Are you hanging Christmas lights? If so, read on...

The month of November marks the beginning of many holidays. With this brings lots of preparation, decorations, parties, food, celebrations, and get togethers. It seems as if we begin this prep work earlier and earlier each year. Stores already have the Christmas sales and mark downs posted, turkeys are everywhere in the grocery isles, and I’m sure Santa will be in the mall any moment now. Don’t get me wrong, I love this season, especially the light displays in my neighborhood.
When I think of holiday lights, I am a bit remiss remembering Chevy Chase in the movie “Christmas Vacation.” “Clark’s” competitive spirit of hanging 250 strands of lights, each with 100 bulbs, totalling twenty five thousand bulbs—enough to cause the electric company to turn on their auxiliary nuclear generator spurs many enthusiastic folks to do the same. I suppose now isn’t the time to tell you about the year I tethered my teenage son to the chimney so he could place the lights on the second story of my house….Of course that was BEFORE I became the Injury Prevention Coordinator.
But seriously, hanging lights should be taken seriously. Every year emergency rooms treat about 12,500 people for injuries related to holiday lights, decorations, and Christmas trees. In the last few years THFW has admitted over 200 patients during this festive season for falls alone!
So, a few things you can do to stay safe this holiday season:
• Never use electric lights on a metallic tree- the tree can become charged with electricity from faulty lights and someone touching a branch could be electrocuted
• Have someone stabilize the ladder while you are hanging lights
• Check each set of lights for broken or cracked sockets, frayed wires or loose connections
• Use only three standard-size sets of lights per single extension cord
• Keep children and pets away from light strings and electrical decorations
• Keep children buckled up—even on those long night time drives to family events
• Remember to extinguish candles
• Keep trimmings with small parts out of the reach of children
• Test your smoke alarms!
• Poinsettias are poisonous to humans and animals
• Turn off all lights when leaving the house or going to bed
Enjoy your friends and family this season, stay safe and make this holiday bright so you can take pleasure in the many more to come.

- Mary Ann Contreras, RN
Injury Prevention Coordinator

Texas Health Fort Worth "Goes Purple"

Tomorrow, Texas Health Harris Methodist Hospital Fort Worth employees, physicians, volunteers and babies are "going purple" in honor of TCU's football team. Stay tuned to the blog for fun pictures from our "purple push."

Holiday Nutrition…Maintain, Don’t Gain!

Did you know the average person gains 7 pounds throughout the holidays?! From Halloween candy to Thanksgiving pies to Christmas baking to New Year’s cocktails…it is easy to add a few pounds. So let’s check out how you can avoid common nutrition holiday pitfalls this season!

Eating on the Run
The holidays bring lots of errands, lots of shopping, and thus lots of eating on-the-go. From drive thrus to mall food courts it is easy to grab a bite and get back to the shopping. So here are some ways to eat fast and eat healthy.
 Order a grilled chicken sandwich, wrap or salad and get the sauce on the side
 Substitute a salad, fruit cup, yogurt parfait or carton of milk for French fries
 Skip the soda, milkshake, and sweet tea and go with water

Parties and Family Gatherings
The holidays also bring lots of parties and gatherings of family and friends. The challenge is that all of these events usually revolve around food and cocktails and it is easy to over-eat bite-size foods. So in order to control your cravings at the party, prepare throughout the day.
 Do NOT skip meals all day. Eat small meals and snacks all day so you are not starving upon arriving
 Eat a small healthy snack with carbohydrate AND protein right before the party. This could be a small energy bar, whole grain crackers and a string cheese, a handful of nuts and berries, etc.
 Use the “small” plate at the party and don’t stand by the food table. Get your food and leave the area.

Office Goodies
Many people bring “goodies” to work around the holidays which makes it harder to “be good” nutritionally. Be the healthy person in your office by bringing the fruit or veggie tray and nibble on that. Here are some other office-eating tips…
 Eat a good breakfast of carbohydrate, lean protein and healthy fat so you are not hungry when you get to work and you can avoid the doughnut and pastry table
 Bring your lunch and snacks so you will not graze through the office kitchen all day looking for food
 Pick one day you will “treat” yourself on office goodies and be satisfied with that one day

Cocktails
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 when you get to the party. Then have a drink or two throughout the evening and alternate water in between.
 4-5 oz wine or champagne = 100-120 calories
 12 oz light beer = 110 calories (avoid the regular that has more than 150 calories per serving)
 Avoid things like margaritas and fruity drinks as they can have anywhere from 250-600 calories per drink

- Amy Goodson, MS, RD, CSSD, LD
Registered Dietitian
Ben Hogan Sports Therapy Institute
Executive Health Program

Grief, Loss and Change during the Holidays

The holy days are upon us. The next two months are filled with both religious and secular holidays—days designated to celebrate, reflect, respond, and gather with family, friends and communities of faith. The holidays can be times of great joy and renewal of mind, spirit and body. They can also—often at the same time—be sources of stress, sadness, and frustration. In my experience and research, I’ve found that being mindful of the stressors and sources of sadness and frustration allow me to deal more effectively—and healthily—with them, thus aiding the original intended enjoyment and renewal of the holiday.
A major source of sadness can be if a family member or close friend with whom one is accustomed to sharing the holiday is no longer around. This separation may be caused by divorce, illness, distance (such as being deployed in the military or a family member being far away and unable to come home due to financial constraints), or death. Each of these circumstances in itself is a source of grief and/or putting one in a state of unfamiliarity. Traditions build up around the holidays and become familiar and effective ways of connecting individuals to other people as well as to the Object of Faith around which the holiday is structured and for whom it was originally designated. Any of the sources of sadness listed above—and perhaps some that are not on the list—can interrupt the practice of the very traditions that help make these important and renewing connections. In some cases, individuals avoid celebrating at all due to the stressors involved. Taking charge of the unfamiliar can ease some of the stresses, help one acknowledge or honor the source of the grief and promote healing.
Be creative. Take a look at the way the holiday has been structured in the past and identify wherein the loss will be most keenly felt. Then restructure appropriately. The following are examples of how others have dealt creatively and effectively with some of the stressors:
• In the case of divorce, children may be away from one parent in order to spend time with the other. Plan ahead how that time will be spent in a healthy way and plan ahead—with the children’s input if they are old enough—for new traditions. For instance, one mother I know had found great joy in preparing and sharing traditional foods before and after Christmas Eve worship. Her teenage children were scheduled to spend Christmas Eve day and night with their father. She and the children sat down together ahead of time and identified what could be done to touch on each of the important aspects of the tradition. The teenagers identified the aspects of the celebration that were important to them also. The list they came up with included the following: gathering; opening gifts; sharing food; worship. They identified that mother and children would be together. Gifts would be given, although financial considerations dictated that they be more practical than perhaps they had been in the past. Menus were planned and excitement grew around making the Christmas breakfast—when they would first get together—a new tradition. They discussed the fact that their church did not have a service on Christmas day and they discussed attending another church service that day or setting aside a time during the day to have a home worship service with all the components of the communal one. While the day was different—and the fact of the divorce was not ignored—the family was able to celebrate together. The mother also planned ahead how to creatively and constructively spend the time that she had while her children were away from her.
• In the case of a loved one being unable to be with the group, arrange some type of communication that will include him/her for even a short time. It’s helpful when the group and the missing individual can find something to do in common at some point in the day. For instance, if one is deployed overseas, he/she can arrange with family to read a certain piece of scripture or look up at the sky at a certain point in the day, thus knowing that something has been shared. It will not be the same as being together, but it will ease the strain of being apart.
• In the case of a loved one’s death, remembrance and, hopefully, reminiscing with others who may be missing that person are important aspects of the celebration, especially on the first year of holidays following the death. Set aside a time during the day to personally or communally remember that individual and what he or she brought to celebrations in the past. If the deceased traditionally said the blessing and is no longer there to do so, acknowledge his/her gift of the past and the blessing that he/she has been to the group. Even if his/her role has not been such a formal one, those who are missing him/her can still contribute a “Remember when . . . “ that will affirm his/her place in and influence on the group gathered. The remembrances do not have to feel contrived or formalized. Looking at photos of past holidays can make this time of remembrance more natural. In my family, Thanksgiving is yet to go by that the conversation doesn’t start with a certain dear aunt and her particular spin on pumpkin pie. From there, the conversation flows to others with whom we have shared the holiday and are now departed. Shared laughter and tears are much more healing than suffering in the silence of thinking that you are the only one who misses the person absent.
These examples, I hope, will set the stage for you to ponder the upcoming holidays for you and those with whom you share them. Is some advance planning in order that can enhance the group’s experience of the holiday and make it the holy day it was intended to be? Don’t let loss, grief, or resentment keep you from truly celebrating holidays. Celebrating is a spiritual discipline that is so very important to emotional and spiritual health, and those of us involved in health care know how closely intertwined emotional, spiritual and physical health are. Happy Holidays! Be renewed, refreshed and enriched emotionally, spiritually and physically.

- Candace Stroup
Chaplain

Weight Loss and Recipe of the Month

Obesity is a complex and chronic disease, involving many factors. Therefore, losing weight on a permanent basis requires multiple approaches for success. There is no perfect diet or single pathway to successful weight loss and maintenance. What works for one person may not work for someone else.

In researching long-term weight loss maintenance, I found a great source of information:

The National Weight Control Registry
Brown Medical School/The Miriam Hospital
Weight Control and Diabetes Research Center
www.nwcr.ws

The NWCR is a database of people who have successfully lost between 30 to 300 pounds and have kept if off for at least one year. It was established in 1993 and follows there successful people annually with questionnaires to determine their weight maintenance techniques.

Through these yearly questionnaires, the NWCR has identified 8 trends or factors that this population has found to be successful for their weight loss maintenance. They are:

1. Eat a low kcalorie, low fat diet: Women eat about 1400 kcalories a day; Men eat about 1700 kcalories per day.
2. Eat fewer meals out.
3. Eat breakfast. (75% of the registrants eat breakfast every day)
4. Practice dietary restraint 7 days a week, including weekends and holidays.
5. Keep a food journal or diary.
6. Weigh yourself frequently. (75% weigh themselves weekly)
7. Limit TV time.
8. Exercise more. (90% of the registrants have some kind of physical activity at least 60 minutes a day)

Wow! That’s a lot of permanent lifestyle changes. Successful weight loss and maintenance does not include adopting temporary eating habits. It includes improving all areas of your life. It is not a simple process. That is one reason that the THFW Bariatric Services is an interdisciplinary group that includes a registered dietitian as part of the program. I am available for the patients’ in the program, at now cost for as long as they need me.

Our patients still have to develop the best type of lifestyle for them but thanks to the information from the NWCR, they now have some guidelines to follow that have been proven to be successful in this specific population. I feel that just knowing that other people have lost the weight and kept it off is great encouragement for my patients.

Next time, I will go into more detail on some of these guidelines.
Remember, healthy eating does not happen by chance.

Below is a recipe that is also on the THFW Bariatric Services Website. It includes a scoop of protein powder. Whey protein powder is essential in the diet of bariatric patients during the time of rapid weight loss to provide enough protein that the body needs to maintain muscle mass and manufacture all the substances necessary for daily protein metabolism.

Recipe of the Month:
Pumpkin Spice Latte

Ingredients:
• 1 scoop vanilla protein powder
• 1 tbsp canned pumpkin
• ¼ tsp Pumpkin Pie Spice (cinnamon, nutmeg, allspice)
• ½ cup skim milk
• 2 tsp Splenda or Equal
• ½ cup water
• 1 tsp Instant Coffee
Directions:
• Heat water in microwave then mix in instant coffee
• Add coffee, milk, pumpkin, protein powder, and spices
• Blend until combined
• Heat in microwave until warm or serve over ice

- Jamie Bass MS, RD/LD
Clinical Dietitian, Bariatric Services
Texas Health Fort Worth
jamiebass@texashealth.org


PS - Next month's recipe will be for a caramel/cinnamon latte! Keep checking back for that!

Traveling during the holidays?

November is the beginning of a busy driving season. Many of you will be taking road trips to visit families and friends. I have an upcoming trip scheduled and am planning to let my 16 year old handle most of the driving. It will be a good learning experience for her. If only the auto-makers could install the passenger side brake….. With that thought in mind, here is a top ten list of injury prevention tips that I have learned from being a passenger with a teen driver.

10) Seat belts are your best defense against impaired or distracted drivers
9) Keep loose items secured in the car
8) And do pull off the road to take a break and enjoy a meal
7) DVD’s are for back seat passengers only!
6) Dogs are our best friend, but NOT in the driver’s seat
5) And NO grooming of any kind—human or pet
4) Truck pick up beds are for carrying non-living objects
3) And make sure those objects are safely tied down
2) Program your GPS BEFORE leaving the driveway

And the top injury prevention driving tip this holiday season—
1) NEVER TEXT WHILE DRIVING

Thanks, and have a safe Happy Thanksgiving!!!

- Mary Ann Contreras RN
Injury Prevention Coordinator

What to Expect When You are Expecting…to Breastfeed Your Baby

Mothers want to give their children the best of everything. Without question, the best method of feeding infants is the milk that comes along with the baby; breast milk. Not only that, but it is absolutely free, comes in attractive reusable containers, and not only is it best for baby, it is also good for mom and the family as a whole.

Breast milk has everything your baby needs to be strong and healthy, and babies who are breastfed have fewer illnesses. Mother’s milk is always fresh and immediately ready; it saves time and money, and aids in getting mom back in shape. As your baby grows, your milk will specialize and change for your particular baby at each stage by increasing in quantity and changing in content to meet your growing baby’s needs. The more your baby nurses, the more milk your body makes. Conversely, the less your baby nurses (for example substituting formula feedings), the more your body will suppress the production of milk.

The World Health Organization (WHO) recommends that all infants be exclusively breastfed from birth to six months of age, and following this with a gradual introduction of other forms of nutrition and continued breastfeeding into the second year and beyond. In the United States approximately 70% of women initiate breastfeeding, but by six months of age, less than 40% of infants receive any breast milk at all.

The following practices help to insure the successful initiation and continuation of this important and healthy gift for your baby:
• Before your baby arrives arm yourself with knowledge about breastfeeding; attend classes or breastfeeding support groups, read, talk to women who have successfully breastfed their babies, and discuss your desire to breast feed with your midwife or obstetrition.
• Nurse early and often—put the baby to the breast within one half hour of birth. Keep baby close by rooming in and maintaining skin to skin contact as much as possible.
• If you experience difficulties or just have concerns or questions, ask the nursing staff for help and/or a lactation consultation visit.
• If you have to be separated from your infant request support and help to initiate and maintain your milk supply. Request a lactation consultation and a breast pump as soon as possible if your provider has not ordered this for you.
• Give your baby no other food or drink other than breast milk unless medically indicated.
• Allow the baby to nurse on demand. Watch the baby, not the clock for cues that he is satisfied and ready to end nursing sessions.
• Give no artificial nipples or pacifiers.
• Continue to seek encouragement and support for breastfeeding after you are discharged home from the hospital. Call your health care provider, lactation consultant and breastfeeding support and resource groups to maintain the good start you have initiated for your baby.

Remember, your breast milk gives your baby the very best start in life, so breastfeed for a full six months before initiating other foods. Only YOU can give your baby this gift and it is worth it!

- Gloria Glidewell, CNM, MS