Know Your Nerves

Know Your Nerves

Know Your Nerves

Approximately 20 million Americans have some type of peripheral neuropathy, a condition that can often be prevented and managed.

Tingling, numbness, muscle weakness — when these symptoms occur in the foot, they’re often signs of one of more than 100 nerve disorders called neuropathy.

Damage to the peripheral nervous system typically begins in the nerves farthest from the brain and spinal cord. One of the most common causes of neuropathy is uncontrolled diabetes. Other factors that increase the risk for neuropathy include:

  • Alcohol abuse
  • Smoking cigarettes
  • Nutritional deficiency in B1, B12 or iron
  • Autoimmune diseases such as rheumatoid arthritis or lupus

Take Care

It’s possible to have neuropathy from diabetes without symptoms or with subtle signs that only a health care professional might notice. Numbness caused by neuropathy may make it difficult to notice cuts or swelling on the feet without routinely checking for them.

For this reason, doctors often tell patients with diabetes to do daily foot exams or, if they can’t, have a primary care provider or podiatrist do them. Unmanaged peripheral neuropathy can spread to the legs, arms and hands.

Nicole Everman, MD“Adopting healthier lifestyle habits, such as maintaining optimal weight, exercising daily and eating a balanced diet, can reduce effects of neuropathy,” said Nicole Everman, MD, neurologist with KentuckyOne Health Neurology Associates. “Physical and occupational therapy are also important when treating peripheral neuropathy because they help improve balance and motor strength.”

Other treatment options include oral medications for nerve pain and topical treatments such as capsaicin cream and lidocaine patches. An early diagnosis of neuropathy can help prevent further nerve damage, so people with symptoms should seek medical care.

Keep Your feet in Check

Most of us have heard the saying “an ounce of prevention is worth a pound of cure.” This is especially true when it comes to diabetic neuropathy.

“Studies have shown that those with diabetes can reduce the risk of experiencing nerve damage by keeping blood sugar levels close to normal,” said Dr. Everman. “Peripheral neuropathy can also be a result of vitamin A, vitamin E and vitamin B1 deficiencies, so eat more fruits, vegetables and whole grains.”

Other prevention methods include:

  • Wearing well-fitted shoes
  • Inspecting your feet daily for any redness, swelling or wounds
  • Visiting your primary care physician or a podiatrist regularly

This story originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.

Not only do primary care doctors specialize in diagnosing and managing a wide range of health issues, they also teach you about prevention and wellness.  If you don’t have a primary care provider, find one near you today. To speak with someone about peripheral neuropathy, call KentuckyOne Health Neurology Associates at 859.263.8807.

Farm Safety Tips for Your Hands

Farm Safety Tips for Your Hands

Farm Safety Tips for Your Hands

It’s hard to imagine life without the benefits of powerful farm equipment, but farm implements also pose dangers to the people who use them. Each year in the United States farming is ranked as one of the most dangerous professions, with many farming accidents involving the upper extremities.

Jewish Hospital Hand Care Center offers the following safety guidelines to help keep you, your family and employees safe while working with farm equipment.

Farm Equipment Safety

  • Know the proper use, and limitations of your equipment. If you do not have instructions, contact the manufacturer.
  • Match tractors with equipment of same power and speed levels to prevent machine failure and possible serious injury.
  • Use heavy-duty equipment for heavy-duty jobs.
  • Do not modify or remove safety features such as kill switches, roll bars or control bars. Use safety features and heed the manufacturer’s warnings!
  • Use runners and chain guards on mowers.
  • Keep power transmission shafts covered and shield power takeoff shafts properly.
  • Disengage or unplug all power takeoffs, blades, cutterbars, crimper rolls or other moving parts before handling equipment.
  • Do not use hands to clear jammed equipment.
  • Keep hands and feet clear of moving parts.
  • Inspect controls and parts for loose nuts and bolts before each use.

General Farm Safety

  • Avoid working alone. Use “the buddy system.” Your buddy should know safe usage of equipment and will be able to get help immediately in case of an accident.
  • Never allow children to operate equipment, ride double or play or work nearby. Children may be hit by flying debris or dragged into moving parts. They are not strong or knowledgeable enough to handle equipment properly.
  • Avoid loose or baggy clothing. Clothing can be dragged into machinery.
  • Be vigilant of area and terrain. Stumps, rocks, and hidden debris can cause overturns, and low tree limbs can knock an operator off a tractor.
  • Inspect banks and slopes for stability. On steep slopes, plan path of travel downhill. Never take shortcuts!
  • Report any skin conditions to your physician. Farm soil contains many pathogens conducive to serious infection. Use chemical-resistant work gloves to prevent burns and infection.

To learn more about the Jewish Hospital Hand Care Center, please contact 502.587.4799 or 502.561.4263. For additional information on hand care emergencies, call 502.540.3727.

Caring for Your Feet

Caring for Your Feet

Your feet do a lot for you. Make sure you do right by them.

You depend on your feet to take you everywhere you need to go. It’s no surprise, then, that they may need some maintenance to feel their best.

Dr. Tim Ford“Some of the problems we see, such as bunions and hammertoes, develop due to hereditary factors and the shoes you wear,” said Tim Ford, DPM, FCFAS, podiatric surgeon and director of KentuckyOne Health’s Podiatric Residency Program. “Others, such as diabetes-related wounds, can be prevented with proper medical care and watchfulness. We can help diagnose foot problems and guide patients to relief.”

Some of the most common problems Dr. Ford and his colleagues address include:

  • Bunion — A large bump on the side of the big toe that occurs in certain foot types. Symptoms include pain, redness, inflammation and numbness.
  • Hammertoe — Typically starts out as mild bending of one or both joints in your toes (not the big toe). Hammertoe is often aggravated by poorly fitting shoes.
  • Plantar fasciitis — Inflammation of the band connecting your heel to the base of your toes that often causes heel pain. According to Dr. Ford, people with a high arch or flat foot are especially prone to plantar fasciitis.

Dr. Ford and the podiatry team also help patients with traumatic foot and ankle injuries, which include broken bones, lacerations and even injuries sustained from lawn mowers or other equipment. Treatments provided by the practice range from medication, bracing and other conservative therapies to surgical procedures for bunions and even total ankle replacement.

Wound care management for foot and the lower leg/ankle is an integral part of podiatry care at the new Wound Care Center at Jewish Hospital, part of KentuckyOne Health.

Knowledge Is Prevention

 

It’s important to stay familiar with your feet. Inspect them regularly. That way, you’ll notice quickly if something is wrong.

This is particularly important for individuals with diabetes, who, due to diabetic nerve damage, may not feel pain from slow-healing wounds. Don’t wait to see your doctor if you have any concerns. Podiatrists can help with discomfort and possibly even save your feet.

High Heel How-to

 

High heels are stylish, professional and just plain fun — but if you wear them too often, they could damage your feet. Their instability makes it easier to turn your ankle, which could cause a sprain or fracture.

“If you stay in high heels too long, you also develop a tight (shortened) Achilles tendon, and it becomes difficult to get your foot flat to the ground,” said Dr. Ford. “Swap heels periodically for flat-soled shoes, and you should be OK.”

This article originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.

Are you experiencing foot pain? Don’t wait to get help. View our Provider Directory to find a podiatrist near you. 

Bringing Cancer Treatment Home

Bringing Cancer Treatment Home

Bringing Cancer Treatment Home

Oral chemotherapy can make cancer treatment a little easier.

A cancer diagnosis is never convenient, and traveling to and from the hospital to receive intravenous chemotherapy treatments can be a real drain on patients’ time and morale. Now, for certain patients, KentuckyOne Health offers oral chemotherapy — a treatment option that frees patients from long sessions of infusion therapy.

“Like traditional chemotherapy, oral chemotherapy is used to destroy cancer cells, but it does so through a pill you can swallow,” said Scott Pierce, MD, hematologist and oncologist at KentuckyOne Health. “Oral chemotherapy is considered just as effective as the traditional version and has the benefit of allowing patients to undergo treatment at home.”

Cancer patients who opt for oral chemotherapy also don’t have to deal with being hooked up to an IV, which is a necessary measure for traditional chemotherapy that can cause discomfort or anxiety for patients.

No Magic Pill

 

The ability to undergo treatment from the comfort of one’s home has turned oral chemotherapy into a very popular option. However, this method of treatment isn’t without its drawbacks, including:

  • Strict instructions. The burden of remembering how and when to take oral chemotherapy falls squarely on the shoulders of the patient. Patients must also remember to avoid certain foods, drinks, vitamins and supplements when taking the medication.
  • Pricey pills. Oral chemotherapy can be expensive and isn’t always covered by insurance plans. Because of this, it’s important for people to check with their medical insurance before choosing this line of treatment.
  • Same old symptoms. The side effects of oral chemotherapy are comparable to those of traditional chemotherapy. Fatigue, weakness, nausea, vomiting, appetite loss, diarrhea, weight loss, hair loss, bleeding gums, skin changes, low blood count, loss of menstrual periods and compromised immune system are all possible.

“Oral chemotherapy may be used alone or in combination with radiation therapy, surgery or immunotherapy,” Dr. Pierce said. “Talk with your physician to see if oral chemotherapy might be an option for your type of cancer.”

Handle with Care

 

As with most prescription medications, it’s extremely important to follow your physician’s directions when embarking on an oral chemotherapy treatment program.

Certain oral chemotherapy drugs are hazardous. Follow your doctor’s instructions for handling hazardous medications with care, which may mean wearing safety gloves, storing pills in a certain location or packaging, and being extra cautious about the other medications or supplements you take, even if they come over-the-counter.

This article originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.

Spine Surgery’s New Side

Spine Surgery's New Side

Spine Surgery's New Side

By approaching spine surgery from a different angle, surgeons help patients recover faster.

The disks that give the spine its flexibility are remarkable structures, but they’re not immune to change. Over time, they can weaken and break. These changes may lead to conditions that cause pain or make the spine curve abnormally, such as spondylolisthesis or degenerative scoliosis.

Physical therapy, medication and steroid injections help many patients find relief from disk-related back and leg pain, but others run the gamut of conservative treatments without success. For them, spinal fusion surgery to remove the deteriorated disk and shore up the spinal column is an option — and now, a minimally invasive one.

Splitting the Difference

 

Saint Joseph East, part of KentuckyOne Health, now offers eXtreme Lateral Interbody Fusion (XLIF®), a procedure that uses a 2-inch incision in patients’ left side rather than a larger one in the back.

James Rice, MD“Entering through the side allows us to split muscles instead of cutting them, as is usually done in a traditional fusion performed from the back, so patients experience less pain,” said James Rice, MD, a fellowship-trained spine surgeon at Kentucky Orthopedic Associates and Saint Joseph East. “Once we get to the spine, we remove the damaged disk and replace it with an implant containing bone substitute. The implant will support the spine while bone grows over the area to join the vertebrae. We may use screws or plates to hold the implant in place while fusion occurs.”

Patients typically spend at least one night in the hospital after XLIF, a shorter stay than with traditional spinal fusion. XLIF leaves patients with a smaller scar and allows them to regain mobility and recover faster. Patients can walk and drive short distances soon after surgery but should avoid heavy lifting and repetitive motion short term, according to Dr. Rice.

“When it comes to lower back fusions, individuals who opt to have XLIF are some of my happiest patients,” Dr. Rice said. “They have outstanding results compared with patients who have traditional fusions.”

Part of what makes eXtreme Lateral Interbody Fusion a safe, precise procedure is NVM5®, an electronic intraoperative monitoring system. NVM5 is like a high-tech road map for the surgeon. The system updates the surgeon in real time about the location and function of nerves — important information that helps reduce injury.

This article originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.

If you are suffering from a bone or joint disorder or a sports related injury, an orthopedic specialist can help you get back on your feet. Find a provider near you today

Fuzzy, Feel-good Therapy

Fuzzy, Feel-good Therapy

Fuzzy, Feel-good Therapy

Dogs specially trained to provide patients with inspiration and love are key players in the healing process at several KentuckyOne Health facilities.

There’s nothing like a wet nose and kind eyes to warm the heart and revive the spirit. But animals can offer more than companionship. Pets who have been specially trained to provide certain types of support to individuals facing health challenges can help people recover.

The canine companions at Frazier Rehab Institute, part of KentuckyOne Health, are certified to deliver Animal Assisted Therapy services, and dogs at the Saint Joseph Cancer Center, Saint Joseph Hospital, Saint Joseph East and Saint Joseph East Cancer Center, all part of KentuckyOne Health, socialize with patients and visitors, helping keep smiles on their faces even when they’re dealing with medical concerns.

“Interacting with pets is soothing to many people,” said Jamine Hamner, director of Volunteer Services with KentuckyOne Health. “These animals can help lift spirits and calm people down when they are anxious. Our patients’ moods change when an animal is in the room — it’s amazing to see.”

A Tradition of Wagging Tails

 

Dogs began visiting patients at the Frazier Rehab Institute more than 15 years ago as part of a Pet Therapy Visitation program. Volunteer pet owners and certified therapy dogs visited patients on a weekly basis. The visits were a hit, and the staff decided to add a dog to the team permanently to interact with patients and families, as well as be involved in therapy interventions.

“Animal Assisted Therapy is a goal-directed program in which specially trained animals are an integral part of the treatment process,” said Jill Farmer, CTRS, manager of recreation therapy and adapted sports programs with Frazier Rehab Institute. “The therapy promotes improved physical, social, emotional and cognitive function. We saw real value in officially making dogs part of the work we do.”

Watch the video to hear Jill Farmer, CTRS discuss Animal Assisted Therapy and Animal Assisted Activity.

 

A dog named Madison was the first four-legged staffer to join the KentuckyOne Health canine collaboration in 2006. The Paws with Purpose Organization placed her with the Frazier Rehab Institute, where she served solo until 2014, when she was joined by another facility dog named Charlie.

A breeder in Deer Park, Washington, donated Charlie to Frazier Rehab Institute. Like Madison, he was trained as a service animal. In December 2016, thanks to donations to the Jewish Hospital & St. Mary’s Foundation, Frazier Rehab Institute welcomed a new therapy dog named Stanley.

These three four-legged pioneers forged ahead on a mission to help patients facing a variety of conditions, including working with patients who have had a:

  • Stroke — The facility dogs help encourage individuals to talk, walk, or use an affected arm or leg for grooming or petting.
  • Traumatic brain injury — Trained facility dogs can help improve a patient’s communication and thinking skills. For example, a therapist may ask the individual to identify or recall the dog’s age, color and name or to complete basic tasks, such as petting the dog.

The dogs can be especially helpful in pediatric cases, encouraging children to crawl, stand or speak.

“The dogs can motivate individuals to continue working rather than giving up,” Farmer said. “And receiving a service animal for personal use once they have been discharged home can open up a world of independence for a person. The animal can help with opening doors, pulling off shoes and socks, and retrieving dropped items.”

Patients need an order from a physician to work with a facility therapy animal. If a patient has a compromised immune system, this kind of treatment may not be recommended.

Helpful Volunteers

 

Dogs who visit patients at Saint Joseph facilities serve a purpose that is a little less clinical than the dogs at Frazier Rehab Institute. But their work is just as important.

“These dogs are volunteers, and their human parents are volunteers,” Hamner said. “They show up at the hospital according to a self-determined schedule and then walk around to cheer people up as requested. It’s an awesome experience.”

Volunteer dogs who visit Saint Joseph facilities must already be trained therapy dogs. Pet owners may sign up to volunteer online, and when a dog has been approved, the owner can use the same online system to set up visits. These dogs receive special therapy badges, clock in when they are ready for work and visit patients in need of furry companionship.

Partners in Puppy Love

 

KentuckyOne Health partners with community organizations Paws with Purpose, Pet Partners for Independence, Wonderful Animals Giving Support (WAGS), Central Kentucky Love on a Leash and Alliance of Therapy Dogs.

Paws with Purpose puppies in training visit Frazier Rehab Institute patients on the weekends. Pet Partners for Independence offers facility and therapy dog training. And volunteers with WAGS bring in trained therapy dogs to visit patients during the week.

Together, these organizations brighten the days and improve the health of patients.

Funding for the pet therapy program at Frazier Rehab Institute was provided by a generous gift from June and Stanley Atlas.

More Than Man’s Best Friend

 

While it can be tempting to pet and cuddle the doggy helpers, remember that facility dogs who are working as service animals have to keep their focus on their work when they are on the clock.

“Facility dogs like the ones at Frazier Rehab Institute are highly trained dogs who must go through a minimum two years of continuous training,” said Farmer. “They are not pets. They are allowed to be typical dogs when they are not at work but are required to follow specific commands when they are on the job.”

Charlie, a goldendoodleCharlie, a goldendoodle, celebrated his fifth birthday in April.

Teddy Stapleton, a cocker spanielTeddy Stapleton, a cocker spaniel, is one of the many therapy dogs helping KentuckyOne Health patients.

Stanley, a yellow Labrador retrieverStanley, a yellow Labrador retriever, joined the pet therapy program in 2016.

This article originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.

9 Tips to Keep Your Hands Safe

9 Tips to Keep Your Hands Safe

9 Tips to Keep Your Hands Safe

We use our hands so frequently that we rarely stop to consider how much they are exposed.

With hand injuries being a common cause for emergency room visits, Jewish Hospital Hand Care Center offers some helpful tips to keep injuries at bay.

  1. Use warm water and soap to keep hands clean.
  2. Carefully and routinely clean your fingernails. Clip your fingernails regularly and file any rough edges. Never bite or chew your fingernails.
  3. Wear protective gloves when cleaning with harmful chemicals.
  4. Keep a fire extinguisher in the kitchen. Do not put water on a grease fire. Leave the flaming pan in place and put out the fire with an extinguisher.
  5. If a burn occurs, immediately place the injured area in cold water, then contact a doctor.
  6. Stay alert when using knives in the kitchen. Always cut away from hands.
  7. Trash cans and bags can lead to serious injury – your hands will inevitably find the dirty, sharp object your eye could not see.
  8. Be aware of what dishes have been placed in a dishwater; the blade of a sharp knife may lead to a cut.
  9. Refrain from slamming doors shut to prevent crushed fingers or hands.

Turkey Chipotle Chili [Recipe]

Turkey Chipotle Chili [Recipe]

Chipotle Turkey Chili Recipe

Chili is a cold weather staple. Give this seasonal favorite a spicy, nutritious makeover with this diabetes-friendly recipe.

Ingredients

 

  • 2 cups chopped onions
  • 3/4 cup chopped green pepper
  • 1/2 cup fresh or frozen whole-kernel corn
  • 2 Tbsp minced garlic
  • 2 Tbsp olive oil
  • 2 Tbsp finely chopped, canned chipotle chili peppers in adobo sauce
  • 1 Tbsp tomato paste
  • 1 Tbsp chili powder
  • 1 Tbsp dried oregano, crushed
  • 2 Tbsp ground cumin
  • 1 tsp ground coriander
  • 4 cups low-sodium chicken broth
  • 3 cups chopped or shredded roasted turkey breast
  • 1 15-ounce can no-salt-added diced tomatoes, undrained
  • 1 15-ounce can no-salt-added tomato sauce
  • 1 15-ounce can no-salt-added black beans, rinsed and drained
  • 1/4 cup finely snipped, fresh cilantro
  • 1/4 cup chopped green onions
  • 2 Tbsp lime juice
  • 6 Tbsp plain Greek yogurt

Directions

 

In a 4-quart Dutch oven, cook onions, green pepper, corn and garlic in hot olive oil for 5 minutes or until vegetables are tender. Stir in chili peppers and tomato paste. Cook an additional minute.

Stir in chili powder, oregano, cumin and coriander. Then add broth, turkey, diced tomatoes, tomato sauce and black beans. Bring to a boil, and reduce heat to medium-low. Simmer, covered, for 20 minutes.

Stir in cilantro, green onions and lime juice. Simmer, uncovered for 2 more minutes. Top each bowl with a tablespoon of yogurt.

Nutritional Information

 

Makes 6 servings
338 calories
6 grams fat
34 grams carbohydrates
37 grams protein

This article originally appeared in the Fall 2016 edition of One Health Magazine. For more health news, wellness information and recipes likes this, sign up for your free subscription

Is Your Mammogram Doing Double Duty?

Is Your Mammogram Doing Double Duty?

Routine screenings for breast cancer can help identify calcium buildup — a sign of potentially serious coronary artery disease.

Calcium deposits can collect over time and block your coronary arteries, leading to heart attack and impaired heart function. These deposits are generally detected through coronary calcium scans — detailed imaging of the heart arteries. Now, researchers have found that women whose mammograms reveal calcium deposits in their breast tissue may benefit from talking with their doctors about their coronary artery health.

Research Reveals Link

In a 2016 study published by JACC: Cardiovascular Imaging, nearly 300 women were evaluated for calcium buildup in their hearts and breasts. Researchers found that seven out of 10 women with calcium buildup in their breast arteries also had calcium buildup in their hearts.

Dr. Brian Mattingly“Research is the first step to understanding the connection between breast artery calcification and coronary artery calcification,” said Brian Mattingly, MD, breast imaging radiologist with Medical Center Jewish East, part of KentuckyOne Health. “This could give us another tool for identifying coronary artery disease and helping patients who suffer from it.”

Next Steps

Risk factors for coronary artery calcification include advanced age, diabetes, hypertension, high cholesterol and a history of smoking. Coronary artery calcification can take years to develop and is often a symptom-free condition until it is advanced.

Mammogram results that include signs of breast calcium buildup can help start conversations about heart disease before the condition becomes serious. If calcium buildup is discovered, doctors can perform further screenings to determine if patients also have other known risks of heart disease, such as high cholesterol, or if the buildup is a symptom of more advanced coronary artery disease.

“Mammograms are already a useful tool and could prove even more beneficial once additional studies tell us more about their potential for identifying coronary artery disease,” Dr. Mattingly said. “We’re excited to see where this research leads and about carefully applying it to our patient population once more evidence and best practices are established.”

To schedule your digital mammogram today, find a location near you or call 502.587.4327.

This article originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.

Is It the Flu or Something More?

 

Is it the Flu or Something More?

Though the flu can often be treated at home without a visit to the physician’s office, more serious conditions can present flu-like symptoms or result from the virus unexpectedly.

Typically, a healthy person who contracts the flu virus can recover from the disease safely at home. Common symptoms of the flu include headaches, muscle pain, sore throat, coughing, runny nose, congestion, fatigue, fever and sweaty chills.

What to Watch For

 

In some cases, however, the flu does require the attention of a physician. If you think you have the flu and are trying to treat the illness at home, keep an eye out for symptoms such as a fever above 103 degrees Fahrenheit or that lasts longer than five days, severe earaches or chest pain, shortness of breath, lightheadedness, confusion, persistent vomiting, and coughing up colored phlegm. These symptoms may be the result of a new condition developing as a result of the flu, such as a sinus infection, ear infection or pneumonia.

In extreme situations, organ failure, sepsis, or inflammation of the heart, brain or muscle tissues can also result from the flu.

Risk Factors

 

Certain people should always contact the doctor if they have the flu, especially if they have a pre-existing or chronic condition. If you have asthma, heart disease, a neurological condition, or a disorder that affects your blood, immune system, liver or other organs, then you should schedule a visit with your physician as soon as possible after common flu symptoms present themselves.

Additionally, pregnant women, nursing home residents, children younger than age 5, adults older than age 65 and people with a body mass index greater than 40 should always contact their physician if they develop flu-like symptoms.

If you’re unsure whether or not your flu symptoms warrant a visit to the physician’s office, consider scheduling an appointment regardless to prevent further health complications.

Women, Don’t Let a Heart Attack Sneak Up on You

 

Occasionally, flu-like symptoms can precede a heart attack, especially for women. These symptoms can manifest days or weeks before the incident of a heart attack and are fairly mild. Sometimes, simple nausea may be the only warning that a heart attack is on its way.

If you feel strange or believe that your symptoms may be more than just the flu, don’t hesitate to contact your physician or head to an emergency room. Quick and early action is the best way to recover from — or prevent — a heart attack.

This article originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.

Anywhere CareWhen it’s not possible to see your primary care doctor, try Anywhere Care. Anywhere Care is a quick and convenient way to consult with a health care provider over the phone or by web camera 24/7 without leaving home. Request care online, download the app or call 855.356.8054.