putting you on that same pathway. Artificial sweeteners also change our bacteria in our gut, which change overall health and how we can process foods and eliminate things. So a calorie-free sweetener is not necessarily better than using a small amount of sugar.</p> <p><strong>Pete Kenworthy</strong><br /> I mean you have to add sugar to things like cake and cupcakes and donuts, but we already talked about how bad those are for you, right?</p> <p><strong>Jacob Wolf, ND</strong><br /> Yeah, so you can add a small amount of sugar. That’s a time where using a good sugar or honey or maple syrup or using apple sauce or something else. Bananas that are naturally sweet is a great option versus using tons of artificial sweetener or a lot of regular sugar.</p> <p><strong>Macie Jepson</strong><br /> So is the idea of an artificial but natural sweetener being good for you also a myth? I’m thinking Stevia, I guess.</p> <p><strong>Jacob Wolf, ND</strong><br /> Yeah, Stevia is probably the best option for many people. It is a non-calorie sweetener. You’re just drying that plant and using that as a sweetener. I don’t know if the research is really out there on how it affects blood sugar or insulin. It may do similar things as artificial sweeteners, but at least you’re not using a chemical. You’re using a natural product. You’re using really minute amounts. The problem with Stevia is that some people don’t like the taste. Some people find a little bitter and it could be a little awkward to add to things.</p> <p><strong>Pete Kenworthy</strong><br /> So speaking of sugars, what about those smoothies or fruit juices, right? A lot of people assume that I’m just going to have a smoothie for lunch, right? That’s a healthy option.</p> <p><strong>Jacob Wolf, ND</strong><br /> Yeah. Smoothies and juices can be a good option. I prefer smoothies over juices. Smoothies are blending the whole fruit and vegetable. You’re getting all the fiber still in there. So that’s the part that slows down digestion. Fiber is good for you overall. Most people are deficient in their fiber intake, and you’re using less produce per drink. When you are juicing, you’re getting rid of all the fiber. So now you’re almost changing it into a soda. It’s just the sugar in the liquid. There’s no fiber, and you’re juicing a lot more produce per unit than you are with a smoothie. So now you’re eating 10 apples instead of one apple. There’s just a lot more sugar involved with the juice.</p> <p><strong>Pete Kenworthy</strong><br /> And smoothies can have things like if you go to a store and get a smoothie, things are added into there many times, right? Like syrups or sugars?</p> <p><strong>Jacob Wolf, ND</strong><br /> Oh sure. Yeah. There’s a lot of things that can be added in. If you’re going to get a smoothie, make sure that you can watch them usually just putting in the fruits and vegetables. Focus on vegetables. Add fruit for taste and add fruit for sweetness, but it shouldn’t be all sweet fruits all the time.</p> <p><strong>Macie Jepson</strong><br /> I think when we have protein in our mind, we think about meat. And so how would a vegetarian or a vegan get enough of that protein with a plant-based diet?</p> <p><strong>Jacob Wolf, ND</strong><br /> Vegetarians and vegans have tons of options for protein. We can look at someone like Tom Brady who’s completely plant-based and he’s clearly getting enough protein in his diet and there’s many other athletes who do it as well. There are beans. There’s tofu. There’s all your fruits and vegetables, have a little bit of protein in it. You can get it from nuts and seeds. You can get it from all sorts of different places. Once you’re going to vegetarianism or pescatarian, you’re adding in animal products. So now you’re adding in maybe some dairy or eggs and then you even greatly enhance the amount of protein you can get.</p> <p><strong>Macie Jepson</strong><br /> So there are those Beyond Beef type things out there though. And again, when you look at the ingredients, they’re a little bit scary. Is that something to be concerned about?</p> <p><strong>Jacob Wolf, ND</strong><br /> It’s a chemical product. It’s made from mixing things together to pretend to be meat. Is it better or worse than low quality proteins that you can already buy in the store? Maybe not. There may be a little higher quality proteins in there than others, but it’s not necessarily as healthy as eating beans or something for protein or a lean piece of chicken and/or fish or whatever it may be.</p> <p><strong>Pete Kenworthy</strong><br /> Speaking of fish, we eat a lot of salmon in my house, but when I go shopping, I see a couple options there for salmon, right? You have wild caught salmon and then you have the farm salmon. Is one better than the other or is salmon just good for you because it’s salmon?</p> <p><strong>Jacob Wolf, ND</strong><br /> Salmon is a really challenging question. And the science is changing right now as well. And so we used to say that wild caught is always better than farm raised, but our oceans are getting more polluted. And so now we have less control over where wild fish are living. And so I think salmon is a good option in general. If you had to choose between salmon and hot dogs, then choose salmon, whether it’s wild caught or farm raised. There are maybe a little bit more fats in a farm raised fish because they can add different things to their diet. There’s maybe more nutrients and more micronutrients in a wild caught fish, but never adding questions about maybe there’s more plastics in small chemicals or whatnot. So it really gets challenging. But find the best quality you can find is the best option.</p> <p><strong>Macie Jepson</strong><br /> This seems pretty straightforward, but something tells me it’s not. And that’s calcium. We need it. We all do. Women, especially as we age. So either you get it out of dairy or you get it from a supplement. Is that true?</p> <p><strong>Jacob Wolf, ND</strong><br /> Calcium can be found in many places. And so dairy is one option. It may not be the best option for most people. Many people are sensitive to dairy or choose not to eat dairy for whatever reason. So all of our dairy alternatives have calcium in them: non-dairy milks, non-dairy yogurts, non-dairy cheeses. We can get calcium from leafy greens. We can get calcium from sardines and from tofu and from beans and from nuts and seeds, and you can get calcium all over the place. A supplement is also a good option for those who don’t like those foods, but it doesn’t have to be just dairy.</p> <p><strong>Pete Kenworthy</strong><br /> Alright, let’s talk about some things that we’re told to do to stay healthy. The first one is that one that everybody talks about, certainly at least here in America, they do: getting 10,000 steps a day. Really? Like I feel like I’ve seen reports recently that that number was arbitrary like we talked about the 64 ounces of water, right? It’s just this arbitrary number that someone came up with, but we really only need maybe 6,000 or 7,000. Is there a magic number? Is it person dependent? Where does that number come from?</p> <p><strong>Jacob Wolf, ND</strong><br /> Steps a day is a little bit person dependent. And I actually did some research to figure out where 10,000 steps a day really came from. And it came from an early pedometer that was called 10,000 Steps a Day, and that was the name of the pedometer. And that’s kind of where a lot of this started. The newer research shows that for folks under the age of 60, somewhere around 8,000 steps a day is optimal: over 60, somewhere between 6,000 and 8,000 steps a day is optimal. And you can look at it at more than just steps. It’s really active time. So you need to have a certain number of minutes of either moderate or vigorous active time based off your age. And it’s just trying to get people out and about. So if you don’t like walking, do something else. It doesn’t have to be, oh, I swam today, but I only got 10 steps. I need to do more steps. No, you did an activity for the day and that’s a good step as well.</p> <p><strong>Pete Kenworthy</strong><br /> And this is all about cardiovascular health, right?</p> <p><strong>Jacob Wolf, ND</strong><br /> Cardiovascular health, mental, emotional health, physical health, bone health. There’s lots to just walking other than the heart, but cardiovascular is a big part of it.</p> <p><strong>Macie Jepson</strong><br /> So when it comes to activity, does the time of day matter if it’s hot, cold outside?</p> <p><strong>Jacob Wolf, ND</strong><br /> Yeah. For exercising in general, anytime of day is good. That’s the first step. There’s some benefits to exercising in the morning. Some people find it better to do in the morning just as part of routine and habit. They may have more free time. You may get a little more calorie burn in the morning, particularly if you’re on an empty stomach. But our peak energy and our peak endurance and power is later in the day. So if you’re looking to work on that, that might be more beneficial to do in the afternoon or early evening. Same with calories and temperature. Doing hot yoga will get you to sweat a lot and you’ll lose a lot of water weight and it may increase cardiovascular health, but exercising in cool weather increases calorie burn. Your body needs to exercise and utilize all that energy, but also keep you warm and regulate temperature. So there’s a higher calorie burn in cold.</p> <p><strong>Pete Kenworthy</strong><br /> When I lost 25 pounds a couple of years ago, part of how I did it was cutting out breakfast. I guess that’s a form of intermittent fasting, right? But I kept thinking about that old adage of breakfast is the most important meal of the day. Things have changed with this, right?</p> <p><strong>Jacob Wolf, ND</strong><br /> Breakfast could be the most important meal of the day if that’s the foundation of your day and you’re starting your day with food. Some people do intermittent fast and breakfast is probably the most common meal to skip just logistically and family dynamics. But the important part is that you’re getting enough calories for the day. So skipping a meal can really challenge that for a lot of people. It may lead to more snacking, more challenged eating habits later in the day, but you can do it effectively with different fasting styles.</p> <p><strong>Pete Kenworthy</strong><br /> Where does that come from though? Cause I would think the old saying came from, you need to fuel your body to get through the day, but for the last two years I’ve kind of proven you don’t have to do that. I’m still getting enough calories for me. Is that what it comes from? You need to fuel your body for the day, but you don’t necessarily need that?</p> <p><strong>Jacob Wolf, ND</strong><br /> Yeah, I mean it’s a good start to the day. Most people are in the most active earlier parts of the day. They need their mental clarity and they need all their energy to start going through the day. So it’s a good way to start. But as you mentioned, you can do things to trick your body into utilizing calories in different ways. So if you are doing things like intermittent fasting, you’ve trained your body to utilize your reserves in that early part of the day, and then you just feed it appropriately later in the day. The group of people that’s most important to eat breakfast is children. They don’t do well with intermittent fasting. It’s much harder to focus in school when you’re in that kind of non-eating time for breakfast. So really important for kids to have a good foundation to the day.</p> <p><strong>Macie Jepson</strong><br /> I can’t think of any need, physical need to eat late at night. Now my emotional need is a completely different thing. But this is something people struggle with. And the myth, if you will, is that you’ll gain weight if you eat late at night. Is that true?</p> <p><strong>Jacob Wolf, ND</strong><br /> So this is also some new science about whether eating at different times of day is important or not. Some of the newer studies show that eating late may actually affect how your body breaks down the calories. Our digestion may slow down at night. We may signal our body to store more fat eating later in the day. And so some of this is about what you’re eating and quantity. So eating one apple at midnight is different than eating a whole box of donuts at midnight. It’s the same concern.</p> <p><strong>Macie Jepson</strong><br /> I’m not going for the apple, just saying.</p> <p><strong>Jacob Wolf, ND</strong><br /> Yeah, most people are not. Most people aren’t hankering for broccoli late at night, but some of that plays a role. But we do know that our body probably utilizes calories differently later in the day.</p> <p><strong>Pete Kenworthy</strong><br /> Anything we missed? Anything you were thinking of when you did get to see this list ahead of time? But anything overall health, overall nutritional myths, anything else you’re thinking of?</p> <p><strong>Jacob Wolf, ND</strong><br /> These were definitely the big ones. I tried to think about some other ones, but we hit a lot of topics today.</p> <p><strong>Macie Jepson</strong><br /> So it sounds like at the end of the day, the message is, pay attention to your body.</p> <p><strong>Jacob Wolf, ND</strong><br /> Certainly.</p> <p><strong>Macie Jepson</strong><br /> What’s your takeaway, Pete?</p> <p><strong>Pete Kenworthy</strong><br /> Look for foods that have things added to them. Right? Be careful of that.</p> <p><strong>Jacob Wolf, ND</strong><br /> Right? There’s this big new focus on whole foods. We want foods that are real, that are the foods that we’re expecting them to be. So looking for additives, looking at nutrient content and what the ingredients are will get you a long way.</p> <p><strong>Macie Jepson</strong><br /> Dr. Jacob Wolf from University Hospitals in Cleveland, thank you so much for joining us and clearing some things up today.</p> <p><strong>Jacob Wolf, ND</strong><br /> Thanks for having me.</p>Thu, 30 Nov 2023 11:00:00 -0500{8664CB47-B8F7-4EC9-B3A9-4D4E4697012F}https://www.uhhospitals.org/blog/articles/2023/11/raw-vs-cooked-vegetablesRaw vs. Cooked Vegetables: What's Healthier?<p>Raw, unprocessed foods – particularly fruits and vegetables – are generally considered to be healthier than cooked or processed alternatives. But is that always true?</p> <p>“There are a lot of benefits to whole, raw and unprocessed foods, but there are upsides to including more variety and cooking vegetables to improve nutrient absorption,” says University Hospitals registered dietitian <a href="/doctors/Traxler-Elizabeth-1659966711">Elizabeth Traxler, MS, RDN, LD</a>.</p> <h2>The Benefits of Whole, Raw and Unprocessed Foods</h2> <p>Whole, unprocessed plant foods have a variety of health benefits. They’re naturally lower in sodium, sugar and saturated fat, which are associated with chronic disease. They’re also good sources of healthy nutrients, fiber and antioxidants that fight inflammation and reduce disease risk.</p> <p>In addition, avoiding high temperature heating or cooking can reduce the intake of certain byproducts that are associated with disease risk. However, there are potential downsides to choosing raw vegetables over cooked.</p> <h2>How Cooking Affects Nutrients</h2> <p>Cooking can have positive effects on vegetables, increasing the bioavailability of nutrients and improving absorption by the body.</p> <p><strong>Fiber:</strong> Cooking vegetables or fruit may improve digestion. It decreases the amount of insoluble fiber that can be challenging to digest. This is especially true for those with gastrointestinal disorders like inflammatory bowel disease. Beans and certain grains are better digested when cooked because heat deactivates compounds that these foods make to fight digestion.</p> <p><strong>Vitamins, minerals and antioxidants:</strong> Boiling decreases certain water-soluble vitamins like vitamin C and B vitamins, but fat-soluble vitamins such as A, D and E are not affected. Cooked carrots, for example, are higher in the antioxidant beta-carotene than raw, and cooking cabbage, kale and tomatoes makes nutrients easier to absorb by the body.</p> <p><strong>Oxalates:</strong> Oxalates are compounds found in plant foods such as leafy green vegetables and beets that are known to bind to calcium and contribute to the development of kidney stones. Cooking reduces the absorption of oxalates and is recommended for those trying to prevent kidney stones.</p> <p><strong>Enzymes:</strong> Enzymes are proteins that help break down nutrients and ease digestion. Cooking can destroy some plant enzymes in fruits and veggies. But when functioning properly, the body makes enough of these enzymes to aid the digestive process without added plant enzymes.</p> <h2>When to Boost Nutrient Value with Fat</h2> <p>Certain vitamins are better absorbed by the body when combined with fat. These include vitamin A (carrots, sweet potatoes and squash), vitamin K (leafy greens, broccoli and onions), vitamin D (mushrooms) and vitamin E (leafy greens, red bell pepper and asparagus). To get the most from these foods, be sure to include a healthy amount of nutritious fat with the meal.</p> <h2>More Benefits of Cooking Fruits or Veggies</h2> <p>Cooking vegetables can also enhance their flavor and texture, improve digestibility and reduce the risk of foodborne illness:</p> <ul> <li>Under certain temperatures, fruits and vegetables may develop a sweeter taste and crispier texture due to caramelization or browning. This can make fruits and vegetables more palatable and we may eat more of them.</li> <li>Heat can provide moisture and modify the texture to make it easier to chew and physically digest.</li> <li>Eating cooked fruits and vegetables reduces the risk of contamination from bacteria that cannot withstand heat.</li> </ul> <h2>The Optimal Salad</h2> <p>A salad can provide a healthy, nourishing meal with fewer calories. But it’s important to include a wide variety of ingredients for satisfying, complete and balanced nutrition. Traxler recommends the following:</p> <ul> <li>In addition to lettuce and leafy greens, include a variety of vegetables such as carrots, broccoli, cucumbers, bell peppers, shredded cabbage or onions. These provide different textures and nutrients and increase fiber.</li> <li>Add whole carbohydrate sources to make the salad more filling and provide a good source of energy. Consider high fiber carbs like fruit, sweet potatoes, brown rice, peas, corn or quinoa.</li> <li>Add high protein foods to keep you full longer. If you avoid meat and dairy, plant-based options include eggs, beans, lentils, edamame or tofu.</li> <li>To aid nutrient absorption and increase satiety, choose a healthy fat source like avocado, nuts, seeds, olive oil or vinaigrette dressing.</li> </ul> <h3>Related Links</h3> <p>University Hospitals has a team of <a href="/services/clinical-nutrition-services">clinical dietitians</a> with the expertise to provide counseling and personalized eating plans for anyone looking to enhance their health, meet nutritional goals or lose weight safely and effectively.</p>Tue, 28 Nov 2023 08:00:00 -0500{4A759127-F825-4434-A74C-70BE1937746F}https://www.uhhospitals.org/blog/articles/2023/11/6-ways-to-make-your-childs-shots-less-stressful6 Ways to Make Your Child’s Shots Less Stressful<img class="UH-Inline-Image-Large" alt="Infographic: 6 Ways to Make Your Child’s Shots Less Stressful" src="/-/media/Images/Blog/Shot-Anxiety-Infographic.png?la=en&hash=2536A0E41874BC305AC733FB8BBCC7E6375EDC75" />Sun, 26 Nov 2023 19:00:00 -0500{F4E83F18-5ABA-46A5-A436-9815006173EB}https://www.uhhospitals.org/blog/articles/2023/11/achilles-tendinopathyAchilles Tendinopathy: What to Do About a Chronic Problem<p>Chronic pain in the heel of the foot could be a sign of <a href="/services/orthopedic-services/conditions-and-treatments/foot-and-ankle-services">Achilles tendinopathy</a>. The Achilles tendon, the largest and strongest in the body, attaches the calf muscle to the heel bone. It can withstand a lot of stress, but is susceptible to injury from intense activity or overuse.</p> <p>Tendinopathy is a common injury among distance runners. But it can happen to non-athletes as well. “People who are active or who do a lot of standing can develop Achilles tendinopathy,” says <a href="/doctors/Schroeder-Allison-1386006682">Allison Schroeder, MD</a>, a sports medicine specialist with <a href="/services/orthopedic-services/conditions-and-treatments/sports-medicine-services">University Hospitals Drusinsky Sports Medicine Institute</a>.</p> <p>“I have patients who do a lot of standing for work or who are walking for exercise and do a lot of hills who develop Achilles tendon problems,” Dr. Schroeder says. “It doesn’t occur just in athletes. But among athletes, it seems to be most common in runners.”</p> <h2>What Is Achilles Tendinopathy?</h2> <p>Not to be confused with tendonitis, which is an acute inflammation, tendinopathy is a spectrum of disease and includes a longer-lasting, more complex condition where healing is impaired. It’s often painful, but doesn’t necessarily involve inflammation after it becomes chronic.</p> <p>Symptoms can last for years in some patients, and there is no single, definitive treatment effective for all patients. Sometimes the tendon becomes calcified, thick or inelastic – conditions that impair mobility and cause pain.</p> <p>“Tendinopathy is a spectrum of problems,” says Dr. Schroeder. “By the time we see most patients, they’ve progressed from tendonitis to what’s called tendinosis, where there’s no longer inflammation, but the tendon hasn’t repaired itself like it should.”</p> <h2>Who Is at Risk for Achilles Tendinopathy?</h2> <ul> <li>Being over age 30 and male</li> <li>Higher body weight</li> <li>Diabetes</li> <li>Weak calf muscles</li> <li>Overtraining or training errors</li> <li>Poor footwear</li> <li>Fluoroquinolones antibiotic use</li> </ul> <h2>Diagnosing Achilles Tendinopathy</h2> <p>Diagnosis is typically based on symptoms and a physical exam, Dr. Schroeder says.</p> <p>“Usually, people complain of pain, which is worse with activity or prolonged standing,” she says. “Often, patients say the pain is okay when they rest and it’s bad when they start activity. But they warm up and work through it. When they stop, it’s worse again.”</p> <p>Imaging tests are not necessary for diagnosis, but can be helpful. X-rays can show if there’s calcification in the tendon or if the patient has Haglund’s deformity (a bony bump or ridge on the heel bone).</p> <p>Dr. Schroeder will sometimes do an ultrasound in the office to look for signs of a tear. “If there is a little tear, I don’t want them to be putting too much weight on the tendon because it’s going to make it worse.”</p> <h2>Treatment for Achilles Tendinopathy</h2> <p>Managing tendinopathy is often challenging. “We haven’t identified a specific treatment is best for a certain type of tendon issue,” says Dr. Schroeder. “We don’t have one thing that fixes everything for everyone.”</p> <p>Physical therapy has the best evidence behind it. “Tendons are used to having weight on it. What happens when we have injury is we stop loading it and the muscles that support it get weaker,” says Dr. Schroeder.</p> <p>“Then, we go back to doing normal activities or trying to exercise. It’s too much load for the tendon to take. In physical therapy, the goal is to gradually build up strength through controlled loading. It’s the best proven way to help the tendon. Physical therapy also works to break up painful adhesions between the tendon and a fat pad (Kager’s fat pad) that is deep in the tendon.”</p> <h2>Other Treatments</h2> <ul> <li>In addition to physical therapy, footwear modifications such as orthotics or heel lifts often help. Dr. Schroeder also recommends a silicone compression sleeve that protects the tendon area and back of the heel.</li> <li>Topical creams may help with pain.</li> <li>Non-steroidal anti-inflammatory pain relievers are okay for acute pain, but aren’t recommended long-term, as they may delay healing and cause other problems.</li> <li>Rest is always helpful, but rest alone will not resolve tendinopathy.</li> <li>If conservative treatments don’t work, doctors may use shockwave therapy, a non-invasive therapy for overuse injuries that helps break up soft tissue adhesions and calcifications and may stimulate healing.</li> </ul> <p>Several ultrasound-guided procedures are available:</p> <ul> <li>Injections of biologic agents such as platelet-rich plasma.</li> <li>A procedure called tendon scraping uses a needle and sterile water to break up scar tissue and adhesions to surrounding tissues.</li> <li>Needle tenotomy is another technique to remove scar tissue.</li> </ul> <p>To prevent Achilles tendon problems, Dr. Schroeder says it’s a good idea to keep your calf muscles and Achilles strong and flexible. Avoid putting too much pressure on the tendon too quickly.</p> <p>“If you’re a runner, you want to gradually build up 10 percent a week in mileage or intensity, but not both at the same time. A rapid increase in activity can lead to many types of overuse injuries.”</p> <h3>Related Links</h3> <p>At University Hospitals, our fellowship-trained sports medicine specialists, primary care doctors, nutritionists, sleep experts and other healthcare professionals ensure the very best <a href="/services/orthopedic-services/conditions-and-treatments/sports-medicine-services">sports medicine care</a> for active people.</p>Fri, 24 Nov 2023 08:00:00 -0500{03F4A880-B164-435B-B51F-C7CEB46B9C14}https://www.uhhospitals.org/blog/articles/2023/11/can-you-outrun-a-bad-dietCan You Outrun a Bad Diet?<p>If you’ve been indulging in doughnuts, cheeseburgers, pizza, ice cream or other guilty pleasures, you may wonder: Does exercising regularly make up for unhealthy eating habits?</p> <p>Unfortunately, the answer is no. Although it’s easy to assume – or hope – that regular exercise will burn away any unhealthy food choices, that’s not the case.</p> <p>“The power of regular exercise to counter the negative effects of poor eating habits is limited, especially when looked at over the long term,” says <a href="https://www.uhhospitals.org/doctors/Goldberg-Laura-1265540033">Laura Goldberg, MD</a>, <a href="/rainbow/services/pediatric-sports-medicine">Pediatric Sports Medicine</a> specialist in the Division of <a href="/services/orthopedic-services/conditions-and-treatments/sports-medicine-services">Sports Medicine</a> at University Hospitals and UH Rainbow Babies & Children’s.</p> <h2>Why Exercise In Not Enough</h2> <p>Among other benefits, exercise can help you manage weight, reduce risk of disease, strengthen bones and muscles, improve brain health, and enhance your ability to do everyday activities. For its part, a healthy diet helps stabilize blood glucose, minimize the risk of cardiovascular disease and provide energy for daily activities. But to optimize your health, exercise and diet must work together.</p> <p>“In terms of nutrition, while balance is good, the idea that ‘calories in must equal calories out’ is often not helpful for people,” says Dr. Goldberg. “Try not to think that exercise earns you the right to eat a cookie or that eating a cookie means you <em>must </em>burn those ‘extra’ calories off by exercising. That’s just not realistic. If we lived that way, we’d need to run 1.5 miles or so for every cookie we ate.”</p> <h2>What Makes a Diet Healthy?</h2> <p>“There’s not one diet that fits all,” says Dr. Goldberg. “But in general, people should strive to consume as many whole foods as they can. Whole foods are minimally processed – they include vegetables, whole grains, nuts, seeds, beans, lentils, milk, unprocessed meats and fish. Also, it’s important to combine proper nutrition with good sleep habits and variety in exercise to allow the body to recover, heal and grow stronger.”</p> <p>Dr. Goldberg points out that, when looking to eat healthier, some people may focus too much on what foods to avoid. Most people know that eating too many foods high in sodium, sugar and fat often leads to health issues. But a comprehensive Global Burden of Disease Study from 2017 found that a leading factor for death is diets that are high in sodium and low in whole grains, fruits, nuts, seeds and vegetables.</p> <p>“This finding suggests that focusing on what to include in your diet – whole grains, fruits, nuts, seeds, vegetables, etc. – may be more important than focusing on what to avoid,” says Dr. Goldberg.</p> <h2>What About Counting Calories or Carbs?</h2> <p>Counting calories or carbs can be tedious and become all-consuming. But not all carbs are bad, just as not all calories are equal. For example, 50 calories of sugar is not the same as 50 calories of nuts if your body needs protein following a hard workout. According to Dr. Goldberg, if you eat a variety of mostly whole foods, you should never have to worry about counting anything.</p> <h2>But Is It Okay to “Cheat” on My Diet Occasionally?</h2> <p>Dr. Goldberg prefers not to look at occasional food indulgences as “cheating” on your healthy eating habits or formal diet. Instead, you should assume that occasional enjoyment of less healthy foods will happen and not feel guilty about it.</p> <p>“I think it’s more important to look at nutrition in the context of your overall long-term lifestyle. Focus on healthy choices in nutrition and engaging in daily activities that you enjoy. Try to eat more foods that have less ingredients or those that are made from scratch. Make exercise a daily priority that is just as important as your meal times.”</p> <p>Dr. Goldberg likes to look at life as balancing act: there are times when we achieve good balance and other times when our balance gets upset.</p> <h2>How Much Exercise Should You Get?</h2> <p>The American Academy of Sports Medicine recommends that most healthy adults get:</p> <ul> <li>150 minutes a week of moderate-intensity aerobic exercise for a minimum of 30 minutes/5 times a week</li> <li><em>OR</em> 75 minutes of vigorous-intensity aerobic activity for minimum of 20 minutes/3 times a week.</li> <li><em>AND</em> 2 or more days of strengthening exercises.</li> </ul>Wed, 22 Nov 2023 08:00:00 -0500