Archive for June, 2016

Surgery insight: What happens while you’re under anesthesia?

Tuesday, June 28th, 2016



What you should know before surgery

Before you schedule your next surgery, ask the hospital the following questions to help ensure a successful procedure:

* How long does the surgical procedure take?
* What can be expected for recovery?
* Who are all the members of the surgical team? Will a physician anesthesiologist be present?
* What should be done to prepare for surgery? (i.e. eating restrictions)
* What pain medications will be administered before, during and after surgery?
* Who is going to care for me immediately after surgery?
* Who will communicate the status of surgery with the patient’s loved one or caregiver?

Who is providing your medical care?

Regardless of the type of surgery you will undergo, you’ll likely require anesthesia or sedation. It is important for you to know who is administering your anesthesia. As the leader of the Anesthesia Care Team, your physician anesthesiologist will care for you before, during and after surgery. You, like the majority of patients, may be unaware that anesthesiologists are in fact medical doctors.

Physician anesthesiologists have 12,000 hours to 16,000 hours of clinical training and 12-plus years of extensive medical education which covers the entire human body and all of its systems, including evaluation, diagnosis, treatment and management of a full range of medical conditions and needs. Physician anesthesiologists are able to intervene should complications arise in a routine surgical procedure or in an emergency.

Anesthesia is safer than ever because of the work and research of physician anesthesiologists. However, each patient comes with a unique set of circumstances and health risks that require the medical training of a physician anesthesiologist.

Take for example, the story of a woman who was administered a routine epidural during childbirth. Without warning, the patient experienced cardiac arrest due to an amniotic embolism. If it was not for the split-second diagnosis and action of Patrick Allaire, M.D. (Ames, Iowa), who was able to restart the patient’s heart and ensure a successful Cesarean section, the outcome would have been grave. Despite an 85 percent fatality rate during such procedures, both the mother and her child survived.

What is the role of my physician anesthesiologist?

ASA President-Elect Jane C.K. Fitch, M.D. notes that physician anesthesiologists play three key roles before, during and after any surgery. Here’s what you can expect as a patient who will be undergoing surgery:

1. Before surgery, physician anesthesiologists draw on their advanced education and training to diagnose illnesses, ensure you are in optimal shape for surgery and help fine-tune surgical plans.

2. During surgery, physician anesthesiologists manage any medical conditions you have, as well as anything that arises during the procedure. They help ensure you remain comfortable and manage pain.

3. After surgery, physician anesthesiologists address any complications from your medical condition or from the surgical procedure itself, helping you to heal properly.

Many people are surprised to learn physician anesthesiologists also have active roles outside of the operating room. Dr. Fitch explains, “After some surgeries, patients may have issues that require close care. Some physician anesthesiologists specialize in critical care medicine to take care of those patients. Likewise in terms of pain medicine, physician anesthesiologists are able to provide comprehensive pain medicine care, either acutely right after a surgery or procedure, or on an outpatient basis for chronic medical conditions.”

When seconds count, when a life hangs in the balance, when medical emergencies or other complications occur, you and your family members need to know that there is a physician anesthesiologist responsible for your care. For more information on patient-centered, physician-led anesthesia care, please visit www.asahq.org/WhenSecondsCount.

Impromptu party planning: How to create great gatherings in 30 minutes or less

Tuesday, June 28th, 2016


(BPT) – Parents have never been more crunched for time. Balancing work demands with parental duties is complex – 56 percent of working moms and 50 percent of working dads say they find it very or somewhat difficult to balance these responsibilities, according to a recent report about modern parenthood from the Pew Research Center. But just because you’re time strapped doesn’t mean you need to stress when it comes time to host after-school activities or weekend gatherings with friends and family. With a few key strategies, even impromptu parties are a snap to pull together.

Did your teen just call to tell you he’s having the baseball team over for an Xbox live tournament tonight? Has a pop-up neighborhood party suddenly happened at your house? Did you forget about the Girl Scout meeting after school today? Whatever the reason, embrace spontaneous gatherings and go from zero to party in 30 minutes or less with these ideas:

Astounding activities

Great parties make everyone feel included, no matter how young or old. For spur-of-the-moment parties, gather your favorite board games and a few decks of cards to spread around on various tables. For outdoor gatherings, nothing beats classic lawn games like Frisbee, bocce, ladder ball or horseshoes. Groups are sure to gather to indulge in the fun, and lively conversation will inevitably follow.

To appeal to younger kids, create a makeshift theater stage with a blanket or shower curtain, and pile up costumes, hats and props. Even wallflowers are sure to bloom during this fun activity that inspires make-believe.

For teenagers, video games are ideal – just make sure your system, game options and high-speed Internet are ready for intensive group play and there are plenty of snacks on hand. Add some comfy pillows and throws so everyone can spread out and enjoy the friendly competition. Ask friends and neighbors to bring over their games too for even more variety.

Fantastic food

Time-crunched parents don’t have to worry about fancy food when parties suddenly pop up; guests don’t expect an elaborate meal. Take a no-nonsense approach by serving flavors everyone will love. Frozen appetizers you can pop in the oven and serve beside fresh seasonal items are ideal.

Bite-size foods are best for easy snacking. Bake some Farm Rich Mozzarella Sticks, which are made with 100 percent real mozzarella and lightly seasoned. Kids and adults alike will devour these snacks with a crispy coating and warm cheesy center. Add some zesty Farm Rich Jalapeno Peppers and everyone’s taste buds will be dancing. These snacks, available at Walmart and other grocery stores, pair well with fresh seasonal fare, so set out fresh grapes or strawberries, juicy sliced melon or chopped veggies with dip – whatever you have on hand or can get quickly at the local market – and you’ll have a spread that will disappear almost instantly.

Set the scene

There’s no need to deep clean, but spending a few minutes to tidy up creates a welcoming environment for guests. Focus your efforts on areas where people will gather – like the kitchen, patio or living room. Don’t forget to stock toiletries in the bathrooms, too.

If you have time, decorate for your last-minute shindig with simple yet clever decor. Hosting a video game gathering? Make a banner such as “Nelson’s Awesome Arcade” and hang above the TV. Have memorable photos of your guests? Run a ribbon and attach photos side-by-side with clothespins so everyone can enjoy the fun imagery. Want to add a summer vibe to your party? Skip the florist and cut some fresh buds from your backyard. If you’re stuck, a quick visit to Pinterest is sure to inspire.

When really strapped for time, skip decor and focus on the music – play songs everyone will enjoy and that reflect the theme of the party. Upbeat songs that embrace the warm weather always set the right mood. From the Beach Boys to the most current chart-toppers, some toe-tapping tunes will help guests get in the party groove.

With these tips and tricks, you’ll throw a party or get together that’ll make everybody happy. You’ll stress less and no one will know you put the whole thing together in minutes.

Summer health: stop frequent heartburn

Wednesday, June 22nd, 2016


Summer is here, which means it’s time to pack your bags for vacation, dust off your beach umbrella and fire up the grill. Unfortunately many people will not only feel the summer heat outside with friends, but also inside their chest. Summer is prime time for heartburn. 

 
Barbecue season is the time of the year when people experience frequent heartburn symptoms the most, according to a recent survey by Wakefield Research for P&G, which brings you Prilosec OTC(R). The survey revealed that many frequent heartburn sufferers – those who experience heartburn two or more days per week – are not treating symptoms as effectively as possible, and there is a general lack of understanding about heartburn and available treatments. 

 
One of the top misconceptions is that all over-the-counter (OTC) heartburn treatments are the same. Although frequent heartburn symptoms can be reduced with antacids or H2 blockers, proton pump inhibitors are indicated specifically for frequent heartburn.

There are important differences among the available therapies:

 

* Proton pump inhibitors (PPIs) treat frequent heartburn by shutting down many of the acid pumps in the stomach and stopping symptoms before they start. Effects can last 24 hours.

 
* Histamine2 (H2) blockers partially block production of acid in the stomach. The effect of H2 blockers generally lasts six to 12 hours.

 
* Antacids neutralize existing stomach acid and provide relatively rapid but short-term relief of heartburn symptoms lasting one to three hours.

 
Two myths many believe are that drinking milk can help relieve symptoms and that weight gain has no impact on frequent heartburn. In actuality, a glass of milk increases one’s acid production (like any food) and maintaining a healthy weight is one key to treating heartburn. 

 
Dr. Su Sachar, gastroenterologist at Cedars-Sinai Medical Center in Los Angeles, says that sufferers do not have to accept frequent heartburn as “normal.”

 
“One way to treat frequent heartburn is to take a medication that can help block the acid that causes heartburn, so you don’t get it in the first place,” Dr. Sachar observed. “It’s possible that, while taking just one pill a day as directed, a 14-day course of Prilosec OTC can control, and in many cases, eliminate frequent heartburn symptoms.

Prilosec OTC may take one to four days for full effect and should not be taken for more than 14 days or more often than every four months unless directed by a doctor. It is not intended for immediate relief.” 

 

People can take measures to avoid heartburn symptoms this summer. Dr. Sachar offers the following tips for those suffering from frequent heartburn:

 
* Get educated. One of the best defenses is to arm yourself with information. With all the over-the-counter medications available, my patients are often overwhelmed and don’t know what is right for them. Additionally, people often fall prey to the common myth that experiencing symptoms daily is normal, without realizing there are treatments available. The more you know about frequent heartburn, the better you will be able to treat it. 

 
* Talk to your doctor about the right treatment for you. Dr. Sachar recommends over-the-counter PPIs, like Prilosec OTC because it’s possible with just one pill a day to block the acid and stop heartburn before it starts for a full 24 hours of zero heartburn. It’s possible while taking Prilosec OTC. Use as directed for 14 days to treat frequent heartburn. Do not take for more than 14 days or more often than every four months unless directed by a doctor. Not for immediate relief.

 
* Quit smoking. Smoking relaxes the valve at the top of your stomach, allowing excess stomach acid to reflux into your esophagus.

 
For more information on how to best manage your frequent heartburn or to see if you qualify for a free sample, visit www.prilosecotc.com.

Hiring tips to help avoid nanny nightmares

Tuesday, June 14th, 2016


(BPT) – Movie nannies might work for a spoonful of sugar, and hugs and kisses, but in the real world nannies – no matter how loving and attentive they are – need to get paid a salary. When you’re ready to hire a nanny, you can go through the most rigorous background checks, confirm references, interview extensively and hire the caregiver of your dreams – and still find yourself in the middle of a nanny nightmare if you run afoul of tax laws.

Fortunately, online payroll services can help take the confusion out of paying your nanny, and ensure he or she gets paid on time and according to the law. Although nanny-hiring goes on year round, many more families may undertake the task as the school year gets started. SurePayroll offers some tips for hiring and paying a nanny:

* Make a list of nanny must-haves, such as schedule availability, disciplinary practices, experience with multiple kids, etc. Next, create a list of preferences that are negotiable. Setting your priorities before you begin looking for a nanny will help you make the right decision.

* Involve others, including people whose referrals you trust, such as family members, friends, teachers and co-workers. Ask them for help in finding candidates, and don’t forget to involve your kids. Give them a few minutes to meet each nanny candidate during the interview; after all, they’ll be the ones most affected by your choice.

* Remember, you’re entering a business relationship – albeit one of the most important ones in your life. Keep things professional during the interview and be sure to ask all the tough questions about topics that are important to your family.

* Don’t overlook online resources and professional organizations. Selection services like SitterCity can help you identify and screen appropriate candidates, and the International Nanny Association provides information, advice and a directory on its website. Be sure to use background checks, which can easily be done online, check multiple references and personally interview every candidate at least once before making a final decision.

* Discuss wages and base your offer on the nanny’s level of experience and what other nannies in your area are getting. Federal law requires nannies must get at least minimum wage, and they may be entitled to overtime.

* Prepare paperwork to ensure you can avoid tax penalties. You’ll need a 1040-ES, a signature-ready Schedule H, the annual 1040 and a W-2. If you pay a seasonal nanny more than $1,000 per quarter or $2000 per year, you’ll probably need to pay the “Nanny Tax,” which includes Social Security, Medicare and federal unemployment tax (FUTA).

* Set up payroll for your nanny, and plan to pay him or her by either direct deposit or check. You’ll need to make provisions to pay Social Security, Medicare, FUTA and other payroll taxes, including any state or local taxes that may apply. Track tax deductions, medical benefits and other insurance. Remember, mistakes can cost you: failing to pay the IRS nanny taxes can lead to back taxes, penalties, interest and fines of up to $25,000.

An online payroll provider like SurePayroll can help you stay on the right side of the law by managing the pay, tax and filing tasks for your nanny. Log on to www.surepayroll.com to learn more.

Bunion blues: Don’t think you’re immune

Tuesday, June 14th, 2016

Bunions are bumps that form on the outer edge of the big toe when the bone or tissue of the toe joint moves out of place. If you have a bunion, the spot is likely red, swollen and may hurt like crazy. About 23 percent of people between 18 and 65 have bunions, 35 percent of people older than 65 have them, and women are more likely than men to have them, according to a study published in the Journal of Foot and Ankle Research.

According to the American Podiatric Medical Association, bunions can form at any stage in life, and several factors influence their growth, including:

* Genetics – People with flat feet, low arches, arthritis or inflammatory joint disease – all ailments that tend to run in families – are more prone to developing bunions.

* Footwear – Shoes that are too tight or that squeeze the toes together (like those stylish pointy-toe shoes you love) can aggravate a bunion-prone foot. In fact many of the trendiest footwear fashions are harbingers of bunions to come – so you can’t possibly be too cool to develop a bunion.

* Injuries – Any injury that causes damage to the big toe joint could inspire the formation of a bunion.

If your bunion is just beginning to form, you may be able to inhibit its growth with a few lifestyle changes. Avoid wearing heels higher than 2 inches, and purge your shoe wardrobe of all styles that have tight toe-boxes. Using a bunion pad inside your shoes can also provide some protection and slow down the bunion growth.

But if your bunions are getting the best of you – and interfering with your mobility – it’s time to see a podiatrist. Podiatrists are uniquely qualified to treat ailments of the feet and lower extremities, including bunions. Your podiatrist will be able to diagnose your bunions and he or she may recommend treatment options that range from:

* Using padding and taping to minimize pain and keep your toes in a normal position, which will reduce stress and pain.

* Prescribing anti-inflammatory medications or cortisone injections to ease acute pain and inflammation.

* Physical therapy, including ultrasound therapy.

* Orthotics or shoe inserts to control foot function and prevent bunions from getting worse.

* Surgery if your bunion problems are extreme.

Every year, bunions bring thousands of Americans into podiatrist offices around the country. A few simple lifestyle changes can help reduce your risk of developing bunions, and treatment for existing bunions can help ensure they don’t interfere with your mobility and enjoyment of life.

Living with depression – What you need to know about treatment

Wednesday, June 8th, 2016


Do you or does someone you know constantly feel sad, empty, tired, or have difficulty concentrating? Have you lost interest in activities that once made you happy? Do you think you may be depressed but don’t know how to talk about it? If so, you are not alone. More than 15 million Americans suffer from a serious condition known as Major Depressive Disorder. Dr. Prakash Masand, Consulting Professor of Psychiatry at Duke University Medical Center, has answered some important questions to help you or a loved one determine if talking to a healthcare provider about your depression symptoms is needed.

Q: What is Major Depressive Disorder (MDD)?

A: Major Depressive Disorder, or MDD, is a serious medical condition requiring treatment. More than 15 million Americans suffer from MDD, about 7.3%; of the adult U.S. population. Despite the seriousness of the condition, nearly 50%;  of people with MDD do not receive treatment.

Q: How do you get MDD?

A: There is no known single cause of MDD. Psychological, biological, and environmental factors may all contribute, but whatever the cause, scientific research has firmly established that MDD is a biological, medical illness. Scientists believe that people who suffer from MDD have an imbalance in certain brain chemicals. However, MDD is treatable with antidepressant medications that improve the function of these neurotransmitters. There may also be an increased risk for developing depression when there is a family history of the illness, but not everyone with a family history develops depression.

Q: How can I tell if I have MDD, or if someone I know has it?

A: Sufferers of MDD may display a lack of interest in or pleasure from activities they once enjoyed, and may be persistently sad or in an irritable mood with noticeable changes in sleep, appetite, and energy. They may have difficulty thinking, concentrating, or remembering. They may think or talk about feelings of guilt, worthlessness and emptiness, or death. Sometimes these feelings can be so severe they turn into physical symptoms, such as headaches, digestive disorders, and chronic pain, that do not respond well to treatment.

Q: How do I get help?

A: There are a number of treatment options for MDD. The majority of people diagnosed with MDD can be effectively treated. Speak with your healthcare provider to determine if you are a candidate for antidepressant treatment. Along with medication, seeking the help of a healthcare provider for talk therapy treatment can help many individuals manage symptoms of depression.

Q: Are there any recently approved antidepressants?

A: Yes. VIIBRYD® (vilazadone HCl) received approval from the FDA in 2011 and is available in pharmacies. VIIBRYD is the first and only FDA-approved selective serotonin reuptake inhibitor (SSRI) and 5-HT1A receptor partial agonist for the treatment of adults with Major Depressive Disorder. The mechanism of the antidepressant effect is not fully understood but is thought to be related to its enhancement of serotonergic activity in the central nervous system (CNS) through selective inhibition of serotonin reuptake. VIIBRYD is also a partial agonist at serotonergic 5-HT1A receptors; however, the net result of this action on serotonergic transmission and its role in antidepressant effect of VIIBRYD are unknown. Talk to your doctor about the benefits of treatment with VIIBRYD and visit the website www.viibrydhcp.com.

Important Risk Information

What is the most important information I should know about VIIBRYD?

VIIBRYD and other antidepressant medicines may cause serious side effects. Call your healthcare provider right away if you have any of the symptoms described below, or call 911 if there is an emergency.

Suicidality and Antidepressant Drugs

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, teens, and young adults. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. VIIBRYD is not approved for use in patients under 18.

Call your healthcare provider right away if you have any of the following symptoms as they may be signs of rare but potentially life-threatening conditions: Agitation, hallucinations, coma or other changes in mental status, muscle twitching or coordination problems, fast heartbeat, high or low blood pressure, fever or sweating, muscle stiffness or tightness, nausea, vomiting, or diarrhea.

Who should not take VIIBRYD?Do not take any drugs known as MAOIs within 14 days of stopping VIIBRYDDo not start VIIBRYD if you stopped taking an MAOI in the last 14 daysPeople who take VIIBRYD close in time to taking an MAOI may have serious or even life-threatening side effects.

What should I talk to my healthcare provider about?VIIBRYD may increase suicidal thoughts or actions, especially when starting treatment or when the dose is changed. Call your healthcare provider right away if you have suicidal thoughts, or if you become agitated, irritable, hostile, aggressive, impulsive or restless, or if your condition gets worse.Tell your healthcare provider about all prescription and over-the-counter medications you are taking or plan to take, including: – Medicines to treat migraines, anxiety, psychotic or thought disorders, or mood disorders, including triptans, tricyclics, lithium, SSRIs, SNRIs, buspirone, or antipsychotics; this is necessary to avoid a potentially life-threatening condition – Aspirin, NSAID pain relievers, or blood thinners (warfarin, Coumadin or Jantoven) because they may increase the risk of bleeding – Tramadol, mephenytoin (Mesantoin) or over-the-counter supplements such as tryptophan or St. John’s Wort

Before starting VIIBRYD, tell your doctor if you: -  Have kidney or liver problems – Have or had mania, bipolar disorder, seizures or convulsions – Have or had bleeding problems. VIIBRYD may increase your risk of bleeding or bruising – Have low salt (sodium) levels in your blood. Elderly people may be at greater risk – Are nursing, pregnant, or are planning to become pregnantCall your healthcare provider right away if any of these symptoms or conditions occur while you are taking VIIBRYD. Some may be signs of serious side effects.

Do not stop VIIBRYD without first talking to your healthcare provider.

Stopping VIIBRYD suddenly may cause serious symptoms including: anxiety, irritability, high or low mood, feeling restless or sleepy, headache, sweating, nausea, dizziness, electric shock-like sensations, tremor, and confusion.

What should I avoid when taking VIIBRYD?Until you know how VIIBRYD affects you, be careful driving a car, operating heavy machinery or engaging in other dangerous activities. Avoid drinking alcohol while taking VIIBRYD.

What are the most common side effects of VIIBRYD?The most common side effects in people taking VIIBRYD include diarrhea, nausea, vomiting, and trouble sleeping.Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of VIIBRYD. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects.

Please also see the Medication Guide within the full Prescribing Information.

A fun approach to teaching kids nutrition wisdom

Wednesday, June 1st, 2016



“The more parents can do to involve children in the process, the decisions on what they are eating and where their food comes from, the better off they will be at helping them learn reverence and appreciation for food,” says Anni Daulter, professional cook, nutrition expert, and author of several books, including “The Organic Family Cookbook.”

Here are some simple yet effective tips from Daulter to get your kids excited about nutrition and help them make good food choices:

1. Make mealtime special

“In our fast-paced lives, we have somehow lost the concept that eating is not just about the actual food. It’s about the connection, the time spent enjoying every bite, laughing, talking and sharing. Our families need this time together,” Daulter says.

Create a routine. Consider starting dinner at a similar time each night. Designate different nights for different types of meals, such as vegetarian Monday, or make-your-own pizza Saturdays. Have children help with the meal prep and cleanup, if age-appropriate. Light a candle during dinner, and allocate plenty of time for conversation – it’s one of the best ways to bond with loved ones.

2. Adopt a healthy morning routine

While most families are time-crunched on weekday mornings, it’s important to make time for breakfast so kids get the nutrition they need before heading to school. Healthy breakfasts incorporate whole grains, protein, fresh fruit, and supplements that support brain and body health.

“Supplements can be an easy way for mom and dad to ensure that their children get the important nutrients they need, especially during busy mornings,” says Daulter. “I recommend giving kids a boost of brain-building nutrition with a kid-friendly omega-3 supplement. I like chewable, strawberry-flavored Nordic Naturals Children’s DHA. This essential nutrient is brain food, proven to support brain growth and health. Additionally, omega-3s support a healthy immune and nervous system, too.”

3. Create tasty school lunches

“When your children are fed better, they learn better,” says Daulter. “Their bodies react to being fed good pure foods that give them the fuel they need to get through each and every school day.”

Save time by making lunches the night before or do a big Sunday cut-and-chop day for raw ingredients throughout the week. Here is a sample of what you’ll find in Daulter’s children’s lunch baskets:

Black Bean Soup Lunch
 * Classic Caesar salad
 * Homemade wheat parmesan chips
 * Raw: Asian pears and clementines

4. Have healthy snacks on hand

“Kids bodies tend to be more in tune with their internal signals and they inherently seem to know that they need more little meals throughout the day, rather than three big meals,” Daulter says. “Eating smaller portions frequently throughout the day provides more energy when we need it and is easier for our bodies to digest.”

Daulter keeps several small kids tables throughout the house so her children can nibble on snacks while they continue to play. What sorts of things does she like to feed her kids for snacks? Nuts, homemade fruit roll-ups, pumpkin seeds, veggie popcorn, fresh fruits, carrot sticks, and cheese are all healthful snacks that keep kids’ bellies full.

5. Teach healthy eating habits through activity

“My kids and their friends love to cook and help us prepare meals, and the more we include them in the process, the more invested they become in their own health,” says Daulter.

You may be surprised by how excited your children get by being involved in the entire meal process. When you go to the grocery store or farmers market, have children help pick out veggies. If you grow your own, let them pick the produce and help wash, peel and prep it for meals.

“Even the youngest child can help mix in flour for fresh bread or learn to whip her own honey butter,” says Daulter. “These tasty teachings will not only give them practical and valuable life skills, but will leave them with loving memories of family cooking days that were spent laughing, creating, and of course, eating!”