Tips for a Healthy Fall

Later, summer.
It’s been real. But, it’s time to welcome back short days, crisp air and colorful leaves of fall time. Time to stow away swimsuits in favor of sweaters for apple picking. Fall is incredible in the PNW; beautiful weather, colorful leaves and fall foliage make it for a great time of year for both exercise and wonderfully fresh seasonal foods. Here are some tips to make your fall a healthy and happy one:

All hail The Great Pumpkin!
Pumpkins are more than just pies and jack-o-lanterns, they are rich with vitamins A and C. Of course pumpkin seeds are a wonderful and healthy fall treat. There are a ton of possibilities with pumpkins. Check some of these healthy recipes out:

12 Healthy Pumpkin Recipes

Get your flu shot and yearly check-up.
This one is pretty simple. You don’t want to be sniffling, aching, coughing and sneezing all winter long. Get your shot, keep the flu away. Schedule your appointment today by calling 509.444.8200

Boost your immune system! Hydrate throughout the day. adequate hydration has a huge impact on your immune system. Water helps all of your body’s systems function at optimum levels. Eat foods that add to your immune system with probiotics and vitamin C such as yogurt, oranges, peppers, garlic, yes even pumpkins can pack vitamin C.

Get outdoors. The bright colorful leaves on the trees add a visual treat to your walks as do the crunching of leaves under foot. What better season to put on a beanie and get active? In addition, outdoor time increases vitamin D levels, which can make you happier and improve concentration according to Harvard Medical School

Keep the treats in check. When you are stuck inside with delicious Halloween candy everywhere, it can be hard to resist eating 10 mini Snickers in a row. Don’t resist entirely, just don’t become a sugar zombie. Also, when it comes to game days make healthier choices by setting out veggies and dip instead of chips. You can also cut some of your favorite unhealthy snacks in to smaller portions.

Spring Allergies- Common Activities to Minimize Symptoms

With the spring season here and pollen in the air, there are a few daily activities you can do to minimize allergy symptoms including:

Eat healthy foods- Improper eating habits aggravate many health problems, including asthma and seasonal allergies. Foods that contain antioxidants such as fruits and vegetables can help battle inflammation which helps with controlling allergies.

Reduce stress– When you are stressed, your body releases stress hormones which sends signals to various parts of your body to prepare for actions. If this is a common occurrence in your body and there is not a physical release, the stress can affect your immune system. In addition, a weakened immune system increases your chances of allergic reactions.

Use your air conditioner– Having windows or doors open is a common way to bring allergens inside your home so instead close your windows and use an air conditioner.

Clean door mats– Cleaning your door mats prevents mites, mold, and fungus- all common allergens, from being tracked into the home.

Spring clean– Dust is a common allergen and cleaning in those tough to reach areas can help minimize allergy symptoms.

These are simple tasks you can do to minimize allergy symptoms, but if you still suffer from symptoms, seek treatment from your health care provider.

 

By Sarah Giomi, Communications Intern and Bill Bomberger, PA-C

Spring Allergies- Symptoms and Treatment

Spring season brings the blooming of many plants and flowers and that means the blooming of spring allergies. What are allergy symptoms and how can you treat them? The most common allergy symptoms to look for are:

  1. Runny nose
  2. Watery eyes
  3. Sneezing
  4. Coughing
  5. Itchy eyes and nose
  6. Dark circles under the eyes

If you experience these symptoms during the spring allergy season, you should visit your primary care provider who can refer you to an allergist for tests. There are two forms of common allergy tests including a skin test, also known as a prick test or a blood test.

The skin test involves either a pricking of the skin with a tiny amount of allergen, or injecting a small sample of a diluted allergen under the skin of your arm and back. If you are allergic to the substance, a small red bump, also known as a hive, will form. The blood test is also another common option for an allergen test.

If the symptoms are caused by an allergy, there are over the counter prescriptions and medications that a provider can prescribe to ease the symptoms.

This is the 3rd part in a 4 part allergy series, be sure to follow for more!

By Sarah Giomi, Communications Intern and Bill Bomberger, PA-C

Spring Allergies- Is it an Allergy or a Cold?

Spring is here and so are allergies but how do you know your child’s runny nose is from allergies instead of a cold?

Colds are caused by a viral infection, while allergies are caused by your immune system overreacting to harmless substances.  Several of the symptoms are the same for colds and allergies, however there are a few differences that may give you a clue to the true culprit.

  1. Length of symptoms. Colds last 1-2 weeks while allergy symptoms can go on for weeks or months.
  2. You will not get a fever, chills, or body aches with allergies, however these are common symptoms of colds.
  3. A common symptom of allergies is itching: itching skin, itching eyes, itching throat, and itchy nose.  This does not occur with a cold.
  4. Colds tend to develop thicker nasal secretions, while allergies tend to have clear watery discharge.

Understanding the differences can help you decide what steps to take to give your child the right treatment they need!

This is the 2nd part in a 4 part allergy series, be sure to follow for more!

By Sarah Giomi, Communications Intern and Bill Bomberger, PA-C

Too sick for school?

Flu season is officially here! Over the next few months, many parents of ill children will be faced with the decision whether or not to send their child to school. The most important thing for parents to consider when making this decision is if the child will be able to learn and participate in school activities. We also don’t want to unnecessarily expose other children to illness causing germs. However, we all want to minimize missed school and work days for both students and their parents. Below are a few guidelines that can help parents make this often tricky call.

Fever

A fever is body’s way of fighting off infection and is the most common reason parents keep their children home from school. The definition of a fever is a temperature of 100.4 or higher, though some schools and daycare centers will have their own rules. The general rule of thumb is to keep your child home until they have been fever free for 24 hours.

Upper respiratory Infections

Most children will have several different cold viruses each winter. A child with typical cold symptoms including a runny nose, sore throat, and cough can usually participate in school without any restrictions. Coughs may linger for several weeks after the other symptoms have resolved. It is important to go over the importance of coughing or sneezing into an elbow or a tissue and proper hand washing techniques with your sick child to limit the spread of these germs.

It may be necessary to keep a child home if they have more severe symptoms, such as extreme fatigue, loss of appetite, or anything else that will keep them from learning and participating at school. If a child has influenza (the “flu”), they should be kept home from school until their symptoms have resolved. The flu is similar to a cold but is accompanied by high fevers and body aches. We recommend an annual influenza vaccine to help lower the risk of this illness.

If your child has an ear, sinus, or strep throat infection it is recommended that they stay home from school until at least 24 hours after antibiotic treatment has been started. Conjunctivitis (also known as “pink eye”) can be caused by allergies or a virus, but when it’s caused by bacteria it is very contagious and needs antibiotic treatment before the child returns to school.

Vomiting and Diarrhea

Children with vomiting and diarrhea should also be kept home until their symptoms have resolved. If there are no other symptoms, older children with mild diarrhea that are able to use the toilet and wash their hands on their own may go to school if they don’t have any other symptoms.

Skin

Most childhood rashes are caused by viruses and most are not cause for concern. Certain rashes, such as chicken pox are more severe and highly contagious. If a rash is accompanied by a fever, the child should not attend school. If you are unsure what is causing a child’s rash, it’s a good idea for them be seen by their healthcare provider to find out what the rash is and any precautions that should be taken.

Lice is another common reason for children to miss school. In the past, many schools had a “no nits” policy. Experts now agree that these absences are unnecessary and children can return to school as soon as they have had one lice treatment.
Illnesses are a normal part childhood. We can’t keep our children home for every sniffle and sneeze, but we do want to minimize the spread of germs and make sure that our children go to school ready to learn. If you have any questions about whether or not to send your child to school, talk to your child’s healthcare provider.

Autumn Barbero, Pediatric Nurse Practitioner

Gestational Diabetes: Do I HAVE to drink that?

 

Short Answer:  Yes.

Long Answer:  You actually don’t HAVE to do anything you don’t want to do.  We won’t MAKE you do anything you don’t want to do.  This concept supports your autonomy as a patient.

However, you trust us to be the lifeguard of your pregnancy.  Throughout your pregnancy, we will monitor your blood work, vital signs, and the baby’s growth and development by using ultrasound, drawing your blood, listening to your baby’s heartbeat, and measuring the size of the uterus.  Trust us when we say that the second trimester glucose screen is very important to the health of both you and your baby.  We might even recommend it earlier in the first trimester if we are concerned about impaired glucose tolerance.

One complication of pregnancy that we screen for and treat is called gestational diabetes.  Gestational diabetes can occur in women of any size, even without a personal history of family history of diabetes.  Insulin is a hormone produced by the pancreas, and the body uses insulin to help transport blood glucose (sugar) from the bloodstream into the cells of the body.  The hormones of pregnancy can cause you to be resistant to insulin.  If you become resistant to insulin, your blood glucose levels become elevated and the glucose easily transports across the placenta to your baby.  This can cause the baby to grow very large, and at the same time it impairs the development of the baby’s lungs.  You can end up with a very large baby who, at the same time, has very immature lungs and needs help breathing after birth.

Maternal Complications of Gestational Diabetes:

  • You have a 70% chance of developing Type 2 Diabetes within 10 years
  • You are at a higher risk of high blood pressure or preeclampsia in pregnancy
  • You might require medication to help manage your blood glucose
  • You are at higher risk of miscarriage or stillbirth

 

Fetal Complications of Gestational Diabetes:

  • Your baby can grow very large
  • Your baby might experience a shoulder dystocia at delivery, which is an emergency situation where the head delivers but the large body is stuck behind your pelvic bones.  We might have to break the baby’s collar bone to help your baby deliver.
  • Your baby might require assistance breathing at delivery or in the first few days
  • Your baby might need to be observed or treated in the special care nursery for low blood glucose.

What happens if your one hour glucose screen comes back elevated? 

We will ask you to take a three hour glucose screen.  If the three hour glucose screen comes back elevated, you will have the diagnosis of Gestational Diabetes.  At that time, we will send you for a consultation with a Maternal Fetal Medicine physician called a Perinatologist.  These physicians are specially trained in high-risk pregnancy and obstetric ultrasound.  They can help us monitor the growth of your baby.  In addition, a diabetic educator will teach you how to test your blood glucose daily.  They will also teach you how to eat well to keep your blood glucose as stable as possible.  You will also be asked to increase your daily exercise, which will help your body be more sensitive to insulin and help you regular your blood glucose.

 

The glucose screen is usually done at the 24-28 week visit.  We ask that you eat normally that day, with good protein and not a heavy carbohydrate load.  Plan for the visit to take at least an hour because we have to draw your blood one hour after you finish drinking the liquid.  Pack a healthy snack with protein for the ride home.

 

So… yes.  Your midwives are aware that the glucose screen can cause nausea and discomfort.  You may not like the taste of the drink.  However, it is an important screening test that can help us provide the very best care for you and your baby.

 

For more information:

http://www.diabetes.org/diabetes-basics/gestational/

http://www2c.cdc.gov/podcasts/player.asp?f=11504&loc=WhatIsGestational

By: Kirsten Johnson | Certified Nurse Midwife

5 Rules for Screen Time.

 

 

 

 

 

 

 

 

 

 

Everyone loves screen time.  Whether it is watching a movie, playing a video game, reading the news, or talking with friends, technology is at the center of all of our lives.  Media and screen time, like most things, should be used in moderation.  While technology use is important in most facets of life today, too much screen time has been linked to obesity, difficulty sleeping, problems in school, aggressive behavior, and bullying.  It is important to help your child find a healthy balance.  A few simple guidelines can help keep screen time in check for you and your family:

  1. Remove all screens from the bedroom. Kids with TVs in the bedroom have been found to watch 1 ½ hours more TV than kids without TVs in the bedroom.  TVs in the bedroom have also been linked to obesity.  Availability of internet and texting in your child’s bedroom gives them unmonitored access to anything on the internet.  Keep all screens (including your own) out of the bedroom.  Try setting up a charging station for all devices in a common area.
  2. Monitor what your children are doing during their screen time! Just like you would ask who they are spending time with on the weekend, ask who they are spending time with on social media.  It is important to teach children what is and is not appropriate to share on social media.  Also, be aware of the websites they are going to and the apps they are using.  Play apps and video games with them!  Then you know what they are doing and if it is appropriate.
  3. Make sure screen time is age appropriate and educational. Not sure if a movie or video game is good for your child? Check out commonsensemedia.org.  This website is run by a nonprofit organization that provides independent ratings for movies, TV shows, video games, and apps.  It provides you with a summary of the game or video and suggested ages for appropriate use.
  4. Limit screen time for everyone in the family. All children should spend no more than 2 hours in front of a screen for non-school purposes.  Think of things you can do as a family that does not involve a screen: go for a walk, play a board game, go to the park, or read a book together.  Any activity that provides family interaction is preferred to screen time!
  5. No screens after dinner. We know that looking at a screen keeps your body from releasing melatonin.  Without melatonin you don’t feel sleepy when bedtime comes.  Sleep is important to help with mood, concentration, and learning.  If sleep is a problem for your child, try a screen fast (by eliminating electronic device use for a few weeks) to see if this helps restore a good sleep pattern.

 

Screen use is here to stay.  Help your child form good, healthy screen habits!

-Ashlee Mickelson, MD Pediatrician

Birth Plans!

Should I write a Birth Plan?

Many women want to write out a birth plan to clarify the care they hope to receive while they are in labor.  A birth plan can be a short wish list or a long explanation of your circumstance, such as if you are adopting the child out or if there are known anomalies incompatible with life.

Is a Birth Plan required?  No.  The nurses, midwives, and physicians are highly trained professionals who will take care of you to the best of their abilities.  We have not performed routine shaves, enemas, or episiotomies for over 25 years, so you do not need to request that we refrain from these procedures.  We have many tools in our bag of tricks to help your labor progress well and hopefully avoid complications.

In addition, every woman and every labor is different.  It is a good idea for you to relax, let go, and accept the labor that comes to you.  There really is no other choice but to deal with the reality of the moment.  Your care providers will help you.  Honest.  That’s what we have chosen to do for our career.  We want the best outcome for you and your family.

I do recommend that my mammas write up a short, one-page wish list that gives the labor team a frame of reference of what experience you are hoping for in labor and delivery.  It is a good idea to designate one person to speak for you if you are unable to speak for yourself due to an intense labor.  It tells us if you have specific requests, such as dad cutting the umbilical cord or your desire to avoid an epidural or even GIVE ME THE EPIDURAL THE MOMENT I WALK IN THE DOOR!

Bring your birth plan to one of your prenatal visits to discuss with your midwife or physician.  Then when you have a final draft, bring a printed copy for the nurse caring for you in labor and delivery.  That way, your entire team is on board with the plan and works with you!  Remember to keep it short and flexible.

Some ideas of what women specify in a birth plan:

  • Who will be present for the birth?
  • Are you bringing a doula?
  • Will there be siblings present?
  • Do you want mobility or do you want to stay in bed?
  • What activities or positions do you plan to use (walking, birthing ball, standing, tub, squatting, etc)?
  • What is your plan for pain relief (massage, hot packs, position changes, hypnobirthing, Lamaze breathing, jacousi tub, medication)?
  • How do you feel about fetal monitoring?
  • Who will care for the baby?
  • What is your plan to feed your baby?
  • Do you want to wear your own clothing and listen to music?

 

You can always google “birth plans” on the internet for more ideas, remembering to keep your wish list to one page!

-Kirstin Johnson, Certified Nurse Midwife

Welcome to Summer!

 

Helmets– Are highly recommended with all wheeled sports. You only have one head and need to protect that brain for many years to come. If you happen to get in a wreck, get help to make sure you don’t have a serious injury.

Swimming– We have so many awesome lakes, rivers, and pools within a short distance which is why it’s important to practice good water safety. Even if you’re a good swimmer, make sure someone is around to watch you.

Sunblock- We recommend you use a sunblock that covers both UVA and UVB; and an SPF of 70 would be best (with the way most people put on sunblock you only get about half the SPF number listed on the bottle). Don’t forget to drink lots of cool water when the heat rises outside or if you’ve been sweating more than usual! Be sure to stay hydrated to keep your body from overheating.

Camp Physicals-Summertime is a great time to go to camp! Ask your parents to call and schedule an annual physical appointment now so you’re ready for all your activities at camp – and get a jump on the next school year.

Summer Treats– What summer is complete without a few sweets? Remember that we don’t get a summer break from brushing our teeth; we have to do it every day. If you haven’t been into the dentist in a while, now is a great time to let your tooth shine. For extra protection, remember we also have fluoride supplements for kids from 6 months old until 16 years old.

Last, but not least, make sure you talk with your parents about expectations for summer, make sure you know your home address, parent’s phone, and who to contact in case of emergency. Have a fun and safe summer!