Although there is much to consider when deciding to have a child, it’s important to remember that most women are well suited from both a health and lifestyle standpoint to have a healthy pregnancy.
]]>After having a hysterectomy at an early age, Jane* rapidly gained weight, over 100 pounds in just one year. She began experiencing knee pain, high blood pressure and high cholesterol.
Years later, after many failed diets, she heard about the IU Health Arnett bariatric weight loss program and decided it was time to get her health back.
“People say [bariatric surgery] is the easy way out, but it’s really not,” Jane says. “It takes a lot of time.”
Jane spent eight months before surgery changing her lifestyle. She will follow those changes for the rest of her life.
Candidates for bariatric surgery have to undergo supervised weight loss. Jane had to lose two pounds each month and keep a food journal of everything she ate or drank for three months.
“Food journaling drove me nuts,” Jane said. “I have to do it [after the surgery], too.”
Candidates also address issues that contributed to their weight gain by meeting with dietitians, support groups and psychiatrists. Jane attended Overeaters Anonymous meetings three times a month and met with a dietitian once a month.
Jane says the support she receives, from Overeaters Anonymous, family and IU Health Arnett staff, helped her through the preparation process.
“You have a lot of support,” she says. “You can call anytime. [IU Health Arnett staff] are always there for you.”
She has even called a dietitian from the grocery store to ask where she could find hummus.
After months of journaling, meetings, lab tests and losing weight, Jane was approved for surgery. Her work wasn’t over.
Two weeks before surgery, she began a strict liver reduction diet, consisting of instant breakfast, yogurt, lean meats and vegetables.
She also met with Dr. Ruban Nirmalan, bariatric surgeon at IU Health Arnett, to discuss her laparoscopic adjustable gastric banding, or lap band, surgery, including preparation, risks and recovery.
Jane says all the time and hard work has all been worth it.
“I’m really excited about surgery,” she says. “I’m not doing this because I want to be thin and beautiful. I’m doing this because I’m only 47 years old. I have heart problems, arthritis in my knees, all because of my weight gain. I have seven grandchildren. I want to be around to take care of them.”
“I just want to be healthy again.”
*Name changed for privacy purposes.
This is the first part of a three part series about Jane’s weight loss journey. Check back for parts two and three in the coming weeks.
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Give the body an adjustment period.
Adjusting to seasonal temperature and humidity changes can take seven to 10 days under the best circumstances. Whether you’re an elite athlete, a casual runner or an outdoor gardener, Wang says it’s best to give the body a few days of transition outdoors before exerting yourself at 100 percent your normal capacity. Spraying the body down with water, staying out of direct sun from 11 a.m. to 3 p.m. and wearing loose, light-colored clothing are smart ways to minimize the effects of heat.
Stay hydrated.
Old thinking encouraged everyone to drink eight glasses of water a day or until your urine was clear for proper hydration. That’s changed in recent years. “Currently, expert opinion is to drink until you aren’t thirsty,” Wang says. Heat exhaustion can occur very quickly when you aren’t sufficiently hydrated.
Be aware of symptoms.
“If you develop symptoms like blurred vision, weakness and confusion, consider it a medical emergency,” Wang says. Those are signs that your body is so overheated you could suffer a heat stroke. Another major warning sign is when the body remains hot, but sweating stops. Seek immediate treatment and medical care, which initially involves ice baths and cold showers to lower body temperature.
Consider your age and health conditions.
Elderly people and those with chronic health conditions should be especially cautious about being outdoors in heat and humidity. If you are already prone to swelling due to other health issues, Wang says you can easily develop heat edema—swelling that occurs when blood vessels dilate. To relieve swelling and heat edema, elevate the legs, wear compression hose and stay out of the heat. People taking medications that cause increased urination should take extra caution to stay hydrated. Certain blood pressure medicines are good examples of that.
Be vigilant about kids.
“We used to think kids were at greater risk in the heat because they don’t sweat as much as adults,” Wang says. Current medical literature suggests they—and the adults watching them—simply don’t recognize when they are getting overheated. “They can get into trouble quickly unless there’s an adult there to encourage them to take breaks and rehydrate,” he says.
Be wary about moisture-wicking clothing.
Sweating is normal and necessary. “If you have any history of heat illnesses or haven’t yet acclimated to hot weather, moisture wicking clothing can be a problem because it prevents the evaporation of sweat from the skin, which is the body’s primary method of cooling itself,” Wang says.
Wear sunscreen.
An SPF factor of 30 provides all the protection that’s needed. “Realistically, there’s no clear advantage to higher SPF factors,” Wang says. “The important thing is to reapply often, about every two hours.”
Athletes, beware of heat-related muscle cramps.
If you know you are prone to cramping, be sure to hydrate with a sports drink that replaces those electrolytes,” Wang said. Some athletes replace sodium with tablets or by adding a small amount of salt to water.
At Riley, the family alternated their time between the NICU and the lounge. Initially it was hard, seeing tubes connecting Jessica to needed oxygen, IV’s and monitoring equipment. Despite all the equipment, they were able to spend most of their time simply holding their newborn and learning how to bathe and care for her. “It really helped to be able to care for her ourselves,” says Kara.
Kara admits they were fortunate to have experts teaching them so much about how to care for their baby. But what they’re most grateful for is simply having a hospital like Riley available when they needed it.
“When you’re in a NICU, you see babies with so many issues. We were lucky; Jessica’s never had any issues since then – her growth’s been amazing, she’s almost the tallest in her class,” says Kara. “The doctors, the nurses – everyone was wonderful, so personable and caring. We had great care and it all worked out. It was a real blessing for sure.”
These days Jessica is a happy, healthy and active child – just what Kara and Jim imagined their first-born would be.
Riley Hospital for Children Neonatology at Indiana University Health provides the most comprehensive care in the state for newborns and infants with medical or surgical problems. Children like Jessica receive the best possible care in a warm, family-centered atmosphere. As a leader in Neonatology, Riley at IU Health was recently ranked 44th by U.S.News and World Report's 2013-14 Best Children's Hospitals.
]]>Most medical experts realize that online research by patients is here to stay—and that can be a good thing because informed people who use credible sources are more prepared to take an active role in their own wellness.
Learning how other people resolve their health challenges can be a big boost when you’re facing one of your own. Thanks to a new interactive feature on the IU Health web site, you can find live video stories with people who’ve already traveled the path you may be on.
These resources allow you to search for patient experiences using a graphic of the body. Searching the site by body part, you can watch and hear content about treatment and recovery from people like:
Jack, a retired senior whose shoulder replacements helped him recover his active lifestyle.
Video content is also tied to specific information about treatment and recovery to help you research conditions similar to your own. Try the new interactive content by visiting our Active Living and Joint Replacement resources.
]]>X-rays showed a severe break, one an orthopedic surgeon at their local hospital in Hutsonville, Ill., said needed specialty care. He referred them to Riley Hospital for Children at Indiana University Health, two hours away.
Christine Caltoum, MD, an orthopedic surgeon at Riley, explained that Kaleigh’s break would require surgery the next day, using a plate and pins to repair the break. She also explained compartment syndrome – a serious condition that can develop when swelling after an injury compresses nerves and blood vessels, leading to muscle and nerve damage, possibly permanent.
Despite medication to keep her comfortable until the surgery, by the next morning, Kaleigh’s pain had become unbearable, a symptom of compartment syndrome. “Dr. Caltoum said the pressure in Kaleigh’s leg was high and they needed to do the surgery immediately to save her leg,” says Kaleigh’s Mom, Karen. “We had no idea it could come to this. To come to Riley and have this…we were at the right place, that’s for sure.”
After surgery, which included two, six-inch incisions on either side of the calf to relieve the pressure caused by swelling, and a plate and screws to repair the break, Riley physical therapists put Kaleigh to work. “It was pretty scary to watch her go from being athletic and fearless to being afraid to stand up and take steps with a walker,” says Karen. “But the physical therapists helped her overcome her fears and motivated her to do more things independently,” says Karen. Kaleigh steadily progressed from using a wheelchair and walker to crutches, and three months after the surgery she began walking on a treadmill and started swim therapy.
Today, Kaleigh’s back to competitive cheering and volleyball, stronger than ever. “It was an emotional time for us but Dr. Caltoum and the staff at Riley got us through,” says Karen. “We’ll be forever grateful. ”
The Pediatric Orthopedic specialists at Riley at IU Health offer coordinated care plans and the latest treatment options for children like Kaleigh who suffer sports injuries, trauma and other various skeletal or neuromuscular conditions. As a leader in Pediatric Orthopedics, Riley at IU Health was recently ranked 19th by U.S.News and World Report's 2013-14 Best Children's Hospitals.
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What are the main types of diabetes?
• Type 1
• Type 2
• Gestational (GDM)
Type 1 diabetes is a chronic disease that typically affects children and young adults but may occur at any age. This type of diabetes is also known as insulin-dependent. If someone is diagnosed with Type 1 diabetes, that means their body doesn’t make insulin and they require daily injections of insulin to maintain proper glucose levels in their blood without daily injections this disease could result in death.
Type 2 diabetes is a chronic disease that typically affects adults age 40 and over; but due to high obesity rates, teens and young adults are now developing the disease. This is the most common type of diabetes affecting 90-95% of those diagnosed and is often associated with being overweight and physically inactive. People with Type 2 diabetes are insulin resistant which leads to higher glucose levels in their blood.
Gestational diabetes (GDM) affects approximately 18% of pregnant women. Women are screened for GDM between the 24th and 28th week of gestation. Pregnancy hormones cause you to need more insulin. All pregnant women need extra insulin as the pregnancy progresses and if the pancreas cannot make enough extra insulin the glucose stays in the blood leading to high blood glucose. To provide the best care for you and your baby is to work with a healthcare team, follow a meal plan, monitor blood glucose levels, be active and, if needed, take medication as prescribed. GDM generally goes away after the baby is born in more than 90% of women but does increase your risk of developing Type 2 later on in life.
If diabetes is not adequately controlled, the patient has a significantly higher risk of developing complications. Long term complications include cardiovascular disease, kidney disease, nerve disease and eye disease.
How do I prevent diabetes?
Type 1 diabetes is not preventable, but there are lifestyle changes you make to decrease your likelihood of developing Type 2 and GDM. You can prevent or delay the onset of Type 2 by maintaining a healthy diet and engaging in regular exercise. Results from the Diabetes Prevention Program (DPP) showed a 58% reduction in diabetes (71% if over 60 years of age), and an estimated 11 year delay in the progression to diabetes with lifestyle interventions. These lifestyle interventions includes: 7% weight reduction and 150 minutes of exercise each week.
How do I know if I have diabetes?
If you experience weight loss, excess thirst, increase in appetite, increased urination especially at night, feeling of tiredness, have numerous infections, wounds that are healing slowly, numbness in hands or feet, your vision is blurred; you may have diabetes.
If you are experiencing these symptoms on a regular basis you may want to contact your local doctor to schedule an appointment.
What resources or educational programs are available locally?
The Indiana University Health Diabetes Center located at the IU Health Ball Memorial Jackson Street Center offers individual instruction, dietary instruction, diabetes class series and a diabetes prevention class. The education has been recognized by the American Diabetes Association for quality self-management.
Advance registration is required for all education services at the IU Health Diabetes Center. To register, call 1.866.888.3468 and request the Muncie site.
In addition, the Diabetes Support Group of Delaware County meets the last Thursday of each month at the same location at 2901 W. Jackson Street at 7 pm. Advance registration is not required for the support group.
Ilona Lambert, BSN, RN, CDE, is a certified diabetes educator at the IU Health Diabetes Center. For more information about diabetes call, 765.747.3101 or visit iuhealth.org/ball-memorial.
]]>It didn’t take long to know they’d made the right decision. “It was like 10 tons got lifted off our shoulders when we walked in,” remembers Robert. “We got there at 1:00 in the morning and they took care of us. We felt like we were the only people in that hospital. It’s just the way you get treated.”
It was more of the same with Ryan’s doctor, Tamara Hannon, MD, a pediatric endocrinologist. “When she walked in, we just connected. Still today, every time we see her we feel like he’s her only patient, that she came to work just to see him,” says Robert.
During Ryan’s four-day stay at Riley, he and his parents teamed up with his doctor and diabetes specialists, learning about the disease and what would be involved in managing it. For Ryan it would mean insulin injections four times a day, monitoring his diet, including calculating the carbohydrates he ate.
Within a month, he says they felt like they were “in their groove”, though they had a learning curve when baseball season started, having to monitor his numbers and make adjustments due to the activity and excitement of playing. “Dr. Hannon and the Riley nutritionist explained what to look for,” says Robert.
Now two years later, the Daines say the support hasn’t let up. “Whenever we have a question we can call,” says Robert. “Dr. Hannon, Linda, her nurse practitioner – they’ve been great about helping us keep on track.”
The multidisciplinary pediatric diabetes team at Riley at IU Health are dedicated to providing excellent care and the latest treatment options for children like Ryan who suffer from diabetes, or disorders of the thyroid or endocrine glands. As a leader in Pediatric Diabetes and Endocrinology, Riley at IU Health was recently ranked 9th by U.S.News and World Report's 2013-14 Best Children's Hospitals.
]]>After conservative non-surgical options are exhausted, some patients may be candidates for an increasingly common procedure. "We can leave the undamaged part of the knee untouched and replace only the damaged parts," says Orenstein, who’s been performing partial knee arthroplasties since 2005, using an Oxford prosthesis made by Biomet.
The advantages of a partial joint replacement are numerous. It’s a smaller procedure that often leads to less pain, fewer complications, shorter hospital stays and quicker recoveries. Unlike total knee replacement, patients aren't required to meet age or weight restrictions before having a partial replacement. The procedure is sometimes ideal for younger people, who are more likely to have problems over time with a total knee replacement.
Above all, patients report a higher level of satisfaction than their counterparts who undergo total knee replacement. "We are learning that they last just as long as a total joint replacements and patients are more satisfied because it tends to feel more like their own knee," Orenstein says. The satisfaction rate is 95 to 98 percent versus 85 to 88 percent for patients with total knee replacement.
With all these advantages, you might wonder why we don’t hear more about partial replacements. "A lot of it depends on the practice," Orenstein says. Over the past eight years, the percentage of people receiving partial knees has increased from 10 percent to 50 percent of some physician practices. Orenstein says some doctors suggest total knee replacements because they are more comfortable and skilled with the procedure. “I think we really need to be more critical when we look at determining what's right for our patients."
In four percent of partial replacements using the Oxford knee, Orenstein says there can be persistent pain for up to a year. During that painful phase, patients sometimes seek a second opinion. They may hear that they should never have had partial knee arthroplasty. Some doctors giving second opinions may even suggest a total replacement to revise the original surgery.
Orenstein says patients should be cautious about rushing into revision surgeries. "The blame is sometimes placed on the partial knee, but in most cases the pain would subside on its own after a year," he says.
]]>Prior to her diagnosis, a long line of doctors had examined Allie, run extensive tests and conducted countless procedures to determine why she was dangerously underweight and frail, unable to run and play, and had unexplained fevers. Up until that point, tests had ruled out juvenile rheumatoid arthritis and metabolic disease, but revealed that Allie was allergic to an extensive list of foods.
It wasn’t until Sandeep Gupta, MD, a pediatric gastroenterologist with Riley Hospital for Children at Indiana University Health, made the diagnosis that the family could finally get on the right track for treatment. It was also the beginning of a special doctor-family relationship that Allie’s mother, Jane, says has brought stability to their lives.
“Dr. Gupta wants quality of life for his patients,” says Jane. “You feel that as a parent, you feel that as a patient. I look at him and think, ‘this man has my daughter’s life in his hands and I’ve never once second-guessed him.”
For Allie, life is now a continuous cycle of medications, first to bring the disease under control when infection caused by the disease is active, and then changing to a different medication for maintenance, to prevent painful flair ups of infection. But despite these challenges, the family is grateful to have answers and a plan of action. “I have a daughter who smiles and can, for the most part, be a normal kid. Yes, she has restrictions, but that’s life. We are so blessed,” says Jane.
The team of board certified pediatric gastroenterology specialists and nurse specialists at Riley at IU Health provide comprehensive care for children like Allie who suffer with disorders of the digestive tract, liver and pancreas. As a leader in Pediatric Gastroenterology, Riley at IU Health was recently ranked 23rd by U.S.News and World Report's 2013-14 Best Children's Hospitals.
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