Taking Care of New Moms

No matter their ages, people often look to their mothers (and fathers, too!) for guidance and support. But moms – especially new ones – are in need of the same thing. In honor of the recent Mother’s Day holiday, GBMC would like to share some important information from its “Guide to Postpartum Recovery and Newborn Care” to help women who have recently delivered a child.

• Try not to lift, push or pull anything heavier than a baby in a car seat for the first two to four weeks after giving birth.
• Expect some cramping after birth as the uterus goes back to its normal size and position. If they become very strong, call your doctor. You can use Tylenol®, Motrin® or any medications your doctor prescribed for cramping.
• Rest often throughout the day, especially when the baby is sleeping.
• Try to avoid sitting in one position for more than one hour or standing for long periods of time.
• Call your doctor if you experience severe depression or depression that lasts more than three days! It is not uncommon, however, to have a day or two of depression after your baby is born due to the sudden change of hormones in your body and the demands of motherhood.
• Drink at least eight to 10 glasses of fluid daily. Have a glass of water, juice or low-fat milk each time you feed your baby.
• Eat a healthy, well-balanced diet that includes lean meats, poultry, fish, fresh fruit or juice, fresh vegetables and dairy products. If you breastfeed, you will burn about 300 calories per day, which will help you return to your pre-pregnancy weight.
• If you had a cesarean section, keep the incision clean and dry. You may use the cool setting of a hair dryer after showering to dry the incision. If you notice any redness, discharge or increased tenderness of the incision, call your doctor.
• If you are breastfeeding, it is normal not to have a period for several months or longer. If you do not have a period six weeks after you stop breastfeeding, call your doctor.

The full “Guide to Postpartum Recovery and Newborn Care” is available for download from GBMC’s website. Additional information about Maternal Newborn Health Services can be found at: www.gbmc.org/women. 

May is National Stroke Awareness Month

As National Stroke Awareness Month, May is the perfect time for everyone to reflect on what they know about stroke. Stroke is the fourth leading cause of death in the United States and the leading cause of adult disability. A stroke, or “brain attack,” can occur if a blood vessel leading to the brain either is blocked by a blood clot (ischemic stroke) or bursts (hemorrhagic stroke). A transient ischemic attack (TIA) is a "warning sign” of stroke. Although a TIA does not result in permanent damage, it is a medical emergency. A person experiencing a TIA should get to a hospital immediately to identify why the TIA occurred and get treatment. Immediate treatment can significantly reduce the risk of stroke in the future.

The National Stroke Association recommends using the “FAST” acronym to quickly recognize stroke symptoms in others and get help:

• FACE: Ask the person to smile. Does one side of the face droop?
• ARMS: Ask the person to raise both arms. Does one arm drift downward?
• SPEECH: Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?
• TIME: If you observe any of these signs (independently or together), call 9-1-1.

If you think you or someone around you is having a stroke, call 9-1-1 immediately! Time is of the essence. Prompt medical treatment may reduce damage to the brain and improve the outcome!

The most common signs and symptoms of stroke include:

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
• Sudden confusion, trouble speaking or understanding.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, loss of balance or coordination.
• Sudden, severe headache.

According to the National Stroke Association, a number of controllable and uncontrollable factors can increase stroke risk. Controllable risk factors include high blood pressure, atrial fibrillation, high cholesterol, diabetes, atherosclerosis, circulation problems (such as peripheral vascular disease), tobacco use and smoking, alcohol use, physical inactivity and obesity. Risk factors you cannot control are age (being over 55), gender (being male), race (African American, Hispanic or Asian/Pacific Islander) family history of stroke, personal history of stroke or TIA, Fibromuscular Dysplasia or other diseases of the arteries or Patent Foramen Ovale (hole in the heart).

Some risk factors may be out of your control, but being aware of your risk will help you better understand the warning signs of stroke and get help faster. If your risks fall in the “controllable” category, making healthy lifestyle changes and focusing on diet and exercise can greatly decrease your risk. If you have concerns about your stroke risk, feel free to openly discuss them with your primary care physician.

To learn more about stroke, visit www.gbmc.org/stroke.

Bug Bites and Stings – When to Seek Medical Help

As the weather starts to warm up, many people enjoy spending more time outdoors; trips to the pool or playground, cookouts and gardening are all fun outside activities for children and adults. Unfortunately, insects also tend to like the warmer temperatures, which leads to an increased chance of people being bitten or stung during the spring and summer months. Not all bugs are harmful, but some, like ticks and mosquitoes, can carry disease. Others, like bees and wasps, have venom in their stingers that may cause severe allergic reactions.

Most bites and stings can be treated at home with soap and water to keep the area clean and ice to reduce swelling. Over-the-counter products (both oral and topical) may offer additional relief from pain and itching. How do you know if medical attention is needed? Watch for the following symptoms:

• Worsening of redness/soreness, or development of fever. These may signal that the bite or sting has become infected. Your primary care physician may prescribe an antibiotic to treat the infection.
• Fever, headache, fatigue and a circular “bull’s-eye” red patch on the skin. These are symptoms of Lyme disease, which is spread by the bite of an infected tick. The good news is that early treatment with antibiotics usually results in a quick recovery.
• Fever, nausea, vomiting, severe headache, muscle pain, lack of appetite and red, spotted rash that appears six or more days after initial symptoms begin. All are signs of Rocky Mountain spotted fever, which is also treated with antibiotics. Some people may not develop the characteristic rash, however.
• Flu-like fever, headache, body aches and skin rash. These may indicate possible infection with West Nile virus. While West Nile can be fatal in severe cases, most people have mild disease and recover on their own.
• Sneezing, hives, nausea, vomiting, diarrhea, dizziness, difficulty breathing, chest tightness, and itching/swelling of the eyes, lips, or other areas of the face within seconds or minutes of a bite/sting. Symptoms like these indicate anaphylaxis, a severe, life-threatening allergic reaction. This is a medical emergency that warrants calling 9-1-1 immediately.

To help prevent bugs from biting and stinging in the first place, use an insect repellent that has an EPA registration number on the label. This means it has been evaluated to ensure that it won’t have unreasonable harmful effects on people and the environment. You can also:

• Avoid wearing perfumes, scented soaps or lotions.
• Cover food and drinks when you dine outdoors.
• Try not to wear bright colors, which can attract bees.
• Eliminate sources of standing water on your property (mosquitoes use standing water as a breeding ground).

Under Control: New Procedure Frees Patient from Incontinence

It took about 40 years for Josephine Shearn, 71, to declare independence from an uncomfortable condition that had been controlling her life. Like many who suffer from it, she was uneasy talking about fecal incontinence.

The Medtronic InterStim II
neurostimulator

Mrs. Shearn began having bowel control problems after having rectal surgery due to an anal fistula. During the surgery, one of the rectal muscles was damaged which resulted in improper bowel function. “It took many difficult years for anyone to realize that was the root of the problem,” she explains. As a minister, Mrs. Shearn often speaks in front of groups of people, attends banquets and travels from place to place to go to conferences. “This issue profoundly disrupted my lifestyle, making me extremely conscious about what I ate and affecting my self-confidence, but I kept it as secret as possible.”

After seeing several doctors who were unable to help, she was referred to George Apostolides, MD, FACS, FASCRS, GBMC’s Chief of Colorectal Surgery. Because Mrs. Shearn’s condition did not respond to conservative measures like dietary changes, Dr. Apostolides suggested a new option—InterStim® Therapy for bowel control. “InterStim works like a pacemaker,” explains Dr. Apostolides. “Wire leads are implanted under the skin and connected to a small battery device. The device uses gentle electrical pulses to stimulate the nerves that control the anal sphincter and neck of the bladder, improving function and alleviating incontinence symptoms.”


The first portion of the two-phase procedure allows the patient and surgeon to determine the best placement of the wires, over a two-week testing period. During phase two, the temporary wires are replaced with permanent ones, connected to a small battery under the skin. Usually, patients require a simple procedure approximately every five years to replace the battery.

A diagram illustrating the
placement of the stimulator
within the body

Since she had the surgery in October 2012, Mrs. Shearn has experienced a complete turnaround. “I can eat the foods I want without having to be prepared for accidents. I can travel without pain or fear and live without worry now. I am very thankful for Dr. Apostolides, who put all those problems at bay.”

Dr. Apostolides stresses that fecal incontinence happens for a variety of reasons and not all patients need surgery. “We start with the most conservative approach possible, which includes a period of dietary management in conjunction with stool softeners or other medications that help slow down bowel activity. If that is not effective, other treatments are available, including a simple office procedure to inject bulking agents into the anal canal to make the sphincter muscles tighter. If that or the slightly more invasive InterStim are not options, a more complex surgical repair may be necessary. “The most important thing for patients to know is that they don’t have to suffer in silence. We can offer many alternatives that will improve quality of life,” he says.

Health Nut Blueberry Muffins

Ingredients

• 3/4 cup all-purpose flour
• 3/4 cup whole wheat flour
• 3/4 cup white sugar
• 1/4 cup oat bran
• 1/4 cup quick-cooking oats
• 1/4 cup wheat germ
• 1 teaspoon baking powder
• 1 teaspoon baking soda
• 1/4 teaspoon salt
• 1 cup blueberries
• 1/2 cup chopped walnuts
• 1 banana, mashed
• 1 cup buttermilk
• 1 egg
• 1 tablespoon vegetable oil
• 1 teaspoon vanilla extract

Directions

1. Preheat the oven to 350 F. Grease a 12-cup muffin pan, or line with paper muffin cups.
2. In a large bowl, stir together the all-purpose flour, whole wheat flour, sugar, oat bran, quick-cooking oats, wheat germ, baking powder, baking soda and salt. Gently stir in the blueberries and walnuts. In a separate bowl, mix together the mashed banana, buttermilk, egg, oil and vanilla. Pour the wet ingredients into the dry, and mix just until blended. Spoon into muffin cups, filling all the way to the top.
3. Bake for 15 to 18 minutes in the preheated oven, or until the tops of the muffins spring back when lightly touched.

Yield: 12 muffins

Nutrition:

Calories: 196
Carbohydrates: 33.4g
Cholesterol: 18mg
Fat: 5.8g
Fiber: 2.8g
Protein: 5.1g
Sodium: 223mg

Recipe by Allrecipes.com