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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

Winning Weighs速 for Kids: Much more than a weight management program

Making knee pain a memory Alternatives to total knee replacement available

Organ and tissue donation touches many lives

Manage your care with MyCare

Online tool offers convenience for busy parents like Kelly

Are health insurance changes coming my way? That depends. A key piece of the Affordable Care Act is soon going into effect. On Jan. 1, 2014, almost all Americans must have health insurance coverage. If you don’t have health insurance, you risk a penalty. What does that mean for you? That depends on many factors including your income, your insurance today, the number of people in your family…even where you live. To help you learn how the changes may impact you, Gundersen Health System has created a website, gundersenhealth.org/marketplace. Here, we’ll answer some of your most frequently asked questions and provide resources for you. Who should be sure to log on? • Single people or families who have Medicaid insurance now or who think they might qualify for Medicaid in the future.

• People with no insurance right now. • People who feel they are under insured. Remember, your insurance can come from your employer, the government or you by buying a plan through the Insurance Marketplace. To help make insurance affordable for those who buy a plan through the Insurance Marketplace, federal tax subsidies are available for some individuals and families. Open enrollment for the Insurance Marketplace opens Oct. 1, 2013 and runs through March 31, 2014, so don’t delay. Learn more today.

GUNDERSENHEALTH.ORG/MARKETPLACE

Open wounds: Don’t just live with them Do you have a sore that just won’t heal? You do not need to simply live with it. Gundersen Health System has a dedicated Wound Center team whose goal is to provide care that will result in faster healing. Whoever coined the phrase “Some wounds Bradley Abicht, DPM never heal” never met this group of Podiatry clinicians. Podiatrist Bradley Abicht, DPM, is part of the Wound Center team which aims to heal through advanced practices and old-fashioned vigilance. The team understands that everyone, and every wound, is different. Each person has different obstacles and conditions which affect their treatment. “No two wounds are the same,” says Dr. Abicht. “We say they are kind of like snowflakes. You have to look at the entire patient.” The Wound Center starts with a baseline evaluation: Is there proper blood flow? Is there infection? Has the patient cleaned the wound site every day? If it’s a foot wound, has the patient stayed off their feet? Are other consultations needed to get a better understanding of the wound’s nature and the proper path to recovery?

Underlying conditions in patients with diabetes, such as poor blood flow, can make infections dangerous and very hard to cure. Bad infections increase the possibility of eventual limb amputation. The longer a wound stays open, the greater that risk, Dr. Abicht says. After determining the treatment path, the Wound Center uses advanced therapies to treat patients. For example, a patient with a larger wound might be a good candidate for a skin graft, which Dr. Abicht says can often heal a wound in weeks, instead of months. If an infection is so bad that amputation is necessary, the Wound Center’s surgical techniques and know-how can result in the preservation of part of the foot and most of the leg, as opposed to full amputation below the knee. In a related method, a patient’s tendons are re-attached to different parts of the foot, so that the foot is “balanced.” This reduces the chance of new ulcers and new open sores. If you or your healthcare provider determine enough is enough, make an appointment with a Wound Center specialist. To schedule an appointment, call the Gundersen Wound Center at (608) 775-6882 or (800) 362-9567, ext. 56882.

When needed, specialists throughout the Gundersen system are brought together to discuss the patient and their treatment path. According to Dr. Abicht, there are many variables which must be evaluated in determining proper care for wounds. Diabetes patients, for example, are more susceptible to wounds and sores on their extremities and are at risk for infection in their feet and legs. Insulin and blood sugar control are possible reasons why a wound isn’t healing at a reasonable pace. Other complicating factors could include tobacco use, poor circulation and diet issues. 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 prior to any change in medical treatment, exercise routine or diet. For permission to reprint any portion of this magazine, to change your address, to let us know if you are receiving more than one copy or if you’d like to be taken off our mailing list, write to Gundersen Business

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Is it heartburn... or a heart attack? Imagine you’re out raking leaves or shoveling snow after a big meal. Or you’re watching the big game on TV while snacking on chicken wings and nachos. Then it happens. You feel pain in your chest. Is it a heart attack or an attack of heartburn? Experts at Gundersen Health System say knowing the difference could save your life. Before chest pain strikes, read, clip and save the symptom card below. When in doubt, call 9-1-1 right away Anytime you have chest pain and you’re not sure if it’s a heart attack or not, don’t take chances. Seek medical help right away. With a heart attack, time lost is muscle lost. Quick medical intervention can save your life and reduce damage to the heart. Heart attack It’s important to know your risks for heart disease. Chest pain is more likely to be heart trouble if you have risk factors such as: • Smoking • Overweight/obesity • High cholesterol and/or blood pressure • Family history • Previous heart attack or heart disease

Busy parents like Kelly Skifton have a major ally when caring for themselves and their families: MyCare. MyCare is Gundersen Health System’s online resource that allows patients to manage much of their healthcare electronically.

Learn more at gundersenhealth.org/know-your-risk. Heartburn Chest pain may also be heartburn caused by acid reflux, an ulcer or hernia, muscle spasms, gallbladder attack or pancreatitis. Most people get occasional heartburn, but frequent, chronic heartburn can damage the lining of your esophagus over time and increase your risks for serious health problems, including cancer. If you have frequent heartburn, talk with your doctor. Learn more at gundersenhealth.org/heartburn. Region’s only accredited Chest Pain Center Chest pain is serious business. So serious, in fact, Gundersen provides priority care to patients with chest pain or other symptoms that may indicate a heart attack. They receive treatment within the critical window of time that not only saves lives, but prevents or minimizes damage to the heart. Because of our rapid evaluation and treatment of chest pain, Gundersen has been accredited by the Society of Chest Pain Centers.

✁ CLIP, SAVE AND POST SYMPTOMS OF A HEART ATTACK

SYMPTOMS OF HEARTBURN

• Chest pain, pressure or tightness lasting more than a few minutes –More noticeable during physical activity or stress –Spreading to the back, neck, jaw, shoulders or arms • Chest pain with other symptoms such as: –Trouble breathing –Sweating –Feeling dizzy –Nausea/vomiting –Irregular pulse –Unusual fatigue or weakness –Tingling in hands or feet

• Burning or pain—may start lower and move up to the chest and throat • Pain can last a few minutes or a few hours • Sour/unpleasant taste in the mouth • Pain may be more pronounced after eating fatty or spicy foods, or a large meal • Worse when lying down or bending over • Antacids should provide some relief • Difficulty or pain with swallowing • Frequent burping, coughing or choking while swallowing • Burning or lump in the throat • Hoarseness When in doubt, don’t take chances–seek medical help.

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Online tool offers convenience for busy parents like Kelly

While some risk factors, such as family history, cannot be changed, with many risks, once you’ve identified them, you can take steps to change them.

Learn more at gundersenhealth.org/chest-pain.

CALL 9-1-1 IMMEDIATELY!

Manage your care with MyCare

Kelley Bahr, MD Family Medicine

Dr. Bahr is a MyCare enthusiast in large part because the resource is so efficient. “MyCare is worth gold when it comes to people’s time,” she says. “Let’s say a patient visits the lab in the morning. Using MyCare, I can usually get results to them the same day— and before lunch. If the same notification is handled with a letter, the patient’s wait can be a week or longer.”

“I love MyCare,” Kelly says. “For my busy schedule, it’s perfect.” Kelly is a wife, a mother of two, a stepmother of one, works full-time and is in school earning a master’s degree. She uses MyCare for herself and her children to: • Get answers to questions • Access test results • Retrieve immunization records • Get medication refills • Schedule appointments and review details about past or upcoming visits “The best part is I can use it when it’s convenient for me,” Kelly explains. “If it’s Sunday night and I’m at home and I’m worried or I have a question, I send a message through MyCare.” An automatic email notification arrives when a patient has a response waiting. “If I waited to contact my physician until Monday, I might not remember or find time to do it.” Kelly and her family receive care from Gundersen physician Kelley Bahr, MD, Family Medicine. “It’s great to have reassurance from a doctor I trust,” she says. She and Dr. Bahr communicate through MyCare regularly. “MyCare helps me take better care of my family, and saves me time and money,” Kelly continues. “For instance, two of my children have allergies, and I’ve used MyCare to ask Dr. Bahr about medication dosages. It eases my paranoia communicating with her. If she recommends a dosage change and I don’t have to schedule an appointment, it saves me from leaving work and paying for a visit.” For her own care, Kelly uses MyCare primarily for medication refills and appointment scheduling.

ley Skifton

, Kelly and Kens

Jaron, Jameson

Kelly agrees, adding “MyCare creates a lot of efficiency in my role as a mom.” She says it’s particularly helpful for accessing immunization records and other information required by schools and daycare facilities. “I used to have to call every year and it was such a time consuming process,” Kelly recalls. “Now I go to MyCare, print the immunization list and I’m set.” Kelly summarizes, “I use MyCare all the time. Without it, half of my questions would go unanswered.” Sign up for MyCare today at gundersenhealth.org/ MyCare.

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Winning Weighs® for Kids: Much more than

When Ira Rainey was handed a brochure about Gundersen Health System’s Winning Weighs for Kids program for her son, Jacob, she was somewhat skeptical. “I was concerned the classes would focus exclusively on physical activity and be too regimented for kids.” Like many children his age, 15-year-old Jacob struggled with portion control and lack of physical activity. As a result, he had been seeing a Gundersen doctor to keep his blood pressure in check. “My greatest fear was sending my son off to a mini fat camp,” his mom admits. But, Ira was pleasantly surprised by many aspects of Winning Weighs for Kids—the instructors, kid-friendly philosophy, positive reinforcement, and most of all, her son’s drastic improvements. “Winning Weighs for Kids is held in the fun atmosphere of the Children’s Museum of La Crosse and encourages a nondiet approach to healthy eating that the whole family can adopt,” says Winning Weighs for Kids instructor Margie Ley, RD, Gundersen Nutrition Therapy.

a weight management program encouraged active participation from the kids. In addition, Jacob and I often found ourselves talking about concepts at home that we learned together in class,” says Ira. Even the physical activity portion of the class turned out to be fun. The instructors used different locations throughout the Children’s Museum to help make physical activity exciting—from the shadow room and large maze to the rock climbing wall. “Whenever Jacob attempted a more strenuous or challenging activity, the instructors were great about providing positive reinforcement—never criticizing him or any other children,” Ira shares. Margie is happy to report that Jacob had phenomenal results in the program, decreasing his body fat by 7.5 percent with a corresponding increase of 7 percent in his muscle mass.

But it wasn’t only his weight loss that was remarkable. Margie and Ira agree that Jacob really learned how to slow down and control his eating, while also increasing his fruit and vegetable consumption. “Signing up for the class was definitely the right thing to do,” says Ira. To learn more about Winning Weighs for Kids or to register for an upcoming session, visit winningweighs.org or contact Gundersen Nutrition Therapy at (608) 775-3901 or (800) 362-9567, ext. 53091.

TOP FIVE WAYS TO EMBRACE A HEALTHY LIFESTYLE Many of the principles taught in Winning Weighs for Kids can be adopted by children and adults alike. If you’re motivated to get healthy as a family, here are five simple ways to start: 1) Eat three to five fruits and vegetables daily. 2) Limit screen time to no more than two hours per day. 3) Be physically active at least one hour daily. 4) Limit sweetened beverages. 5) Pay attention to your body’s signals. Eat when you’re hungry; stop when you’re full.

Highlights of the eight-week class include: • Group nutrition sessions and healthy snack preparation • Fun physical activities • Recipes and reference materials • Individual sessions including body composition analysis tests Ira says she enjoyed the hands-on approach to learning as much as Jacob. “During the educational portions of the class, the instructors used a variety of visuals rather than simply lecturing. For example, to demonstrate how much sugar was in various foods and beverages, they filled tubes with sugar. To explain serving sizes, they brought in real food portions. And, they always encouraged questions,” she says.

In addition to Winning Weighs for Kids, Gundersen offers classes for adults, too, including: • Winning Weighs, the original series that has helped hundreds of people take control and change their lifestyles for the long-term • Winning Weighs After Baby • Winning Weighs in the Kitchen

Equally important, they incorporated parents into the activities, so they weren’t just bystanders. “This really Margie Ley, RD, Gundersen Nutrition Therapy discusses healthy food choices with Winning Weighs for Kids participant Jacob Martin.

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“This young man suffered from a low self-esteem and anxiety upon entering the program. I wish you could have seen the look of pride and total self-confidence he exhibited at our final visit. I am so proud of him,” states Margie.

For more information about these class offerings, visit winningweighs.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 | 6

Making knee pain a memory Alternative to total knee replacement available If you suffer from ongoing knee pain, you may be wondering, “Is total knee replacement my only option?” The good news is that there is an alternative to total knee replacement for many patients. It’s called partial knee replacement. Bradley Fowler, MD Sports Medicine

Partial knee replacements are an option for younger patients, too. Once reserved for older adults who were not active, the knee implant Dr. Fowler uses, called the Oxford® Partial Knee, has changed that thinking. The implant features a unique moving plastic bearing that studies have shown to increase patients’ range of motion and reduce wear and tear. This gives the partial knee replacement a life expectancy similar to total knees.

“Arthritis in the knee commonly only affects the medial, or inside, compartment of the knee. With a partial knee replacement, we only replace the arthritic medial compartment and preserve the remaining healthy cartilage and ligaments that would otherwise have to be removed with a total knee replacement,” explains Bradley Fowler, MD, orthopaedic surgeon, Gundersen Sports Medicine.

Good candidates for partial knee replacement include people who: • Suffer from osteoarthritis that primarily affects the medial (inside) of the knee. (Osteoarthritis is a disease in which the cartilage that protects the ends of the bones in the knee wears out, causing bone to rub on bone.) • Experience pain and/or swelling while standing, walking or during activities of daily living. • No longer get relief from medication or other nonsurgical treatments.

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Mustering up the courage to schedule a colonoscopy is not always easy. We’ve all heard less-than-desirable stories about the preparation involved, but 58-year-old Jim Martin of Coon Valley, Wis., will tell you it’s worth it in the end. The screening saved his life.

Genetic counseling is just one of many services offered as part of Gundersen’s comprehensive cancer center. “For the sake of my family and two sons in their 20s, I underwent genetic testing and discovered I have Lynch syndrome,” says Jim.

“I took the advice of my Gundersen primary care doctor, Ricky Waniger, MD, and scheduled a colonoscopy at age 50. During the procedure, two small non-cancerous polyps were found and removed,” recalls Jim.

Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer (HNPCC), is an inherited disorder that greatly increases a person’s risk of developing colon cancer. Families who carry the gene for Lynch syndrome typically see several relatives affected and often at younger ages than the general population.

Gundersen Health System Preventive Care Guidelines recommend a colonoscopy every 10 years starting at age 50; earlier and more frequently if there is a family history of colon cancer or polyps.

That’s a good thing for patients for many reasons. “Because two-thirds of the knee’s cartilage and ACL is left intact, patients have a smaller incision, much less pain, a quicker recovery and a much more normal feeling knee,” Dr. Fowler says. In fact, people who have partial knee replacement are typically back to their full everyday activities in six to eight weeks. That compares to three to six months for a total knee replacement. Partial knee replacement is also often done as an outpatient surgery, meaning patients can go home the same day they have surgery.

Would you avoid a screening that could save your life?

“Many of my partial knee replacement patients are in their 40s and 50s. I am always amazed by how quickly they recover from surgery and are back to leading their active lifestyles,” Dr. Fowler says, adding, “For many years, total knee replacements were the only option for people who had chronic knee pain caused by arthritis. We’re happy to have another option to offer patients at Gundersen.” Don’t continue suffering. Schedule a consultation today. For Gundersen Sports Medicine, call (608) 775-8600. For Gundersen Orthopaedics, call (608) 775-2276.

Because two polyps were found during Jim’s first colonoscopy, Dr. Waniger recommended a second screening at age 55. Jim didn’t think twice about scheduling the colonoscopy, but the news that followed came as a complete shock—two cancerous lesions were found. Fortunately, the cancer was discovered early (stage I), and surgery was scheduled promptly to remove the affected portion of Jim’s colon, as well as 43 surrounding lymph nodes. But, Jim wasn’t in the clear yet. Pathology reports confirmed that one of his 43 lymph nodes was cancerous, which meant chemotherapy would be the most effective way to eliminate the cancer. Jim’s care team in the Center for Cancer & Blood Disorders was also concerned about how quickly the cancer had metastasized (or spread) to his lymph node. He was referred to Peter Levonian, a genetics counselor at Gundersen.

“Knowing that my sons now have a 50 percent chance of inheriting Lynch syndrome is concerning. But, it’s reassuring to know they can be tested and take preventive measures, such as scheduling a colonoscopy, at an early age,” he says. Jim considers himself lucky that the cancer was discovered early. He completed his last round of chemotherapy on April 5, 2013. “I still fill up with emotion about it. Everyone at Gundersen was so good to me, and the coordination of my care was excellent. For a bad situation, my care team made it the best it could be!” he says. Take a lesson from Jim and ask your primary care provider about a colonoscopy if you’re age 50 or older, or if you have a family history of colon cancer or polyps. When colon cancer is detected early, there is a 90 percent chance of survival.

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It’s about how we live

Quality of living at the heart of Hospice and Palliative Care The quality of a person’s life is as important as the excellence of their medical care. At Gundersen Health System, Hospice and Palliative Care offer peaceful and comforting options for patients and their loved ones. “Many people who have chronic or advanced diseases, such as heart or kidney disease, cancer or dementia, don’t realize the options available to them that can help improve their quality of life. So often we hear, ‘I wish we had known about this sooner,’” shares Jackie Yaeger, MD, Gundersen Hospice and Palliative Care. Patients often begin working with Gundersen’s Palliative Care team first. “Our Palliative Care team cares for people who are struggling with symptoms associated with a chronic medical condition and helps them learn to live with their illness. Along with helping them find physical comfort, our team treats our patients’ emotional and spiritual suffering,” Dr. Yaeger explains. If the patient’s goal is to treat their disease aggressively with chemotherapy or surgery, for example, palliative care will have a strong focus on symptom management. If the illness progresses in spite of aggressive treatment and the patient’s goals change, palliative care providers

will transition the care to meet the patient’s new goal of comfort and quality of life versus quantity of life. “Patients of any age and at any stage of serious illness can benefit from the extra layer of comfort and support provided by palliative care,” Dr. Yaeger says. When a patient with advanced illness is ready to stop life-prolonging treatments, Dr. Yaeger says early hospice care can greatly enhance the patient and family’s quality of life. Hospice also allows comfort care to be provided in the place most people feel most secure: their home. “A discussion about getting hospice involved can be difficult. It requires us to acknowledge a person’s time on earth may be limited. However, a timely and loving discussion of hospice with the patient initiated by their loved ones, a physician, maybe even a concerned pastor, can be one of the greatest gifts we can give each other,” she says. In order to receive hospice care, a patient’s life expectancy must be six months or less, however, many patients live longer than this. With hospice care, conditions which might otherwise require a hospital stay or an emergency room visit, such as chest pain or shortness of breath, can be managed in the patient’s home. Hospice provides support for the patient’s caregiver as well. “So often we see patients and their loved ones wait to begin hospice care. There is a misconception that hospice is ‘for the last days of life.’ Although Hospice can assist and provide care at this time, the patient and family can benefit much more if they get support early,” Dr. Yaeger says. If you or a loved one could benefit from palliative care or hospice, contact Gundersen’s care teams: • Palliative Care: (608) 775-9336 or (800) 362-9567, ext. 59336 • Hospice: (608) 775-8435 or (800) 848-5443; TTY (608) 782-3784 Additional information is available at gundersenhealth.org/palliative-care and gundersenhealth.org/hospice.

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Organ and tissue donation touches many lives As an EMT for her local ambulance service in Blair, Wis., Mary Myskewitz has witnessed many tragedies. But nothing prepared her for that night: Sept. 13, 2001. She was working when she heard the page go out…

had to happen to make Rob’s organs available is a miracle in itself,” says Mary. For example, it was two days after the tragedy of 9-11 so special permission was needed to fly the recovery and transplant team from Madison.

The emergency call was for her 20-year-old son, Rob. “That night I reacted as a mom, not an EMT. All I could do was hold him and tell him I loved him,” she remembers.

Ultimately, more than 55 people benefitted from Rob’s heart, liver, pancreas, kidneys, eyes, bone and tissue. Mary and Ron have met some of the recipients. One was the recipient of Rob’s heart. “Chuck was tall and soft spoken like Rob. At our first meeting, he embraced me so I could listen to Rob’s heart beating. It was very healing,” Mary recalls.

From the local hospital, Rob was flown to Gundersen Lutheran Medical Center in La Crosse. There he was evaluated and put on a ventilator. When Mary and her husband, Ron, arrived they were given the devastating news: Their son was brain dead. There was nothing more that could be done.

Mary asks: “If you or a loved one needed an organ transplant, would you accept that gift? If so, why not give the gift of life?”

“We are forever grateful that the doctors asked if we would consider organ donation. It was like a ray of sunshine in the void,” Mary explains. “Rob made the decision to be a donor when he got his driver’s license, but his license didn’t follow him to the hospital. He had shared his decision with us, but in our grief we hadn’t thought about it until the doctors asked.” She adds, “We couldn’t ask for a better gift than to have something positive come from our tragedy. A part of Rob would now live through others.” Just 2 percent of people die in a way that makes organ donation possible. “To think of the chain of events that

Become a donor If you are a Wisconsin resident, 15½ or older with a driver’s license or state ID, go to YesIWillWisconsin.com or donatelife.net to register as an organ and tissue donor. You can also indicate your donation decision on your driver’s license. But as Rob’s story illustrates, it’s also important to share your decision with your family. Rules vary by state, so if you live outside Wisconsin, check with your state’s registry: • Minnesota: lifesourcedonorregistry.org • Iowa: iowadonorregistry.org • Any state: donatelife.net 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 0

Healthy eating on the go

Sloopy’s A lma Mater

When you are constantly on the go, it can be hard to find time to prepare home-cooked meals and eating healthy may seem difficult. But, Gundersen Health System’s registered dietitians say it can be done. The easiest way to identify healthier choices is to look for Gundersen 500 Club® options. The 500 Club, developed by Gundersen registered dietitians, offers convenient and healthy options at restaurants, vending machines and convenience stores. Member restaurants even include well-known names such as White Castle, HuHot and Taco Johns. When eating on the go, Gundersen’s registered dietitians also recommend: • Choosing water, fat free milk, unsweetened tea or other drinks without added sugars • Checking the food nutrition facts • Ordering steamed, grilled or broiled dishes instead of those that are fried • Asking for whole-wheat bread for sandwiches Check out gundersenhealth.org/weight-loss for more information on the 500 Club® and local, regional and nationwide healthy eating options. McDonald’s

COMPASS NOW: Moving forward In 2012, Gundersen Health System joined the United Way, five county health departments and seven area hospitals in conducting a community needs assessment. The purpose of COMPASS NOW was to identify and address the most urgent needs of the Coulee Region. Using the findings of COMPASS NOW, Gundersen Health System has created an implementation plan to help solve the key community health issues. The established goals and objectives aim to help find solutions to the issues of: • Alcohol use • Healthcare access and cost • Mental health • Obesity • Food availability (a community issue that is directly related to overall health) For more information about the goals and activities that are being implemented to solve these problems, visit gundersenhealth.org/wellness/ community-support.

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Best defense against flu Each year there are about 36,000 flu-related deaths in the United States. Experts at Gundersen Health System say the flu vaccine is our best defense against getting the flu. While it will not prevent every case of influenza, experts highly recommend everyone older than 6 months of age get the vaccine. In addition to getting the flu vaccine, here are other simple tips to help you and your family members avoid getting the flu: • Wash your hands often with soap and water. • Avoid touching your eyes, nose or mouth (this is how germs are spread best). • Do not share drinking cups, bathroom linens or sleep in the same room with someone who is ill. • Clean items that are often touched or shared such as remote controls, phones, light switches and bathroom fixtures. • Keep fresh air coming into your room or home. Open windows. For more tips on flu prevention, protection or the flu vaccine, talk to your primary care provider or visit gundersenhealth.org/flu.

Blood pressure: Even a bit high is too high With an ability to exist virtually undetected, high blood pressure, or hypertension, is a serious and dangerous medical condition. Blood pressure rises when the heart has to work harder than normal to pump blood. Jon Zlabek, MD, FACP Vascular Medicine Experts at Gundersen Health System

say what’s most concerning about high blood pressure is even when slightly elevated, it can cause damage to blood vessels, the heart and other parts of the body. “You’re still at risk even if your numbers are only slightly higher than normal,” cautions Jon Zlabek, MD, FACP, Gundersen Vascular Medicine. “Any increase can lead to other serious health issues over time.”

If your blood pressure isn’t in the normal range, and especially if it is above 140/90 mmHg, many lifethreatening medical conditions can occur, including: • Stroke • Heart attack • Heart failure • Kidney failure Fortunately, high blood pressure is easily treatable in most people. And while it generally can’t be cured, it can be controlled. Lifestyle changes and medication are the two options for treatment. Lifestyle changes are a best first attempt at resolving the problem: • Maintain a normal body weight • Reduce salt intake • Get at least 30 minutes of physical activity daily • Limit alcohol consumption • Don’t smoke • Eat a diet rich in fruits and vegetables

“ You’re still at risk even if your numbers are only slightly higher than normal. Any increase can lead to other serious health issues over time.” –Jon Zlabek, MD, FACP

High blood pressure is more common than you may think. According to the Centers for Disease Control and Prevention, one in every three American adults suffers from the condition. Unfortunately, unless you have been tested, it is impossible to know if your blood pressure is at a safe level. The good news is having the test is quick, easy and painless. The test involves only a visit to a healthcare professional, an inflatable arm cuff and a pressure-measuring gauge.

Hypertension is measured in millimeters of mercury (mmHg) and is normal when it is lower than 120/80 mmHg. In this case your doctor or nurse might say “120 over 80” as your blood pressure reading. The first number, systolic pressure, measures the peak pressure in the arteries. The second number, diastolic pressure, measures the minimum pressure in the arteries.

Lifestyle changes may not be enough, so your doctor may prescribe daily medication to help get your blood pressure under control. The type of medication will depend on your test results and any other medical issues you may have. “Hypertension is a silent disease,” Dr. Zlabek continues. “You feel fine until something significant happens, and then it may be too late. It’s very important to have your blood pressure checked and to properly manage it.” If your blood pressure is consistently 120/80 or below, have it rechecked once yearly. Talk to your Gundersen care provider about more frequent testing if your blood pressure exceeds the normal range.

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The risks and realities of energy drinks

With today’s busy lifestyles, more and more people are turning to energy drinks for their daily dose of caffeine. But do they know what they are putting into their bodies?

builds up in their system. People start losing sleep and experiencing changes in appetite, which ultimately leads to many health issues.”

Energy drinks contain caffeine in combination with other stimulants like taurine, guarana and B vitamins, which can give drinkers their sought after energy boost. But, at what cost? In excess, these drinks are known to promote heart arrhythmias (heart rhythm problems), seizures, restlessness, anxiety, insomnia, mood changes and headaches. The Food and Drug Administration is even investigating claims linking them to consumer deaths.

It’s also important to remember caffeine is a drug and can lead to addiction. When people drink caffeinated beverages habitually, they build up a tolerance. They need more caffeine to become energized, but their body still processes the drug in the same way. This is often when heart problems and other negative side effects occur.

So how much is too much? More than 400 mg of caffeine per day is considered excessive for adults and more than 100 mg for adolescents. Doug Larsen, PA-C, Gundersen Emergency Medicine, has seen more patients coming in with caffeine-induced symptoms. “People don’t realize how much caffeine is actually in an energy drink,” he says. “They drink several very quickly like a regular can of soda. But compared to the 50 mg of caffeine in a 12 oz. soda or 100 mg of caffeine in a cup of coffee, energy drinks can have up to 500 mg of caffeine per drink—even if only 100-200 mg is listed on the packaging.” According to registered dietitian Marisa Pruitt, RD, Gundersen Nutrition Therapy, “We are seeing more people drinking energy drinks, coffee and soda rather than water as their primary beverage. When they drink less water they become more prone to dehydration, and over time caffeine

“It’s all about balance and moderation,” Marisa says. “The problem happens when people consume a combination of multiple sources of caffeine on a daily basis, as well as the mega-doses of vitamins, stimulants and supplemental ingredients that we don’t know a lot about at this time… not to mention all the added sugar.” People with known heart issues or other related health concerns should talk to a healthcare provider before drinking energy drinks. If you consume energy drinks, do so in moderation and contact your healthcare provider if you experience negative side effects such as irregular heartbeat. To increase your energy level, hydration, alertness and brain function without the aid of caffeine, you should: • Drink plenty of water • Get enough sleep • Eat small frequent meals • Exercise regularly

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