7-3-2015 4-30-49 PMAccording to data from the American Academy of Pain Medicine, over 100 million Americans and 1.5 billion people worldwide struggle with chronic pain. Chronic pain is defined as pain that persists over weeks, months, or even years, while acute pain is a trigger of the body to alert you to injury, and the need to take care of yourself (www.pain.org). There may be an initial injury that causes acute pain and turns into chronic, or there may not. The most common sites for chronic pain include back, headaches/migraines, and the neck, but can occur anywhere in the body.

Over the last several years, pain management has been a huge focus in the healthcare world. It is so much so that we have begun to deem pain as the “fifth vital sign” in addition to blood pressure, heart rate, respiratory rate/oxygen saturation, and temperature. If you have been treated in a hospital or doctor’s office recently, you have likely heard them ask about your pain level on a 0-10 scale with 0 being no pain, and 10 being the worst pain imaginable.

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There are many ways available to treat both acute and chronic pain, including over the counter medications, prescription drugs, and alternative pain management solutions. Always discuss your pain management goals with your healthcare provider, and come up with a plan that you can both agree on together for you. Below you will find some alternative therapies to research to see if they might fit your unique situation.

1. Be Active. Exercise is the last thing many sufferers want to think about. However, light exercise can improve quality of life in chronic pain sufferers. Stretching, walking, yoga, and aquatics are all good options when beginning an exercise plan. Talk to a personal trainer and/or your healthcare provider to come up with a plan that is tailored to you and your ability level.

2. Eat healthy foods. Many people struggling with chronic pain have difficulty doing simple tasks like grocery shopping, preparing meals, and even walking around their home. Understanding the relationship between food and disease is an important aspect to dealing with many health challenges. Eating a balanced diet high in plants (fruits, vegetables, berries, etc.) can aid in weight loss, improve mood, decrease in other chronic health conditions, and will provide the necessary nutrition and energy required to maintain an active and healthy lifestyle. Consider cutting out highly processed foods and replacing them with fresh produce and lean meats.

3. Get a good night’s sleep. A majority of chronic pain sufferers also report difficulty with sleeping. It is vital to create a healthy environment as the first step to better sleep. Maintaining little to no light, turning off devices such as televisions, computers, and cellular phones at least an hour prior to going to bed, and breathing exercises are all ways to improve your environment. You may also consider purchasing a device that can track how well you are sleeping (unless you have a pacemaker, defibrillator, or implanted neurostimulator).

4. Technology. New technology is emerging every day in every arena, and healthcare is no exception. There are biofeedback machines, transcutaneous nerve stimulators (TENS units) and electromyography units. Before use, talk to your healthcare provider and do not use if you have the implanted devices mentioned above.

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5. Acupuncture and Acupressure. This is an ancient Chinese healing art that has been around for thousands of years. It involves inserting needles or putting pressure on various points of the skin in order to regulate and balance the body’s meridian systems. There are a number of studies that show the effectiveness of this treatment for pain.

6. Aromatherapy, Essential Oils, and Herbal Remedies. These therapies uses the oils found in various plants that are either inhaled or applied to the skin, or in the case of herbs, taken orally. This practice also dates back to ancient practices of the Chines, Romans, Egyptians, Greeks, and Indians. Studies show improvement of pain in cancer patients and many other conditions. Many hospitals have begun using aromatherapy as an intervention in dealing with pain and insomnia. Speak to your practitioner and an experienced herbalist for assistance on choosing the right therapies. Make sure that they will not interact with any of the current medications that you take.

7. Chiropractic care. Though it is now more mainstream, it is still considered a form of complementary medicine. Chiropractors look at the relationship between the structure of the body and its function. Many focus mainly on realignment of the spine, but also other bones and joints to promote self-healing. It has been shown effective in dealing with headaches, back pain, and sports injuries. Make sure you talk with your healthcare provider before beginning a chiropractic regimen, and seek out a chiropractor whose ideas of healing are in line with your own.

8. Massage. Like chiropractic care, this is now considered to be more mainstream than it has been in the past, but still is considered complementary medicine. Rather than manipulating bones/joints, massage manipulates muscles and soft tissues. It has also been shown to be effective in several clinical studies at treating various painful conditions.

9. Relaxation and Meditation. Stress can worsen or even create disease, including pain. When we are stressed, we release a chemical called adrenaline, the same chemical that floods our bodies when we are in a dangerous situation. Over time, this can cause muscle tension, increased blood pressure and heart rate, and wreak all kinds of havoc. Some ways to combat this include prayer, meditation, breathing exercises, tai chi, guided imagery, and meditation.
By: Rachel Clark, RN, BSN

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6-18-2015 4-42-06 PMAfter a long, cold winter and a humid, rainy spring, summer has finally arrived in full force. The days are longer, with the sun being up well before 6AM and not going down until past 8PM in the evenings. When I was a kid, I loved this time of year. It meant no school and playing outside all day.

June is National Safety Month, and below you’ll find some tips to keep you and your kids safe this summer as you enjoy the break from school or work.

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Tick Bites:
One of the major things to be on the lookout for this summer is ticks. They are everywhere, especially if you live in rural areas like Limestone County where fields and forests abound. Ticks carry a variety of illnesses such as Lyme’s Disease and Rocky Mountain Spotted Fever, both of which can have serious lasting effects if not recognized and treated early on.

To keep the ticks away:
• Wear protective clothing such as long pants and long sleeves, tucking pants into socks if you are going to be doing any hiking or playing in wooded areas where ticks are common.
• Use tick or bug repellent. There are many different brands available, and it is important to find the best fit for you and your family. Any repellent containing DEET can be extremely hazardous to your health. Some families choose to make their own insect repellents using essential oils like peppermint, lavender, pennyroyal, geranium, lemongrass, eucalyptus, or lemon oil in a witch hazel base. My personal favorite recipe uses Young Living Essential Oils, though any therapeutic grade oil will work. It calls for 14oz of Witch Hazel, 12 drops of lavender, 15 drops of citronella, and 15 drops of lemongrass.
• Perform tick checks on a daily basis, especially if you have been in wooded or rural areas. Check heads, armpits, and any fold/creases, as these are prime areas for ticks to hide.
• Be aware of signs and symptoms with tick-born illness, and call your healthcare practitioner for any questions or concerns. Some signs and symptoms are so subtle that they can be missed or may mimic other conditions. For more information, check out the Centers for Disease Control website.
• If you get bitten by a tick, use fine tipped tweezers and grab the tick as close to the skin as possible. Pull upward with steady, gentle pressure and DO NOT twist or jerk as you can leave pieces of the insect behind. After removing the tick, clean the area well with rubbing alcohol, iodine, hydrogen peroxide, or chlorhexidine. Wash your hands thoroughly before touching any other part of the body, especially mucus membranes. Dispose of the tick by either flushing it down the toilet or drowning it in alcohol; NEVER crush a tick with your fingers.

Beat the Heat:
In states like Alabama where the heat index is high, it is extremely important to be aware of how heat can wreak havoc in your body if it isn’t accustomed to high temperatures.

Remember to:
• Keep yourself hydrated. Drink more water in the summer months. Stay away from sodas, caffeine, and sugary drinks as these increase the risk of dehydration. Offer fluids BEFORE someone complains of thirst because they are already dehydrated at that point.
• NEVER leave anyone unattended in a vehicle during the summer. The heat inside a vehicle is much greater than outside and can cause severe or fatal consequences. Children, animals, and the elderly are at the highest risk for negative outcomes associated with heat.
• Cover skin and/or use sunscreen to prevent sun damage that can lead to skin cancer. Some sun is necessary for the body to be able to absorb Vitamin D and can help fight off symptoms of mild depression. Make sure to get sun on bare skin in the early morning or late evening when the suns rays aren’t at their peak. If you choose to use sunscreen, there are options for making your own that is a safer alternative to commercial ones that can be harmful.

Water Safety:
Water sports are a big hit, especially in this area where pools, rivers, and streams abound. Adult supervision is mandatory for your enjoyment of water activities.

Keep in mind:
• No one, including adults, is drown proof.
• Always wear life jackets when on a boat, jet ski, or any other watercraft.
• NO DISTRACTIONS! Looking away for even a moment can have disastrous effects.
• Practice touch supervision, meaning that a supervising adult who can swim is within arms reach at all times when children are in or near water.
• Children can drown in many different places including bathtubs, buckets, swimming pools, baby pools, streams, creeks, lakes, and rivers. It doesn’t take much water.

Fireworks Safety:
The 4th of July is right around the corner. Many children enjoy fireworks displays and want to play with sparklers, firecrackers, and other fireworks.

Make sure you:
• Supervise children with any fireworks at all times. Even sparklers can reach temperatures in excess of 1000 degrees.
• Attend displays put on by professionals who are experienced and have access to emergency medical equipment and personnel.
• If you or a child experiences burns, seek immediate emergency medical treatment. The chemicals in fireworks can linger and burn longer and hotter than a normal burn.

Enjoy a safe, fun summer.
By: Rachel Clark, RN, BSN

6-6-2015 11-58-41 AMSeveral weeks ago, I saw a Facebook post about how secrets can be dangerous things. Webster’s Dictionary defines a secret as something we keep hidden from the knowledge of others. Teaching children about secrets is an important part of keeping them safe from the long-term effects that can be caused by abuse.

According to a sexual abuse prevention workshop called “Parenting Safe Children,” secrecy is a key element to childhood sexual abuse. A Denver mom wrote a blog post about her experience with teaching her son an alternative to secret keeping. In her home, she teaches her children about surprises instead. She recounts the story of a friend who gave her son a cookie and said “shhh…it’s a secret.” To the mom’s utter delight, the son told the woman that in his home, they don’t do “secrets,” but instead they do “surprises.”

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The mom explains “Surprises are something we keep quiet about temporarily; then you share the surprise and people are happy. But secrets are meant to be kept quiet forever and they are often protecting something that would make people unhappy.” Surprises are things like a birthday party or a gift. Secrets like sexual abuse leave long-lasting scars on everyone involved.

Often times, sexual predators will test children by asking them to keep smaller secrets (like cookies or other treats), building up to bigger and bigger secrets about what is happening to them. By teaching her children different terminology, she is bypassing this common method of trapping children in the abuse cycle. This little boy was bold enough to say that he doesn’t keep secrets. He is no longer a vulnerable target because of the wisdom of his mother in teaching him about body safety.

It is vital to start early teaching children about their bodies and which parts are ok to touch and which parts aren’t. If these important lessons are instilled in them early on, they are less likely to experience abuse, and the devastating effects it can lead to in the future such as anxiety, depression, and suicidal ideation/attempts.

Body Safety Rules include the following (adapted from Parenting Safe Children Workshop developed by Sandy Wertele, Ph.D. and Feather Berkower, MSW):

1. No one is allowed to touch your private parts
2. You should not touch someone else’s private parts
3. No one is allowed to take pictures of your private parts
4. If someone tries to touch your private parts, say “NO!”
5. When playing friends, play with your clothes on
6. You are allowed to have privacy when bathing, dressing and using the toilet
7. You have permission to say “No” and get away if someone tries to touch your private parts or breaks any of your body safety rules
8. We don’t keep secrets in our family. If someone tells you to keep a secret, tell an adult.

Also, educate children that doctors and nurses sometimes have to examine these private parts of their bodies and that is ok, because Mommy or Daddy is with them. Begin to teach your children these rules now to eliminate them as targets later. If you don’t yet have children, adopt the practice now of not keeping “secrets” so that it will be easier to instill in them these principles when you do.
By: Rachel Clark, RN, BSN

5-15-2015 3-39-02 PMThe American Trauma Society (ATS) and the Society of Trauma Nurses recognize the month of May as National Trauma Awareness Month. This year’s slogan is “3D Trauma Prevention,” focusing on 3 major contributors to motor vehicle accidents (MVA): Drugs/Drinking, Distraction, and Drowsiness.

According to the ATS website, there were 32,000 fatalities and 2.3 million injuries from MVAs in 2013 alone. Of those, 31% were linked to an alcohol-impaired driver and another 18% were linked to a distracted driver.

Most of us are aware of the risks of getting behind the wheel after drinking or using drugs. Below are a few statistics from the ATS and the Centers for Disease Control (CDC) regarding drinking/drugs and driving:

• Drugs other than alcohol are involved in about 18% of MVA driver deaths, and are often used in combination with alcohol.
• Someone is injured every 2 minutes due to a drunk driving crash.
• On average, 2 of 3 people will be involved in a drunk driving crash in their lifetime.
• In 2009, 18% of fatally injured drivers tested positive for at least one illicit, prescription, or over-the-counter drug.
• Of the 239 child passengers 14 and younger who died in alcohol-impaired driving crashes, over half were in a car with an alcohol-impaired driver.
• Of the motorcyclists killed in 2012, 29% had blood alcohol levels greater than 0.08%.
• In a study done in 2013, 9.9 million people admitted to driving under the influence of illicit drugs in the year prior to being surveyed.
• In 2012, 29.1 million people admitted to driving under the influence of alcohol.
• In 2011, 15% of drivers in fatal crashes were drunk compared to 31% on the weekends.

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Distracted driving is also a big problem. Actions such as the use of electronic devices (cell phones, GPS, radio, etc.), the driver’s state of mind, conversations with passengers, eating/snacking, reading, taking notes, and applying makeup all contribute to MVAs. Many adults and teenagers are aware of the dangers of using an electronic device while driving, but will also admit to their use while behind the wheel. There is no text or social media post that can’t wait until a time when you aren’t behind the wheel of a motor vehicle.

Many drivers are less aware of the effect of their state of mind on their ability to drive safely. Being distracted can involve intense conversations with passengers, being upset or being overly tired. Eating also distracts you. Take a few minutes to pull over and enjoy your meal rather than risk harming yourself or someone else.
Drowsy driving is another problem that drivers face, especially those doing shift work. It is especially dangerous as it slows reaction time, decreases awareness, and impairs judgment just like drugs or alcohol. AAA surveyed police officers and 9 out of 10 drivers they suspected of being drunk turned out to be drowsy instead. Some danger signals include:
• Having trouble keeping your eyes open and focused
• Inability to keep head up
• Daydreaming or wandering, disconnected thoughts
• Frequent yawning or rubbing eyes repeatedly
• Drifting from your lane or tailgating
• Missing signs or driving past your exit
• Drifting off the road/hitting rumble strips
• Inability to remember how far you’ve traveled or what you recently passed

Some suggestions for avoiding driving while drowsy are:
• Don’t drive when you know you are sleepy
• Get enough sleep the night before, especially if going on a long trip. Less than 6 hours of sleep increases risk of falling asleep at the wheel. Don’t plan to work all day and then drive all night as drivers being awake for 20 hours or more have high risk of falling asleep while driving. Travel at times when you are normally awake, rather than driving straight through.
• Travel with a passenger. They can watch for signs of fatigue and take over if necessary.
• Take a power nap. Pull off the road in a safe, well-lit area such as a parking lot or rest area.
• Schedule breaks every 4 hours or 100 miles.

Next time you get behind the wheel, make sure you haven’t been drinking/using drugs, get rid of the distractions, and that you aren’t drowsy.

*Information above adapted from the website and posters presented by the American Trauma Society for National Trauma Awareness Month.
By: Rachel Clark, RN, BSN

5-1-2015 1-17-59 PMTechnology changes the world we live in on a daily basis. There is always a new gadget or gizmo coming out on the market that is supposed to save us time, make our lives easier, or benefit us in some way or another. The marketing is usually well-planned, and it targets people of all ages, not just the GenY and technologically savvy. It is also changing how we do healthcare.

The federal government mandated that all hospitals and physician’s offices across the country have some type of electronic medical record by the beginning of this year. The thinking is that it will help make things more standardized across the board, and will make the charting process more efficient. The goal is to make medical records containing history, allergies, diagnoses, medications, and treatments available to clinicians around the country quickly and easily.

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As a nurse, I work with electronic medical records every day. I have always had computerized charting, ever since I started as a new-graduate nurse. I never learned the art of paper charting, or how to read the infamously atrocious handwriting of doctors. All of my orders have been neatly typed, with little room for errors in interpretation. I have always had the ease of entering into the computer whatever treatments I’ve given to my patients, be that medications, physical assessments, or vital signs.

Most of the time that task has been as simple as selecting the correct treatment from a dropdown menu of choices. Sometimes I’ve had to add in notes in a free text box to explain what isn’t exactly covered by the dropdown selection. I now use a system where I don’t even need to use a mouse. All I have to do is tab, arrow, and enter to select the value I want to enter into the patient’s chart.

Sounds like a wonderful, high-tech solution to a problem, right? It is. And most of the time it is truly a marvelous thing! As a GenY-er, I quickly and easily adapt to the changing face of technology in the healthcare world like the rest of my generation. But not everyone does. And it’s not always all it is cracked up to be either.

Sometimes, older nurses have problems with the system, and it is much harder for them to navigate it. If they haven’t familiarized themselves with the basic functions of a computer, they have more trouble than their peers who have done so. I know such nurses; they do their jobs well, and their patients are always well taken care of. They’re old school, and I enjoy working with them quite a lot. They have a great deal of wisdom, and have seen things change drastically over the many years they have been doing what they do. But some of them struggle with the computerized part of their job.

Not only is it a problem for some of the more seasoned nurses who have been doing this for years, it can be a problem for the GenYers. Not in the same sense of course; our problems come when for one reason or another, the system is not functioning as it should, is completely down, or is being updated.

We all know our personal computers, phones, and tablets need to be updated from time to time. It’s annoying when your device informs you it needs to shut down in order to install an update that it thinks you need. Sometimes, until that update is done, you are left scrambling because you’ve become dependent upon that piece of technology.

Magnify that stress by 100. That is what it is like when the computer system of a major hospital or hospital system is down. Suddenly, those nurses like myself who have always had the ease of technology no longer have that comfort to fall back on. We have to chart on paper. We have to decipher the scribbling that is supposed to constitute a physician’s signature or order. We are totally and completely lost. For most of us, it can be one of the worst days in our career. If we have the ability to schedule ourselves for our weekly shifts, most of us will avoid working on days where there is a planned downtime of the system.

Not all of us are that lucky. This was the exact situation I found myself in this past weekend. I also became more grateful for those nurses who have been around for several years, those who knew what it was like before we became completely digitized. All of a sudden, I was a brand new nurse again who had no idea what to do. I couldn’t read my orders, and was constantly asking either the nurses around me or the doctors themselves what was written on the page.

It’s days like Sunday that make me question whether or not this electronic health record system is as efficient and valuable as it is said to be. Nursing is a science, but it is also an art. We are beginning to lose some of that art, especially as it relates to communication with doctors and each other.

Some days, technology makes my job easier, and some days it makes it more complicated. And isn’t that always the case when the law of unintended consequences is in effect?
By: Rachel Clark, RN, BSN

4-17-2015 10-15-39 AMWhat is stress? According to the dictionary, there are several definitions of stress, but our focus will be the following aspect: “ a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances.”

We have all experienced stress at some point in our lives. And not all stress is negative. Stress can motivate us, but it can also do damage to our bodies if we are continually living in a state of tension and strain. In fact, Yale-trained physician, midwife, and herbalist Aviva Romm, states that 60% of all illnesses are linked to a stress component-that’s right folks, 60%!

Each of us has our own symptoms related to stress. They may be the same or different from the symptoms experienced by your family, friends or coworkers. You likely already know yours. There is a list of 50 common signs/symptoms of stress listed on stress.org. A few most common ones I experience personally include racing heart, ringing of the ears, racing thoughts, difficulty concentrating, difficulty sleeping, crying, feeling overwhelmed, feeling the need to “run away,” and communication problems.

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Many symptoms, such as increased heart rate, muscle tension, head pounding, and increase breathing rate, are all components of the “fight-or-flight” response that is instinctive to the human body. Our body was made to react to stress. Small amounts of stress on a regular basis can be a good thing as it can help improve mental clarity, focus and immune response. However most of us are continually exposed to situations that require the body to react this way, and it is damaging over time.

Stress is a big deal. It is linked to heart attack, depression, suicide, drug and alcohol addiction, eating disorders, herpes outbreaks, autoimmune conditions, high blood pressure, stroke, infections, and even accidents such as car accidents and work-related incidents. Over time, stress decreases our body’s ability to handle exposure to even small amounts of chemicals released by stress such as adrenaline, epinephrine, and cortisol.

In order to combat the stress, we must first learn to recognize it in ourselves and admit it. Admitting it is most of the battle. Once you see it for what it is, you can make choices that reduce the stress and improve your ability to handle it.

Below are some ways to reduce stress, without the use of medications.
• Eat well-increase the amount of whole, plant-based foods in your diet to help boost the immune system
• Get enough rest-take a nap if you can, go to bed earlier, allow your body to wake up naturally without the use of an alarm clock
• Exercise-MOVE your body; go for a run, walk, swim, or bike ride.
• Laugh-find a way to make yourself laugh, it lowers cortisol (a stress chemical) and boosts endorphins (chemicals in the brain that make you happy)
• Listen to music-this simple thing can lower blood pressure, anxiety, and depression; create a playlist of your favorites and crank it up!
• Get a massage-relieve muscle tension and soreness related to chronic stress
• Connect with someone-this strengthens the relationship but also helps give you a new perspective
• Write/journal-this is an avenue I use CONSTANTLY to combat stress in my life; it gives me a way to put onto paper what I am feeling and deal with it in ways that are positive and uplifting, and is especially helpful when I use it in combination with prayer
• Breathing exercises-this will also help lower heart rate and blood pressure; sit up straight with one hand on the belly and the other on the head, breathe in deep through your nose and feel the breath starting in the belly and work up to the top of your head, exhale through your mouth while reversing the process. It is helpful for some people to imagine their favorite color filling up the lungs as they breathe in deeply.
• Meditate/pray-it has been suggested that this can alter the way the brain actually works.
• BE GRATEFUL!-start a gratitude journal to remind yourself of all the positives in your life; keep one in several places so it is accessible at all times
By: Rachel Clark, RN, BSN

4-3-2015 1-56-49 PMSpring has sprung! The days are beginning to get longer, the rain is plentiful, and things that have lain dormant during the long winter months are beginning to grow. Trees are budding, flowers are blooming, and gardens are being planted. This is a time when we are reminded that all things are made new. While most people enjoy the beauty and wondrous scents that are ushered in with spring, many have a love-hate relationship with it.

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Seasonal allergies are an issue for approximately 50 million people in the United States. That translates to about 30% of adults, and 40% of children. There is no cure for seasonal allergies, but there are many ways to combat the symptoms.

Symptoms of Seasonal Allergies:
• Sneezing
• Stuffy nose
• Runny nose
• Watery eyes
• Itchy eyes, nose, and throat
• Headaches
• Poor sleep

Many people go to their primary care physician and receive prescription drugs or over the counter drugs to deal with allergy symptoms. Some allergy medications include Benadryl, Allegra, Singulair, Claritin, and Zyrtec.

For those of us trying to approach health and wellness from a more natural standpoint, there are many options available to deal with these annoying symptoms.

Natural Remedies for Seasonal Allergies:
• Neti pots-a saline rinse that cleanses the nasal cavity, flushing out allergens and loosening mucus
• Local honey-the honey is pollenated by bees with allergens from your area, and eating a little bit each day seems to help some people increase their tolerance of allergens
• HEPA filters-trap allergens such as pollen, dust, and pet dander inside the home
• Herbal supplements such as nettles, spirulina, goldenseal, eyebright, and butterubur. Stinging nettles work similarly to prescription and over the counter allergy medications without unwanted side effects such as dry mouth and drowsiness by inhibiting histamine production by the body.
• Hot showers or steams to open up nasal passages and allow for drainage of mucus
• Eucalyptus oil to open up airways and nasal passages
• Tea-there are good effects from the heat and steam but benefits don’t stop there. Peppermint tea works like a decongestant and expectorant to break up mucus and get it out of nasal passages. Green tea has antioxidants that inhibit allergic reactions.
• Apple cider vinegar with the “Mother”-reduces mucus production and cleanses the lymphatic system
• Probiotics-allergies are usually an over reaction of the immune system to a stimulus, and new research indicated that healthy gut bacteria can help reduce the incidence of allergies
• Nix the hair spray and hair gel. These act like magnets for pollen.
• Opt for allergy friendly flowers in your garden. In our area these include: periwinkles, irises, begonias, bougainvillea, and for the inside, orchids.
• Pay attention to the pollen count on a daily basis. If you plan ahead, you are going to know when you should do your best to stay indoors. You can get a daily update at AAAAI.org/NAB

So get out there and enjoy the sunshine, soak up some Vitamin D, and may you find success dealing with seasonal allergies.
By: Rachel Clark, RN, BSN

3-20-2015 11-08-45 AMRecently a new study published in The Lancet Global Health has indicated that prolonged breastfeeding may be linked to “higher intelligence, longer schooling, and greater earnings” as an adult. This study was done in Pelotas, Brazil and measured participants for an average time span of 30 years.

Dr. Bernando Lessa Horta, the lead author of this study, had this to say of the research: “The effect of breastfeeding on brain development and child intelligence is well established, but whether these effects persist into adulthood is less clear. Our study provides the first evidence that prolonged breastfeeding not only increases intelligence until at least the age of 30 years but also has an impact both at an individual and societal level by improving educational attainment and earning ability.”

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According to the Mayo Clinic, breastfeeding is the “gold-standard” in infant nutrition for the first year of life, with exclusive breastfeeding for at least the first six months. This is because breast milk contains the right balance of nutrients for the baby, in addition to boosting the immune system.

Some women find it hard to breastfeed their babies for any length of time, let alone the one-year mark for various reasons. Sometimes that is due to issues with the baby’s latch, maternal health problems like mastitis, a decreased milk supply, or premature babies with extended stays in the Neonatal Intensive Care Unit (NICU). Below you’ll find some nutritional tips during the time you choose to breastfeed your baby.

General Nutritional Tips:
• Make your calories count. Limit those foods high in hydrogenated fats, sugar, and “empty calories.” Examples include desserts, fried foods, and soda.
• Eat a variety of colors of fresh, raw fruits and vegetables. This is true for people of all ages and genders, but especially for breastfeeding mothers. It is now recommended that we eat fully HALF our plate at each meal in fresh, raw fruits and vegetables.
• Eat 8-12 ounces of seafood each week. Fish has nutrients that help develop your baby’s brain and eyesight. Eat a variety of healthy choices such as Salmon, Cod, White (Albacore) Tuna (no more than 6 ounces each week), and Tilapia.
• Drink plenty of fluids. Your body needs increased fluids to meet the demands of breastfeeding. Good choices include water, milk, and very low processed fruit juices that have little or no artificial sugar/sweeteners.

Foods To Avoid While Breastfeeding:
• Alcohol-there is no amount of alcohol in breast milk that is considered safe for your baby. If you are going to drink while breastfeeding some tips to remember include: (1) wait until baby is 3 months old and has an established pattern, (2) drink no more than ONE drink per day, (3) wait at least four hours after having a drink to breastfeed your baby, (4) plan ahead for how to feed your baby if they become hungry
• Caffeine-this could agitate your baby or cause issues with sleep. If you choose to drink caffeine while breastfeeding, limit it to 24-ounces or less per day and avoid drinks high in sugar content.
• Seafood with high mercury content-this could inhibit the development of your baby’s brain. These fish include King Mackerel, Tilefish, Swordfish, and Shark.

If you are having trouble breastfeeding, see a certified lactation consultant. If you need help with your own diet, consider visiting a registered dietician.
By: Rachel Clark, RN, BSN

3-5-2015 3-02-57 PMOn Sunday, March 8, we will “spring forward.” Many countries around the world have been doing this for almost a century now. It was started in order to take advantage of all available light during the longer days starting in early spring and extending into late summer. Many now question whether or not Daylight Savings Time is as useful as it once was. We can use electricity rather than sunlight in order to perform jobs later into the night, and having our clocks reset doesn’t seem quite as necessary. Several countries, as well as some U.S. states, are beginning to opt out of this observance.

Many Americans, young and old alike will have to readjust their circadian rhythms that have become unbalanced as a result of this change of time. It can take days or weeks to readjust one’s sleep pattern. This is concerning, especially because sleep is so important in keeping your body healthy. Getting enough good quality sleep at the right time can help protect mental and physical health, and improve quality of life and safety.

3-5-2015 3-03-09 PM

Losing an hour of sleep (which we do in the Spring when we “spring forward”) has significant adverse affects on our health, not to mention the ripple effect that it can cause for several days or weeks afterward. When circadian rhythms are interrupted or altered, it can take significant amounts of time to even out, and cause mayhem in the meantime.

According to Dr. Joseph Mercola, and research published in the European Journal of Epidemiology, more cardiac events occur on Monday than any other day of the week. This could be linked to changes in sleep habits in transition from weekend to work week. Dr. Martin Young, an associate professor at UAB in the division of Cardiovascular Disease, says that the Monday and Tuesday following the start of Daylight Savings Time in the spring shows about a 10% increase in heart attacks while the reverse is true for when the clocks fall back in October.

Your heart isn’t the only thing to worry about with sleep deprivation. It also increases the risk of diabetes, inflammatory processes, and accidents/death both in vehicles and the workplace.

Young says “Every cell in the body has its own clock that allows it to anticipate when something is going to happen and prepare for it. When there is a shift in one’s environment, such as springing forward, it takes a while for the cells to readjust. It’s comparable to knowing that you have a meeting at 2 p.m. and having time to prepare your presentation instead of being told at the last minute and not being able to prepare. The internal clocks in each cell can prepare it for stress or a stimulus. When time moves forward, cell clocks are anticipating another hour to sleep that they won’t get, and the negative impact of the stress worsens; it has a much more detrimental effect on the body.”

So how can you prepare your body this weekend and during the next week for the coming change?

• Eat a good breakfast
• Wake up 30 minutes earlier than originally intended Saturday and Sunday
• Exercise in the mornings
• Go outside in the early morning sun
• Consider setting your clock forward on Friday night instead, giving yourself an extra 2 days to acclimate to the change

According to Dr. Young, “Doing all of this will help reset both the central, or master, clock in the brain that reacts to changes in light/dark cycles, and the peripheral clocks — the ones everywhere else including the one in the heart — that react to food intake and physical activity. This will enable your body to naturally synch with the change in the environment, which may lessen your chance of adverse health issues on Monday.”

Some other things you can do, as mentioned in an article by Dr. Mercola, include:

• Be particularly mindful of using electronic devices in the days prior to the switch-over. Research on teens shows that using electronics for four hours during the day can increase your risk of needing more than an hour to fall asleep by nearly 50 percent. Using any device for more than two hours per day increases the likelihood of needing more than an hour to fall asleep by 20 percent. So, if you’ve ever considered “unplugging” for a day or two, the weekend of the DST switch-over is a perfect time to turn everything off, or cut down your use of electronics to a bare minimum so that you can optimize your sleep.
• Pay attention to your diet, making sure you are consuming plenty of fresh, whole foods, preferably organic, and minimal amounts of processed foods and fast foods. Keep your sugar consumption very low, especially fructose.
• Practice good sleep hygiene, including sleeping in complete darkness, checking your bedroom for EMFs (electrical and magnetic forces, a source of radiation), and keeping your bedroom temperature no higher than 70 degrees.
• Optimize your vitamin D levels.
• Manage your stress with whatever stress-busting techniques work for you.
• Consider supplementing with melatonin if you have trouble sleeping.
• If you have a fitness tracker that tracks sleep, start using it. If you don’t have one, you may want to consider getting one. During daylight savings time, making sure you’re getting enough sleep may be more important than ever. One of the keys to optimizing your sleep is going to bed early enough, because if you have to get up at 6:30am, you’re just not going to get enough sleep if you go to bed after midnight. Chances are you’re getting at least 30 minutes less sleep than you think, as most people do not fall asleep as soon as their head hits the pillow.
• Many fitness trackers can now track both daytime body movement and sleep, allowing you to get a better picture of how much sleep you’re actually getting. Newer devices, like Jawbone’s UP3 that should be released sometime this year, can even tell you which activities led to your best sleep and what factors resulted in poor sleep.

Don’t forget to set your clocks forward this Sunday evening. But prepare yourself starting today in order to minimize your risk of adverse health effects and maximize your sleep.
By: Rachel Clark, RN, BSN

2-20-2015 1-35-36 PM

Nursemaid’s Elbow:
Children between the ages of 2 and 4 are susceptible to certain injury patterns because of the stage of skeletal development. A common injury that is seen frequently in the ER is nursemaid’s elbow.
More specifically the injury is subluxation of the radial head. This means that one of the bones in the elbow called the radial head becomes partially dislocated. The injury has been described most often when adults are simply playing with the child and while swinging the child by the arms the injury occurs. The child will complain of elbow pain, often the injury mechanism is not recognized because of the playful nature of the event.

The child will not use the arm and often hold the arm in a straightened position. Most often the child is taken to the ER. The treatment consists of x-rays to rule out a fracture. Many times the radial head subluxation will reduce during the x-ray positioning. If not, the doctor will perform a simple reduction maneuver that moves the bone back into place. Usually within minutes the child uses the arm with no pain.

Growing Pains:
Have you ever taken your child to the doctor with knee pain or ankle pain and been told, “Oh, it’s just growing pains?” You may have felt like you were just getting brushed off, but it actually is a common source of pain in the growing skeleton.

The two most common locations are pain in the front of the knee on the shin bone, and over the heel in the back. These disorders have fancy names that are grouped into a medical term “apophysitis”, which refers to strain at the attachment site of a tendon to an open growth plate.

In the knee, the specific diagnosis is called Osgood Slaughter’s disease. This refers to an apophysitis at the attachment of the Patellar tendon to the Tibia (shin). What causes the problem is that as the long bones grow longer, it puts more strain on the tendons as they stretch to stay up. The weak link is the tendon attachment on the bone. A layperson’s way to think of this is the long bones outgrow the tendons. Once growth reaches maturity, the pain is gone and the problem is solved.

In the ankle, this is called Sever’s disease and occurs where the Achilles tendon attaches to the heel bone (calcaneus). Again, the long bones grow too fast and it puts a strain on the attachment of the Achilles, on the heel bone. These kids will complain of possible heel or ankle pain and often times walk on their toes to get relief.

Treatment for both disorders is stretching, stretching, stretching, and anti-inflammatory medication. It rarely has any long-term consequences.

Knee Cap Pain:
A very common complaint during the adolescent years is anterior knee pain. Especially common in girls, this pain is often attributed to knee cap pain. The condition is called patella femoral syndrome. This name describes the knee cap (patella) and its relationship to the leg bone (femur).

It is a disorder where the knee cap does not move, or track, correctly in its groove on the femur bone. If you feel your knee cap when you move your knee through range of motion, you will feel your knee cap move up and down as your knee moves. To make this happen, there is a joint in the front of the knee called the patellofemoral joint. When the knee cap tracks improperly it produces pain.

It has to do with the attachment of the quadriceps muscle to the knee cap. As the quad contracts, it moves the knee cap up and down within the knee joint. The problem arises when the knee cap pulls too hard toward the lateral side of the knee. In the short term this causes pain and in the long term it causes abnormal wear underneath the knee cap.

Earlier we said that females experience this problem more than males. This is because God created the female pelvis in a different shape in preparation for childbirth. Because the quad muscle is anchored from the pelvis, it creates a more lateral pull on the knee cap and thus more knee cap pain.

Treatment for Patellofemoral Syndrome is physical therapy, bracing, and avoiding deep knee bend exercises. In difficult cases, sometimes arthroscopic surgery is performed to release the lateral knee structures to assist in improved tracking. Left untreated, it will develop into arthritis often times as early as the mid-40’s. Injections can be used to treat symptoms, but they do not correct the underlying mechanics, so therefore are often not used. Bracing can be very effective when performing certain activities that are known to aggravate symptoms.

If you think your child may be experiencing these or other issues, give Dr. Boyett’s office a call at OrthoSports in Athens at (256) 233-2332.
By: Patrick Boyett

2-20-2015 1-36-01 PM