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Last week I was at the gym and saw a friend of mine down the hall from me in the lobby. She was standing up, stooped over her phone. Somewhat jokingly, I called over to her to stand up straight while she's texting because her posture was giving ME a headache.

Are we all slowly dying.... from texting?

Last week I was at the gym and saw a friend of mine down the hall from me in the lobby.  She was standing up, stooped over her phone.  Somewhat jokingly, I called over to her to stand up straight while she's texting because her posture was giving ME a headache.  With a look of bewilderment, she turned to me and said, "Do you really think this is why my neck hurts so much?"  I had to stop myself from laughing, did i THINK this was what it was? Really? The poor woman was hunched so far over her phone, she looked like she might have nodded off standing up!
The interaction reminded me of a study I saw a few weeks ago on "iPosture".  The researchers in the United Kingdom had found a very large percentage of 18-24 year olds who had missed more work days than their elder co-workers due to neck and back pain.  The reported cause? Hours and hours each day spent slumped over smart phones and tablets.  You probably don't even have to go beyond your own kitchen table to see examples of this.  Heads tilted down, shoulders slumped forward and curled inward while our thumbs type feverishly away on a tiny screen.  
Forward-head posture has always been a big key word in the world of neck and back pain, but this extreme version is taking our bodies to a whole new level of tension.  The relative increased weight of a person's head when it's held 3-4 inches in front of their shoulders produces a MASSIVE increase in the amount of work your back muscles have to do to hold it up.  Over the course of just one day, that increased muscle fatigue can lead to severe neck and back pain, not to mention the headaches!  And the worst part is that we are, for the most part, oblivious to the fact that we're even doing it!
Correcting this posture can pose a challenge in itself.  How many "good posture" videos have you watched only to go right back to where you started?  Fatigue and long hours of screen time are often unavoidable, but even just becoming aware of how we sit and stand can make a huge difference.  I often tell my patients to pay attention to their reflection when they're out and about.  Do you look like you're standing up straight? The visual cues alone can often make a big difference.  Another great resource are online videos and tutorials that give you exercises to work on during the day.  One such video from Physical Therapist and Cross-Fit Form guru 9014680002 might seem a bit dramatic at first, but really does emphasize how detrimental this poor posture can be on our overall health.  
I'm not sure that all of our screen time is actually "killing" us, but it's certainly leading our bodies down a very uncomfortable path.  Take right now for example, did you just read this on a phone or tablet? Look beyond your phone, is that your shoes you can see, or are you still standing up straight?  Hopefully you're standing or sitting up straight, or if not, at least this little rant prompted you to do so.

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During a recent conversation with a friend of mine who is also a new first-time-mom, she asked me a question that (coming from her) caught me off guard. "How did you start running again?" To add a little context, this woman is a life-long athlete, whom on my best day would run circles around me at a dizzying pace.

First-time-mom Fitness

Meghan Dukes, DC, MSPT

During a recent conversation with a friend of mine who is also a new first-time-mom, she asked me a question that (coming from her) caught me off guard.  "How did you start running again?"  To add a little context, this woman is a life-long athlete, whom on my best day would run circles around me at a dizzying pace.  She has always been a runner, always been fit, and as I did, ran throughout the length of her pregnancy without any problems.  It seemed almost unfathomable to me that she hadn't just naturally rolled back into her past routine and that somehow I was now running more than she was (which, to be honest, still isn't that much).
Beyond this being a question about how to find the hours in the day or the energy to return to running, it was actually more about the motivation to get out there and start from square one all over again.   She had run throughout her pregnancy, but now with a 5 month old little man in her world, hasn't gone back to it.  She explained that even with all the gear ready to go in the garage to take the little guy along or the option to go on her own while he's with the nanny, she just couldn't get over the mental block of how much work she had ahead of her to get back on track.
I had to stop and think for a minute about how I did the same.  It was certainly not pretty the first time I laced up & headed out the door.  I was realistic, only trying for 2 miles, but it was definitely a slow go.  I distinctly remember pacing myself to hit as many red lights as I could time at the crosswalks to catch my breath.  Even though I'm now only up to 4 miles, it's a much less daunting task to get out the door. I still have a long way to go to get back to where I was, but I'm content with the progress and am trying to be realistic with my goals.  Right now I'm trying to run the distance in miles that my son is in months, 4 miles at 4 months, next up is a 5-mile loop.
Here are a few tips for getting back on track with running (or any other sport for that matter) in the post-baby world: 
1. Expect setbacks & be flexible.  Planning a walk or run tomorrow doesn't mean your baby will cooperate and sleep soundly tonight.  Stay flexible with your timeline and don't try to force something into the day without having the time, or energy to make it work.
2. Keep your main focus on healthy eating.  Exercising to burn off extra calories is tempting, but focusing on eating healthy foods and staying hydrated will work out much better in the long run.  Healthy fuel for both you and the little one is an important top priority.
3. Be patient.  Stress fractures, higher susceptibility to illness and muscle strains are all common problems of trying to do too much too soon.  Pace yourself and your progression.  Adding too much distance or speed too soon can leave you with more complications than it's worth.
4. Be realistic about your pregnancy fitness level. If you were active, you can probably continue (always checking with your doctor), if you were sitting on the couch, take it slow. Add a few walks per week rather than trying to set a daily ritual. 
Most importantly, listen to your body.  There's a difference between being sore from exercise and pushing too far.  Even with childbirth now in the rear-view mirror, be honest with yourself about how your body is coping with different activities.  You are your own best judge of what your current limits are. 

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If you have ever experienced a raging headache, you don't need to be told how debilitating it can be. As one of the most common conditions in medicine, headaches are also one of the complaints that we as chiropractors see the most of. Millions of Americans experience one or more migraines per year with even higher numbers suffering from tension headaches.

Releasing the grip of headache pain.

Alison Yager, MD

If you have ever experienced a raging headache, you don't need to be told how debilitating it can be. As one of the most common conditions in medicine, headaches are also one of the complaints that we as chiropractors see the most of.  Millions of Americans experience one or more migraines per year with even higher numbers suffering from tension headaches. Though many patients find relief with over-the-counter or prescription medications, there are other options.

Tension headaches are most commonly attributed to stress and fatigue; however, there is almost always a structural component within the joints and muscles of the upper back and neck that triggers the discomfort.

Modern-day life lends almost all of us to some form of headache-producing posture on a daily basis. This posture is found in just about anyone who spends time at a computer, watching TV, reading, driving long commutes or glued to the newest and greatest personal electronic gadget. With a forward bent head and neck and rounded shoulders this posture puts an immense strain on the muscles at the back of the neck and base of the skull.

With many of the nerves that become irritated in these headaches directly related to the structures of the neck and upper back, chiropractors tend to have great success decreasing this type of pain.  The more we can reduce the pressure on these nerves, the more relief we can bring to our patients.

There will always be traffic jams, work deadlines and family gatherings to plan, but with a good care team on your side you can keep a fighting chance against the debilitating strong-hold of headache pain.

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two-piece bow

Holidays and warmer weather are prime time for celebrating and are meant to be enjoyed, but you don’t have to sacrifice your healthy habits every time you attend a BBQ. At the KP CCM Midtown office, we have recently started a series of Demo Kitchen classes to provide healthy recipes and tips for all types of meals and snacks.

Healthy Holiday Snack Tips

Holidays and warmer weather are prime time for celebrating and are meant to be enjoyed, but you don’t have to sacrifice your healthy habits every time you attend a BBQ. At the KP CCM Midtown office, we have recently started a series of 6177860242 classes to provide healthy recipes and tips for all types of meals and snacks. In that spirit, I’ve compiled a list of five survival tips to potentially save hundreds of calories this holiday season, keeping your health and fitness goals on track.

1. Use small plates:  People who choose smaller plates almost always eat less without even noticing it. Try borrowing a plate from the kids’ table or the dessert tray.

2. Eat slowly and mindfully:  People who eat more slowly eat fewer calories over the course of a meal. BBQs are a perfect opportunity to pace yourself as you mix and mingle with friends and family. The more you’re chatting, the less you’re eating.

3. Eat healthiest foods first:  If you are eating slowly and off small plates, you may as well fill up on the healthiest stuff first. Salads and veggie platters are a great place to start because watery vegetables slow digestion and have very few calories. Try to choose something with protein that will help you feel full sooner.

4. Skip the chips, crackers and bread:  Refined carbohydrates are the worst things you can eat because they offer little satisfaction, loads of calories and dangerous insulin spikes. You don’t have to eat your burger without a bun, but pass on the pointless chips and other snacks that lure you when you’re not thinking.

5. Keep dessert small:  The difference between a large slice of cake and a smaller slice of cake can literally be hundreds of calories. You don’t have to pass on dessert completely, but keep your portion sizes in check for this course.

Small tricks can save you hundreds and potentially thousands of wasted calories that you will never notice or miss and will keep your health goals on track throughout this warm and festive season.

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Exercise may be the best prescription to help you feel better. Our bodies are built to move. Getting 30 minutes of moderate exercise at least five days a week helps to lower your risk of serious illness — and improves your energy level and mood.

Feeling blah? Take a walk.

Exercise may be the best prescription to help you feel better.

Our bodies are built to move. Getting 30 minutes of moderate exercise at least five days a week helps to lower your risk of serious illness — and improves your energy level and mood.

Exercise is described as the universal medicine because it can help everyone, even those with other medical problems, feel better.

You don’t have to be an athlete to be fit. And you don’t have to join a gym. Now that the weather is getting warmer, all you have to do is put on your sneakers to start your exercise routine. Eric Harker, MD, a Kaiser Permanente internist, often prescribes brisk walking to patients who complain of fatigue. “I’d say ‘tired’ is probably one of the most common things I see,’’ he says. “Usually we don’t find a disease. Tired patients almost always feel better once they incorporate exercise into their day.’’

Dr. Harker offers these three tips to get moving:

  1. Fit it in. Drive to work 30 minutes early. Park the car and walk away from your work place for 15 minutes and back for 15 minutes.
  2. Exercise in the morning. This wakes you up, improves your mood and “primes’’ you for the stress of the day.
  3. Have fun. Dance, exercise with a buddy, or spend time with the family playing ball or tag.

Learn more tips and tools to stay active.

Health benefits of exercise

Exercise has been shown to help reduce blood pressure and cholesterol, and help reduce the risk of cancer, cardiovascular disease, dementia or Alzheimer’s disease, and disability. Research shows exercise also helps relieve anxiety, depression, and insomnia, Dr. Harker says.

Improve your health by using the 5–2–1–0 method

  • 5 — Five servings of fruits and vegetables a day can lower your risk of disease while helping to slim your waistline. Try single-serve containers of apples, blueberries, melon, carrots, or celery. This goes for kids’ meals too.
  • 2 — Limit your non-work (or non-school) TV, computer, and video game screen time to two hours a day.
  • 1 — Perform up to one hour of moderate activity a day for kids and 150 minutes a week (approximately 30 minutes, 5 days a week) for adults. You can break this up into 10-minute segments if needed.
  • 0 — There is zero room in a healthy lifestyle for smoking and sugar-sweetened drinks. Reach for water instead.

Visit kphealthyme.com for more healthy eating tips and programs.


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Female athletes are as much as ten times more likely than male athletes to tear their anterior cruciate ligaments (ACL). Kaiser Permanente’s board-certified sports medicine physician, James MacDougall, MD, explains why.

Ladies: Don’t get sidelined by ACL tears

Each year in the United States, 1 in 100 high school female athletes suffers a serious knee injury. In fact, female athletes are as much as ten times more likely than male athletes to tear their anterior cruciate ligaments (ACL).
Why? Bodily differences and training.
When it comes to ACL injuries in female athletes—whether in high school or older— the difference between sitting on a therapy table or playing on the field may be your training regimen, says James MacDougall, MD, a board-certified sports medicine physician with Kaiser Permanente Colorado.
“In the past, many physicians concentrated on how to repair or rehab the injury,” Dr. MacDougall says. “We need to be more concerned about prevention.”
ACL injury risk factors
The ACL is one of the four major ligaments of the knee. When it tears, many people feel their knees give out from under their bodies. ACL tears can also be accompanied by a loud pop and swelling of the knee joint.
An estimated two-thirds of all ACL tears in females occur during non-contact activities such as when they stop quickly, jump, turn or twist, says Karl Rodriguez, PT, a sports physical therapist with Kaiser Permanente Colorado.
Female athletes are more prone to ACL tears based on:

    • Anatomic differences– Women have wider pelvises than men, creating a greater hip to knee angle that puts more stress on the ACL. This leads to different patterns of movement and decreased knee flexion angles during running. “The notch where the ACL moves in the knee joint is also narrower in women, which increases the chances of a tear,” Rodriguez says.


    • Muscular differences­– “Females tend to have weaker hamstring muscles and strong quadriceps,” Rodriguez explains. “Since the hamstring protects the ACL, a weaker hamstring sets women up for an ACL tear.” This is also known as a quadriceps dominant pattern. When compared to males, females have weaker quadriceps and hamstrings.


    • Laxity and range of motion– Female hormones, such as those present during certain times in the menstrual cycle, allow for greater flexibility and laxity of muscles, tendons, and ligaments. The looser the muscles and ligaments surrounding the knee, the more stress the ACL absorbs during activity. Increased laxity also comes from decreased muscle pre-activation when preparing for landing or control of their joints relative to the rest of their body. 


    • Training techniques– “Neuromuscular control has a lot to do with preventing ACL injuries in females,” Dr. MacDougall explains. “Females plant their foot differently when they jump and land.” Females also have greater rotation forces in the knee with cutting and landing. Also, decreased joint awareness and delayed muscle reflex can lessen the protective mechanisms of the knee. Teaching athletes the proper training techniques could prevent knee injuries, he adds.




Proper conditioning may reduce the impact of these differences and 845-742-8315Kaiser Permanente is not responsible for the content or policies of external Internet sites.. “By training the muscles to work together through jumping and landing exercises, we get the ultimate support to the knee,” says Rodriguez, who is also certified in Sports Metrics – the first ACL injury prevention program designed for female athletes by the Cincinnati Sportsmedicine and Orthopaedic Center.
Training tips
Training programs help teach the body movements to reduce the risk of ACL injury. Rodriguez and Dr. MacDougall recommend:



    • Warming up– Jog slowly, run backward, or shuffle side to side for short distances to engage the knee joint and jump start your muscles.


    • Stretching– After warming up your muscles, slowly stretch your calves, quadriceps, hamstrings, inner thighs, and hip flexors to improve range of motion and reduce stiffness.


    • Strengthening– Improve leg strength and stabilize the knee joint by performing walking lunges and single toe raises.


    • Using plyometrics– High-intensity training techniques, such as side-to-side, forward/backward, and single leg jumps can help build power and speed. The key is to land softly with your knees bent on the balls of your feet when landing the jump.

    • Improving agility– Forward/backward, diagonal, and bounding runs will increase your leg strength.


  • Cooling down– Take 10 minutes to stretch the legs to prevent soreness and stiffness.



New prevention program
Dr. MacDougall and Rodriguez are part of a team of orthopedic specialists and physical therapists at Kaiser Permanente Colorado developing an ACL injury prevention program specifically for female athletes.
Taking cues from the 9134849097Kaiser Permanente is not responsible for the content or policies of external Internet sites., the six-week program teaches female high school and college athletes to condition the knee through exercise.
“The basis of the program is to teach them to have better body control,” Dr. MacDougall says. “We’re introducing it to our current patient population first and will then roll it out to the Colorado community.”
For more tips on how to prevent ACL tears visit kp.org.  
Dr. MacDougall received his medical degree from the University of Chicago Pritzker School of Medicine. He completed his residency at the University of Chicago Hospitals and a fellowship at Long Beach Memorial Medical Center. 

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A Doctor with Heart

Do you struggle with maintaining a healthy heart? Our featured expert, Stephen M. Dodge, MD, FACC, Cardiologist and board certified in Internal Medicine, covers healthy routines that can reduce your risk of heart disease.

A Doctor with Heart

Your heart may very well be your best friend.  It can drive your emotions, inspirations, and new ideas. When you nod off to sleep, it’s still hard at work, pumping life through your body while you rest. In fact, you could say the centerpiece of your circulation system is like a loyal dog – just give it some love and attention and you’ll get twice as much in return.

Genetics, age, and gender can contribute to heart issues that are outside our control. Most everyone, however, can help reduce their risk of heart disease by making a few adjustments.

“It starts with healthy habits and healthy routines,” says Stephen Dodge, MD, cardiologist with Kaiser Permanente Colorado. “Focusing on your diet, moderate exercise, and a work-life balance will maintain a healthy heart. Finding the healthy foods, exercise and hobbies you enjoy is the key to sustaining the new routine.”

Dr. Dodge suggests the following:

  • Buy fresh, and more often. Eat fresh fruits and vegetables, lean meats, whole grains, and more fish than red meat. As a rule, make a point to eat at home most of the time rather than dining out.

If you prepare your own meals, you can better control your portions, and the health benefit of the food itself.  Use smaller plates when serving and avoid second helpings. Of course, eating fresh foods at home will require more shopping trips to the grocery, which might require a change in your routine.

Maintain a regular list of healthy, fresh core foods in the house so they’re readily available for meals. “Take an inventory of your eating habits. What you eat is important for heart health; how much you eat is important for weight,” says Dr. Dodge.

  • Identify the right exercise. Pick an activity you enjoy, either individual, team or with a partner, with a goal of exercising 30 minutes a day, five or six days a week.  The more consistent in time and location, the easier it will be to make this a routine.

“It could be skiing, walking, jogging, biking, swimming, hiking, tennis, racquetball, handball, basketball or soccer – the specific exercise is less important,” Dr. Dodge says. “The important thing is having an exercise you enjoy that’s separate from your normal, daily activities and that increases your heart rate more than your usual day-to-day movements. If you really enjoy it, you’ll look forward to it.”

  • Make time for relaxation. Just like regular shopping and exercising, make a habit of finding time for activities apart from work and household chores, such as hobbies, recreation, and time with friends and family.

“Daily stress can be managed by having fun and enjoying the lighter side of life,” says Dr. Dodge. “Reducing your stress levels also helps while you’re trying to change your eating and exercise habits. Higher stress levels can lead you back into old patterns and habits. Also know that times of high stress aren’t the best times for making major changes.”

“Everyone has important responsibilities and obligations, but the most important responsibility you have is to take care of yourself. No one else can do it for you,” Dr. Dodge says. “You have to take your good intentions and put them into action every day. By integrating better food and fun activities, you’ll get a healthier lifestyle that benefits you, and your heart.”

For more information on heart disease prevention, visit 2078621587.

What are your heart-healthy tips?

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Walking in a Colorado Winter Wonderland? The cold weather can do a number on your skin! KP Colorado’s expert, Jarod Conley, MD offers the Top Five Tips to Keep your Skin Hydrated this holiday season.

Tips for a Hydrated Holiday

You can’t beat Colorado’s white winters and snowcapped peaks. But the same mile-high climate that covers the Rocky Mountains and the Front Range with fluffy snow also creates dry and itchy skin, especially for residents in the Denver area.

“Denver’s high elevation creates an arid climate all year long, and when the humidity decreases in the colder winter months, the skin’s natural tendency is to lose moisture,” says 218-651-7408, a board-certified dermatologist with Kaiser Permanente Colorado. “The arid environment, cold temperatures, and even genetics all can trigger dry, irritated skin.”

“Making simple changes to your skin regimen at home will translate into healthier, hydrated skin,” he notes. Dr. Conley suggests the following preventive measures to keep your skin hydrated during these unusually dry winter months:

  1. Buy moisturizers in the jar. Rich moisturizers that contain petroleum or dimethicone are extremely effective at helping the skin hold moisture. “For about 99 percent of people with chronic dry skin, over-the-counter moisturizers are adequate,” Dr. Conley says. The best time to apply moisturizer is after showering when it can easily penetrate the skin. “Avoid moisturizers with added chemicals, fragrances, or preservatives, which act as irritants,” Dr. Conley suggests. Follow the same rules when using cosmetics or deodorants if possible.
  2. Keep it cool and limit shower time. Hot water and lengthy showers can strip oils and natural lipids from the skin. Limit yourself to 15 minutes or less in the shower (it also helps conserve water, one of Colorado’s most precious resources), and keep the water at room temperature. Also, pat your skin dry rather than rubbing it, which can irritate skin that is already sensitive.
  3. Use caution with soap. Soaps are detergents that strip the skin of impurities and natural lipids. Follow this simple rule: If it’s not dirty, don’t wash it. “During the winter months, we’re not nearly as active outdoors so we tend not to perspire as much,” Dr. Conley notes. “Plain water is more than adequate for removing oil and dirt.” Where needed, use a mild body wash, which tends to be gentler than bar soap.
  4. Invest in a humidifier. As comforting as sitting in front of the fireplace can be, dry indoor air can parch dry skin and lead to itching and flaking. Purchase a portable home humidifier to add moisture to the air in your home. Running a smaller unit near your bed each night can help your skin maintain its own moisture.
  5. Consult a dermatologist. “If your skin shows signs of excessive itching, scaling, redness, or swelling, it’s best to seek help from a dermatologist,” Dr. Conley notes. Intense itching or extremely dry skin can cause minor breaks in the epidermis, which can get infected. To prevent this, a dermatologist can diagnose the condition and prescribe a topical treatment if necessary.

Chronic dry skin can be controlled. For more advice on managing dry skin or to find a dermatologist, visit (217) 559-6226. 

(806) 674-8230

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Juggling a million things in your life? “Having it all” might not be what it’s cracked up to be. Learn more about chaos and balance from KP Colorado Expert, Joyce Gottesfeld, MD.

Balance, Shmalance

It’s not often that I quote Ashton Kutcher...well, I never have.  But a quotation from a speech he gave at some awards ceremony went viral on the web and I kind of like it.  He said:  “I believe opportunity looks a lot like hard work.”  I really like that.
I also believe in the sister principal:  “Balance looks a lot like chaos.”  That’s my version.
As a doctor, wife, and mother, sometimes I get asked: how do I do it all?  All I can think is: don’t look down -- I accidentally put on two different shoes this morning.
How do I do it?
My life is chaos.  The kids are running around to a bazillion activities that they often don’t have rides to or from.  I have unanswered emails at home, at work, unanswered voicemails on my iPhone, Blackberry, work phone, and home phone.  I have piles of snail mail at both my offices and my home. 
But I have checked all my Facebook messages.  But not my ask.fm, Twitter or Instagram.
My house is a mess, there are piles of laundry in various stages of done-ness.  The fridge is empty, or, rather full of left-overs that are way past their prime.
I forget birthdays, and birthday parties (but not my own), I leave a kid somewhere, I buy the same thing three times, each time putting it some place different and then forgetting about it.
It’s chaos. 
Supposedly, women nowadays can “have it all.” Well, I have it all, but it’s all a mess.  I do know families who similarly “have it all,” but they seem to be able to keep it together.   I really don’t know how they do it.  They eat healthy, their clothes are clean, they are oriented to person, place and time.  Good for them.
I went to a therapist once to ask for help in how to manage all the chaos, all the stress of these competing priorities.  The therapist asked me what I had going on in my life.  When I told her, she said, “this is simple, you need to give something up.”  So I decided to give up therapy.
Everyday I am so thankful for all of the great things going on in my life: job, kids, husband, running, etc.  But it’s not easy to fit all of that in, and I am never able to give all that I want to give to any one particular area.  And my house really is a total mess. But I “have it all,” and don’t want to give anything up, so to do that, I have to tolerate the chaos.
Balance is just tolerated chaos.  To all of you out there who are juggling so many things in your life, and doing it way better than you think you are, I say, GOOD JOB!  Keep up the good work.  Balance is an illusion, reality is messy, and that is ok.

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Start 2014 with Less Stress!

Looming deadlines? Worried about your job? Health issues holding you back from living your fullest life? KP Colorado Expert, Albert Ray, MD, provides advice on starting your new year off on the right foot.

Start 2014 with Less Stress!

Looming deadlines, a troubled economy and layoffs are all reasons why employees may be feeling more anxious and stressed than ever before in the workplace.

Employers can have a major impact on workplace health by making stress reduction a priority in 2012. Helping employees manage stress is critical because stress can cause a variety of emotional and physical health problems for an individual, not to mention lost productivity. In fact, a rapper-dandies published in the journal BMC Public Health found that employees with high-stress jobs visited their general practitioners 26 percent more often compared to those with low-stress jobs.

The good news is there are many ways to help employees manage their stress. Simple measures employers can encourage include walking, 850-826-3636 and stress-reduction breathing techniques.

In a two-part Kaiser Permanente podcast, Albert Ray, MD, physician director for Patient Education and Health Promotion for Kaiser Permanente in Southern California, offers specific steps employers can take to cut stress on the job. Dr. Ray is featured in the book, (651) 200-0816.

Dr. Ray offers advice that he follows and has found to be successful with his staff.

Tips include:

  • Have managers lead by example — hold walking/exercise breaks
  • Add walking/exercise breaks to meeting agendas
  • Get to the office a little earlier vs. later
  • Create a space for quiet time or meditation
  • Encourage or create social activity/team building/laughter
  • Allow pets at the office 

Take a listen to 9175095095 and Part 2, and help your company’s most valuable asset — your workforce. 

Part 1:

  • What causes stress
  • How stress affects an employee’s health
  • Helping employees manage stress

Part 2:

  • How to recognize when an employee is stressed
  • How to talk about stress with your employees
  • How empathizing with employees gains their respect

At Kaiser Permanente, employees have the option to download stretch-break reminders on their computer. These reminders appear throughout the day and provide employees with a different stretch each time, reminding them of the importance to step away from their desks throughout the day.

Kaiser Permanente offers a lot of information about ways to reduce stress — employers can obtain the book Healthy Employees, Healthy Business or download a free workbook from HealthWorks by Kaiser Permanente. Go to businessnet.kp.org to find the workbook. Click the Total Health and Productivity tab and then click Tools and Resources. You can also access relaxation tools on kp.org under Health and Wellness.

Did you know?

  • One million workers call in sick every day because of stress.
  • Calling in sick can cost employers $602 a year per employee in direct costs. 
  • Calling in sick on the same day of the week, week after week, could be a sign of stress.
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Wouldn’t it be nice if you could email your physician directly? 55% of patients agree.

What is an Electronic Medical Record?

According to the 5166644179,Kaiser Permanente is not responsible for the content or policies of external Internet sites. many patients in the United States are ready for a dose of digital medicine. In the survey, the Deloitte Center for Health Solutions reports that although only 9 percent of consumers surveyed have an electronic health record, nearly half (42 percent) want to establish one with their physicians and 55 percent were interested in exchanging health information with their doctor via e-mail.

Since President Obama identified $20 billion to bring medical records into the digital age, patients will likely see paper-based systems replaced by EMRs.

To help explain what this might mean to you, Paulanne Balch, MD, a board-certified family physician with Kaiser Permanente Colorado, helps answer some important questions surrounding electronic medical records and how the technology stands to improve your health.

What is an electronic medical record? 
EMRs track a patient's health and medical history in a computerized, electronic form.

What information is stored in an electronic medical record?
These records typically contain a patient's health history, lab test results, medications prescribed, referral orders, treatment plans, instructions for care, educational materials, alerts for return visits and, in some cases, billing information.

What makes electronic medical records better than traditional paper-based records?
Unlike paper charts, electronic health records can be instantly accessed by multiple care providers from any location within a health care system. “The biggest benefit of EMRs is that they track information from all locations, making it simultaneously available to multiple people who are working to help the patient,” says Dr. Balch. “We can avoid the inconsistencies in how the chart is stored and updated between departments by using an electronic medical record. I don’t have to wait to get the chart to know what to do, and the patient does not have to wait to see me.”

Electronic records also allow physicians to improve the speed and quality of care.
“I don’t have to walk a half an acre across the hospital to get notes where I can’t read the handwriting on the paper chart. It’s easier to apply guidelines for standard of care.”

Why would a patient prefer using electronic health records?
Some electronic medical records (including Kaiser Permanente's) have applications that allow patients to access their health information online. Patients can schedule appointments, securely e-mail their doctors, view lab/diagnostic test results and immunization schedules, refill medications online, view summaries of their health conditions, and access health information for their family. “Patients love that they have access to the chart and that they can e-mail me,” Dr. Balch says.

Who has access to my EMR? 
At Kaiser Permanente, primary care physicians, pharmacists, nurses, and other medical specialists typically create and maintain your information in the electronic medical record. They can then instantly and securely share information with each other to which streamlines services and saves time for patients, limits duplication of tests, reduces errors and overall improves quality according to Dr. Balch.

Even better, patients can often see their information by logging on to their account using a computer or mobile phone.

“Communication is easier and we’re capturing data that we can use later to contact patients to make sure they are addressing their health issues,” Dr. Balch notes.

How will my information remain secure? 
Only authorized users may access an electronic medical record and the system secures records with backup files in case of emergencies. “These are highly secure systems, meeting many government required security tests.” Dr. Balch says.

To learn more about how EMRs are impacting patient outcomes at Kaiser Permanente, read (386) 418-8194 with Dr. Jeffrey A. Kerr-Layton, or visit (940) 666-3367.

Dr. Balch received her medical degree from Case Western Reserve University School of Medicine. She completed her residency at University Hospitals.

Glossary of terms

EHR (Electronic Health Record)/ EMR (Electronic Medical Record):
A record consisting of an individual's history of health status and medical care. The terms are frequently used interchangeably.

PHRs (Personal Health Records):
The PHR includes data such as critical current health and medical history information. It also includes information that is tracked by the patient such as personal health maintenance and over the counter medications. For example, it would include daily tracking of insulin levels for diabetics.

Health IT (Health Information Technology):
The software and infrastructure used in the clinical practice of medicine to support documentation, storage and exchange of patient data. An EMR would be an example of this.

Source: American Medical Association 

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Not sure what all the hype is about? Kaiser Permanente Colorado Expert, Joyce Gottesfeld, MD, helps you find your inner yogi.


I try to go to a yoga class once a week.  I'm not very good at it.  Sometimes I will comment to my teacher about what a pathetic yogi I am, and she will say something positive like "it's a journey."  I think to myself, she must be joking, I can barely lift my arm above my head and no matter how long this journey is, I just don't think its going to happen.  I don't think I will ever get my leg over my shoulder or be able to do a "dolphin stand, " or "birds of paradise," or get into any of those poses that frankly, have these beautiful sounding names, but are really just torture on my old, sore body.   But I go, week after week.  My yoga teacher is one of the most kind and positive people I know.  And despite the continued practice, I think I may actually be getting worse at the physical poses.  But, on the flip side, I leave class feeling better and better each week.  All this talk about staying focused, staying in the moment, keeping my breathing regular even when my body is trying to do something it does not want to do.  I think that part may be working.   I've never been one to model the concept of "inner peace," but I don't think any of us can count on "outer peace," so I think these yogi's may be on to something.   When you hear week after week about cultivating an inner balance on your yoga mat, and then bringing that inner balance, or inner peace out into the world with you, and ideally sharing it with those around you, well, eventually, it's got to help at least a little bit.   As a mother of 3 kids, wife, and physician, my life can get totally out of balance, and 1 hour of yoga a week is not going to fix that.  But every little bit helps, and that positive energy, that practice to stay in the moment, breathe deeply, and focus on what is important right here and now...every once in a while, it comes to my rescue during a diffiuclt situation.   Give it a try, and let me know how it goes!  Namaste, and thanks for reading!

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The average American spends over 3 hours per day online. KP Colorado Expert, Meghan Dukes, DC, MSPT provides some useful information on ways to un-plug and regain your health.

Resolve to Un-Plug

Every year around this time I start to read more and more articles about resolutions for the new year.  Gym parking lots will be as full next week as the mall was last week, and juice bars and health food stores will have lines out the door.  From more exercise, to less indulgences, everyone has their own idea of what the new year can bring.  Though I'm not normally one to spread "one size fits all" type of prescriptions, there is one resolution that I think can help (almost) everyone.

Less time tied to our electronic lives.

I am fully aware of the ironic nature of prescribing less screen time in the realm of an online blog that will be promoted over the wide world of social networks.  If I could print this in old fashioned black & white on real hold-in-your-hands paper and presume anyone would ever see it, I would, but that's not the world we live in anymore, hence the need.  I'm also well aware that right after the holidays while we all have our newest, latest and greatest tech gadgets in our hot little hands, the idea of giving it all up is a bit absurd.   Instead, let me propose a gradual system of separation.  A few years back a friend of mine took on the resolution challenge of daily push-ups.  It seemed simple enough, on January 1st, you do one push-up, on the second you do two, three on the 3rd and so on.  Easy enough to start, but if successful (which she was!), by the time December 31st rolls around, you'll have done 66,795 push ups, averaging out to just over 180/day!  Early on missing a day (or three) is easy enough to catch up on, but once you get in the routine, you have to work to stay with it - no one ever said behavior change was easy, right?   So, if we apply the same principle to stepping away from screen time, all you have to give up on January 1st is one minute! Just resist that urge to log on for 60 seconds, and your first day goal is complete.  By January 31st, still only a reasonable unplug time of 31 minutes - SO much easier than 31 push ups!  By summertime, you could be enjoying an additional 3 hours of time out in the sunshine with your friends and family, smart phones and tablets safely tucked away out of arms reach.

Just imagine all the other activity-related goals you could accomplish with three extra hours living in the world around you, "liking" new activities in true real time after actually doing them instead of just clicking a button.  Less aches and pains from being hunched over your phone all day.  Not to mention the decreased stress from not having to worry about the ever-diminishing battery life of your phone!  It really is win-win.   So as another year draws near, try to take the one small step that can have amazing positive repercussions throughout all the facets of your life.  Put down the phone, you can do it.

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About 57 million people in the United States have pre-diabetes, a condition that can lead to full-blown, type 2 diabetes and a host of other problems. Learn how to minimize your risks with small changes that can make a big impact.

Changing the Course of Diabetes

It’s an alarming statistic: About 57 million people in the United States have prediabetes, a condition that can lead to full-blown, type 2 diabetes and a host of problems that come with it. Whether or not the disease progresses into something more serious is almost entirely up to the individual. “Most people with prediabetes can control whether or not it develops into a serious condition,” says Deb Friesen, MD, a board-certified internal medicine physician with Kaiser Permanente Colorado. “If caught early, the course of the disease can be changed through a healthy diet and daily exercise.” Prediabetes: Why so serious? Prediabetes occurs when the body does not properly respond to insulin – a hormone secreted by the pancreas to keep blood-sugar levels within a healthy range. If blood sugar is elevated over time, it can damage blood vessels, nerves, and organs in the body. Therefore, prediabetes not only increases a person’s risk for type 2 diabetes, but also for heart disease, stroke, and kidney failure. Since prediabetes typically has no noticeable symptoms, it can easily slide under the radar until it develops into a chronic condition. So how can you address a health condition you may not even know you have?

Know your risk: Age, family history, weight and ethnicity can all increase your risk for prediabetes. Determine your risk by talking with your physician or taking a simple risk assessment test.

Make healthy lifestyle choices: Exercise, diet, and weight management are factors you can control to prevent the onset of prediabetes. o Diet: Eat low-fat, high-fiber foods and limit refined sugars and carbohydrates. A balanced diet will help you accomplish stable, healthy blood-sugar levels.

Exercise: “Exercise increases insulin sensitivity, which helps you utilize the glucose you already have in your body,” Dr. Friesen says. “Even just 30 minutes of exercise per day can work wonders.” Find inspiration to exercise during the winter.

Weight management: Keep your body weight in the ideal range for your body type. Using a BMI calculator can help determine this. “A 5 to 10 percent weight reduction can decrease your risk of diabetes by 58 percent,” Dr. Friesen says. Sticking with a diet and exercise plan will help you control the scale.

Get screened: Even making healthy lifestyle choices can’t change other risk factors such as family history of type 2 diabetes or getting older. Screening tools such as the blood-glucose test or hemoglobin A1C test are simple ways to gauge your risk. A blood-sugar level between 100 and 125, or an A1C level of 5.7 to 6.4 percent indicates prediabetes.

Small changes, big benefits: So what can you do if you’re diagnosed with prediabetes? “Get educated,” Dr. Friesen says. “Talk to your doctor, a diabetes educator, or a dietitian about lifestyle choices that prevent it from escalating.” Research shows that the window of opportunity to prevent or slow the progression of prediabetes to type 2 diabetes is about three to six years. During that time, significant lifestyle changes can make a difference. “Even losing as few as 10 pounds can make a big difference in changing diabetes outcomes,” Dr. Friesen says. Read a Colorado man’s story on how he beat Type 2 diabetes through healthy lifestyle changes. If you think you or a loved one might have diabetes, schedule a screening with your primary care physician. Find more advice on preventing diabetes at kp.org.


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Speaking of Donating...

Donating blood serves a vital need in the community. There is also another donation that is commonly overlooked but essential for our future generations – breast milk. KP Colorado Expert, Joyce Gottesfeld, MD, board certified Ob/Gyn, discusses the benefits of breast milk which include decreased infections, diabetes and obesity for little ones later in life.

Speaking of Donating...

You know what else you can donate besides blood? Breast milk! Breast milk is so good for babies. The benefits of breast milk include decreased infections in babies, less diabetes and obesity later in life, it is more convenient, less expensive, bonding, etc. For premature infants, the benefits are even greater. For example, breast milk-fed babies have a decreased incidence of Necrotizing Enterocolitis, or NEC, an infection of the baby’s intestines that can be fatal. If a baby is born prematurely, the milk may not have come in yet in the mother, and yet that baby especially needs the breast milk. Now, donated breast milk can be purchased. We are fortunate in Colorado to have the Mother’s Milk Bank right here in Denver. They ship milk all over the country. Our NICUs here also use the donated milk to help the babies locally. Besides in cases of prematurity, if the mother is sick, and unable to breastfeed, then donated milk can be be purchased for the baby. Some mothers make a lot of milk, more than they need. That milk can be pumped and stored and then donated to the milk bank for later distribution to a baby who needs it. A lot of people don’t know that you can donate your extra breast milk, and don’t realize how easy it is to do. The milk bank makes it very easy for the mother to donate the milk and ship it back to the bank. Here is their website: /milkbankcolorado.org/home/ So whether you need breast milk for your baby, or have some extra to donate, now you know what to do!

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Pregnancy is one of the most joyous times in a woman’s life. KP Colorado Expert, Sharman L. Reed, MD, board certified Ob/Gyn, provides vital information to help minimize your chances of a high-risk pregnancy and ensure a healthy delivery.

High-risk pregnancy: Could you be at risk?

Pregnancy is one of the most joyous times in a woman’s life. Ideally, a woman goes into labor close to her due date, delivers a healthy baby, and returns home within a few days. In reality, pregnancies can be complex – especially when they are considered high-risk. The good news, however, is that most of these concerns can be alleviated through planning, preventive steps and ongoing communication with your doctor. According to Sharman Reed, MD, board-certified Ob/Gyn with Kaiser Permanente Colorado, a pregnancy is considered high-risk when there are potential complications that could affect the mother, baby, or both. Below, she outlines the most common risk factors for a high-risk pregnancy, and how you can manage them.

Being older than age 35: Women who become pregnant after age 35 have a higher risk for miscarriage and delivering a baby with genetic defects, such as Down Syndrome. Although these factors can be scary, many women in their late 30s and early 40s go on to have healthy pregnancies. The key is discussing the appropriate screenings with your Ob/Gyn to check for genetic defects.

Living with a pre-existing medical condition: A mother’s health prior to conceiving is almost equally as important as it is during pregnancy. Complications such as asthma, heart disease, blood-clotting disorders, or other chronic infections or diseases present risks for the mother and baby. “The two most common chronic conditions are hypertension and diabetes,” Dr. Reed says. Make sure any conditions are controlled with a healthy lifestyle, and make sure to discuss your health and any medications you take with your doctor. Mothers-to-be should not stop medications that help manage pre-existing conditions during pregnancy.

Developing medical complications during pregnancy: Even the healthiest of moms can develop medical conditions during pregnancy that could lead to pre-term delivery. Pregnant women should be monitored closely for complications and treated appropriately. Two common pregnancy-induced conditions your doctor will screen for are:

- Preeclampsia – This is a blood circulation problem that causes high blood pressure, urinary protein, and swelling, which places strain on the mother's kidneys, liver, brain, and placenta.

- Gestational diabetes – Pregnant women can develop diabetes when the pancreas does not produce enough insulin to keep blood sugar levels in a healthy range. If left unmanaged, high blood sugars can cause the baby to grow too large, and damage the mother’s organs. Although the condition typically resolves itself after delivery, women with gestational diabetes are at a greater risk for developing type 2 diabetes.

Being overweight and excessive pregnancy weight gain: “Ideally, women should work with their doctors to reach an ideal weight for their body type before becoming pregnant,” Dr. Reed says. “Pregnant women who are obese typically already suffer from conditions like diabetes or hypertension.” Excess weight can also make it difficult for physicians to monitor the baby’s growth during pregnancy, and can present health problems for the child later in life. 

And remember, pregnancy is not a license to eat in excess or become sedentary. A (304) 417-0387 suggests women who gain excessive weight during their first trimester may increase their risk of developing gestational diabetes, and their child’s risk of developing diabetes and obesity later in life. To determine how much weight gain is healthy, your Ob/Gyn will consider your pre-pregnancy weight and (506) 446-2629. 

Creating a 4322836550 and developing peritoneum options with your physician will not only help you maintain a healthy weight during pregnancy, but also after the baby is born.

Care for you and your baby

The improvement of your overall health can be a by-product of monitoring a high-risk pregnancy.  “In many cases, we handle a patient’s chronic conditions as well as their maternal care,” Dr. Reed says. “We track medications, blood pressure, blood sugar levels, and the overall health of the mother and the baby.”

If your pregnancy is considered high risk, your doctor may refer you to a perinatologist – an obstetrician who specializes in high-risk pregnancy care. To improve communication between your care team, Kaiser Permanente uses an electronic medical record system, which allows a woman’s care providers to share her medical history, track medication changes, and send instructions for follow-up care. “We can also send results and communicate with the mother-to-be through secure e-mail,” Dr. Reed notes.

Find more tips to manage a high-risk pregnancy, as well as prenatal classes and programs at 4805150557. 


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From baby boomers to senior boomers: 10 tips to keep you healthy and fit

An ounce of prevention… Your teeth, gums and vision can last a lifetime if you care for them properly. Get regular check ups to ensure you grow old gracefully!

From baby boomers to senior boomers: 10 tips to keep you healthy and fit

What do Sylvester Stallone, Cher, Diane Keaton and George W. Bush have in common other than fame? They’re among the first wave of baby boomers, who turn 65 years old this year, to become “senior boomers” and Medicare-eligible. In January 2011, more than 10,000 baby boomers a day turned 65 – that’s one every eight seconds, a pattern expected to continue for the next 19 years.

How times have changed! Aging is different now than it was for our parents and grandparents. Today, there are more people living longer than at any other time in history. In fact, boomers will number 78 million by 20302. “This generation, associated with social change including the civil rights and anti-war movements in the 1960s, has another important cause – staying healthy,” says soon-to-be 65-year-old Arthur Hayward, MD, a geriatrician and clinical lead physician for Kaiser Permanente. “We need to become activists in promoting healthful behaviors and try our best to remain active and healthy the rest of our lives.”

Dr. Hayward recommends 10 easy tips to help baby boomers live long and thrive!

Quit smoking: Take this critical step to improve your health and combat aging. Smoking kills by causing cancer, strokes and heart failure. Smoking leads to erectile dysfunction in men due to atherosclerosis and to excessive wrinkling by attacking skin elasticity. Many resources are available to help you quit.

Keep active: Do something to keep fit each day — something you enjoy that maintains strength, balance, flexibility, and promotes cardiovascular health. Physical activity helps you stay at a healthy weight, prevent or control illness, sleep better, reduce stress, avoid falls, and look and feel better too.

Eat Well: Combined with physical activity, eating nutritious foods in the right amounts can help keep you healthy. Many illnesses — such as heart disease, obesity, high blood pressure, type 2 diabetes, and osteoporosis—can be prevented or controlled with dietary changes and exercise. Calcium and vitamin D supplements can help women prevent osteoporosis.

Maintain a healthy weight: Extra weight increases your risk for heart disease, diabetes, and high blood pressure. Use our BMI (body mass index) calculator to find out what you should weigh for your height. Get to your healthy weight and stay there by eating right and keeping active. Replace sugary drinks with water. Water is calorie free!

Prevent falls: We become vulnerable to falls as we age. Prevent falls and injury by removing loose carpet or throw rugs. Keep paths clear of electrical cords and clutter, and use night-lights in hallways and bathrooms. Did you know that people who walk barefoot fall more frequently? Wear shoes with good support to reduce the risk of falling.

Stay up-to-date on immunizations and other health screenings: By age 50, women should begin mammography screening for breast cancer. Men can be checked for prostate cancer. Many preventative screenings are available. Those who are new to Medicare are entitled to a “Welcome to Medicare” visit and all Medicare members to an annual wellness visit. Use these visits to discuss which preventative screenings and vaccinations are due.

Prevent skin cancer: As we age, our skin grows thinner; it becomes drier, and less elastic. Wrinkles appear, and cuts and bruises take longer to heal. Be sure to protect your skin from the sun. Too much sun and ultra violet rays can cause skin cancer.

Get regular dental, vision and hearing check ups: Your teeth and gums will last a lifetime if you care for them properly – that means daily brushing and flossing and getting regular dental checkups. By age 50, most people notice changes to their vision, including a gradual decline in the ability to see small print or focus on close objects. Common eye problems that can impair vision include cataracts and glaucoma. Hearing loss occurs commonly with aging, often due to exposure to loud noise. Manage stress Try exercise or relaxation techniques – perhaps meditation or yoga – as a means of coping. Make time for friends and social contacts and fun. Successful coping can affect our health and how we feel. Learn the role of positive thinking. Fan the flame – sexual intimacy and aging Age is no reason to limit your sexual enjoyment. Learn about physical changes that come with aging and get suggestions to help you adjust to them, if necessary. A Boomer’s Guide to Medicare, American Association of Retired Persons U.S. Census Bureau

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Prostate Cancer Screening: The Pros & Cons

To test for prostate cancer, or not to test? Michael Chen, MD covers the pros and cons of prostate cancer screening.

Prostate Cancer Screening: The Pros & Cons

To test for prostate cancer, or not to test?

New research — and new American Cancer Society guidelines based on the research — leaves some men asking the question.

At issue is the most common method for prostate cancer testing. Each year, approximately 30 million American men get screened for prostate-specific antigen (PSA), an enzyme produced by the prostate.

Until now, physicians viewed elevated PSA levels as a key indicator of the presence of cancer, an infection, or some other prostate problem.

Annual PSA screening for men 50 years and older has become the standard recommendation. But the 2010 (450) 281-5644 guidelines de-emphasize the need for annual PSA screening.

So what’s a guy to do?

“It’s really a personal call between the patient and his physician,” says (828) 304-4332, a board-certified urologist with Kaiser Permanente Colorado. “At Kaiser Permanente Colorado, we have the conversation about the risks and benefits of PSA testing with our patients.”

Early detection
The principal idea behind PSA screening is to detect cancer in its early stages so it can be treated successfully.

According to the American Cancer Society (ACS), 90 percent of men treated for early stage prostate cancer live 10 years or longer after their diagnosis – a high survival rate compared to other diagnoses.

PSA screening has saved lives since the Food & Drug Administration approved it in 1986. “Detecting prostate cancer increased after the introduction of the PSA test,” says Dr. Chen, who also serves on Kaiser Permanente’s national prostate cancer guideline development team.

The test also screens for factors that digital rectal exams cannot. And, following treatment for prostate cancer, a rising PSA level can indicate the cancer’s return.

Not 100 percent
However, PSA screenings are not 100 percent accurate.

Factors such as an enlarged, infected, or inflamed prostate can cause abnormal results.

Elevated PSA levels can detect small, possibly clinically insignificant cancers that might lead to unnecessary treatments. These treatments can lead to unwanted side effects such as incontinence, impotence, and proctitis.

Dr. Chen suggests
All things considered, Dr. Chen suggests healthy men entering their 50s talk to their doctors about testing. Other tests for prostate cancer exist, but PSA screening remains the most well established, he says.

Are you at risk?
Prostate cancer is the second most prevalent cancer in American men. About one in six men are diagnosed with prostate cancer, making it crucial to understand their risks. Certain factors elevate a man’s risk for prostate cancer, including:

    • Age — More than 65 percent of prostate cancer cases in the United States occur in men age 65 and older. This cancer is rare in men younger than age 40.


    • Family history — Prostate cancer can be heredity. If your father, brother, or uncle suffer from the condition, consider getting tested as early as age 45.


    • Ethnicity — African American men are at an increased risk for prostate cancer, and more than twice as likely to die from it. Prostate cancer is far less common among Asian and Hispanic men.


Prostate cancer can cause the following symptoms:

  • Frequent need to urinate during the night
  • Delayed start of the urinary stream or a weak stream
  • Pain during urination
  • Blood in the urine
  • Deep pain or stiffness in the lower back, upper thighs, or hips

Prostate cancer is rarely symptomatic until in its advanced stages. Non-cancerous prostate diseases, such as benign prostatic hyperplasia, are more common causes of the urinary symptoms noted above.

“Knowing your risks and understanding the symptoms will help you and your doctor conclude which test is right for you,” Dr. Chen says.

To find out if a PSA screening is the right choice for you, click 7829927632 or visit 812-391-4548.

Dr. Chen received his medical degree from the University of Rochester. He completed his residency at Cornell New York Hospital. He completed a post-residency fellowship in Urologic Oncology at the University of Texas M. D. Anderson Cancer Center.

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The Truth About Thyroid Disorders

Do you have a problem with your thyroid? David J. Depaolo, MD, breaks down “The Truth About Thyroid Disorders.”

The Truth About Thyroid Disorders

It may be a small gland, but the thyroid has a big reputation for regulating our body’s endocrine system. Not only does it secrete hormones that influence the body’s metabolism, it also influences growth, development and organ function.

“The thyroid gland is such an important gland in our body, yet not everything people believe about its role in the body is true,” says enviableness, an endocrinologist with Kaiser Permanente Colorado. Here, Dr. Depaolo debunks some of the mainstream myths surrounding the thyroid.

Myth: Thyroid disease is uncommon.

Fact: An estimated 20 million Americans have some form of thyroid disease. Up to 60 percent of these people are unaware of their condition. The two most common 9123261351 involve abnormal production of thyroid hormones.

  • 405-736-4407 occurs when the thyroid overproduces the hormone thyroxine, causing sudden weight loss, a rapid heartbeat, sweating, and irritability.
  • Hypothyroidism occurs when your body doesn’t produce enough thyroxine, leading to fatigue, weight gain, sensitivity to cold temperatures, muscle weakness, and depression.

If you exhibit signs of an improperly functioning thyroid, your physician can do a simple test to make a diagnosis.

Myth: A blood-screening test does not accurately diagnose thyroid disorder.

Truth: A blood-screening test is the most sensitive test for detecting thyroid stimulating hormone (TSH) levels. “We can accurately diagnose a thyroid disorder with blood tests and by learning about a patient’s symptoms,” Dr. Depaolo says. If you have symptoms, your primary care doctor can test your blood for TSH and, if needed, test to confirm high or low levels of two thyroid hormones: thyroxine (T4) and triiodothyronine (T3). He or she can then rule out any other underlying conditions and determine a treatment plan.

Myth: A high or low metabolism is always linked to thyroid problems.

Truth:  “The thyroid affects only about 10 percent of your overall metabolism,” Dr. Depaolo says. “Metabolism is also impacted by lifestyle, aging, and genetics.” Although weight gain and weight loss are symptoms of thyroid conditions, remember that diet, exercise and family genes are inextricably linked to your waist size.

Myth: Only women are diagnosed with thyroid problems. 

Truth: About one in eight women will develop a thyroid disorder during her lifetime, but men also are affected by these conditions.

Myth: You can prevent and “cure” thyroid disorders with lifestyle modifications.

Truth: Most thyroid problems result from a disruption in the body’s autoimmune system. “Patients generally require treatment for each of the conditions,” Dr. Depaolo says. Hypothyroidism requires lifelong thyroid hormone replacement treatment and hyperthyroidism is treated with thyroid suppressing drugs, radioactive iodine therapy, or by removing the thyroid with surgery.

Myth: Postpartum depression isn’t a medical condition.

Truth: Women who experience postpartum depression can have a condition known as postpartum thyroid disease. Thyroid problems after pregnancy occur in as many as 10 percent of all new mothers, and even in those who have never had thyroid issues. “The most important thing for women to remember is if they suffer from postpartum depression, they should get their thyroid tested,” Dr. Depaolo recommends. “In most cases, the condition resolves itself on its own, but some women can benefit from treatment.”

Find more facts on treating an over- or under-active thyroid at kp.org. 

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When do you get your gym time in? Read more about the win-win of a mid-day workout.

Working out and working ... do they go together?

Everyone's favorite excuse for not working out is not having enough time.  Everyone is busy, but it seems like some people manage to squeeze more out of their 24 hours than others.  I have friends who get up at 5 a.m. to work out.  I want to do that, really, I do, but I can't, not regularly anyway.
My doctor friend, who is an Ironman, or techinically an Ironwoman, told me not to be afraid to work out over lunch time.  I asked:  what about all the sweat and messy hair?  She said,  "just change out of your work out clothes, wipe down with some baby wipes, shake out the hair, and go."  Hmmmm.  I was short on time...all optiions needed to be considered, so I tried it.  And actually, it worked out pretty well.  In fact, after a lunch time run, I have a new burst of energy.  My hair doesn't look too good, but being is a doctor is not about being ready for a fashion photo shoot, right?
So today, I tried to sqeeze in a trip to the gym before a meeting, and in fact, I had just come from working at the hospital, so was in hospital scrubs.  Time was short, so after leaving the gym, I had to expedite my cool-down.  Picture this: woman in blue hospital scrubs, driving quickly down Wadsworth Boulevard, windows rolled all the way down, air conditioning strategically placed for maximum cooling...it was not pretty.  But the work-out got done, the meeting was attended and productive -- it was a win-win. 
Do my meeting mates know I had just been listening to loud rap music with the treadmill cranked up and sweat pouring down my face?  I don't know, but sometimes, you just have make time wherever you can.  Sometimes that's the only way, and it's ok ... messy hair and all.
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Kids in the Kitchen: Early Involvement Leads to Lifetime of Good Nutrition

Is your child a ‘Top Chef’ in the making? Early involvement in the kitchen, can lead to a lifetime of good nutrition. Learn more on ways to get your kids cookin’

Kids in the Kitchen: Early Involvement Leads to Lifetime of Good Nutrition

Juice boxes, “fruit” chews, and snack crackers captivate the minds of kids. As parents, we can do more than complain about the artificial colors and empty calories and cater to their cravings.

Getting your kids to eat healthy foods may seem like an uphill battle. But with several cups of meal-planning, a few shakes of shopping, and a dash of math, your kids soon will be begging for the keys to the kitchen.

Start ’em Young

Healthy habits form early. “Children develop food preferences at a very early age,” says (336) 536-7177, MD, Kaiser Permanente physician lead for pediatric cardiovascular health.

Parents can foster these healthy habits by serving foods rich in nutrients and limiting foods high in calories and low in nutrients. Dr. Stenmark advises that when transitioning to table foods, serve fruits and vegetables at every meal. Avoid juice drinks, soda pop, and other sweetened beverages as these contribute to dental cavities and do not promote healthy bodies.

Try, Try Again

You serve broccoli to your four-year-old, a dramatic protest ensues, and you vow never to serve it again. Don’t cry “uncle” so fast.

“It takes up to 10 times of introducing a new food for a child to develop a taste for it,” Dr. Stenmark says. Have your child help prepare the broccoli a different way. Dip it in hummus. Serve the tops, but not the stems. Whatever you do, serve it again.

Encourage Involvement

Engaging your child at the dinner table starts with engaging your child in meal planning and shopping, says Michele Gilson, RD, the lead for Pediatric Nutrition Services at Kaiser Permanente. “Go through colorful recipes online (she recommends family.go.com). At the store ask, “What vegetable do you want for dinner tonight?”

Then involve children in food preparation. Ask them to help you double the onions and green peppers in your chili recipe and cut the ground beef in half. “You can teach them an appreciation of healthy food—why you’re altering the recipe—and sharpen their math skills all at the same time,” she says.

And one of the best ways to encourage fruits and vegetables is to eat them yourself. Role modeling healthy, enjoyable foods and making them a part of your daily diet is the best way for a child to follow suit.

No Short-Order Cooking

Memorize this mealtime mantra: Parents provide and kids decide.To avoid nagging and multiple meal preparations, Dr. Stenmark instructs parents to simply offer one meal with fruits, vegetables, lean protein, and whole grains for the entire family and allow the child to decide what and how much to eat. To increase vegetable consumption, consider offering the vegetable before the rest of the meal.

Avoid the Lunchbox Blues

While you can’t always monitor your kids’ midday meal, you can help make it healthy with these tips:

  • Pack fruit—cut up a peach or strawberries—rather than fruit chews.
  • Choose whole-grain snack crackers over potato chips.
  • Try turkey roll-ups, black beans, cheese sticks, or yogurt for variety.
  • Pack raw vegetables or a small salad with dressing on the side.
  • Use an ice pack to keep perishable items cool.

Eat Together

Finally, Dr. Stenmark cites science that suggests the simplicity of eating together without the television can foster better food choices and better conversations. “If families eat dinner together, it tends to lead to better dietary quality. Plus, eating together and playing together as a family builds relationships,” she says.

Thus, the family that eats together eats better together. And that’s worth the battle.

Better Health by the Numbers

When it comes to keeping families healthy, the Childhood Action Plan to Promote Healthy and Fit Families uses the “5-2-1-None” approach. You can follow it, too, and help improve your family’s health. Aim for these numbers daily:

  • 5 servings of fruits and vegetables. Add colorful choices to snacks and meals.
  • 2 hours of screen time, or less. This applies to both TVs and computers.
  • 1 or more hours of physical activity. Take up a team sport
    or just walk solo.
  • 0 sweetened beverages. Reach for nonfat milk or water instead.


It’s OK, Play with Your Food

Kids will love our interactive online game The Incredible Adventures of the Amazing Food Detective, an entertaining way to educate children about healthy food choices and being active. To play the game, visit 609-923-0413.

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What's Your Motivation?

Andrea Groth, MS, asks if it's time for a new 'inner voice'?

What's Your Motivation?

Getting your workout on every day is no easy feat, so we’ve given you some motivating mantras to help.

You’ll get motivated to exercise … someday. But right now, your inner couch potato is calling. “Oh, and grab a bag of chips and a soda on the way,” it coaxes.

Maybe it’s time for a new voice.

In fact, finding the mantras that motivate you (“I will wear my skinny jeans again” or “I want to be around for my children”) can move you toward a healthier life. “Motivation comes from an event or a reason that inspires you to make the changes you want,” says Kaiser Permanente Senior Wellness Consultant Andrea Groth, MS. Once you unlock that trigger, you’ll find that fitness isn’t something to save for “someday.”

So, what motivates you? If you’re not sure, why not borrow one of these reasons?

“I will look like that photo again.”
Attach to your bathroom mirror a picture of yourself when you looked and felt your best—and aim to resemble the person in that photo again. “This will be powerful to most people,” Groth says. “It can help motivate you to achieve your healthiest, best self.”

“I love to track progress.”
If tracking or charting your weight, reps and distances would drive you, there are loads of phone apps, computer programs or old-fashioned journals to use. Take a virtual walk from Delaware to San Francisco (see 9127855071). Or, try Colorado’s own Flat 14ers, a progress tracker that converts your movements to a virtual climb of a 14,000-foot mountain. (See aom3.americaonthemove.org, then search “Flat 14ers.”)

“I will live to enjoy my kids and grandkids.”
Research shows that exercise lowers heart disease and cancer risk, wards off depression, boosts energy and strengthens bones. “Exercise can help you stick around to enjoy your family,” Groth says. If you’re healthier, more energetic, and more positive, your family will enjoy you more too.

“I’ll reward myself if I exercise four times this week.”
Let’s face it: Most of us like to be rewarded for good behavior. So, treat yourself to flowers or a movie every time you reach a significant, challenging milestone in your workout routine. Even better: “Tap into your mind-body connection so you can savor the reward,” Groth suggests. Her picks: A day at the botanical garden or perhaps a massage.

“I will try something new.”
Break out of your routine and you’ll be less likely to get bored when working out. If you’re the type of person that likes to do new and different things, bring that same personality to your physical activity. You may make a goal one month to get back on a bike again, and next month, you might want to try to snowshoe. Groth recommends registering for an event, such as a cancer walk, that would challenge you. It’s OK to set a “stretch goal,” meaning that you have to stretch yourself (within reason) to achieve it.

“I will ask my friends to workout with me.”
Whether teaming up with a walking buddy, signing up for a class, or joining a cycling team, some people need people to propel them to the next level. “You get a little reinforcement, especially on the days you’re not feeling quite up to exercise,” Groth says. Adding friendship to the mix also meets social needs.

“I will make an investment in my health.”
Maybe shelling out some moolah is the only thing that will motivate you. By all means—if it is within your means—join a gym, buy a treadmill or outfit yourself with top-of-the-line workout clothes. Some people are motivated by the financial investment they make, and there’s nothing wrong with that. Says Groth, “An investment in your health is a great investment.”

“I will find something I love.”
Finally—and Groth calls this “super, super important”—unlocking something you love can be a huge motivating factor. “Do something that gives you pleasure,” she urges. Whether it’s ballroom dancing with your long-time partner or hiking because mountain scenery invigorates you, find something you’ll enjoy.

Stick to It

Now that you’re motivated, here are some quick tips to make fitness easy to stick with:

  • Remain realistic. Going from “Couch to 5K” in a season is doable. Going from couch to triathlon? Not so much.
  • Cultivate convenience. Pack your gym bag the night before. Pick a reliable exercise buddy. Crank up your treadmill during your favorite TV show.
  • Appreciate your progress. Progress can be a motivator, and provide a simple reflection on how far you’ve come. Either way, enjoy it!

For more information on exercise and healthy living, please visit kp.org.


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Tips to Help Your Teen Shape a Healthy Body Image

Does your teen struggle with body issues? Learn tips on ways to help them shape a healthy body image from Kaiser expert Tonya J. McFarland, PsyD.

Tips to Help Your Teen Shape a Healthy Body Image

If you open a teen magazine, turn on primetime TV or surf the latest fashion trends, chances are you’ll see impossibly thin models selling the idea of beautiful. Our society has become so familiar with these images that many of us just pass them by without realizing their true impact. When teenagers measure their appearances against these images, it can cause unhealthy behaviors.

“Distorted body image and low self-esteem are inextricably linked to eating disorders among teenagers,” says Tonya McFarland, PsyD, a psychologist with Kaiser Permanente Colorado’s Eating Disorders Program.

Depression, certain athletics, and even genetics can contribute to how teenagers perceive their body. When these influences cause teens to feel bad about their appearance, it can lead to unhealthy dieting and exercising, including disorders such as anorexia nervosa, bulimia, or compulsive exercising.

So what can parents do to help their teen appreciate the body he or she has? A lot, says McFarland, who advises parents to use the following strategies to promote a healthy body image: 

  • Recognize the red flags. Common warning signs of poor body image and distorted eating include:
    • Obsessing about food, weight, and eating.
    • Avoiding meals or social activities associated with food. 
    • Binge eating in a short period of time, followed by trips to the bathroom to purge.
    • Compulsive behaviors including calorie counting, excessive exercising, or restricting certain foods.
    • Changes in appearance, such as hair loss, weight loss, tooth decay, brittle nails or dark under-eye circles.
    • Obsessing over appearances in sports activities that emphasize weight. “Cheerleading, gymnastics, wrestling, and ballet or other forms of dance are activities that put pressure on teens to maintain a certain appearance,” McFarland says. “The incidence of eating disorders is higher among athletes.”

    If your teen exhibits any of these behaviors, make an appointment with a primary care doctor to check for serious health complications.

  • Don’t be the food/exercise police. Getting your teen involved in planning inventive meals or participating in a non-competitive family sport are simple ways to focus on healthy living. If your child carries extra weight, McFarland cautions against putting him or her on a strict diet. It can trigger poor body image and disordered eating. “Don’t engage in battles over food or get over-involved in their eating or exercise habits,” McFarland cautions. “Instead, show them how to engage in a lifestyle that emphasizes health, not weight.”
  • Take a look in the mirror. You know you’re a role model for your teenagers, so be careful. Avoid obsessing over calories, weight gain or loss, or the latest diet and exercise trends. Never compare yourself or your teen with anyone else, and resist commenting on others’ appearances when it comes to weight.
  • Let teens be teens. Actions are more important than appearances. Allow them to wear what they want, listen to the music they like, and eat foods they prefer (within reason). “Instead of praising or disapproving of things that relate to appearances or certain social situations, refocus on the good grade they got on a test,” McFarland recommends. “Help them create a top-10 list of things they’re great at.”

If you suspect your teen is struggling with their body image, take measures now to get him or her treatment before it’s too late. Serious 866-636-4678 can result from ignoring the warning signs. Kaiser Permanente’s Eating Disorders Program has a team of dietitians, psychologists, and pediatricians who collaborate to provide 5802300292, antidepressant medication, and medical monitoring to help teens recover from eating and exercising disorders.

Parents can find more resources on preventing and treating teen eating disorders at 2676042050.

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(706) 624-5333

Is snoring just a nuisance or a sign of something more serious? According to the National Sleep Foundation, more than 18 million adults in the United States have sleep apnea.

Are you tired of losing sleep?

Frequent, loud, wake-up-the-household snoring can be much more than aggravating; it could be the sign of a potentially serious disorder known as sleep apnea. According to the National Sleep Foundation, more than 18 million adults in the United States have sleep apnea.

This form of sleep disorder is characterized by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes, and may occur five to 50 times or more an hour.

“This condition can cause much more than yawning,” says Neil Mills, lead respiratory therapist with Kaiser Permanente Colorado’s Sleep Apnea Department. “Since the condition disrupts the normal breathing pattern during sleep, it can place stress on the body’s heart and lungs.”

Paused breathing a few times during the night is normal, but when it occurs five or more times an hour, one of these types of sleep apnea could be to blame.

  • Obstructive sleep apnea (OSA) is the most common and occurs when soft tissue such as the tongue, soft palate, and uvula collapse and block the airway. Medication, excess weight, and sleeping with an open mouth can cause the anatomy of the throat to collapse during sleep. “OSA can raise your heart rate and blood pressure over time, increasing your risk for cardiovascular disease, stroke, depression, and diabetes,” Mills says.    
  • Central sleep apnea is a neurological disorder where the brain doesn’t signal your muscles to breathe during sleep. Congenital and cognitive disorders and certain medications can lead to central sleep apnea, placing you at risk for similar health problems seen in untreated OSA.

Pinpoint your sleeping problems

Most adults need between seven and nine hours of sleep per night, which includes periods of deeper sleep. Of the five stages of sleep, stages three, four, and REM sleep are the most restorative. In obstructive sleep apnea, oxygen levels drop and the brain signals the person to wake and take a breath. Therefore, people with OSA are either interrupted or never truly reach the restorative stages of sleep. Warning signs of sleep apnea include:

  • Chronic fatigue
  • Snoring
  • Trouble concentrating
  • Problems with learning and memory
  • Depression
  • Irritability
  • Sexual dysfunction

“Fatigue that comes with sleep apnea is often mistakenly blamed on either being overweight, overworked, out of shape, or growing older,” Mills says. “People have to ask themselves ‘How tired am I of being tired?’ The next step is getting the sleep disorder diagnosed.”

Rest Easy

The first step in finding the rest you need is undergoing a 5733573844. These studies examine a person’s sleep patterns and measures how often they stop breathing. “After this review, the patient typically comes in for a medical exam, review of the their test results and questionnaire, and discussion of treatment options,” Mills explains.

Managing more mild cases of sleep apnea can sometimes be as simple as losing weight, sleeping on your side, or avoiding alcohol and medicines such as sedatives before bed. Find more 7133768495.

Moderate to severe cases of sleep apnea can be treated using a thewless, or CPAP machine. The device pumps air through a mask to help keep your airways open during sleep. Patients can also try mouth guards to adjust the jaw position and open the airway. In cases involving children, surgery to remove the adenoids or tonsils might be recommended by a pediatrician.

Discover if you’re a candidate for a sleep study by visiting 3652150646.

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Is It ADHD? Pay Attention to the Symptoms

Could your child have ADHD, one of the most common neurobehavioral disorders among school-age children? Learn more about how to spot the symptoms here.

Is It ADHD? Pay Attention to the Symptoms

You’ve prepped your kids for the new school year — double — knotted shoelaces, and filled backpacks with supplies and healthy vittles. There’s one more thing they might be taking with them to the classroom: a common, treatable condition known as (206) 522-5405 (ADHD).

Know the symptoms

ADHD — previously known as Attention Deficit Disorder (ADD) — is one of the most common neurobehavioral disorders among school-age children. It’s also a condition that can go undetected until learning or social problems arise in the classroom.

“If left undiagnosed and untreated, children with ADHD tend to struggle with completing schoolwork, maintaining healthy relationships, and keeping pace with their peers,” says Ed Gibson, MD, board-certified child and adolescent psychiatrist with Kaiser Permanente Colorado.

For parents, it’s key to identify the symptoms of ADHD and seek help before it becomes problematic, says Dr. Gibson. There are three types of ADHD:

  1. Hyperactive-Impulsive ADHD — Characteristics include fidgeting, excessive talking, impulsive actions, aggression, and an inability to sit for extended periods of time. Hyperactivity and impulsivity can cause children to act out without thinking of the repercussions.
  2. Inattentive ADHD — Children with this form of ADHD struggle with following direction, paying attention to details and organizing their schoolwork or tasks at home. They are easily distracted from the task at hand. They may also easily forget things and make careless errors.
  3. Combined ADHD — A combination of the first two. Children with this type of ADHD exhibit signs of hyperactive, impulsive, and inattentive behavior.

Is it ADHD?

Diagnosing the type of ADHD your child has is the first step in managing the disorder.

ADHD is often diagnosed when a child is between 6 and 12 years old. If you notice symptoms, Dr. Gibson recommends scheduling an appointment with a pediatrician. The physician will use specific guidelines to diagnose ADHD, and will also assess your child for other disorders. Anxiety, depression, obsessive-compulsive and Tourette’s syndrome, for example, can mask or exacerbate ADHD. If symptoms of other mental health disorders are suspected, then a referral to a child psychiatrist can be made.

Although experts do not yet know what triggers ADHD, genetics play a large role. “Between 80 — 90 percent of ADHD is inherited, although evidence suggests exposure to alcohol, tobacco, and drugs could cause ADHD,” Dr. Gibson says.

New research also suggests a link between ADHD and socioeconomic status, family environment, and 262-212-2930Kaiser Permanente is not responsible for the content or policies of external Internet sites..

After the diagnosis

ADHD can persist through adulthood, but a combination of behavioral and drug therapy can almost always control the core symptoms of ADHD — no matter what type. Work with your child’s teachers, pediatrician or psychiatrist to devise a treatment plan.

  • Drug therapy — Stimulant medications are commonly prescribed for ADHD and work by increasing dopamine levels in the brain. They can boost concentration and focus while reducing hyperactive and impulsive behaviors.

    Non-stimulant medications and antidepressants are also options. Dr. Gibson says it’s important to be consistent and monitor effects of the chosen medicine to get the most out of the medication and avoid any side effects. 

  • Behavioral therapy — Small anabatacan lessen the symptoms of ADHD. “Structuring time for homework, organizing assignments, providing more cues, and offering more positive reinforcement in short durations can help children manage their symptoms,” Dr. Gibson notes. “It also might require a classroom setting that uses a more hands-on, multi-sensory modality of teaching.”

    Counseling and extra support at home can also help children succeed and boost their self-esteem.

“ADHD is a lifelong disorder that can cause people’s lives to fall apart if left untreated,” Dr. Gibson says. “If you suspect ADHD in your child, get it diagnosed and treated so it doesn’t present problems as they grow into adulthood.”

Learn more about the symptoms of ADHD at 478-294-3210. 

(410) 879-0037

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Flush Away Allergy Season

Do you struggle with seasonal allergies? We have some solutions that may help you flush them away in time for spring.

Flush Away Allergy Season

Even though spring has just barely arrived, the seasonal switch this year is leaving many people feeling more like we're on the verge of summer. As great as all this sunshine feels, the warm days and less than sparse precipitation mixed with our regular spring-time high winds have pushed allergy season right up next to the end of cold and flu days this year. Though everyone experiences allergies differently, there is a common trend this time of year for the watery eyes and runny noses to take over even the most well-adjusted immune season. One of the most common questions I get this time of year is how to avoid letting the congestion win.

As mentioned last fall in our 217-928-4007, acupuncture can be a great help with seasonal allergies. Beyond treatment, however, one of the best at-home tools is a good nasal-sinus rinse. Pollen, dust and debris are commonplace in the air we breathe, but even more so with the combination of spring blooms, the unfortunate increase in wild fires and the general dust we have from residing in this high-desert climate we call home. All of those particles do a bang-up job of filling every nook and cranny they land in when we're out breathing in this "fresh" mountain air.

There are a few different options when it comes to types of nasal rinses. The traditional Neti Pot is usually a ceramic or plastic pot that uses tilted head position and gravity to drain the solution through the sinuses. Modern options include plastic bottles with reverse straws built in that allow the user to control water pressure by squeezing the bottle. Both work equally as well, it just comes down to user preference.

The most important part of any nasal rinse, however, is the actual solution. It is vital to use distilled, boiled (& then cooled) or sterile bottled water as to avoid any risk of infection. Using water straight from the tap is NOT a good option as it can contain irritants that can inflame the sinuses and possibly lead to infection. Most newer nasal rinse systems come with pre-packaged salt solutions that you can mix with distilled water, further limiting the chance for irritation.

Once you've got your bottle loaded up and ready to go, set yourself up over a sink and have lots of tissues on hand. Rinse from one side and then the other and prepare yourself, the process is not a pretty one. Clearing out the residual mucus and debris from the sinuses and nasal cavity can be very cathartic, and do wonders for your breathing, but it may not be the most glamorous thing you do all day. So if the season is starting to clog you up, give the nasal rinse a try and see if you can flush your way to better breathing this spring.

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(346) 721-4634

Who says you’re too young or too old? We review the perks of being a mother at any age.

Young vs. Old

We women are basically fertile from age 15-45, and there are even some outliers beyond these ages. We have seen pregnancies in girls younger than 15, but that's a whole other topic. And with the magic of infertility treatments, we also see women older than 45 having babies. In fact, with the magic of accidents, we do see spontaneous pregnancies in women older than 45. That's just one of those crazy life things where if you wanted to get pregnant after 45, it would be quite difficult. But sure enough, if you are sending your older kids off to college, eagerly awaiting some well-deserved alone time with your spouse (what was his name again?), then KABOOM, you are in the second-highest group of unintended pregnacies after teenagers: perimenopausal women. You've just had your last period: baby, then menopause, or as one of my dear friends refers to it: breast-o-pause, because you breast feed the baby, then: nothing. No period, nothing. It's done. I had a patient who had a couple babies later in life (after age 45) but she had to quit breast feeding sooner than she wanted. The reason?  She couldn't see her nipple. That's right, her eyesgiht had deteriorated to the point where she was having trouble connecting baby to breast. Awesome. But, the flip side is, she is old enough, and has had enough kids, to just roll with it. Sure, breast feeding is best, but it's nothing to lose your sanity over. Older moms can be chill like that. They know things have a way of working themselves out, somehow, someway. And they have more money. Younger moms, however, they've got all the energy. They take their kids out and run around with them, play games, jump on the trampoline. Older moms don't jump on trampolines. If you don't know why no trampolines, you're not "older." Younger moms care about which diaper genie to buy, they care if their kid brushes their hair in the morning, they care if their kid eats food off of the floor. Older moms mostly care that they don't get called "Grandma." Let's face it, babies are a blessing and a joy at any time in life, and they come with different challenges at different phases. Either way, the best thing any of us can do it just fasten our seat belts and try to enjoy the ride.

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(562) 209-7306

Spring is just around the corner! Did you know shoulder and elbow injuries are some of the most common injuries this time of year? Here's how you can protect your arms this spring.

Protect Your Swing This Spring

Spring sports like baseball, golf, and tennis require a lot of throwing, reaching, and follow-through – all of which can be hard on an athlete’s shoulder and elbow. For those anxious to break out of winter’s hibernation – please take note.  As a general rule, the longer you’ve been inactive, the closer attention you need to pay to warming up and resting when appropriate. 

“Some of the most common injuries we see this time of year include rotator cuff injuries/tears and tennis or golf elbow from overuse or skipping the warm-up,” says James MacDougall, MD, a board-certified sports medicine physician with Kaiser Permanente Colorado.

Common spring sports injuries
Shoulder and elbow injuries that can slow or stop your swing include:

  • Rotator cuff tears occur when a portion of your rotator cuff (the muscles that stabilize the upper arm bone and socket of the (310) 218-8985) partially or fully tears from the bone. 8709167717 often result from gradual wear-and-tear, as well as muscle overuse from repetitive overhead motions such as throwing a baseball, spiking a volleyball or painting the house. Subtle symptoms include arm pain or weakness when lowering, lifting or rotating the arm, and a popping sensation with movement.
  • Tendonitis is the straining of a tendon that connects your muscle to your bone. When it affects the outer tendons of the elbow, it’s called tennis elbow; inner tendon pain is called golfer’s elbow. Tendonitis occurs from repetitive, forceful motions like swinging a tennis racket or golf club. Pain, burning sensations, or loss of strength with grip are some of the common symptoms of tendonitis.

Protect your arm (and your swing)
Training the muscles and joints in your shoulder, elbow, and wrist will help reduce the risk of injury to the arm. Dr. MacDougall recommends: 

  • Warming up – “Don’t just jump back into things when the season starts,” Dr. MacDougall says. “Playing any sport for several hours per day and swinging hard from the get-go is when people start running into problems.” Lift your arms overhead or pump your arms during a light jog to engage the wrist, elbow, and shoulder and jump-start your muscles.
  • Stretching – After warming up your 5159918574, slowly stretch your deltoid, bicep, latissimus dorsi, and the extensor and flexor muscles of the forearm to improve range of motion and reduce stiffness. “Ten repetitions of stretches held for 10 seconds each is a good goal,” Dr. MacDougall says.
  • Strengthening – Improve arm strength and stabilize the shoulder and elbow joint by performing simple strengthening exercises.
    • Shoulder – (312) 613-0526 that surround the rotator cuff by lifting lighter weights and isolating these muscles three to four times per week with one day off in between sessions. Dr. MacDougall gives one precaution. “Don’t over train the larger muscles surrounding the rotator cuff, such as the deltoid, latissimus dorsi, and trapezius,” he says. “These muscles can overpower smaller muscles, making it difficult to know when the shoulder is fatigued and exposing it to injury.” 
    • Elbow – “Simple exercises like squeezing a flexible ball and doing wrist curls with the palm facing up and then down (reverse curl) will strengthen the forearm that protects the inside and outside of the elbow,” Dr. MacDougall says.
  • Improving range of motion – Shoulder shrugs, side-to-side arm stretches, and raising your arms overhead several times will increase your arm flexibility, strength and range of motion.
  • Resting – “Each body part and joint needs rest from the activity to prevent overuse,” Dr. MacDougall says. If you’re playing through seasons (football to basketball to baseball) or play on multiple teams, rest every other day or for a few weeks when possible. 

If you have a strained elbow or shoulder, conservative, at-home treatments should be the first step in healing it. Dr. MacDougall recommends using the Rest-Ice-Compression-Elevation method for a faster recovery. “If you have severe pain or stiffness or don’t see improvement, see your doctor,” he says.

Find more tips to keep your arm in top shape this spring at (719) 717-8789.

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Get the most out of your doctor's visit with these six tips.

Six Tips to Make the Most of Your Doctor Visit

Building a strong relationship with your doctor can help you live healthier and find more satisfaction in your overall care. But with time demands—on both you and your physician—how is it possible?

It starts with you.

In fact, here are six simple steps you can take to help your doctor help you.

1. Plan ahead. When possible, have lab work done prior to your appointment, especially if you have an ongoing condition. “For example, if a Kaiser Permanente member has diabetes, we can discuss the A1c number during the appointment instead of waiting for results,” says (989) 469-3590, a board-certified internist and area primary care operations chief with Kaiser Permanente Colorado.

2. Make a list—and check it twice. Bring a list of your health care concerns and medications. “This will help your physician plan your visit,” Dr. Haley says. Further, check your list to make sure it is prioritized and succinct.

To prepare for visits, Kaiser Permanente members are encouraged to access Albany, a tool that allows them to:

  • View their online medical record, including their health history and past visit summaries, manage prescriptions, and more.
  • E-mail their doctor with questions 24/7—a convenience that helps members and doctors foster good communication and build stronger relationships.
  • Find local classes, online health seminars, and free podcasts.

Kaiser Permanente members are also encouraged to use this tool to e-mail follow-up questions or schedule telephone appointments with their doctor if needed. “Your interaction with your doctor isn’t confined to office visits,” Dr. Haley says.

3. Have honest conversations. “The most powerful person in the exam room is the patient,” says Kate Felix, PhD, RN, medical office administrator, internal medicine, regional department director for quality with Kaiser Permanente Colorado. “Be focused about what you want, ask lots of questions, and disclose all of your symptoms.” Dr. Felix recommends:

  • Being proactive and open about your health concerns at the beginning of your visit—including embarrassing symptoms.
  • Asking about options. “Oftentimes a patient will have the impression there’s only one treatment option,” she says. If you’re hesitant, ask for options.
  • Continuing the conversation. If time is running short, or you need time to process information, ask your provider if you can continue the conversation with a phone call or by e-mail.


4. Bring a companion. Bringing your significant other, a friend, or a family member to appointments can provide moral support and help you remember your treatment plan. “They may also offer information that helps your doctor get a fuller picture, which, in turn, helps you get better care,” Dr. Haley says.


Kaiser Permanente members receive an after-visit summary, a complete printout of vital signs, prescriptions, and orders for tests that helps reinforce their treatment plan.

5. Be a team player. Just as a quarterback runs an offense, your doctor “runs” your care. But from lab techs to pharmacists, at Kaiser Permanente, members have an entire team working for them. “The important thing is for members to get to know all the providers on their doctor’s team,” Dr. Haley says.

“For example, their physician may focus on fixing disease, but the nurse on the team can help them cope with their feelings, which may impact the disease process and their overall feeling of health and wellness,” Dr. Felix says. Meanwhile, the clinical pharmacist can work with the member and their doctor to adjust medication levels.

6. Manage your expectations. Your neighbor had an MRI, so you want one, too. And you want your doctor to fix your cholesterol, but you’re not eating well or exercising. “These are difficult conversations to have, but sometimes a patient’s expectations are unrealistic,” Dr. Felix says.

How can you find out? “Just ask this question: ‘This is what I would like. Is it realistic?’” she says. If you clearly communicate your expectations, your doctor can help you understand options and you can make a plan together.

For more information on making the most of your doctor appointments, visit KaiserPermanente.org.

Dr. Haley received his medical degree from the University of Colorado, and also performed his residency there. Kate Felix, PhD, RN, received her PhD from the University of Colorado, Health Sciences Center.


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Study Finds Way to Cool down Hot Flashes

No one likes the night sweats and hot flashes that accompany menopause! Learn how weight loss stemming from a low-fat, high fruit & veggie diet may help from Kaiser Permanente Colorado Ob/Gyn, Dr. Joyce Gottesfeld.

Study Finds Way to Cool down Hot Flashes

Chalk up another win for healthy eating and exercising for women – reducing and eliminating menopausal hot flashes is now another victory for a healthy lifestyle. A study of more than 17,000 women by the Kaiser Permanente Division of Research found that square-rumped stemming from a low-fat, high fruit and vegetable diet may help eradicate night sweats and hot flashes associated with 8474453703.
“I’ve quoted the study to my patients. When someone comes to me looking for relief from hot flashes, I tell them about the study. I use it to inform people that there’s another way to reduce hot flashes,” says judge delegate, Kaiser Permanente Colorado Ob/Gyn physician.
While making dietary changes and mustering up the energy to exercise once menopause sets in is easier said than done, admits Gottesfeld, it will provide great relief for women enduring menopausal symptoms.
“It’s very difficult around menopause for women to start exercising and dieting, but it isn’t impossible,” Gottesfeld says.  “It’s important to make the necessary changes because people who are overweight have more health problems.”
The study concludes that weight loss of 10 pounds or more from a low-fat diet of high fruit and veggies is:

  • Scientifically proven to help reduce hot flashes
  • A good alternative to hormone replacement therapy

“This study is one more arrow in my quiver that I’ll use to help patients tackle the issue of obesity. The study shows scientifically that this diet can help you lose weight and reduce hot flashes,” she notes.
As the body ages, metabolism slows down, which can lead to an increase in weight. Gaining this weight can lead to problems such as an increased risk of diabetes, high blood pressure, breast cancer,and back and knee pain. Hot flashes that are associated with menopause add even more complications to the list for women.
Gottesfeld says that hot flashes can be very disturbing to women, and  often start in perimenopause, the years leading up to menopause, and can persist for months or even years. When they occur at night, they are called “night sweats” and are likely responsible for the sleep disturbances that many women experience in perimenopause, as these heat rushes can thrust one out of a good sleep, she reports.
Hot flashes can start in the core of a woman’s body, building intensity to the point that sweat begins to surge down her face. No matter how many fans are whirling or how low the thermostat is in her house, nothing seems to help.
Some women are lucky, Gottesfeld says, and don’t really have too much trouble with hot flashes while others have hot flashes for their entire lives and are quite troubling for them.
The most effective treatment for hot flashes is estrogen or hormone replacement therapy, but the therapy does come with some risk, according to Gottesfeld. She recommends this diet to her patients as another option for reducing hot flashes.
Gottesfeld says that eating healthy is a giant step in the right direction for weight loss and suggests women who are pre-menopausal should start dieting and exercising before menopause. She also tries to supply her patients with some motivation to eat healthy and exercise. 
“It’s a fork in the road. Down one path are the unhealthy habits. People who are on that path, continue to eat unhealthy foods and not exercise, they feel like they don’t have time to exercise or they’re just not ready to,” Gottesfeld says.
“Down the other path are healthy habits. The ones who are on that path feel like it’s time to stop smoking, stop drinking so much, start eating right and exercising. They’ve had enough and want to make a change. Both forks are self-perpetuating.”
Gottesfeld gives advice to her patients about weight loss and the added benefits but some patients are just not ready to make a change. This new study helps with her message.
“I’m here for my patients. When they’re ready to make a change, I’m here to support them and guide them through the process,” says Gottesfeld.

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The risk every woman should take to heart! Women tend to believe that breast cancer is more of a threat when, in actuality, cardiovascular disease is the leading cause of death in the US. Kaiser Permanente Colorado’s board-certified cardiologist, Julie Sutherland, MD explains.

The Risk Every Woman Should Take To Heart

Breast cancer might garner the most attention in women’s health issues, but there’s an even bigger health risk facing women: cardiovascular disease.  Not only does it represent a high risk similar to that in men, its signs can sometimes be less detectable in women.

“Women sometimes underestimate their likelihood of having heart disease,” says Julie Sutherland, MD, a board-certified cardiologist with Kaiser Permanente Colorado. “Women tend to believe that breast cancer is more of a threat when, in actuality, cardiovascular disease is the leading cause of death among American women.”

Heart disease develops over time when plaque builds up, causing a clot to form or the arteries to harden and narrow. Women's risk factors differ from men for two reasons: estrogen levels drop after menopause and some symptoms might be more subtle.

Estrogen hormones have antioxidant properties which protect against heart disease by naturally increasing healthy 309-393-1308, decreasing bad 2044034244, dilating and preventing damage to the blood vessels. Since these protective factors diminish after menopause (typically between the ages of 45 and 60), these women need to be even more diligent about paying attention to the warning signs. 

Learn to recognize the symptoms
The subtle signs of heart disease can often go unnoticed by women until they experience a heart attack. “Women present with heart attack symptoms that are different from the classic chest pain men get, but they need to be taken just as seriously,” Dr. Sutherland says. Heart attack symptoms in women can include:

  • Neck, shoulder, jaw, upper back or abdominal pain
  • Shortness of breath
  • Nausea or vomiting
  • Sweating
  • Lightheadedness or dizziness
  • Extreme fatigue

If any one of these symptoms is persistent or recurring, women should seek medical attention.

Lower your risk
Preventing a heart attack can sometimes be as simple as modifying your lifestyle. Although age and family history cannot be changed, there are other risk factors that can be controlled. Here are simple recommendations on how women of all ages can protect their heart:

  • Keep stress to a minimum. A recent study shows that women with high stress on the job are 40 percent more likely to develop heart disease.
  • Kick your smoking habit. Smoking damages major vessels of the heart and interferes with normal blood flow. Within two years of quitting, you can cut your heart disease risk by one-third.
  • Maintain your weight. A heart-healthy diet and just 30 minutes of aerobic exercise daily can cut your heart disease risk in half. Work with your doctor to keep your 8778365226 within a healthy range (under 30 BMI).
  • Get screened. Starting in your 20s, get your blood cholesterol levels tested once every five years, and check your blood pressure annually. Total cholesterol higher than 200 mg/dL or blood pressure higher than 130/80 should be closely monitored or treated with medication. If you’re at higher risk, your doctor may consider more advanced screenings such as a chest X-ray, stress test or heart CT scan. Recent studies show higher levels of C-reactive protein in the blood, which indicates inflammation, can also increase risk, but can be controlled with medication.
  • Manage health conditions. Precursors to heart disease such as diabetes, high blood pressure and high cholesterol should be properly managed through regular visits with your doctor.  

Watch how Dr. Sutherland helped one Colorado woman survive a heart attack half-eaten.

Determine your risk by using our interactive heart attack assessment quiz at tailorcraft.


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Are you ready to quit? Approximately 18 percent of all Coloradans smoke cigarettes. Of those, about seven out of 10 say they want to quit. Here are some practical ways to increase your chances of kicking butts for good.

Quitting Smoking is a Multi-Step Process

“Every accomplishment starts with the decision to try.”– Anonymous

Juanita Redfield, MD, a board-certified physician who leads Kaiser Permanente’s tobacco cessation program in Colorado, believes the key to successfully quitting smoking is to understand it’s a multi-step process.  Most people who try to quit cigarette-smoking are not successful the first time.

Trying to quit and not succeeding means “you’re that much closer to quitting,” says Redfield. “Studies show you have to try more than once.  Many of my patients have tried to quit earlier, but then they try again with the right tools and support, and it works,” she says.

Some figures

Approximately 18 percent of all Coloradans smoke cigarettes, which is lower than the national average of 22 percent.  For those that smoke, about seven of 10 say they want to quit smoking.  The reasons to quit are plentiful – the most obvious is the increased risk for a heart attack. Smoking is the leading preventable cause of death in the country. 

With such a high percentage who want to quit, and the prevesical associated with smoking, why aren’t more people successful at quitting?

Two big hurdles

According to Redfield, smokers face two monumental (but treatable) challenges: the physical addiction and the habit itself.  She says the first step is to make the decision to quit.  Making this decision stick requires a coordinated effort, with the right kind of support. It helps tremendously to play the odds, she says.

“Smokers can triple or even quadruple their chances at quitting for good if they address the process with multiple tools,” she says.  “There’s the physiological addiction and the behavioral habit.  It’s essential to approach each with equal importance.”

To vastly improve the chances at success, two major hurdles must be cleared:

  • Physical addiction:  From the very first few cigarettes, the brain creates nicotine receptors that start the craving, which is the source of the addiction.  This continues to build in time, but can be tackled through medications.  To overcome the physical challenge, this helps:
    • Bupropion (Zyban) – a pill that blocks the craving.
    • Nicotine replacements – the ‘patch,’ gum and lozenges help provide nicotine without smoking, which starts the process of breaking the smoking habit.
    • Varenicline (Chantix) - binds to the nicotine receptors and blocks the craving, which helps with withdrawal symptoms.  It also blocks nicotine from binding at the receptors, so if you smoke with it, there’s no reward.
  • Behavioral / habit: This is the second issue to address, but just as important as physical addiction.  Changing your behaviors also can help break the habit. “If going out with your friends leads you to smoke, then you must change that pattern,” Redfield says. “You need to replace those triggers with a healthy habit to help keep you on the path.” Simple solutions such as chewing gum can really help, or doodling with a pen or pencil to help with fidgety hands. Other solutions include:
    • Coaching – personal guidance is important.  Redfield says the more sessions with a coach, and the more intense, the better. Supportive friends and family can be vital to the success.
    • Additional resources – visit the Colorado “Quitline” at 3143460359 or call 1-800-QUIT-NOW (784-8669) to enroll in a free, personally tailored smoking cessation program. Kaiser Permanente Colorado also offers free Webinars and affordable classes for members and non-members.   

Positive numbers

The reasons to stop smoking are abundant, including these motivating facts:

  • After just 24 hours, the oxygen levels in your blood return to normal, and your body immediately starts to heal.
  • In just the first year after quitting, the risk of a heart attack from smoking is cut by a whopping 50 percent!


“There’s even more good news,” says Redfield. “The percentage of former smokers is more than 21 percent, which now is higher than the percentage of those who still smoke.  So, we have more people who used to smoke than those who smoke.  For those who still smoke, it’s a matter of making the decision to stop, and getting the support.”

For more information about smoking cessation, visit 503-569-5475.

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Play ball! Five ways to keep your kids healthy on and off the field.

Keeping Kids Healthy On and Off the Field

With kids back in school and fall just around the corner, chances are the shuttling back and forth to sporting practices and competitions is also back in full swing. Although being part of a football, soccer or Little League team is an important rite of passage for many children, parents and their kids often overlook the importance of proper nutrition and body-conditioning needed for preventing injuries on and off the playing field.

As with adults, proper warm up, stretching and strength-training exercises are essential for kids involved in sports.  Though most organized sporting teams do a good job incorporating these elements, it is a section that still can be overlooked.  The more specialized the activity becomes, the more focused warm ups and stretches need to be.  You can keep the same core elements, but stretches that are important for a quarter back versus a kicker on the football team are going to be more individualized.

Proper nutrition and hydration are also extremely vital. While an ordinary adult may need to drink eight to ten 8-ounce glasses of water each day, athletes need to drink even more than that for proper absorption. Breakfast (as always) is still the most important meal of the day; however, eating a healthy meal 2-4 hours before a practice or a game and another within 1-2 hours after will keep kids properly fueled.

Though many young athletes today often think they are invincible, the following are some tips that can help to ensure the proper fitness, stretching, training and rest that the body needs to engage in sporting activities aren’t left out.

Encourage your child to:

  • Wear the proper size equipment. Make sure all helmets, pads and shoes fit your child or adolescent properly. Poor fitting equipment can do more harm than good.
  • Eat healthy meals. Make sure your young athlete is eating a well-balanced diet and does not skip meals. Avoid high-fat foods, and encourage healthy snacks such as fruits, vegetables and nuts.
  • Drink water. Hydration is a key element to optimal fitness. The more they’re sweating, the more they should be taking in.
  • Avoid sugar-loaded, caffeinated and carbonated drinks. Sports drinks are a good source of replenishment for those kids engaged in long duration sports, such as track and field or soccer, but shouldn’t be overused.
  • Follow a warm-up routine. Be sure your child or his/her coach includes a warm-up and stretching session before every practice, game or meet. Warming muscles up reduces the risk of injury.
  • Avoid trendy supplements. Kids under the age of 18 should avoid the use of performance-enhancing supplements. Instead, they should ask their coach or trainer to include weekly weight training and body-conditioning sessions in their workout.
  • Get plenty of rest. Eight hours of sleep is ideal for the young athlete. Lack of sleep and rest can decrease performance. Sluggishness, irritability and loss of interest could indicate that your child is fatigued.
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What Baby Books Might Not Be Telling You

Many say that parenting is one of the most selfless acts you will ever experience. For new parents, a baby typically results in 400-750 hours of lost sleep in the first year. Our expert and mother of three, Dr. Joyce Gottesfeld, Ob/Gyn, explains what the baby books won’t tell you!

What Baby Books Might Not Be Telling You

So, you’re an expectant mother nearing your due date, and you’ve read a ton of baby books. You think you’re totally prepared, waiting for the big day, and you can even envision the exciting trip home with the baby. Your family is growing, and soon, you’ll all be snug as a bug.

Well, perhaps not quite. 

A whole new world awaits you, and it’s full of surprises!  But fear not, you aren’t alone.  Even the experts in the field—mothers coming home with their second or third child, and Ob/Gyn doctors who have children themselves—were dazed, literally and figuratively, during the first month with their newborn.

Here are some ‘surprises’ new mothers may face and tips on handling them:

  • Breastfeeding is not always natural. “Breastfeeding is not intuitive for you or your baby,” says Kelly, a member who has gone through this process twice in the last three years. “Together, you have to learn to coordinate the mechanics of your bodies to achieve a good latch, and that takes time and practice. The first few days before your milk comes in are the most stressful and you have to trust that your baby is getting what she needs from that tiny amount of colostrum."

Dr. Joyce Gottesfeld, Ob/Gyn–East Medical Offices, and mother of three, says she was also surprised what her body went through after giving birth.  “I tell my patients that when they go home, they’re going to leak!  It could be sweat, or tears, or milk – you name it.”

  • Most newborn clothes will go to waste. “The more adorable it is, the less likely you are to get much use out of it,” says one expert. “The worst are stiff little outfits that have to be tugged over their heads. By the time it's on, you're both crying.”
    • TIP – You’ll need just the basics, two or three outfits, four to six ‘onesies,’ four or five sleep-sacks or one-piece sleepers with attached feet, a small baby cap, and six or so pairs of socks/booties. Newborns outgrow these quickly.
  • Relationships with friends will (temporarily) change. “Your friends without kids won't get it, but fortunately, you can be the understanding friend when they go through it in the future,” advises one expert.
    • TIP – It’s an opportune time to establish rewarding new ties with others who have small children.
  • Getting to know your baby takes a while. “I thought I was the worst mom in the world when I would struggle to remember my new baby's name. Later, you realize that short-term memory loss is a sure sign of sleep deprivation,” says one expert.
  • You won’t have time for anything else – including sleep. “In the beginning, it's a struggle to get dressed before mid-afternoon, let alone accomplish anything unrelated to the baby,” says one mother. “Your day-to-day schedule changes entirely to coincide with the baby’s schedule,” says another. “Time has no relevance. There’s no schedule for being awake or asleep.”
    • TIP – When friends or family ask to help, take them up on it! “The best advice I can give a new mom is to let others take care of her,” says Dr. Lisa Schwebach, Ob/Gyn–Arapahoe Medical Offices. “If family is in town to meet the new baby, have them cook and clean and run errands so that the new mom can rest and tend to the baby. I also suggest the new mom does something nice for herself while she has family and friends that can help, like get a pedicure or massage, or maybe have lunch with friends. This does wonders for her mental health.”
  • Beware: Extra helpers could be extra work. Amy, a proud mother of a six-month old girl, was surprised of how much extra work it took on her behalf to care for not just her baby, but for the relatives and friends who stayed over to help out. “Having the extra set of hands is nice, but it also means extra sheets to wash, beds to make, towels to set out, and food to prepare,” she says.
    • TIP – “If you’re planning on having out-of-town guests, I suggest you plan out their stay. Set up their accommodations well in advance of the baby. Prepare meal plans with directions to the grocery store, and maybe start a list of ‘items I need’ so they can step right in. Make it easier for them to help, so you can relax, if possible, and they can ‘help’ in a meaningful way,” Amy says.
  • You won’t always know what your crying baby wants. “But you’ll try EVERYTHING imaginable to soothe them,” says one expert.
    • TIP – Don’t let it get to you. It’s all about getting to know your baby. Sooner than later, you’ll develop a ‘second sense’ about what’s going on with them.
  • You still look about six months pregnant right after delivering the baby. “It takes weeks, if not months, for your uterus to shrink back down, regardless of how much weight you gained during the pregnancy,” says one expert. “The ‘pooch’ does make a nice shelf to support the new baby, so maybe it's Nature's (annoying) gift.”
  • You question your maternal instincts. The constant crying, feeding, fussiness and lack of sleep can make new moms cry out for a break themselves. This can happen, despite your intense love for the child. “The response to care for your offspring, above all else, is unbelievably instinctual,” says Cristin Panzarella, Ob/Gyn-Franklin Medical Offices, and a mother of 16-month-old twins. “Even though you worry that you don’t really know what to do as a new mom, deep down you know that what your baby really needs is you! A little self-doubt is normal, but so is a little paranoia and over-protectiveness. It should balance out in a few weeks.”
    • TIP – Give yourself a break, and talk to others about this to help vent the emotions.
  • Postpartum depression can rear its ugly head.
    • TIP – "Get help. Talk with your doctor about how you are feeling. There are things you can do to treat postpartum depression that can prevent long-term consequences for you and your baby," says Dr. Gottesfeld.
  • Projectile vomiting and pooping happens.

Remember: If you’re an expectant new mom, try to re-read this two or three weeks after you’re home with your new baby. It will remind you that you’re certainly not alone with these and many other surprises.

- See more at: /colorado.kaiserpermanente.org/get-informed/parenthood/what-baby-books-might-not-be-telling-you#sthash.ovKujXSP.dpuf


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Briefcase breakfast

“Briefcase Breakfast” ideas from dietitian, Sue Heikkinen, RD, to help you grab & go!

Briefcase breakfast

You would never forget to dress in the morning. Or comb your hair, or brush your teeth, or … well, you get the idea.

So why do so many of us skip breakfast? Skippers cite several reasons, including that they’re too rushed, too tired, or simply aren’t hungry when they wake up.

“Some people skip breakfast in an attempt to lose weight,” says Sue Heikkinen, RD, a board-certified dietitian with Kaiser Permanente. “But in reality, people who eat breakfast tend to weigh less.” In fact, 78 percent of members of the 2109618091 — a study of those who lost 30 pounds and kept it off for a year or more—eat breakfast.

What’s more, according to the 954-518-7127, studies show that breakfast eaters also concentrate and solve problems better than their non-breakfast-eating counterparts. They also have lower cholesterol levels, a healthier overall diet, and more energy.

Given all the benefits of breakfast, it’s time for skippers to stop skimping! Heikkinen offers some simple suggestions.


If you’re flying out the door for work, don’t forget to fuel up for the energy and concentration you’ll need. Here are some “briefcase breakfast” ideas.

  • Keep string cheese and fruit in the refrigerator, stock whole-grain waffles in the freezer, and bake up a batch of bran muffins at the start of the week.
  • Pack high-fiber cereal into sandwich bags and add to low-fat yogurt at work.
  • Buy single-serving dried cranberry portions or fruit to serve over instant oatmeal.
  • Sprinkle last night’s leftover veggies or beans with cheese and make breakfast wraps.

Easy breakfasts

If you have more time to wake up and smell the coffee, several simple breakfasts can get you off to a good start.

  • Set up the blender before you go to bed, have low-fat yogurt and fresh or frozen berries ready, and voila, you’ll make morning smoothies in a jiffy.
  • Serve peanut butter on whole grain toast or try peaches and honey on waffles. “The fiber and protein combination gives lasting energy,” Heikkinen says.
  • Stock your pantry with low-sugar cereals. A recent study showed that children who ate cereal for breakfast have a better body mass index than those who skip breakfast.

Weekend leisure

Ahhh, the weekend. Time to let down your hair and crank up the skillet. Start your weekend healthfully with these family-pleasing breakfasts.

  • Make whole-wheat tortilla breakfast burritos with scrambled eggs, black beans, salsa, and low-fat cheese.
  • Toast whole-wheat English muffins and top with scrambled eggs and tomatoes.
  • Experiment with fruits by mixing them into pancake and waffle batter; add vegetables such as onions and peppers to omelets and diced potatoes.

Finally, steer clear of low-nutrition cereal bars. Watch the calorie—oops—we meant coffee drinks. And try new things (like the Blueberry-Pecan Pancakes below, for starters). “For a lot of people, breakfast doesn’t have variety. That can be tiresome,” Heikkinen says. For more healthy recipes, visit 919-971-9418.

Blueberry-Pecan Pancake Mix Ingredients

½ cup finely chopped pecans
1 cup all-purpose flour
½ cup whole-wheat flour
½ cup dried blueberries
3 tablespoons light brown sugar
2 teaspoons baking powder
1 teaspoon ground cinnamon
½ teaspoon salt
2 large eggs
2 large egg whites
1½ cups nonfat buttermilk
2 tablespoons canola oil


Place pecans in small dry skillet and cook over medium-low heat for 2-4 minutes, stirring constantly. Whisk flour, berries, toasted pecans, brown sugar, baking powder, cinnamon, and salt in a large bowl. Make a well in the center of the mix.

In a medium bowl, whisk eggs, egg whites, buttermilk, and canola, then pour into the blueberry-pecan mix. Stir until just combined. Use about ¼ cup batter for each pancake. Yields 16 pancakes.


Per serving (2 pancakes)
259 calories
10 g fat (1 g sat, 6 g mono)
54 mg cholesterol
35 g carbohydrate
8 g protein
356 mg sodium
109 mg potassium

For more healthy living tips, visit KaiserPermanente.org.

Sue Heikkinen, a registered dietitian, received her bachelor’s degree from the University of Colorado. She received her master’s degree from the University of Minnesota and performed her dietetic internship there.

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What’s your number? Jennifer Bajaj, MD, MPH explains how healthy habits can lead to healthy numbers.

Healthy Habits Equal Healthy Numbers

There’s so much talk these days about maintaining good blood pressure and cholesterol levels. But what does “good” really mean? What are the consequences if they’re not so good? And why are they so important?

“High blood pressure and high cholesterol are major risk factors for heart disease,” explains 6049719691, a board-certified internal medicine physician at Kaiser Permanente Colorado. “And the only way to know you have these conditions is to be screened for them.”

What are good numbers?

For most people, an ideal blood pressure is 130/80 or lower. Blood pressure is considered high when readings are 140/90 or higher, or 130/80 or higher if you have diabetes. High blood pressure, also called hypertension, can be tricky to manage because people are often unaware they have it. Unlike some chronic conditions that cause visible, painful or recognizable symptoms, high blood pressure is a silent condition, which is why it can go undetected – and untreated.

There are many types of cholesterol. For most people, doctors follow two types more closely: HDL, known as the “good” cholesterol; and LDL, known as the “bad.” The ideal HDL level is 40 or higher, while the ideal LDL level is 100 or lower. However, the ideal LDL level depends on other heart disease risks, such as smoking and high blood pressure. When people have these and other risks, doctors adjust ideal levels accordingly.

“It is important to view the two kinds of cholesterol separately,” Dr. Bajaj explains. “HDL cholesterol has a protective effect on your heart and helps reduce the amount of bad cholesterol in your system. LDL cholesterol is known for clogging arteries, so this is the one you and your doctor need to watch.”

Understanding blood pressure

Blood pressure measures the force of blood pushing against artery walls. The first number measures pressure when the heart beats; the second measures pressure when the heart rests between beats.

Just as too much air pressure can damage a balloon, consistently high blood pressure can damage your arteries. It can also cause your heart to work harder than it should, which can lead to an enlarged heart or (417) 630-8380.

Understanding cholesterol

Cholesterol is a fat-like substance circulating in your blood. Much of your cholesterol is made in your liver, but some comes from food, especially dairy products, eggs, and meat. Your body needs some cholesterol to function properly, but too much can be dangerous.

“Having a diet that’s high in fat or sugar will rev up your body’s production of cholesterol,” Dr. Bajaj explains. “Sugar is dangerous because it causes your body to make triglycerides, which increase the bad cholesterol and decrease the good cholesterol.”

Change for the better

High blood pressure and cholesterol are caused by many factors – some you can control and some you cannot. You can usually improve your blood pressure and cholesterol by eating a healthy diet, which includes lots of fruits and vegetables, lean proteins, low-fat or fat free dairy products and whole grains. It also helps to maintain a healthy weight, 775-348-4109, and limit salt and alcohol consumption. For tips on menus, visit 681-539-6195.

Also, if you smoke, quit. “You can have the best diet in the world and get regular exercise, but if you smoke cigarettes, it greatly increases your risk for a heart attack or stroke,” Dr. Bajaj continues. “If you do nothing else, quitting smoking is one of the most important things you can do to prevent heart disease.”

When lifestyle changes are not enough to achieve the desired results, physicians typically prescribe medication. If you need help with lifestyle changes, Kaiser Permanente Colorado has many classes and programs to help you take control of your cholesterol, diabetes and other conditions that can lead to heart disease. It also offers classes to help you (810) 234-5424.

To learn more about controlling blood pressure and cholesterol, visit 312-434-5995.

Dr. Bajaj received her medical degree from the University of Colorado Health Sciences Center and also completed her internship and residency there. She is board certified in internal medicine.

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Staying fit with baby-on-board

No excuses! How to stay fit with baby on board.

Staying fit with baby-on-board

From biking and hiking to walking and jogging, today's parents are keeping fit and bonding with their babies in the process. With an array of products unheard of a generation ago - like baby carriers, joggers and trailers - even the youngest family members are enjoying the great outdoors. But while these items can make life easier and more enjoyable for both parent and child, they can be the cause of pain and injury if not used properly.

If you and your family are going to be out enjoying the milder weather this autumn, here are a few tips to keep you moving in good form.



If you’re heading out for a run and want to bring your child along for the ride, the baby jogger is your best option. A baby jogger is a rolling pushcart that a parent can jog behind, using handlebars to maneuver.

Here are some rules of thumb to consider:

  • Make sure the handlebars of the jogger are both large and adjustable, so that they fit comfortably into your hands for complete control.
  • Hand-brakes and a locking mechanism are a necessity.
  • Look for a jogger with a good shoulder harness to keep the child secure.
  • Large, bicycle-style tires offer more control and stability.
  • Jog only on smooth surfaces such as sidewalks or well-groomed trails.


Backpack-Style and Front-Side Baby Carriers?

For parents who prefer walking or hiking with their little ones, a backpack-style or front-side baby carrier could be for you. A front-side carrier is better for a very young child as it allows the parent to better control the infant’s head position.

Here are a few other tips to consider:

  • A backpack-style or front-side carrier decreases the parent's stability when walking or hiking. It is a good idea to work on some balance exercises to train ahead of time.
  • If using a backpack-style or front-side baby carrier, make sure to select one with wide straps for your shoulders and waist. This will help distribute the carrier's weight evenly and decrease muscle strain.
  • The carrier should include a harness to keep the child stable.


Take Care of Yourself

Finally, don't forget about your own health and comfort. When lifting a child to place him or her into a trailer or jogger, exercise caution. Don't bend from the waist, but begin in a squatting position and implement a two-stage lift that consists of pulling the child up to your chest and then lifting straight up with your legs – not your back. Always try to avoid excessive stretching or twisting as the further the child is from your body, the more strain you will place on your spine and musculoskeletal system.


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Do you suffer from food allergies? Kaiser Permanente Colorado’s Meghan Dukes, DC, MSPT, provides some fun and healthy alternatives that taste great too!

Enjoying the Alternatives

It seems everywhere you turn these days there is another ailment caused by the foods we eat. From dairy to gluten to the simplicity of peanuts, it's sometimes hard to keep track of, and even harder to figure out great options for alternatives meals and recipes.  Luckily the experts are stepping in to provide a host of great options for you to try.
Join us this month as we share a few fun and healthy alternatives for those who have gluten and/or dairy intolerances. You'll be amazed at how wonderful these dishes taste. They are perfect for those with food allergies!
May 1st: Sundried Tomato Cashew Cream "Cheese"
May 8th: Zucchini "Pasta" with Avocado Cream Sauce
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Learn how to feel (and look) younger with strength training from Kaiser Permanente Colorado’s board-certified obstetrician/gynecologist, Sally Berga, MD and Senior Wellness Consultant, Andrea Groth, MS.

Feel (and look) younger with strength training

It’s said that 40 is the new 30. But you also hear “it’s all downhill” after 40. So, which is it?

Would you believe, both?

Regular exercise can help you look younger and feel better as you age, but once you hit the big 4-0, you start to lose muscle mass and your metabolism begins to slow down.

“As women age, weight-bearing exercise helps to prevent osteoporosis and research shows that regular activity can help ward off other diseases like breast cancer, heart disease, and diabetes” says Sally Berga, MD, a board-certified obstretrician/gynecologist with Kaiser Permanente Colorado.

For the past four years, this 54-year-old physician and mother of three children has dedicated six hours per week to strength training and cardio. After a 10-minute warm up on the bike, Dr. Berga hits the weights with her trainer. “If life gets crazy, I will make time for exercise—whether it’s 6 a.m. or 9 p.m. —with my patient schedule you never know. I find time to take a spin class or hop on my eliptical machine,” she adds. Dr. Berga recommends that people find exercise outlets they love and weave them into their schedules.

For the 40-plus crowd, the adage “use it or lose it” is true. “You will still lose muscle as you age, but you’ll lose less if you strength train,” says Andrea Groth, MS, Kaiser Permanente prevention specialist. Here’s an over-40 fitness guide.

In addition to preserving muscle mass, strength training also plays a role in maintaining connective tissue. “Over time, your connective tissues weaken. Strength training keeps those tissues as strong as possible and reduces injury risk,” Groth says. For example, regularly incorporating squats into your routine will keep your tendons and other connective tissues strong and resistant to injury.

“Core body strength helps with agility and balance,” Dr. Berga says. “Keeping your body strong and flexible will help prevent falls and common hip and wrist fractures as we age.”

Strength training may also help you meet weight goals. In the 7183676005 Kaiser Permanente is not responsible for the content or policies of external Internet sites., University of Pennsylvania researchers found that strength training twice a week helped obese and overweight women in their 20s, 30s, and 40s lose body fat, including abdominal fat.

Some common strength-training techniques include:

  • Yoga
  • Pilates
  • Weight lifting
  • Resistance bands and exercise balls
  • Push-ups, ab crunches, and squats

Ready to get started? Just keep these facts in mind.

You need rest. Rest is when your body recovers from the rigors of strength training. “It is one of the most overlooked pieces of a workout,” Groth says. “Rest is when your body rebuilds the muscle you’re asking it to build. It’s when the magic happens, so to speak.”

Groth recommends scheduling an off day tomorrow for whatever group of muscles you are working today. And if you’re combining strength and cardio training for a 10K run, for example, don’t be afraid to craft your own over-40 program. Your gym or popular running sites might recommend a training regimen, but you may need to dial it down to avoid fatigue.

Warm up and cool down. It’s especially important to warm up before any activity to prevent injury and stretch afterward to improve flexibility. “This is big as you age, especially if you neglected flexibility when you were younger,” Groth says. “When you get to be 40, your body simply says, ‘I’m sorry, that’s not an option.’”

Go slow. Some muscle soreness, especially if your body is responding to a new activity, is good. But if you’ve never strength trained, you’ll want to start slowly. For example, if your goal is to do three sets of 10 squats, start with one set of 10 at a weight that fatigues the muscle by the last repetition. Add a set every week until you get to three sets. “You can always add weight and add repetitions,” Groth says.

To help you start your fight against aging, follow these do’s and don’ts:


  • Read instructions for resistance bands, balls, and weight machines.
  • Stay hydrated. As you age, your sense of thirst declines.
  • Listen to your body. It will tell you when to stop.


  • Add too much weight too fast.
  • Focus on what you can’t do. If running has taken a toll on your knees, consider cycling or swimming.
  • Begin a strength-training regimen without talking to your doctor first.

Want to see proper strength-training techniques? Visit KaiserPermanente.org/fitness. Scroll down to Three’s Company and follow the strength training links. For additional healthy-living tips, visit untrolled.

Dr. Berga received her medical degree and PhD in molecular biology from the University of Colorado Health Sciences Center, and performed her residency at Exempla St. Joseph Hospital.

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