Heartburn Hurting You?

Many people suffer from gastric esophageal reflux disease or GERD. GERD results from a combination of excess gastric juices and impaired esophageal clearance of acid leading to a burning discomfort referred to as heartburn.

There are different degrees of GERD ranging from mild symptoms which can be managed by over the counter products and lifestyle changes, to severe or recurrent problems requiring medical treatment.

There are several ways to help with GERD symptoms other than taking medications. Lifestyle modifications such as elevating the head of the bed 4-6 inches can help prevent symptoms of GERD.

Avoiding tight fitting clothes, eating 2-3 hours before bed, and sitting up right after meals can decrease the risk of having heartburn. In addition to lifestyle changes dietary modifications can also decrease the occurrence of heartburn. Avoid acidic beverages such as orange juice, red wine, and sodas as well as fatty foods and foods which exacerbate symptoms. Eating smaller more frequent meals and maintaining a healthy weight can decrease the risk of GERD.

There are several different products available over-the-counter that decrease heartburn. Antacids such as Tums, Rolaids, Maalox, and Mylanta neutralize acid. These can be taken for mild, infrequent heart burn and for relief of current symptoms. Other over the counter medications lower the amount of acid secreted. H2 blockers such as Pepcid®, Zantac®, and Tagamet® are effective and relatively inexpensive. Prevacid® and Prilosec® are the only proton pump inhibitors available OTC, others require a prescription. Over the counter medications are relatively safe but they can interact with other medications. Ask your pharmacist or physician which medication is most appropriate for you.Even though heartburn is common it could be a sign of more serious problems. Patients should see a doctor if they have symptoms two or more times a week, don’t get relief from medications, have difficulty swallowing, acid causes choking, wheezing, or hoarseness, or unexplained weight loss.

Lacey Mullins, Pharm.D.

“Med/Surg Gives”

In the spirit of the season, the Medical-Surgical Division at THFW recently spent 3 hours at the Tarrant Area Food Bank moving food. It’s astonishing what can be done with a bit of time and effort…In the grocery area for boxing food, we packaged 13,960 lbs. of canned and boxed food items. In the back sorting area, we moved another 11,700 lbs. of food. In total, we boxed and sorted 25,660 lbs. of food which will be used to feed the hungry in our community this holiday season.

The teamwork during this project was amazing. We showed up with a job to do and we exceeded expectations. Those that participated came with full knowledge of the work that needed to be done and demonstrated the spirit of the season—GIVING! Our goal was to gather supplies and food for about 8 pallets and we finished 11! We rolled up our sleeves and hustled. Nine units participated and we all worked together to get the most done in the time allotted. Texas Health Resource’s Mission is, “To improve the health of the people in the communities we serve”. We would like to believe that this project allowed us to serve our community on a grand scale outside of our traditional roles in the hospital.

I hope that during this time of year, we all look for ways to give back to our families, friends, and community. The reward in giving to others is seeing their great joy return. It is easy to get caught up in the hustle and bustle of the season. This year let’s take a moment to reflect on our blessings and the blessings we have given others.

Advent: "A Song for all Seasons"

“The Word became human and made his home among us."

~ John 1:14

There once lived a king with dominion over all nations. His courts were of richest splendor. Music and laughter floated from his castle. Clouds wrapped it in ethereal majesty. The peasants, in their valley of violence and hunger, looked longingly at the castle, wishing they might know the king. But none could reach it.

One day in the cold of winter, the king’s tailor entered the king’s chambers with new additions to the royal wardrobe. He had chosen the finest materials and woven them into the most beautiful garments ever seen.

But the king was not pleased. He ordered the tailor out and said, “I will make my own clothes.” The door to the throne room was shut and locked. Weeks passed. All waited in keen anticipation to see what the king would make for himself. Surely they would be blinded by his glory! Finally, the day arrived, the door opened, and the king appeared.

Everyone, especially the tailor, gasped in shock. For the king was dressed in the simplest, cheapest, most “unkingly” garments imaginable! He had the choice of the world’s finest materials, but he had chosen to wear the clothes of a beggar. He spoke softly to everyone and said simplyh: “I am going down into the valley.”

“Behold, I bring you good news of a great joy…
for today…there has been born for you a
Savior, who is Christ the Lord.”

The stage was set. The day had finally come. Prophets had anticipated it for generations. God had hinted at it for millenia. Now was the beginning of that “into which angels longed to look.” The “fullness of time” had finally come.

The world had long been imprisoned, groaning and trapped in a web of sin and death, heartbreak and sorrow.

“Long lay the world in sin and error pining,
till HE appeared and the soul felt its worth.”

Now, God Almighty – King of the universe, Lord of history, rightful ruler of the Earth – is about to invade this rebel-ruled world.

You would think His invasion would come with mighty signs and wonders! You would think the skies would be lit as far as one could see! You would think the shouts of the heavenly host would be ear-splitting! You would think that the whole earth would shake mightily from the impact of His landing – that in some sense all of mankind would know that God had landed!

But, here comes GOD!!! – Almighty Creator, Sustainer of the universe -- by whom, and through whom, and for whom are all things! And the only sound heard is the gentle breathing of a tiny baby sleeping in his mother’s arms.

History’s turning point, the greatest event in all of history – and the only sign we have of it is a baby lying in a manger, a group of shepherds scared silly … and a single, bright star.

“What child is this, who laid to rest, on Mary’s lap is sleeping –
Whom angels greet with anthems sweet, while shepherds watch are keeping?
THIS, THIS is CHRIST the KING!”

Emmanuel! God with US! It is the most outlandish, mind-boggling story in all the Bible, in a million galaxies, in all of eternity. The heavens were stunned into silence and unbridled praise all at the same time.

Even the angels could not have anticipated this one! Gabriel had to be scratching his head! God coming to the valley! God coming to earth … in the body of a human being! “The Word became human and made his home among US!”

And for 33 years, Jesus would feel everything that you and I have ever felt. He blew his nose, he hit his thumb, he cut his hands, and his back hurt. He felt weak. He grew weary. He was afraid of failure. His feelings got hurt. His feet were tired. His head ached. And he felt lost and alone … without his Father.

The Christmas season has always been special to me – trees, lights, decorations, wrapping, giving. My heart is filled to overflowing. Despite all the “What do I get her?” – and, “How much can we afford this year?” – I try with all my being to focus on Jesus.

I grew up in Dallas, where Christmas meant repeated trips to the corner toy extravaganza display at the Sears store on W. Jefferson … wearing out the Sears and J.C. Penney Christmas catalogs…and avoiding sitting in Santa’s lap! But since my childhood, it has been the songs that awaken so much inside me.

As much as I enjoy “Jingle Bells”, and “White Christmas” (ever wonder how those play out for folks in Hawaii?), and the kids’ favorite song -- “Grandma Got Run Over By a Reindeer!” -- it’s the other songs that stir something deep within me:
O Holy Night …
What Child is This? …
Silent Night, Holy Night …
Joy to the World …
Hark, the Herald Angels Sing!

Nothing stirs our heart like song. Nothing expresses the heart like song. And Jesus is the focus of more songs than anyone to ever walk the face of the earth. How fitting that His coming was announced by a heavenly chorus? But “Christmas” is truly only the beginning of the story...

Jesus sent word to John: “The blind can see, the lame can walk, the lepers are made clean, the deaf can hear, the dead are raised to life, and the Good News is preached to the poor.” Good News! Great Joy! For ALL people!

And ever since -- even in the midst of heartbreak, struggle and pain -- the story of Jesus has given hope and new life to the human heart. “A thrill of hope, a weary world rejoices!”

Together with the songs, the most conspicuous, consistent symbol of the season has to be all the lights. Lights are everywhere! Lights cover houses, office buildings, department stores, town squares, hospitals … even a few semis rumbling down the highways!

There has always been a connection between “light” and “glory.” Can you imagine what it was like that night, out on the hillside?! The “glory of the Lord” was a light of such incredible magnitude that the angel had to quickly calm the shepherds, telling them not to be afraid. The Good News not only begins with Jesus the infant, it begins with Jesus the Light: “In Him was life, and the life was the light of men” (John 1:4).

I’ve seen that Light. In fact, it amazes me the number of times every day that I see Jesus in our hospital:
• In the faces of little children…
• In the eyes of patients whose bodies are ravaged by deadly disease and broken by trauma…
• In the tears of those whose loved one has died, or is dying…
• In waiting rooms where families spend sleepless, restless nights in prayer on hard floors, as a loved one clings to this life…
• As doctors lovingly and compassionately share the news that so many don’t want to hear…
• As everyone -- from Nurses, to PCT’s, to Secretaries, to Transportation, to Dieticians, to PA’s, to PT’s, to RT’s, to Social Workers and Case Managers (and all those whose job titles I just left out!), and yes, Chaplains – rushes to the side of those in pain … lifting them up, sharing their pain, holding them up…arms wrapped securely around them, drying their tears, and often in tears with them…
• And as hospital administrators discuss how to more effectively, compassionately, and lovingly meet the needs of the growing numbers of God’s children in need of our care.

Yes, Jesus is in YOU. When those we serve in life go looking for Jesus, needing Jesus … guess where they find Him?! In you. Through you, the light shines even in the darkness. For those of us whose lives have been transformed by the power and presence that was wrapped up in those swaddling clothes 2,000 years ago… “Christmas” means new birth and a living hope – a hope that we share with one another – hope for a time when all of our pains and sorrows will be swept away by endless joy… and in endless SONG.

So why let Jesus be the reason for only one season? Why sing certain songs only one month out of the year? Corrie Ten Boom wrote: “If Jesus were born 10,000 times in Bethlehem, and not in me, I would be lost.”

Let’s keep the message of Jesus alive in our hearts throughout the year. Let’s make the story of Jesus “A Song for ALL Seasons.”

One starry night, our world was changed forever.......

Jim Tenery
Staff Chaplain
Board Certified Chaplain, APC

My name is David Swearingen and this is my story. I am the youngest of three boys in my family and my dad is retired from the United States Air Force. My life was pretty much like many other high school students all across America until the spring of 1979. That spring, I decided to try out for the Stephenville High School baseball team. A pre-requisite to trying out was a routine physical. This routine physical determined there was too much protein in my urine – not routine at all.

I was 16 years old at this time. I was sent to Carswell Air Force Base in Ft. Worth, Texas for testing and it was later determined that a kidney biopsy would be necessary. The biopsy showed that I had a kidney disease known as glomerulonephritis. Eventually I would need a kidney transplant.

All of my family members were tested and it was concluded that my brother, Weldon, would be the best match for a kidney transplant when the time came. Having this reassurance, I was able to live a normal life until January 1981.

I was in my second semester at Tarleton State University in Stephenville, Texas. Just a few weeks into the semester, my kidney function took a drastic turn for the worse. I was in kidney failure and it was necessary for me to go on dialysis for six weeks.

In March of that year, Weldon and I were both admitted into Wilford Hall Medical Center in Lackland Air Force Base in San Antonio, Texas. I was 18 years old and my brother was 21 years old. I was apprehensive about what the future would hold; my brother, on the other hand, didn’t display any fear. At the young age of only 21, he voluntarily would donate a kidney – a heroic and loving gesture.

I will remember the day of my transplant forever. It was like an additional birthday to me – it was the day my brother gave me a second chance at a happy, normal and productive life. At the hospital, Weldon and I were in two different rooms. After the surgery, I asked my parents to roll me into Weldon’s room. When I saw him for the first time after surgery, he was in a lot of pain. His surgery scar is about twice the size of mine. I could not help but cry when I was able to see what he had gone through for me.

He healed well and has never had any problems related to having only one kidney. I, too, healed well and have never gone through any rejection episodes at all. Despite the fact that my brother is three years my elder, the surgeon told me that we were matched almost as well as twins might be. I think this is why I have done so well with this transplant.

Since the transplant, I have lived a normal life. I still have to take anti-rejection medication for as long as I have this kidney. That will be for the rest of my life. I have experienced a “few bumps in the road” along my journey. Now, more than 29 years later, my brother Weldon is still doing well and so am I. I have a wonderful 18-year-old son and I am able to work full time.

I am thankful to God for blessing me with a loving and supportive family and such a giving and unselfish brother. I also feel grateful to God for giving the surgeons and medical staff the skill and knowledge to perform this successful transplant. I now try to “give a little back” for the blessings that God has given me. I work full-time at FMC Technologies in Stephenville. I am an active member and past-president of the Stephenville Kiwanis Club. I participate in National Kidney Foundation walks, I volunteer for LifeGift, I participate on a Relay for Life team and I am the photographer for the Stephenville High School Band. I am also an elder at the First Christian Church of Stephenville and occasionally help with the high school youth group. Additionally, I remain active with the Team North Texas U.S. Transplant Games team, a team of athletes who have all been touched by organ donation.

Please consider being an organ donor. It takes less than five minutes, is free and could save a life.

May God bless you as he has blessed me.

David Swearingen (kidney transplant, March 10, 1981)

I Didn't Know... Did You?

Did you know that for three decades November has served as National Hospice and Palliative Care Month? I didn’t know, and I work in Palliative Care. So now I am here to spread the word…NOVEMBER IS NATIONAL HOSPICE AND PALLIATIVE CARE MONTH.

Why is this significant?

In 1978, President Jimmy Carter signed the first proclamation designating November as hospice month. At that time, hospices served several thousand patients and their families. Current data from the National Hospice and Palliative Care Organization (NHPCO) shows that a record 1.56 million people with life-limiting illness and disease (41.5 percent of those who died in the US in 2009) were served by hospice and palliative care organizations.

What is palliative care?

According to http://www.getpalliativecare.org/, “Palliative care is the medical specialty focused on improving overall quality of life for patients and families facing serious illness. Emphasis is placed on intensive communication, pain and symptom management, and coordination of care.”

In July 2009, Texas Health Harris Methodist Hospital Fort Worth opened North Texas’ first Palliative Care Unit. We are a 16-bed unit that focuses on providing quality care to patients and their families. We see patients at many points during their disease process and should, ideally, become involved as part of the care team when a patient first receives a chronic disease diagnosis.

Why palliative care?

Palliative care at Texas Health Fort Worth provides a holistic approach to treatment. Our interdisciplinary team works together to coordinate a plan of care that best meets the patients’ and families’ wants and needs. Our goal is to relieve the symptoms that may come along with a disease and to improve quality of life.

Many of you may have a personal experience with palliative care or hospice. I know that my family benefitted greatly when we had a loved one in need. I hope that you will take a moment this month to remember those you have lost and thank those that may have cared for them along the way.

References:
http://www.getpalliativecare.org/
http://www.nhpco.org/

Ashley Hodo, RN

Palliative Care Unit Manager

Thanksgiving…Indulge without guilt!

Does your Thanksgiving meal leave you stuffed and on the couch watching football all afternoon? If so, you might just need to “fine-tune” your indulging. There are a variety of Thanksgiving dishes that are scrumptious, but lower in calories. Take a look at how you can treat yourself without killing your waistline!

Before the Meal

Many people make the mistake of “saving up their calories” for the big meal. The problem is that when you skip meals you end up feeling starving and thus overeat. So to prevent overeating:

- Eat breakfast!
- Do NOT skip meals all day. Eat small meals and snacks all day so you are not starving upon arriving at Thanksgiving dinner!
- Drink water throughout the day as dehydration can make you believe you are hungrier than you actually are!

The Table Setting

The best way to prevent over eating is make it “difficult” to get food…if the food is within arm’s distance, typically people eat more because it is convenient! So what can you do?

- Leave the food in the kitchen instead of placing it family style on the dinner table
- Use the “small” plate at the meal and if you are hungry, you can go back for more
- Only put one serving of each item on your plate; don’t create a mountain of food

Drink This, Not That!

Wine, martinis and champagne…oh how the calories can add up! Alcohol is full of empty calories, which means it has a good amount of calories with no nutrients. The real problem, however, is that alcohol does not make you full like food does so you keep drinking those extra calories. Make your first goal to drink water then have a drink or two throughout the day and alternate water in between.

- Drink red wine INSTEAD of a red fruity cocktail
- Drink light beer INSTEAD of regular beer
- Drink hot chocolate or coffee INSTEAD of eggnog

Eat This, Not That!

Thanksgiving dishes are known for their calories, but there are many healthy choices you can make at the meal and even with dessert. Check out the TOP 10 healthiest decisions you can make at dinner:

- Choose a green salad or raw veggie appetizer INSTEAD of chips and dip
- Choose skinless, white meat turkey INSTEAD of fried or dark meat turkey
- Choose fresh green beans INSTEAD of green bean casserole loaded with creamy sauces
- Choose brown gravy INSTEAD of creamy gravy on your mashed potatoes
- Choose a sweet potato INSTEAD of a sweet potato casserole loaded with marshmallow & sugar
- Choose bright colorful veggies INSTEAD of a plate loaded with white starches
- Choose a whole wheat roll INSTEAD of a croissant or flaky biscuit
- Choose water as your beverage INSTEAD of an alcoholic beverage, sweet tea or soda
- Choose desserts that are fruit based INSTEAD of chocolate or cheesecake based
- Choose pumpkin pie INSTEAD of pecan pie

Amy Goodson, MS, RD, CSSD, LD
Registered Dietitian

Words of Holiday Wisdom

Well, it’s almost Thanksgiving already. With the changing color of the leaves comes heightened expectations of holidays, parties, gifts and more. A couple of thoughts on fall and winter holidays:

1. Be patient. Don’t let crowds get you blood pressure up. Plan to give yourself more time, whether at the airport or in the mall.

2. Be active. Even though its dark early, and temperatures have dropped, don’t stop exercising. Walking, jogging, biking…whatever you want. Push yourself to burn a few more calories to keep up with the eating extravaganzas…oh, and have you ever wondered why so few people take the stairs – even for a single flight? Fifteen steps up to the next floor isn’t too many. Get going!

3. Get plenty of rest. All the hype and excitement will upset your sleep patterns. There is plenty of evidence that a good night sleep reduces cardiac risks, as well as other conditions. Don’t forget to take care of yourself even as you enjoy the many social occasions.

4. Eat right. Enough said.

5. Don’t go to gatherings if you are feeling sick. Why offer your bug to everyone else? That’s not the kind of present most people want…

6. Get your flu vaccination. It’s not too late, and it protects you…should you be on the receiving end of someone else’s sneeze…

7. Be thankful. There will always be those who have more than we do, and that will never change. But we have much. And giving thanks is good for the spirit, the heart, the soul.

Joseph Prosser, MD

VP, Chief Quality Officer

Ode to breastfeeding mothers!

My hat goes off to all the women who are reading this blog. As a childbirth educator and lactation consultant for the hospital, we are confronted with moms at many stages of the breastfeeding process. Some have a very positive experience and seem to transition into breastfeeding smoothly while for others, well... I'll let you read for yourself.

"I truly believe breastfeeding is the best for your baby and that is why I continue to stick with it. But let me tell you, it has not been an easy road.

Breastfeeding was a choice and the best choice I feel I have made as a mother yet. Studies show, and I have to agree, that breastfeeding gives your child the healthiest start of life possible. I always knew I wanted to breastfeed my children for as long as I could, but never knew of the dedication and mental toughness this part of motherhood would require. Here is a snippet of my journey...

Breastfeeding is one of the most special bonds a mother and baby can share. You carry this baby for 10 months and bond with it during that time and when he or she is born, breastfeeding is an extension of that bond that you have in utero.

What I was not prepared for is how painful breastfeeding can be and how time consuming it is. The lactation experts at the hospital do a great job of educating you and showing you technique, which is important. The wild card in breastfeeding is how your child will respond and how they will latch.

My baby latched just fine, but has always had poor technique while nursing.
Poor technique=sore nipples!

I was very consistent with my visits with the lactation nurses. You never know the importance or value of the lactation nurses until you have a screaming baby and sore nipples.
After many consultations and working on his technique, I got on the right track. Or so I thought...

This is the part where mental toughness comes into play. After 2.5 months of nursing, I still struggle at times with sore nipples. That is no fault of any ones. I have anatomy that has not complied and a baby who continues to battle poor technique.

I decided long before my baby entered the world that I was going to be successful with breastfeeding. That determination, coupled with a breast shield and lots of nipple cream, has lead to a mental toughness to get through the sore nipples and the occasional discomfort associated with breastfeeding.

On to the issue of time. I am an active person who hates to sit still. Breastfeeding forces you to sit still, enjoy your baby and let them eat - ON THEIR TIME TABLE. This has been a challenge for the "do it" mentality I have. Good news - we live in a world of technology and AWESOME breast pumps. When you need to give your breasts a break and you need to feed your child more efficiently - just pump.

Lactation nurses will tell you that only pumping can lead to a decrease in your milk supply. So, I don't recommend solely pumping. However, I have used pumping as a tool to alternate between breastfeeding and pumping to give my breasts a break and feed more efficiently at times. Just an option!

Bottom line - the benefits of breastfeeding far outweigh the negatives. I have always heard that you lose a lot of weight while breastfeeding. That fact is very true. I also heard that it was more cost-effective to breastfeed. That is also true.

When you go to the grocery store next, price formula. $23 a can for formula that might last a week gets expensive very quickly.

The satisfaction that I know I am giving my baby the very best is mostly what continues to remind me that I CAN do this breastfeeding thing - it is simply a choice.

Must run - baby is screaming and ready to eat."

- Breastfeeding mom

Becky Law, RN, IBCLC, LCCE

Childbirth educator/Lactation consultant

If you have any tips or stories to share, please comment.

Holiday Eating:Cook With This and Not With That

When thinking about the holidays, most people imagine their grandma’s homemade pie, their mom’s scrumptious casserole and their aunt’s candied sweet potatoes. Umm mm! However, all of these foods have one common denominator: lots of calories! And lots of calories can lead to unwanted weight gain. The average person gains 7 pounds over the holidays because typically people eat higher calorie foods and exercise less.

It is not that you have to cut these foods totally out of your holidays, but making some key substitutions can lower the fat and calories in recipes while keeping the same great taste! Remember, it is not just baked goods that are full of calories, some of your favorite dishes are also loaded with them!

When cooking, substitute:

Cook with this - 1 cup oats or crushed whole wheat crackers
Not with that - 1 cup bread crumbs

Cook with this – 1 cup 2% mozzarella cheese
Not with that –1 cup cheddar cheese

Cook with this – ¼ egg substitute or half banana mashed with half teaspoon baking powder
Not with that - 1 egg

Cook with this – 1 cup low-fat sour cream or plain yogurt
Not with that – 1 cup mayonnaise

Cook with this – 1 cup cooked barley, bulgar or brown rice
Not with that – 1 cup cooked white rice


When baking, substitute:

Bake with this – 1 cup yogurt
Not with that - 1 cup buttermilk

Bake with this – 1 cup natural honey
Not with that – 1 cup corn syrup

Bake with this – 1 cup frozen light whipped topping (thawed)
Not with that – 1 cup cream (whipped)

Bake with this – 1 cup low-fat cottage cheese (pureed)
Not with that – 1 cup cream cheese

Bake with this – 1 cup apple sauce or fruit puree
Not with that – 1 cup oil

Note: Don’t substitute every single ingredient because you might alter the taste and integrity of the end result. However, making a few substitutions will help lower the fat and calorie intake of your product!

Amy Goodson, MS, RD, CSSD, LD

Registered Dietitian

If you have a question for the dietitian, visit www.texashealth.org/askamy

Breast cancer awareness all year long

Breast Cancer Awareness Month is officially over, but as the manager of the Kupferle Comprehensive Breast Center at Texas Health Harris Methodist Hospital Fort Worth, it’s ongoing. For those of us who work in the breast center, spreading awareness is an everyday priority.

Regular screening mammograms are an important weapon in the fight against breast cancer. At the Kupferle Comprehensive Breast Center we follow the American Cancer Society’s (ACS) Guidelines for the Early Detection of Breast Cancer which are:

· Yearly mammograms for women starting at age 40 and continuing as long as a woman is in good health.
· Clinical breast exam every 3 years for women in their 20s and 30s and every year for women 40 and over.
· Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.
· ACS recommends that some women -- because of their family history, a genetic tendency and other factors -- be screened with MRI in addition to mammograms. Talk with your doctor about your history and whether you should have additional tests at an earlier age.

It is also important to have your screening mammogram at a healthcare facility you trust with your life, because mammograms save lives. When choosing a mammogram facility, take a moment to ask yourself “what if?”

“What if they find something during my mammogram?”

“What if I have breast cancer?”

At the Kupferle Comprehensive Breast Center, if something is found during your screening mammogram, you are not alone. If it turns out to be breast cancer, you are not alone. If you have questions or need guidance from people who have been through breast cancer, you are not alone. We are here with the support through your journey from beginning to end.

Lesley Kibel, RN

Manager Kupferle Comprehensive Breast Center

Bariatric Diary # 8: Things are looking up

Good day, kind readers!!

Last time I wrote I was about to have an endoscopy due to some internal issues. I had the procedure and thankfully, we found the problem. I had at some point developed a stricture at the bottom of my stomach where the new pouch connects to the intestine. My body essentially overcompensated during the healing process and almost closed off the stomach pouch at the bottom opening. Unfortunately it could not all be repaired in the one procedure. On Tuesday of this week, I had a second procedure and I am glad to report that things are back to where they should be with one small exception. During the 2nd endocscopy they found a small stomach ulcer so I will be taking medicine for awhile until that can be taken care of. No fun, but hey its better than the alternatives.

I did find it very funny my experience with the endoscopy. It really is painless and no big deal. However, both times I had weird experiences in the recovery room. Apparently both times, everybody wanted to tell me very important information while I was more or less in a comatose state of mind. Thankfully, I had my dad with me the first time and my sister the second time. If not I very well might have given away everything I own. The nurses were great, the doctor was great, and I am much better off now.

So other than the medical side of things, life has been good. The job is good, the family is good, the Rangers made it to the World Series (Antlers Up!!), hunting season start next weekend, and life seems to be going in the right direction. As of today, I am proud to say that I have lost approximately 141 lbs and glad that my weight is staying fairly consistent now.

I encourage everyone to come out to the Bariatric Support Group tomorrow, Thursday, November 4. It should be a good time and much knowledge to be shared by all.

The journey continues…..

Casey Armstrong

Be Safe for Halloween!

Halloween is just a few days away. Which reminds me that I need to buy more candy. Why is it that I can remember where I hide the candy, (yum) but I can’t remember where I put the car keys? And speaking of car keys, did you know twice as many children are struck by cars on Halloween than on any other day in the year? So as you venture out on this spooky night, remind your children when crossing the street to look left, and then right, and then left again. Streets should only be crossed at the corner. Try to stay on sidewalks, but if there are none in your neighborhood, walk on the left side of the street, facing oncoming traffic. It is much easier for a driver to see your goblin with reflective gear such as glow in the dark bracelets, necklaces and reflective tape.

Turn on your full headlights between 5:30 and 9:30, which is the most popular hours for trick-or-treaters. Of course you should obey all traffic signs. In residential areas, drive slower than usual where children will be out. Pay special attention when going in and out of driveways. Be mindful of any distractions such as talking on cell phones, or eating to better concentrate on driving. If driving trick-or-treaters through the neighborhood, remember to use seat belts and exit the vehicle on the passenger side.

Halloween is an exciting time for children. They look forward to dressing up and getting heaps of candy! As parents we are responsible for checking out the candy (especially the chocolate ones), and keeping our little ghouls safe and sound. This includes reminding your teens (the scariest ones of all) about attentive driving, no matter how many times they roll their eyes.

MaryAnn Contreras, RN
Injury Prevention Coordinator

Who needs a flu vaccine?

Influenza, commonly referred to as the flu, is a highly contagious viral infection. Symptoms often include a quick onset of fever, muscle ache, sore throat, cough and headache. Influenza symptoms are usually mild to moderate in severity and last for 2 to 3 days. In more serious cases however, the flu can lead to further complications such as pneumonia or even death. Each year more than 200,000 hospitalizations are flu-related. Flu season usually peaks in December and continues through March. The flu vaccine provides protection against contracting the flu. There are two types of influenza vaccines available for the 2010 season, the traditional “flu shot” and a nasal vaccine.

The flu shot is a yearly vaccine that can be given to adults and children as young as six months of age. This vaccine contains three different inactivated strains of the flu virus. One of the strains in the 2010 influenza vaccine will be the 2009 H1N1 virus. Because the peak flu season begins in December, the optimal time to receive the influenza shot should be during October or November. The flu shot is usually recommended for all persons that are high risk for complications such as those 50 years of age and older, healthy children 6 months through 18 years of age, residents of long term care facilities, pregnant women, and those 6 months of age and older with chronic illnesses (such as pulmonary or cardiovascular illnesses). Common side effects are redness and soreness at the injection site that usually lasts for 1 to 2 days. Less than one percent of people experience fever, muscle ache or tiredness. Some individuals have not been able to receive the influenza vaccine in the past because of an allergy to eggs. However, in 2011 a non-egg based vaccine will become available.

Another option for protection against the flu is the nasal vaccine also known as FluMist. FluMist is approved for healthy persons age 2 through 49 and it is given as a nasal spray. Unlike the influenza shot, the nasal vaccine may be given as soon as it is available in the late summer or fall. FluMist contains a live attenuated virus, which is a weakened form of the flu virus. The most common side effects of the nasal vaccine are runny nose, cough, nasal congestion, chills, sore throat and headache.

Visit http://www.flu.gov/ for further information on the vaccines.

~Nicole Day, PharmD

Grateful for Small Miracles

After learning that we were pregnant with twin girls our excitement was beyond measure. We were so excited to share our lives with not one, but two precious babies. Unfortunately, God had other plans for our family. Pre-term labor reared its ugly head in the 19th week of my pregnancy, and I was rushed to Texas Health Harris Methodist Hospital Fort Worth where I would remain for three days.

After my third night at the hospital, my water broke, and our first sweet baby, Lily Grace, was delivered…too soon for any chance of survival. Miraculously, my labor stopped after Lily was born, and Dr. Bradford and her nurses did everything they possibly could to keep our second twin safe for another 25 days. Isabelle “Izzy” Eden was born at 23 weeks and 6 days gestation, weighing 1 pound 9 ounces and measuring 11.75 inches long.

She was immediately rushed to the Neonatal ICU after her birth, and she ended up spending the first four months of her life there. She was released to come home the day after her original due date. Izzy was under the care of Dr. Miao and Dr. Brann, and they both took excellent care of her. And we just can’t say enough about the NICU nurses. They were wonderful! They went out of their way to make us feel at ease while we were visiting Izzy, and they were so patient with all of our questions. It was hard to walk away from our baby every night, but we knew we were leaving her in very capable hands, and most importantly, that she was loved. We are forever grateful to our doctors and nurses at Texas Health Fort Worth for taking such excellent care of our little girl. She wouldn’t be the picture of health she is today without them.

~The Babb Family

Brandon’s Story

My name is Brandon and I would like to share my story with you on how being a tissue recipient has impacted my life. In 2003, I started working at Community Tissue Services – Fort Worth as a customer service representative. My job was to help surgeons and patients get the tissue they needed for surgeries such as ACL repairs, hip surgeries, burn grafting, and many other types of surgeries that helped people walk, work, and live a full life. Seeing the impact that donation made every day for recipients and donor families, I became an avid supporter of donation.
Like most boys in Texas, football is a way of life. I played football my entire life and was given the opportunity to play college football for the University of Pennsylvania. During four years of playing Division I football, I never sustained any injuries.

While playing soccer in 2005, I came down on an opponent’s cleat and completely tore my Anterior Cruciate Ligament (ACL), one of the most important of four strong ligaments connecting the bones of the knee joint, damaged my lateral meniscus, a cartilage-like band that covers the lateral side of the interior of the knee, and tore a ton of cartilage. Needless to say, my knee was in disrepair. When I met with my surgeon, Dr. William Coleman, I told him without any hesitation that I wanted to use a donated ligament. As an employee of CTS, I knew of all the advantages using a donated ligament would bring me. When Dr. Coleman performed my surgery, I was given a “new” ligament.

One of the most important decisions I have ever made was to use a donated graft to repair my knee. Because of the tissue transplant, my knee is as “good as new”. Today, I am a football coach at North Side High School, and my coaching style revolves around being able to show my athletes how to play the game, getting on the sled and bags and being a “hands on” coach. I also have a three –year old son that loves to play, run, and do all the things a wild three-year old does. Without question, receiving my tissue transplant has allowed me to live my life the way I want!

I owe this all to the person that decided to donate the tissue of someone they loved. Soldiers, firemen, police officers, and so many others that come into harms way benefit from the tissue, skin, and bone donated by the families of those that have passed. The decision to “give” can be life saving to some, and can allow others to continue their way of life. This also keeps the memory and spirit of the donor alive.

I am a supporter of donation and plan to become a donor. My family is aware of my decision to “give”. We can’t all be heroes, but we can all help each other by giving the gift of life, the gift of giving someone’s life a second chance, and the gift of helping a family that has lost a loved one carry on their memory.

Too Much of a Good Thing

Acetaminophen is the generic name for the commonly used over-the-counter (OTC) product Tylenol®. Since acetaminophen is most often used to reduce pain and fever, it is found in many combination OTC and prescription medications. Many consumers have the misconception that acetaminophen is extremely safe because it is so easily available and unlike ibuprofen, aspirin, or naproxen, it does not cause stomach pain or bleeding.

Acetaminophen can be most dangerous when the daily recommended total dose of 4 grams is exceeded. An overdose of acetaminophen can lead to liver damage. Patients with liver disease should probably receive less than 4 grams of acetaminophen per day, but should consult their physician for the recommended daily maximum dose.

A study in 2005 showed that acetaminophen poisoning accounted for 42 percent of acute liver failure cases. Many of these cases were caused by unintentional acetaminophen overdose. The FDA held a meeting in June 2009 to help decrease the number of consumers who experience liver toxicity through acetaminophen use. A public education campaign has been started to educate consumers.

Consumers can do their part by reading all of the ingredients in combination products. On OTC medications, check the “Drug Facts” label under the “Active Ingredients” section. On prescription combination products, it can be listed as acetaminophen or APAP, a well known abbreviation for acetaminophen.

Common prescription medications that contain acetaminophen:

Acetaminophen and Hydrocodone (Vicodin®, Lortab®, Norco®)
Acetaminophen and Oxycodone (Percocet®, Roxicet®, Endocet®)
Acetaminophen and Propoxyphene (Darvocet-N®)
Acetaminophen and Tramadol (Ultracet®)
Acetaminophen and Isometheptene and Dichloralphenazone (Midrin®)
Acetaminophen and Butalbital and Caffeine (Fioricet®)
Acetaminophen and Codeine (Tylenol #3®, Tylenol #4®, Tylenol Elixir with Codeine)

Common OTC medications that contain acetaminophen:

Acetaminophen and Diphenhydramine (Tylenol PM®, Excedrin PM®, Tylenol Severe Allergy®)
Acetaminophen and Aspirin and Caffeine (Excedrin® Extra Strength, Excedrin® Migraine)
Acetaminophen and Pamabrom (Midol®)
Acetaminophen and Phenylephrine (Alka-Seltzer Plus® Sinus Formula, Sudafed PE® Sinus Headache, Vicks® DayQuil® Sinus, Excedrin® Sinus Headache)
Acetaminophen and Dextromethorphan and Doxyalamine (Vicks® NyQuil® Cold and Flu Multi-Symptom)
Acetaminophen with Chlorpheniramine (Coricidin HBP® Cold and Flu)

Make sure you are checking your medication lists twice so that you aren't doubling up on your medications. And as always, speak to your family doctor regarding any medication changes.


Alisia Baker, Pharm.D.

Tips for Halloween Safety

Just a little over two weeks to go before the big night of “trick or treat” commences. Personally, I have bought two bags prototype candy. Of course the treats must be tasted and tested before I hand it out to my neighborhood goblins. I am a responsible neighbor after all. I have also checked and made sure my front porch and driveway are clearly lit and there are no tripping hazards (such as garden hoses) for the galloping ghosts. I have a plan for my alarmingly energetic Jack Russell that includes being secured in the house to avoid any potential escapes she might attempt with the overactive ringing of the doorbell.

Now that the basic arrangements are made, I have started talking with my teenage daughter. It is an ongoing dialogue about being aware of her surroundings while driving. Certainly this conversation is frequented often, but as Halloween nears it is even more important. Remember how excited these little ghouls get questing for candy—they run right out into the streets and don’t even think to look both ways. Many costumes are dark and scary, and difficult to see from a driver’s point of view. Extra caution is the answer for everyone, especially the teen drivers.

Remind the witches and warlocks to be wary of parked cars. Crossing the street with an adult or in a group is always a safer approach. And speaking of groups, trick or treating in packs is a sure way to have a more enjoyable evening. Remind the kids to get their goodies from the front door and never go inside the house. Lastly, before they gobble those goodies, they should be inspected by an adult, making sure the candy is securely wrapped and not tampered with. It’s often tough being a parent, but during this time of year, how sweet it is.

Mary Ann Contreras, RN

Injury Prevention Coordinator

Breakfast tips: feed your kids and YOU

Alarm rings, kids won’t get out of bed, you forgot to iron your clothes for work, dog is barking…eat breakfast? Yeah right!

This is a typical morning for many families in the United States. They run out the door without fueling for their day. So what is the problem? A nutrient-rich breakfast is key to helping people feel energized, stay focused and feel less hungry later in the day. Research shows that people who eat a complete breakfast typically manage their weight better and children think better, problem solve more efficiently and stay focused on their school work.

I would like to encourage all MOMS to feed themselves while feeding their kids! So many moms make breakfast and pack lunches for their kids and husband, but forget to fuel their own body. As women age, their metabolism slows down and skipping meals makes it worse! So no, the thought that “less is better” is not always the case, especially not with nutrition. In order to get your metabolism up and running, you have to eat breakfast, more than a yogurt or piece of fruit! Think of it like this…eat breakfast like a king, lunch like a prince and dinner like a pauper!

5 Quick Breakfasts for YOU and your KIDS:

2 slices 100% whole wheat toast each with 1 Tbs. natural peanut butter and top with slices banana
1 scrambled egg, 2 oz turkey sausage, 1 whole 100% wheat mini bagel with 2 Tbs. 100% fruit jelly and 8 oz low-fat milk
1 cup cooked oatmeal topped with ½ cup fresh blueberries and 2 Tbs. chopped pecans, 8 oz low-fat milk
Yogurt Parfait: 6 oz low-fat Greek yogurt, 1 Tbs. honey, ¾ cup whole grain cereal and 2 Tbs. chopped nuts (or flaxseed)
Non-traditional breakfast: 1 – 100% whole wheat tortilla rolled with 2 oz turkey and 1 slice 2% cheese in addition to a pre-made yogurt smoothie

Breakfast Check List:
Make sure your breakfast consists of complex carbohydrates (ex: whole grain cereal, wheat bread, fruit, low-fat milk), protein (ex: eggs/egg whites, lean meat, nuts), and some healthy fat (peanut butter, nuts, light cream cheese)

Look for whole wheat bread and grain products instead of white/refined products
Choose low-fat (skim, 1% or 2%) milk and dairy products
Limit your intake of fried foods, grease, and extra gravies & sauces
Aim to get fruit into your breakfast either as a juice or as a whole fruit

What is your go-to breakfast for yourself and your kids?

Amy Goodson, MS, RD, CSSD, LD

Registered Dietitian

For more tips and stories about moms in the Dallas/Fort Worth area, visit www.texashealthmoms.blogspot.com.

The Road Less Traveled

“Two roads diverged in a yellow wood,
And sorry I could not travel both…” -Robert Frost

Life is unpredictable. Just ask anyone in the medical field. As we travel down the road of life we have to make decisions as to which way to go when we come to a crossroad. But what if you couldn’t tell us that decision? Does your family know what you want? What if you could no longer care for yourself? What if you could no longer feed yourself? Sooner or later this is a crossroad we all must face. In many cases, we as medical professionals can’t always provide our patients and families with immediately clear answers regarding a prognosis on a disease or injury, so knowing which direction your loved one would want to go helps ease the decision-making process during difficult times.

As healthcare providers we often have to help families through these troubled times of “guessing” and “assuming” what a loved one would want because they simply had never had this difficult dialogue. You are never too young or to healthy to have this vital conversation. Questions to consider and discuss with your family could include (but are not limited to):

1) Who you want to make health care decisions for you when you can no longer make them yourself? We should all choose someone to make difficult choices for us. It is vital that this person be able to agree to respect your wishes.

2) What kind of medical treatment do you want or not want? Life is precious. We all want to be treated with dignity, especially during difficult times. Dignity also means that your loved ones know your wishes and respect them when you are unable to communicate them yourself.

3) How comfortable do you wish to be if you have a chronic or life limiting disease? Most people wish to spell out for physicians and care givers that they want to be kept free from pain, nausea, and shortness of breath. Clearly identifying what you want treated and don’t want treated will make these choices that much easier.

4) How you want people to treat you? Do you want to be surrounded by your loved ones as the hours of your life draw to an end? Do you enjoy music and want your family to play music for you? Do you want to have pictures for special memories and share stories of the past? Do you want spiritual support from a church or chaplain? What customs and rituals would you like to have honored?

5) What do you want your loved ones to know as they care for you? It is also important to discuss feelings with loved ones during this time so that the ones you care about know how you feel about them in case you are unable to communicate those feelings at a later date. Leaving a letter with your last will and testament is a very moving way to let your loved ones know how important they were to you if you are unable to voice this in the end.

As an individual it is your right to make these decisions for yourself. Most of us have considered this at some point in our lives, but have we communicated it to those who care about us? If you come to a fork in the road about making life decisions do you and your family know which way to go?

Kenneth Ellis, RN; Ashley Hodges, RN; Jennifer Nelson, RN

Palliative Care

Healthy Harvest Bites…

A healthy cookie twist!

More than just a decorative Halloween candleholder or a pie filling to be eaten only once a year, pumpkin is one of the most nutritional foods available year round. Rich in antioxidants, vitamins, minerals, and low in fat, both the flesh and seeds of the pumpkin provide many health-boosting nutrients. Check out some of the nutrients in pumpkin:

Alpha-carotene
Beta-carotene
Fiber
Vitamins C and E
Potassium
Magnesium
Pantothenic acid

Pumpkin is an excellent source of fiber; one-half cup serving contains 5 grams of fiber. Fiber helps reduce bad cholesterol levels, protect the body against heart disease, control blood sugar levels, promote healthy digestion, and plays a role in weight loss. In addition, alpha-carotene and beta-carotene are potent antioxidants found in pumpkin and are pro-vitamin A carotenoids which converts to vitamin A in the body. Vitamin A promotes healthy vision and ensures proper immune function. Not to mention, the Vitamin C in pumpkin also boosts immunity! Pumpkin also contains Vitamin E which promotes healthy skin by protecting the body from sun damage. So, stock up on pumpkin this fall and start by making the Pumpkin Protein Cookies!

“Pumpkin Protein Cookies” Recipe

3/4 cup SPLENDA® Granular
1 cup rolled oats
1 cup whole wheat flour
1/2 cup soy flour
1 3/4 teaspoons baking soda
1/2 teaspoon baking powder
1/2 teaspoon salt
2 teaspoons ground cinnamon
1 teaspoon ground nutmeg
1/2 cup pumpkin puree
1 tablespoon canola oil
2 teaspoons water
2 egg whites
1 teaspoon molasses
1 tablespoon flax seeds (optional)

Directions:
Preheat oven to 350 degrees F (175 degrees C). In a large bowl, whisk together Splenda®, oats, wheat flour, soy flour, baking soda, baking powder, salt, cinnamon, and nutmeg. Stir in pumpkin, canola oil, water, egg whites, and molasses. Stir in flax seeds, if desired. Roll into 14 large balls, and flatten on a baking sheet. Bake for 5 minutes in preheated oven. Cookies will turn out dry if overbaked.

Nutrition Facts per Serving:
Calories: 89, Carbohydrate: 15 gm, Fiber: 2.5 gm, Protein: 4 gm, Fat: 2 gm, Cholesterol: 0 mg

Amy Goodson, MS, RD, CSSD, LD
Registered Dietitian
Ben Hogan Sports Medicine
Executive Health Program

If you have a question for the dietitian,visit www.texashealth.org/askamy

Halloween: Part One

What are you going to be for Halloween? My children used to pull out the box of costumes to see what would work for that year. There was always lots of princess attire as well as witches and a few odds and ends that could be transformed into aliens, ninja turtles and pirates. This year’s top costumes revolve around pop-culture icons such as Lady Gaga and movies like Avatar and Toy Story 3.

As you prepare for the big night out, remember to keep those costumes safe. Not too long as to cause a tripping hazard. Be careful with candles inside of pumpkins. Masks and head gear should not obstruct the gremlin’s vision. And speaking of vision, remember to take a flashlight, especially when crossing streets. Until next week, happy costume hunting!

Mary Ann Contreras, RN

Injury Prevention

Mother and Babies Need Skin to Skin

Recent studies support what mother’s have known instinctively for generations. Mothers and babies belong together from the moment of birth. Skin to skin contact between mothers and babies immediately after delivery has many benefits for the new family.

Skin to skin contact involves drying the infant and placing him/her immediately from the womb to the bare skin of the mother’s abdomen, then placing a warmed blanket over the two of them. According to mammalian neuroscience, the intimate stimuli inherent in this kind of contact evokes neuro-behaviors ensuring fulfillment of basic biological needs and may program future behavior. Thirty studies involving 1925 participants found the following positive effects to keeping mothers and babies skin to skin immediately after birth.

Benefits to Baby:

· Stabilization of the baby’s heart rate with a decrease in bradycardia episodes
· Improved regular breathing patterns and a decrease in apnea episodes
· Improved oxygen saturation rates
· Improved temperature regulation
· Increased restful and deeper sleep
· Increase in weight gain
· Shorter hospital stays

Benefits to Parents:

· Improved bonding supports closeness to baby
· Increase in breast milk supply
· More successful breastfeeding episodes
· Increased confidence in the ability to care for the baby

Gloria Glidewell, CNM, MS

Nutrition Support in Critical Care

When patients cannot help themselves in any capacity, there are professionals that step in and take the necessary steps to ensure that they receive the type of care that will sustain and nourish them back to the point where they can do it on their own. In the clinical nutrition field, professionals like Debbie Foster do just that.
Debbie’s career as a licensed and certified nutrition support dietitian began with Texas Health HEB and Texas Health Fort Worth.
“When I was a student working part-time, day after day I observed a culture of compassion, care and professionalism at both hospitals. It had a strong impact on me and I knew this is where I wanted to be.”
When asked about her daily motivators, she said “My satisfaction comes from having a direct impact on improving my patient’s overall outcomes”.
“I enjoy being able to use nutrition as part of the healing process that helps to get patients back to a productive and healthy life.”
Family members find it comforting to know that when their loved ones may be unable to eat on their own, there is someone ensuring that they are receiving the best source of nutrition.
Healthcare and science have always been a passion for Debbie. The profession allows her to use her passion to help others. She enjoys being part of a multidisciplinary healthcare team dedicated to the improving the health of the community mind, body and spirit.

Debbie Foster

Registered Dietitian

Get Your Metabolism Fire Burning!

Alarm rings, kids won’t get out of bed, you forgot to iron your clothes for work, dog is barking…eat breakfast? Ya right! This is a typical morning for many families in the United States. They run out the door without fueling for their day. So what is the problem? A nutrient-rich breakfast is key to helping people feel energized, stay focused and feel less hungry later in the day. Research shows that people who eat a complete breakfast typically manage their weight better and children think better, problem solve more efficiently and stay focused on their school work.

September is National Breakfast Month and we would like to encourage you to get your metabolism burning with breakfast! Think of your metabolism like a fire…in order to get a fire going you have to use a sufficient amount of wood. Same with your metabolism fire…you need to fuel your body with a sufficient amount of nutrition to get the fire burning. Try to wake up five to ten minutes earlier and make time for breakfast whether you are a mom, dad, single adult or teenager…everyone needs breakfast!!! Here are some examples to get you started…

5 Quick Breakfasts for YOU and your KIDS:

2 slices 100% whole wheat toast each with 1 Tbs. natural peanut butter and top with slices banana
1 scrambled egg, 2 oz turkey sausage, 1 whole 100% wheat mini bagel with 2 Tbs. 100% fruit jelly and 8 oz low-fat milk
1 cup cooked oatmeal topped with ½ cup fresh blueberries and 2 Tbs. chopped pecans, 8 oz low-fat milk
Yogurt Parfait: 6 oz low-fat Greek yogurt, 1 Tbs. honey, ¾ cup whole grain cereal and 2 Tbs. chopped nuts (or flaxseed)
Non-traditional breakfast: 1 – 100% whole wheat tortilla rolled with 2 oz turkey and 1 slice 2% cheese in addition to a pre-made yogurt smoothie

Breakfast Check List:

Make sure your breakfast consists of complex carbohydrates (ex: whole grain cereal, wheat bread, fruit, low-fat milk), protein (ex: eggs/egg whites, lean meat, nuts), and some healthy fat (peanut butter, nuts, light cream cheese)
Look for whole wheat bread and grain products
Choose low-fat (skim, 1% or 2%) milk and dairy products
Limit your intake of fried foods, grease, and extra gravies & sauces
Aim to get fruit into your breakfast either as a juice or as a whole fruit

Amy Goodson, MS, RD, CSSD, LD

Registered Dietitian

If you have a question for the dietitian, visit www.texashealth.org/askamy

The journey has speed bumps…

Well I have been pretty busy over the last couple weeks. My stress level reached an all time high, but finally settled down a little bit last Friday. I changed careers with little to no notice, went out of town a couple times, posed for a photo shoot, got sick and scared myself senseless, and the list just keeps on going.

So I am a big believer now that stress and bariatric surgery do not mix well. I went to the Bariatrics support group a couple weeks ago and was not feeling all that well. I talked with our dietician Jaime Bass about what was going on and she suggested that I give Dr. Lorimer a call the next morning. Little did I know that before I could make it home that all hell would break loose and I would start panicking enough to make me call the doctor. For those who don’t know me very well, I avoid calling doctors at all cost and very rarely will even take aspirin if I can help it.

On the way home, I started feeling worse than when I was at the hospital so I pulled over on the side of the road to give myself a moment. Next thing I know I was vomiting uncontrollably on I-30 and feeling like I was about to die right there next to my truck. After calling my dad (who is also a bariatric patient) to get his thoughts, I got back in the car thinking the worst was over. This was probably a very bad idea, as it got worse the longer I drove. I got home and called Dr. Lorimer and talked things through. I took it easy all weekend eating mostly soup until I got a chance to go see Dr. Lorimer this last week. Last Wednesday, I got in to see the good doc and we talked everything through further and then I went over to see a gastro doc. The appointment was short and sweet and I am now scheduled for Friday September 16 to have another procedure to get to the bottom of some of these recent issues. I am a little nervous about it just because I am a little worried about knowing what is really going on inside. I will admit though that I am excited about potentially being able to expand my diet further than soup menu!! I will update everyone after I find out more on Friday.

Another exciting thing I did last week was I became a model (Fashion Week, here I come). Only temporarily, but I drove to downtown Dallas to pose for photos for an upcoming article the Dallas Morning News and Fort Worth Star Telegram are doing in a special section for Texas Health Resources. There are going to be some amazing articles in the section. I brought in a bunch of my old clothes from before surgery and diligently stood between them, laid on top of them, and manipulated myself through them for about an hour. It really made me take a look back at how big I had really gorwn just over a year ago. One of the biggest eye openers during this experience was holding a photo of my son and I this past spring from our t-ball team. I don’t think I really ever realized how big I looked until last Friday. I am proud to say that I can now see a huge difference from before.

-Casey Armstrong

Bariatrics Patient

Giving the Gift of Life

My name is Claudia and three years ago I was diagnosed with Good Pastures Syndrome, an autoimmune disease that attacks the kidney and lungs. As I was told by one of the doctors, it was simply my “bad luck” that I contracted this disease because the odds of getting it are very rare. The disease took both of my kidneys, but thanks to the wonderful team of doctors at Texas Health Fort Worth, its progression was stopped before any further damage could be done.
As a single mom it impacted not just me, but my son as well because I am the only family he has. Through everything he was so scared that he would lose me. But I knew the Lord would get us through this. I do often think and say a special prayer for my donor and their family. I sent them a thank you letter for being so thoughtful. While my family and I rejoiced over receiving the gift of life, they were grieving the loss of a loved one. I only wish they knew how much I value them and am so grateful for everything because if it wasn't for them, my son wouldn't have his Mommy.
On June 30, I will celebrate the one-year anniversary of my transplant. This whole experience has changed my life completely. It gave me back my life; my independence and most important, more time to cherish with those I love the most, my family and friends.
I have always lived a good, healthy Christian life, but now I go to the extreme! I exercise regularly and pay more attention to my diet. And most importantly, I enjoy every day. If you are a donor or the family of a donor THANK YOU and if you are not, please consider becoming one. This decision can many lives!

Fall into Nutrition with Winter Squash

Shop seasonal this fall! Winter squash is available from August through March; however, they are at their best from October to November when they are in season. Winter squash, members of the Cucurbitaceae family and relatives of both the melon and the cucumber, come in many different varieties. While each type varies in shape, color, size and flavor, they all share some common characteristics. Their shells are hard and difficult to pierce, enabling them to have long storage periods between one and six months. Their flesh is mildly sweet in flavor and finely grained in texture. Additionally, all have seed-containing hollow inner cavities.

Winter squash are also rich in a variety of vitamins and minerals. It is a great source of Vitamin A in the form of beta-carotene which has powerful antioxidant and anti-inflammatory properties. Beta-carotene is able to prevent the oxidation of cholesterol in the body. Since oxidized cholesterol is the type that builds up in blood vessel walls and contributes to the risk of heart attack and stroke, getting extra beta-carotene in the diet may help to prevent the progression of atherosclerosis. Winter squash is also an excellent source of Vitamin C, potassium, dietary fiber and manganese. Potassium may help lower blood pressure and Vitamin C is known for its ability to strengthen the immune system. In addition, dietary fiber is significant in helping lower bad (LDL) and total cholesterol.

Get to know your 5 winter squashes:
Butternut Squash: Shaped like a large pear, this squash has cream-colored skin, deep orange-colored flesh and a sweet flavor
Acorn Squash: With harvest green skin speckled with orange patches and pale yellow-orange flesh, this squash has a unique flavor that is a combination of sweet, nutty and peppery
Hubbard Squash: A larger-sized squash that can be dark green, grey-blue or orange-red in color, the Hubbard's flavor is less sweet than many other varieties
Turban Squash: Green in color and either speckled or striped, this winter squash has an orange-yellow flesh whose taste is reminiscent of hazelnuts
Pumpkins: The pumpkin with the most flesh and sweetest taste is the small sized one known as sugar or pie pumpkin, the latter referring to its most notable culinary usage

Amy Goodson, MS, RD, CSSD, LD

EHP Registered Dietitian
Ben Hogan Sports Medicine Dietitian

If you have a question for the dietitian, visit www.texashealth.org/askamy