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