Gundersen Magazine by Gundersen Health System

GUNDERSEN Y O U R G U I D E T O H E A LT H A N D W E L L N E S S

EMPTY NEST?

Fill it with activities and ‘you-time’ – p. 6

PROTECT YOUR CHILD

Don’t miss these important vaccines – p. 10

GOING GLUTEN-FREE

Necessary or not? – p. 12

FINDING HOPE “Hope” created the connection between Johnny and Alysta – p. 7

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Gundersen is published four times a year by Gundersen Health System. The information contained in the magazine is to educate consumers about various health subjects and is not intended to replace professional medical advice or service. Personal health concerns should be brought to the attention of your physician or health professional

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Pregnancy pains: What’s normal? What’s not? Pregnancy is an incredible experience. Nothing compares to the excitement and anticipation of what’s to come, but growing a baby is not always a walk in the park. “Physically, women experience many changes during pregnancy,” says nurse midwife Jennifer McGeorge, CNM, of Gundersen Health System. “Sometimes these changes are mild and insignificant. Other times they need to be addressed because, though normal, they cause significant discomfort.” Jennifer McGeorge, CNM nurse midwife

The good news is not all discomforts of pregnancy are experienced by all women, and many of the aches and pains can be managed. Jennifer recommends the following: Nausea and vomiting • Eat crackers or dry toast before getting out of bed. • Enjoy small, frequent meals. • Stay well hydrated. • Avoid triggers. • Stop taking prenatal vitamins until symptoms are under control. • Wear a Sea-Band® (or wrist band) that triggers an antinausea acupressure point. Swelling • Drink plenty of water. One gallon per day is recommended. • Elevate feet several times during the day. Back pain • Perform gentle stretches. • Take Tylenol or Ibuprofen (Ibuprofen is safe until 32 weeks gestation). • Use hot or cold compresses. • Use pillow supports between knees when sleeping. • See a chiropractor, physical therapist or massage therapist who has experience with pregnant women.

Round ligament pain (sharp pain in the lower belly or groin area) • Try position changes, such as lying to sitting or sitting to standing. • Bring your knees to your chest. • Use a heating pad or take a warm bath. Being uncomfortable in late pregnancy is normal, as a woman’s internal organs are crowded by the growing baby. However, there are some symptoms and occurrences that should not be ignored, says Jennifer. Contact your healthcare provider if you experience: • A fall or abdominal trauma • Sharp abdominal pain • New onset headache • Visual changes, such as floaters or double vision • New or worsening depression or anxiety • Shortness of breath • Decreased baby activity from what is normal • Contractions, five minutes apart and lasting a minute • Any contraction pattern that is concerning • Bleeding like the first or second day of your period • Leaking or gush of fluid “Always trust your body,” emphasizes Jennifer. “You are with your baby 24/7, and are your own expert in terms of what is going on with your body. If something doesn’t feel right, it is always best to call your doctor or nurse midwife.” For more tips on easing the discomforts of pregnancy, talk to your healthcare provider or visit gundersenhealth.org/pregnancy. YO U R G U I D E T O H E A LT H A N D W E L L N E S S | 2

For Winona couple, IVF results in amazing ‘Journee’ Peterson, BS, TS, ELD, Fertility Center embryologist and laboratory director. By using cryopreserved embryos in future IVF cycles, as the Kostners did, women do not have to go through egg production and recovery each time. This helps reduce discomfort, time and costs. According to Joy, “Use of cryopreserved embryos has a long proven track record with only a slightly decreased success rate compared to fresh embryos and no increased risks to the mother or baby.” “During cryopreservation, embryos are placed in special solutions that slowly remove water from the cells to limit formation of ice crystals which can damage or kill the cells. The embryos are then frozen and stored at an extremely low temperature. This suspends further development until they are thawed for later use,” Joy says.

Amy and Travis Kostner of Winona, Minn. with their children Journee and Berklee.

In 2012, we spotlighted the Kostner family of Winona, Minn. Amy and her husband Travis were the proud parents of Berklee, born Dec. 7, 2011. We shared their story because Berklee was the 100th baby born with assistance from the in vitro fertilization (IVF) program at Gundersen’s Fertility Center. Two years later, the Kostners welcomed daughter Journee to the family on Jan. 1, 2014. Like her brother, Journee was conceived through IVF. “This time, instead of repeating the entire IVF process, we were able to use a frozen embryo. It was a much easier process,” Amy explains. “At Gundersen, during an IVF cycle we generally transfer only one or two embryos back to a woman’s uterus. Sometimes there are more healthy embryos than are needed for immediate use. The remaining healthy embryos can be cryopreserved for future IVF cycles,” explains Joy 3 | G U N D E R S E N H E A LT H S Y S T E M

The thawing process also takes precision, patience and care to keep from damaging the embryos. Because of the care needed, few places offer the service. Gundersen’s Fertility Center has the cryopreservation technology, expertise and experience to freeze, store, thaw and transfer human embryos and sperm. IVF with fresh or frozen embryo transfer is just one of many options available for women seeking pregnancy. To learn more about all the services offered at the Gundersen Fertility Center, visit gundersenhealth.org/ fertility. The Kostners’ journey with Gundersen didn’t end with Amy’s pregnancy. During delivery, Journee suffered a skull fracture and internal bleeding and had to be flown from Winona to Gundersen’s Neonatal Intensive Care Unit in La Crosse. “Journee spent 18 days in the NICU where she received outstanding care. The NICU staff was amazing,” recalls Amy. “I believe Journee owes her life to Gundersen—twice.” Amy reports that Journee is doing great and will continue to be monitored through the NICU follow-up clinic until at least her 12-month checkup.

No slowing down for teenager with congenital heart disease This year, summer camp was a bittersweet experience for Kristen Meyers of La Crosse, Wis. Having just turned 17, this was her seventh and last summer as a camper at Camp Odayin in Crosslake, Minn.; a camp where she’s made many friends over the years. Camp Odayin is like many other summer camps with one notable difference—all the campers have heart problems. Although too old to be a camper, Kristen will train to be a camp counselor next summer. “Camp is a home away from home. It’s a place where I can re-connect with everyone,” Kristen says. “At camp no one stares at my scar, because we all have scars.” Kristen’s scar is from open heart surgery—the first time in 1997 at just 4 months old and again in 2009. Kristen was born with a heart condition called tetralogy of Fallot. It affects about 1 in 2,500 babies born in the United States. Specialty pediatric heart care Every six months Kristen sees Gundersen pediatric heart specialist Andrea Winters, PA-C. “We perform tests to be sure the heart valves are working well, there’s good heart pumping function and to check the electrical activity of her heart, looking for possible arrhythmia problems. Kristen continues to do great, with no medical restrictions,” reports Andrea. “She is strong, energetic and resilient.” Now a junior at Logan High School, Kristen is an active teenager who plays soccer, runs track, and recently traded her cheerleading pom poms for dance shoes. Chasing her goal of being a special education teacher, Kristen also works in school with kids with special needs. She also has a job and loves being outdoors, hiking, boating and spending time at the beach. Bright future Because of advances in treating heart disease in children, 90 percent now live to adulthood and are living longer, fuller lives. While Kristen will require ongoing specialty heart care, her long-term prognosis is very good.

Kristen Meyers of La Crosse, Wis., leads an active life despite being born with a heart condition.

According to Andrea, “Kristen is a mature young woman who is growing up very fast. She is doing beautifully and is poised to take on life.” Like camp, Kristen will face another transition in a few years. When pediatric heart patients reach their early 20s, they transition to Gundersen’s Adult Congenital Heart Disease Clinic. Staffed by Andrea and pediatric cardiologist Susan MacLellan-Tobert, MD, as well as two adult cardiologists, they collaborate to provide patients with continuity of care. “We encourage our heart patients, even those with no symptoms, to receive regular care,” says Andrea. “With congenital heart disease—even if it’s been successfully treated—there are greater risk for cardiovascular problems in adulthood. Our goal is to catch problems early.” To learn more about pediatric cardiology or the Adult Congenital Heart Disease Clinic at Gundersen visit gundersenhealth.org/heart. YO U R G U I D E T O H E A LT H A N D W E L L N E S S | 4

Get the facts about plastic surgery When you look in the mirror, is there something you’d like to change? Matthew Guzzo, MD, Gundersen plastic surgeon, debunks myths and answers some common questions he hears from prospective patients. Matthew Guzzo, MD Q: Will people think I’m vain if I Gundersen do this? plastic surgeon

This is really a personal decision. Most of us have things about ourselves we’d like to change, and we deal with those things in different ways. For example, if you gain weight, you might start exercising. If you’re unhappy with your hair, you might try a new cut or color. Plastic surgery is an option for addressing something you want to change. People are paying more attention to their bodies and their overall health these days, so plastic surgery is becoming more common and accepted. Q: Can I afford plastic surgery? Discussing cost is important because health insurance does not include coverage for cosmetic plastic surgery. That said, many services are more affordable than you might think. For example, beginner Botox®, one of our least expensive services, costs $325. Prices increase based on a procedure’s complexity. We also offer a payment plan that’s a great option for spreading costs over time. Q: Do men have plastic surgery? Yes, and it is gaining popularity. Typical services are Botox® for reducing wrinkles, injectable fillers for plumping out permanent facial creases and abdominal contouring. Q: Will I look significantly different if I have something done? Our goal is to provide you with an improved look, one where you appear refreshed and rejuvenated. That tends to provide the most rewarding result for patients. Q: What about my privacy? We are very aware of the need for patient confidentiality, especially in small communities like those in our area.

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Because your privacy is important to us, the Plastic Surgery Center offers a discrete entrance and confidential visits from the first consultation through postoperative care. Q: What is the first step if I want to learn more? It’s important to come in just to talk. You’ll meet with a board-certified plastic surgeon to discuss what you’d like to change, the options you can consider, risks and benefits of those options, and recovery time so you have a comfortable understanding of what’s involved. To meet with Dr. Guzzo or one of his colleagues, contact Gundersen Plastic Surgery and Aesthetics at (608) 7752376 or (800) 362-9567, ext. 52376. Or, to learn more about the services available, visit gundersenhealth. org/plastic-surgery.

Fill your empty nest with together time, projects The kids are gone. The house is quiet. There will be no sudden interruption. You stare deep into each other’s eyes and say …“OK, now what?” When your children leave the nest, it’s perfectly common for parents to feel Ethan Everett, PsyD out of sorts. After all, your kids have Gundersen been under your feet and under your therapist care for 18 years. The vacuum they leave in their wake as they head out the door needs to be filled. It’s something Gundersen Health System therapist Ethan Everett, PsyD, and his wife, Mary, are experiencing fully for the first time as their youngest daughter, Katira, recently left for college in Salt Lake City, Utah. “For the first time in 26 years, my wife and I will have the house to ourselves and we’re planning things that are not kid-centered. We are talking about taking a dance class together; I’ve wanted to learn how to weld for years. We don’t resent our focus on our kids but we’ve been doing that for 25-26 years and now there are more options.”

Here are some suggestions on how to process your own new-found freedom. Find your own identity. Parents often define themselves through their children. With your children gone, you can redefine yourselves as individuals. Rekindle your romance. Reconnect as a couple by planning for the future or going on a second honeymoon. Talk about yourselves as a couple, your shared interests and your changing roles. Do something. The transition is easier when parents put other activities in their lives. Anticipate your child’s departure and find interests long before he/ she leaves.

Dr. Ethan Everett and his wife, Mary, have many new activities planned as their youngest child moves off to college.

Develop a relationship with your child as an adult. Talk to your teenager about the future and collaborate on plans.

Let them make their own mistakes. Your way of doing things might be different from their way. Offer opinions and advice if asked, but let them solve the problem. For more information about adjusting to life in an “empty nest,” contact Gundersen Behavioral Health at (608) 775-2287.

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Pediatric cancer patients “Hope” created the connection between Johnny Brevik and Alysta King. Now they are members of the same club— cancer survivors! Following six months of intense chemotherapy, 10-year-old Alysta was given the most wonderful news—no evidence of Burkitt’s lymphoma. She could get back to being a kid again, but initially, “Alysta didn’t want to leave the hospital,” recalls her mother, Tara King. “I think we both cried. We became so close to everybody at Gundersen.” This is not a rare occurrence in the Pediatric Cancer & Blood Disorders department at Gundersen Health System. From the moment patients step through the door, they are surrounded by experienced staff who get to know them like family. “You can’t top the one-on-one attention. I would never go anywhere else,” says Tara.

Johnny Brevik is known for giving back to his community. At his annual Hope Lives Here fundraiser, an adorable Labrador puppy named “Hope” was auctioned off and given to 10-year-old Alysta King. “Hope” was just what Alysta needed amidst her cancer treatment and hospitalization at Gundersen Health System.

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Care that is comprehensive Gundersen offers full-service pediatric oncology care, meaning children and adolescents with any type of cancer can be treated. Specially trained pediatric cancer doctors and nurses work with experts in multiple areas to meet the needs of children and their families. The extended team includes: child life, social work, spiritual care, behavioral health, nutrition, music and pet therapy, and palliative care. There are cases when even young adults receive treatment by Gundersen’s Pediatric Cancer team. Take Johnny Brevik of La Crosse, for instance, who was diagnosed with acute lymphocytic leukemia at age 23. “I was immediately sold on the way Gundersen ran their pediatric clinic. The oncologists don’t work on rotations, so you see one doctor the whole way through,” says Johnny. “And, they’re literally available 24/7 to answer questions.”

find HOPE close to home Acute lymphocytic leukemia, the most common type of childhood leukemia, has a high cure rate in kids, according to Gundersen pediatric oncologist Robert Ettinger, MD. But, Johnny was at higher risk due to his age. “Dr. Bob [Ettinger] did a phenomenal job helping me understand the difference between the adult and children’s treatment protocols,” says Johnny, who opted for the aggressive pediatric regimen requiring more chemotherapy and radiation. “I didn’t care how hard it would be. I just wanted the cancer gone, and Dr. Bob was there to help me accomplish that.”

adolescent patients to statistically answer important clinical questions regarding the best therapies for these rare diseases. By combining patients from treatment centers across the nation, such as MD Anderson, St. Jude Children’s Research Hospital and Gundersen Health System, COG can answer these questions definitively.” Care that is life-changing Johnny and Alysta, and their families, are grateful for the care they received and the relationships they built at Gundersen. “So many nurses, child life specialists, pet therapy dogs, and of course, Dr. Bob, spend so much time with each patient. For Alysta, it helped to make every day happy and keep her mind off her illness. At one point, Alysta asked Dr. Bob if she could move in with him,” smiles Tara.

“I was immediately sold on the way Gundersen ran their pediatric clinic. The oncologists don’t work on rotations, so you see one doctor the whole way through. And, they’re literally available 24/7 to answer questions.”

Care that is cutting-edge When you’re spending days—sometimes weeks— in the hospital, there is no greater feeling than having your family and friends by your side. Fortunately, Gundersen’s model of care is focused on keeping children and their families close to home and within their support networks.

For patients living in rural communities, lab work can be done at their local Gundersen clinic, saving them the time and money of traveling to La Crosse. Care close to home is also possible due to local partnerships and nationwide research collaborations. For instance, Gundersen participates in the Children’s Oncology Group (COG), the world’s largest pediatric and adolescent cancer clinical trials organization, thanks to its partnership with the University of Wisconsin. For patients, this means receiving the latest and best treatments in the country. “The access to care is incredible when you’re being served by Gundersen,” says Johnny, who enrolled in a clinical trial for his treatment. “Many advances in the treatment of childhood cancer have resulted from clinical trials,” states Dr. Ettinger. “No single institution in America sees enough pediatric and

“I came out of this a very different person than when I went in,” shares Johnny who has become an advocate for young cancer patients in our community. Rather than celebrating victory over cancer with a party for himself, Johnny hosted a fundraiser called “Hope Lives Here.” The event was so successful in its first year—raising $47,000—that Johnny was able to transform a portion of Gundersen’s Pediatric Cancer Unit to better suit the needs of adolescents and young adults undergoing treatment. But, that was just part of his vision… Johnny and fellow cancer survivor Garrett Jerue have since started “Bump in the Road,” a peer mentoring program for adolescent cancer patients, as well as Hope Lives Foundation, a non-profit organization focused on preventing cancer and providing support to survivors. When children and young adults are faced with something as difficult as cancer, it’s good to know hope lives…right here in our community. Learn more at gundersenheatlh.org/kidscancer and hopelivesfoundation.org.

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A kick start to a new life: one woman’s fight against her weight Gale Bagstad of West Salem, Wis., used to think she was really shy. She now looks back and admits, “It wasn’t actually shyness; it was more embarrassment because of my size.”

“In addition to significant weight loss, our patients see dramatic improvement in health issues such as diabetes, high blood pressure, sleep apnea and joint pain. As a result, they can reduce the medications they have to take,” reports Dr. Baker.

Gale had a body mass index (BMI) of Matthew Baker, MD 38. BMI is a measure of body fat based Gundersen on height and weight with a normal bariatric surgeon

range of 18.5-24.9; and 30 or higher considered obese. On top of the social and physical discomforts, Gale’s weight was affecting her health. She had high blood pressure, sleep apnea and was borderline diabetic. “I tried everything to lose weight. I’d have little successes but gain it all back and then some,” Gale recalls. “I decided to have bariatric surgery after many, many years of fighting the battle of weight.” Choosing surgery “Having made the decision to have surgery, I had to keep telling myself that this wasn’t a magical fix. I would have to work hard to change my life. The surgery was just the beginning, the kick start to my new life,” Gale recalls. According to Gundersen bariatric surgeon Matthew Baker, MD, FACS, “You should make the decision to have weight-loss surgery only after careful consideration and consultation with an experienced bariatric surgeon or knowledgeable family physician. A qualified surgeon should answer your questions clearly and explain the reality of the procedure, expected results and follow-up care.”

Success beyond weight loss Gale learned that Gundersen offers three weight-loss surgery options and chose sleeve gastrectomy because of its good recovery and results. Since her procedure in February 2012, Gale has lost 96 percent of her excess body weight—well above the expected 50-60 percent after the sleeve procedure.

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Gale Bagstad’s overall health has improved significantly following her bariatric surgery.

That’s exactly what Gale experienced. She is off of her blood pressure medication, no longer pre-diabetic, her sleep apnea has improved and she has a healthy BMI. Now Gale has a happier attitude. “I can actually do things. I want to do things! I don’t have to ask myself ‘can I do that?’ I just do it!” she exclaims. If she had one thing to tell people struggling with obesity or weight loss issues, Gale would say, “If you’ve tried and failed at everything else, talk to your doctor about weightloss surgery and don’t give up!” To hear Gale’s story and learn more about bariatric surgery, visit gundersenhealth.org/bariatrics. To register for a free informational seminar, call (608) 775-5187 or (800) 362-9567, ext. 55187.

Four vaccines to protect your preteens and teens If you’re the parent of a pre-teen or teen, you’ve likely been busy recently checking off boxes on their back-toschool checklist. With so many boxes to know and check, one of the more important boxes can sometimes be missed—vaccinations. Stephen Randall, MD Gundersen Gundersen Health System recommends pediatrician

that adolescents, ages 11-12, get the following vaccinations: • Tdap booster shot – protects against tetanus, diphtheria and pertussis/whooping cough • MCV4 shot – protects against meningococcal infections, including meningitis (booster shot also recommended at age 16) • HPV shot – three doses protect against human papillomavirus that can cause several types of cancer • Flu shot – recommended yearly to protect against flu viruses Data from the National Immunization Survey show that many adolescent boys and girls are not being vaccinated with HPV and meningitis vaccines when they receive the Tdap booster. “Teenagers who go unvaccinated put themselves, their family and community members at risk for several potentially life-threatening diseases,” states Gundersen Health System pediatrician Stephen Randall, MD. Dr. Randall suspects low vaccination rates, particularly HPV, are due to newer recommendations and concerned parents. Below Dr. Randall helps dispel several common myths.

Myth: I have a preteen son so he doesn’t need to worry about the HPV vaccine. Preteen girls and boys, ages 11-12, should receive the HPV vaccine. Gardasil, one of two HPV vaccines, is approved by the U.S. Food and Drug Administration for males. Myth: Only a small percentage of sexually active people will get HPV in their lives. Approximately 79 million people in the United States are infected with HPV, according to the Centers for Disease Control and Prevention. Most people infected with the virus don’t know they have it because they don’t experience symptoms. However, the virus can still be passed to other sexual partners. Myth: My child is not sexually active, so it’s ok to wait to get the HPV vaccine. Being vaccinated (a series of three shots over six months) before having sex for the first time is the most effective way to prevent HPV. This allows the body time to develop an immune response to the vaccine.

Myth: The HPV vaccine is only effective in preventing cervical cancer.

Immunizations shouldn’t be taken lightly. They can prevent serious illnesses and even save your child’s life. “If your child is over age 12, it’s not too late to get vaccinated,” reminds Dr. Randall. “Start by talking to your child’s pediatrician or family doctor today.”

In men and women, HPV can cause anal, mouth and throat cancers, and genital warts. It can also cause cancers of the cervix, vulva and vagina in women, and cancer of the penis in men. The HPV infections that cause these cancers can be prevented with the HPV vaccine.

Visit gundersenhealth.org/prevention for an immunization and preventive care timeline. For more information, visit cdc.gov/vaccines or vaccineinformation.org/teens.

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Does your child suffer from vision problems? Good eyesight is essential for learning. Children with vision problems may avoid reading, struggle to read the board in classrooms and have poor depth perception. If vision problems are not caught early, they may lead to permanent vision loss. It’s important to watch for the following signs of vision problems in children: • Squinting • One eye turning out or in • One eye having a bright red-reflex in pictures while the other reflex appears dim or white • Tilting of the head • Double vision • Running into things, balance trouble • Poor hand-eye coordination • Sitting too close to the TV or computer • Holding reading material very close to the eyes If your child shows any of these signs, he or she should be seen by an eye doctor. Children should have their first eye exam between 6-12 months of age unless they are born premature or have a family history of eye problems. If no problems are found, children should have an eye exam again at 3 years, before entering the first grade and every two years after that or as recommended by their eye doctor. Call your local Gundersen Eye Clinic today to schedule an exam.

Is your child’s backpack too heavy? Using a backpack incorrectly can lead to long-term back, shoulder and neck pain as well as poor posture. Help teach your children the right way to carry a backpack, using these tips: • Carry less – Make more trips to the locker and leave unneeded items at home. • Keep it light – A backpack should weigh less than 10 to 15 percent of your child’s bodyweight. • Pack it right – The heaviest items should rest closest to your child’s back. Use all the pouches to distribute weight more evenly, and keep items from sliding around. • Pick a good one – Choose a lightweight, canvas backpack with two straps. Select padding on the shoulder straps and back area. Waist belts and wheels can help. • Make adjustments – Secure the backpack snug against the back with straps, and keep the bottom of the backpack from sagging too far past your child’s waistline. For more health and wellness information, visit balanceyour7.com.

Back to the basics: Clean hands are better Heading back to school can make you wonder how to stop germs from spreading. The answer is simple – cleaning your hands is the best way to prevent sickness and infection. It’s important everywhere, at school and at home. Wash your hands often using soap and running water, especially when they’re visibly dirty. During other times, hand sanitizer can help too. Hand washing should be done for 20 seconds – the same amount of time it takes to sing “Happy Birthday” twice. Visit gundersenhealth.org/cleanhands to learn more.

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Going gluten-free: Necessary or not? Do you know someone who has gone gluten-free in hopes of losing weight? Unfortunately, removing gluten from your diet won’t help lower the number on your scale. It can also leave you lacking important vitamins, minerals and fiber. Valerie Pampuch, RD Gundersen registered “There are those who voluntarily dietitian nutritionist

take gluten out of their diets and those who must because of celiac disease,” explains Valerie Pampuch, registered dietitian nutritionist at a Gundersen Health System. “Others also believe they are gluten intolerant, but research on that lacks any significant backbone.”

Gluten is a protein found in wheat, barley and rye that’s present in many bread products. It helps food maintain its shape, almost like glue. Some of the following foods may also contain gluten, so read labels carefully to be certain: processed lunch meats, french fries, energy bars, soups, salad dressings and candy. “Gluten is especially troublesome for people with the autoimmune disorder celiac disease,” Valerie explains. “When they consume gluten, they experience something similar to an allergic reaction.” Gluten damages the lining of their small intestine, hindering nutrient absorption. Until the lining has a chance to repair itself, symptoms can include abdominal pain and bloating, fatigue, weight loss, chronic diarrhea, vomiting and mental irritability.

It’s been estimated about one percent of Americans have celiac disease. The condition occurs in adults and children, and negative effects from a flare-up can last days to weeks. Contrary to popular belief, gluten-free products do not help with weight loss. “For example,” Valerie says, “a glutenfree brownie could contain more fat, sugar and calories than a traditional brownie. Any weight loss that occurs may be attributed to the fact that eliminating gluten may direct people to more whole and natural foods such as fruits and vegetables.” When a person stops eating gluten, they’re eliminating an entire grain group from their diet. “Many products that contain gluten are also fortified with valuable vitamins and minerals,” Valerie notes. “It’s important not to miss out on those.” If weight loss is the goal, Valerie recommends focusing on the basics. “Maintaining a healthy weight is all about eating in moderation, eating a balanced diet, staying active and getting enough sleep,” she reminds. “If you put too much energy in your body and you’re not burning it, you’ll gain weight. “Why eliminate something from your diet if you don’t have to? It’s a lot of hard work. Believe me, people with celiac disease would love to enjoy foods with gluten without the debilitating consequences.” Gundersen Health System’s Nutrition Therapy staff is committed to leading the way to improved health. Contact them at (608) 775-3447 or (800) 362-9567, ext. 53447, or email nutrition@gundersenhealth.org. YO U R G U I D E T O H E A LT H A N D W E L L N E S S | 1 2

Regain your quality of life with pelvic floor physical therapy

Tiffany Calteaux, DPT, WCS, CSCS Gundersen physical therapist

Do you suffer from urinary incontinence, constipation, painful intercourse or frequent pain in your low back, abdomen, hip or tailbone? If the answer is yes, you’re not alone. As many as one in three women are affected by pelvic floor dysfunction (PFD), according to the American Urogynecologic Society.

PFD is a broad term used to describe pain or disruption of bladder, bowel and/or sexual function due to restrictions of the muscles and nerves of the pelvis. Tiffany Calteaux, DPT, WCS, CSCS, physical therapist and women’s health clinical specialist at Gundersen Health System, says many factors can weaken pelvic floor muscles, such as pregnancy and childbirth, surgery, injury, cancer treatment, age, weight and lifestyle. Incontinence, for example, may develop slowly over the years until the problem becomes very disruptive to everyday life. Gundersen has a team of physical therapists, specially trained in pelvic floor physical therapy, to help patients improve the strength and function of their muscles.

Myth or fact: Pelvic floor dysfunction only affects older women. Myth – Women of childbearing age, men and even children can be affected by pelvic floor dysfunction. Gundersen’s pelvic floor therapy team treats patients of all ages.

“Many people think incontinence and other pelvic symptoms are a normal part of aging or will go away with time, especially after childbirth,” states Tiffany. “We want people to know there are things they can do to take control of their symptoms and improve their quality of life. Physical therapy is one of the options.” Pelvic floor physical therapy can be an easier, more cost-effective treatment option often resulting in less need for medication, shorter recovery time after surgery or an injury, improved strength and balance, and more independence. So what does pelvic floor physical therapy entail? “It is much more than just ‘kegels’ or pelvic floor muscle contractions,” according to Tiffany. “Physical therapy may include: behavior modification, biofeedback, muscle strengthening or relaxation, proper body mechanic instruction, electrical stimulation, exercise recommendations, braces/assistive devices or manual therapy. We spend a lot of time educating patients about tools to help them self-manage symptoms, and develop treatment plans to meet their individual needs.” Tiffany points out that 60 to 70 percent of women notice improvements in incontinence symptoms with physical therapy alone. “Success rates, like these, depend upon compliance with home exercise recommendations,” she notes. Gundersen offers pelvic floor physical therapy in La Crosse, Onalaska and Winona. Talk to your healthcare provider about your symptoms. A referral is often needed for physical therapy, so check with your insurance company. To schedule an appointment or for more information, call (608) 775-8140 or visit gundersenhealth.org/pelvicfloor.

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Itchy eyes bothering you?

The last summer picnic, the first crimson leaf tumbling to the ground and the brisk fall air tend to draw us outside. But if you suffer from eye allergies, this time of year can quickly send you back indoors. John Sterling, OD Gundersen optometrist

Red, itchy and watery eyes are the marks of having seasonal eye allergies. Sneezing, congestion, rubbing your eyes and feeling like you have a cold can also be signs. “Eye allergies are an immunological response to the allergens in our environment,” shares Gundersen Health System optometrist John Sterling, OD. “It could be grasses, weeds, or in the fall especially, it could be molds.” Spring, summer and fall are all allergy seasons. The good news for those suffering is that relief may not be far away. Sometimes, simple solutions help, such as cold compresses, flushing your eyes with saline solution or using a nasal spray. Many over-the-counter products are designed to stop the itch and take out the redness. Antihistamine eye drops can be an effective solution. For some people, simply taking an oral allergy medication can take care of their eye symptoms.

“Some people just have a problem when they go out and mow the grass, cut flowers or weed in the garden. They come back in and their eyes are itchy and watery. Then there are others, and all they have to do is go outside, period, and they feel miserable,” shares Dr. Sterling. People with consistent symptoms can often benefit from using eye drops or oral medication on a regular basis. Instead of waiting for symptoms to surface, use your preventative measures immediately and continue until the allergens have passed. “For some, that might be every day until it freezes,” notes Dr. Sterling. Every morning the local meteorologist gives pollen counts to help indicate when allergies might flare. Each person’s allergies are different, however, so pay attention to what specifically bothers you. If over-the-counter products aren’t working, it is time to schedule a doctor’s appointment. If you experience eye allergies, don’t wait for relief any longer. Find out what works for you. For more information or to schedule an appointment, call your local Gundersen eye clinic today or call (608) 782-7300.

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