Inspired Tampa Bay: Spring 2017

The Health and Wellness Magazine of Florida Hospital

S PR ING 2 017

BENEFITS OF OUTDOOR EXERCISE IDENTIFYING PEDIATRIC EMERGENCIES

HEART DISEASE WHAT’S DIFFERENT FOR WOMEN?

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A MEMBER OF ADVENTIST HEALTH SYSTEM

Keep your face always toward the sunshine— and shadows will fall behind you.

–Walt Whitman

SPRING 2017

IN THIS ISSUE

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OBSTETRIC EMERGENCY

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A quick diagnosis and emergency surgery saved Alyson Krillies.

6

TAKE IT OUTSIDE The health benefits of exercising outdoors.

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KIDNEY STONES Easy ways to reduce your risk.

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PLANNING FOR BIRTH Create a birth plan to share your wishes for labor and delivery.

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3 EXERCISE MYTHS

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Don’t let these rumors derail your workouts.

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THE FEMALE HEART How heart disease affects women differently.

ON THE COVER: Anne Schleper, a member of the U.S. women’s national hockey team that won silver at the 2014 Sochi Winter Olympics, skates at the new Florida Hospital Center Ice complex along with Tampa Bay Lightning mascot, ThunderBug (on the cover), and Florida Hospital Center Ice mascot, IC (at right).

Anne is also a Health and Wellness/Sports Medicine Ambassador for Florida Hospital Tampa. Florida Hospital is the Official Health and Wellness Partner of the Tampa Bay Lightning.

PHOTO BY DANIEL W. BAKER

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PEDIATRIC EMERGENCIES Tips to help you recognize when a child needs immediate care.

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DECODING COUGHS Know thy cough, and its possible cause.

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ENDOMETRIOSIS Learn about this painful condition and how it’s treated.

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ASPARAGUS This nutrition powerhouse is a tasty sign of spring.

from

Obstetric emergency SPRING 2017 | inspiredtampabay.com

to

JOyful family

After giving birth, this mother experienced A life-threAtening emergency. thAnks to her physiciAn’s quick diAgnosis And successful emergency surgery, todAy she is the picture of heAlth, enjoying every minute with her fAmily.

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LEFT: Lucas and Alyson Krillies with son, Niko, and daughter, McKenna. RIGHT: Alyson with Dr. Kristen Barrie, the anesthesiologist who held her hand throughout her life-saving surgery.

Everything changes But before Alyson had the chance to hold Niko, she started feeling sick. Alyson remembers the day like it was yesterday: “All of a sudden, I felt hot, really strange and very sick.

The next thing I knew, nurses were rushing into the room.”

“We felt Alyson was having an amniotic fluid embolism,” says Dr. Von Thron. “This is where the amniotic fluid that surrounds the baby gets into the bloodstream.

Normally, this can cause a cardiac event and causes your blood not to clot. Most people this happens to do not survive. It’s extremely serious.” Immediately, Alyson was rushed to the operating room and the team began implementing the postpartum hemorrhaging protocol.

The entire team took action.

A life-and-death situation

with me. She never let go of my hand. It was incredible.” There was controlled chaos in the room, but Dr. Barrie continued to reassure Alyson.

“It’s important to show a patient we care, because that’s everything,” says Dr. Barrie. “It’s really the heart of what we do.”

Gratitude and joy The entire OB team at Florida Hospital Tampa’s Women’s Health Pavilion worked together to save Alyson’s life. “Everyone was amazing,” she says. “The expertise, the knowledge, the care that was provided to me was unbelievable. I am so thankful for all of them. I am here because of them.”

Today, Niko is a thriving toddler full of energy. Alyson and Lucas are enjoying life with their family in Tampa Bay. “Life could not be any better,” says Alyson. “McKenna is 13 years old, and she and Niko adore each other. After everything I went through, I now have a different outlook on life and am so grateful for each new day. There is no doubt that I wouldn’t be here to share my story if it wasn’t for the doctors and staff at Florida Hospital Tampa.”

The labor and delivery nurse Alyson had spent time with immediately joined the team in the operating room. “It was scary,” says Becky Coggins, RN. “There was a point …

I was watching her and I didn’t know what the outcome was going to be.”

During this life-and-death situation, Alyson was awake. This was important because she was able to talk to Dr. Von Thron and the anesthesiologist, Dr. Kristen Barrie, about how she was feeling.

“My anesthesiologist, Kristen, never left my side,” says Alyson.

“She was there for me the entire surgery. That was exactly what I needed. I needed her. I needed a human FOR MORE INSPIRING STORIES, touch. I thought I can GO TO INSPIREDTAMPABAY.COM do this, someone is here

FLORIDA HOSPITAL (844) 804-9378 | SPRING 2017

O N A H O T J U L Y afternoon, Alyson and Lucas Krillies arrived at Florida Hospital Tampa. After nine long months, the day was finally here … they would soon meet their baby boy. Alyson’s daughter, McKenna, was anxiously waiting at home, excited to welcome her new brother.

Alyson’s physician, Dr. Jim Von Thron, a board certified obstetrician and gynecologist, had sent her to Florida Hospital Tampa in possible labor. After a few hours of walking the hallway, she was dilated enough to be admitted. “Everything was great,” says Alyson. “It was going according to plan. I was in labor all night. The next morning, July 8, I gave birth to Niko at 7:20 a.m.” The healthy baby boy weighed in at 6 pounds, 15 ounces and measured 20.5 inches long.

Lucas had the chance to spend time with Niko right away. The Florida Hospital Tampa nursing team taught Dad how to change, feed and swaddle the baby, almost ready to present to Mom.

5

Exercising Outdoors Beats the Gym by a Mile SURE, A CLIMATE-CONTROLLED

gym with all the bells and whistles can be a pleasant place to work out, especially in winter, but science suggests there are powerful benefits to leading an active lifestyle in the great outdoors.

When the weather permits, take your activity out in nature for a variety of benefits to body, mind and soul. Writer Laura Ingalls Wilder was on to something when she said, “Some old-fashioned things, like fresh air and sunshine, are hard to beat.” And now, there’s research to support her claim.

Boost energy and reduce tension

SPRING 2017 | INSPIREDTAMPABAY.COM

For example, a team from England’s Peninsula College of Medicine and Dentistry analyzed 11 trials that included more than 800 adults.

They found that, when compared with indoor exercise, outdoor exercise was associated with increased energy and revitalization, as well as decreased confusion,

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DON’T LET ALLERGIES KEEP YOU INDOORS Do you love exercising outdoors but fear an allergy attack? Three key strategies will help you stay comfortable:

anger, depression and tension.

Outdoor exercisers also reported enjoying their workouts more, and were more likely to say they planned to repeat them than exercisers who were holed up inside a gym. Many also had lower levels of cortisol (a hormone produced in response to stress) than their indoor counterparts, and said exposure to sunlight improved their mood. In addition, people who walked outdoors completed an average of 30 minutes more exercise per week than those who exercised indoors.

So, which outdoor activities provide the greatest benefit?

Walking is at the top of the list.

It boosts cardio, is gentle on the joints, strengthens bones, can be done almost anywhere and is free.

From a mental-health standpoint, it can reduce stress, improve mood and spark creativity.

Gardening is another favorite outdoor activity for many. It promotes tranquility and relaxation, and has

1. Prep your system.

During days or seasons when your allergies are at their worst, use an over-the-counter antihistamine before you exercise. This will help stave off allergens’ effects and may prevent an attack before it starts.

many physical benefits as well.

According to the Centers for Disease Control, moderate activity, such as active gardening, for as little as two-and-a-half hours each week can reduce risk of obesity, high blood pressure, Type 2 diabetes, heart disease, stroke and depression.

Keep it simple and start kids early Outdoor activities can be as simple as teaching a grandchild to ride a bike, shooting hoops with friends, hiking or going for a brisk swim.

If you have children, introduce them to outdoor fun at an early age.

They’ll be more likely to carry your example into their teen and adult years, when stress-busting and health-enhancing activities become even more vital.

Being active outdoors lets you improve your fitness, while enjoying nature and relieving daily stress in the process. Now that’s what we call effective multitasking.

2. Pick your time.

If you have a pollen allergy, exercise early morning or late evening when pollen counts are lowest. If you’re allergic to mold, avoid exercising right after a rain shower, when molds are at their peak. Check the weather and use smart-phone apps to review allergen counts in your area.

3. Keep allergens outside. After exercising, shower, wash your hair and change your clothes. You might also wish to rinse out nasal cavities using a neti pot filled with a saline solution—allergens tend to accumulate in nasal cavities after exercise.

“Some old-fashioned things, like fresh air and sunshine, are hard to beat.”

Laura Ingalls Wilder, writer

FLORIDA HOSPITAL (844) 804-9378 | SPRING 2017

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KIDNEY STONES

REDUCE YOUR RISK BY FOLLOWING OUR PREVENTION TIPS.

E A C H Y E A R in the U.S. kidney stones cause more than half a million people to visit emergency rooms.

You’ve probably heard that kidney stones can be very painful, which is true, but there’s good news, too: You can take steps to reduce your risk.

Kidney stones are formed when minerals crystallize and harden in the kidney. Some stay there, and others travel through the urinary tract. Tiny stones are sometimes eliminated in the urine with only mild discomfort. But larger stones can force urine to back up behind them, causing dull aches between the ribs and pelvis, or pain on either side of the lower back, in the stomach or groin.

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Drink more fluids

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Most stones can be treated by drinking more fluids and taking over-the-counter pain relievers, and are eventually excreted in urine. Some, however, need to be either broken down or removed during an outpatient procedure. In rare cases, surgery that requires hospitalization is the best option.

The impact of a kidney stone can vary greatly from individual to individual. “A small stone can have a minimal effect, or it can land you in the ICU,” says Ralph A. Highshaw, M.D., board certified urologist with Florida Hospital.

The comprehensive and coordinated care at Florida Hospital means that treatment is tailored to the specific characteristics and effects of each stone—and the needs of each patient.

doctors need to know the size and location of the stone or stones. Typically, ultrasound imaging is used to determine this.

Doctors also need to understand the role your personal history may be playing.

Kidney stones have many causes, including inherited conditions, dietary factors and infection. Risk factors include obesity; diets high in salt, sugar or animal protein; weight-loss surgery (gastric bypass), and certain medications and medical conditions.

A personal history of kidney stones is itself a risk factor: One episode brings a 50 percent chance of recurrence within 10 years.

How stones are removed For stones that must be removed, the two options most commonly used are noninvasive shockwave treatment (lithotripsy) or ureteroscopy. Shockwave therapy works well for most stones, and is often used for those in the kidney. Administered in an outpatient setting, shockwaves are aimed directly at the stone, blasting it into bits that then pass through the urinary system. It creates a level of discomfort that’s similar to a colonoscopy.

Ureteroscopy, a more complex procedure, is often the treatment of choice for large stones located in the ureter (the duct through which urine passes between kidney and bladder). A short, flexible lighted tube called an endoscope is inserted through the bladder into the ureter.

This scope allows the surgeon to see the stone and either remove it using a tiny wire basket or break the stone into small pieces using a laser.

Dr. Highshaw notes that neither procedure is likely to have side effects, and says that most patients return to normal activities quickly.

See your doctor promptly “The most common problem,” says Dr. Highshaw, “is that people delay diagnosis and treatment.” To determine the best treatment,

TO FIND A PHYSICIAN, CALL (844) 804-9378 OR VISIT FLORIDAHOSPITAL.COM.

PREVENTING KIDNEY STONES 1. Drink plenty of fluids. Dr. Highshaw recommends drinking at least eight 8-ounce glasses (a total of 64 ounces or 2 quarts) of liquid daily. Water is best. If you perform strenuous outdoor work, you’ll need to drink close to a gallon daily.

2. Stick to a diet that’s low in salt, sugar and animal protein.

3. Reach or maintain a healthy weight.

4. Drink lemonade. Both lemonade and limeade are rich in potassium citrate, a substance that helps to prevent kidney stone formation. Just avoid versions with sugar, which can increase kidney stone risk.

Make your own sugar-free lemonade by adding a tablespoon of lemon concentrate per quart of water. To help mask the tart taste, try using stevia, a natural sweetener extracted from the leaves of the stevia plant.

5. Don’t avoid calcium-rich foods.

Though most kidney stones are made up primarily of calcium, calcium in food is not linked to an increased risk of kidney stones. However, calcium supplements may be. Ask your doctor what preventive steps are important for you.

Ca

Some patients with a kidney stone experience dull aches between ribs and pelvis. Others develop severe pain (often in waves) in the side, abdomen, lower back or groin. Urine may look cloudy or smell bad.

Emergency symptoms include: • Pain with nausea and vomiting • Pain with fever and chills • Blood in the urine • Difficulty passing urine • Pain that makes it difficult to find a comfortable position

FLORIDA HOSPITAL (844) 804-9378 | SPRING 2017

SYMPTOMS TO WATCH FOR

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Birth Plans Consider Creating a birth plan to share your preferenCes for labor and delivery.

ExpEctant mothErs today have

a number of choices about labor and delivery. That’s why many childbirth educators suggest a written birth plan.

These documents can take the place of multiple conversations with doctors and nurses—conversations you may find difficult when labor is underway.

Ease anxiety. A carefully thoughtout plan can ease a lot of anxiety. It records your wishes in advance, and it’s kept in your hospital chart, so that nurses coming on duty when shifts change will see it right away. reduce surprises. A birth plan prompts you to consider your preferences, and discussing it with your Birth Advocate (see sidebar) gives you a chance to learn hospital policies so you won’t be taken by surprise.

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Be flexible. Birth plans do have their limits, however. Pain thresholds differ greatly from one woman to the next. And levels of pain can be very different, even from

one delivery to another in the same woman, so pain-management plans may need to change.

Safety first. Everyone on your medical team has the same top priority that you do: a safe delivery that leads to the best possible outcome for both you and your baby. So birth plans should not be thought of as set in stone. As much as you may prefer to give birth vaginally, for example, medical circumstances could require that a Cesarean section be performed instead, for your safety and that of the baby.

Learn more about our birth advocate and the birth day experience™ programs at insPiredbirthday.cOm.

your birth AdvocAte Planning for the birth of your child is exciting, but can also be laced with questions: How can I make sure that the medical team understands my preferences? What will happen if there’s an emergency? Who can be with me during delivery? And that’s just before the baby arrives!

One Of the special services we offer moms is our Birth Advocate program.

Birth Advocates are registered nurses with expertise in labor and delivery, postpartum care and newborn care.

Your Birth Advocate will provide a personal consultation to customize your birth experience, answer questions you may have about creating a birth plan, schedule your childbirth classes, and arrange your tour of The Baby Place.

She can help with appointments, connect you with programs such as lactation assistance, and more. in shOrt, when you have questions during your pregnancy, and even after the birth of your baby, your Birth Advocate is here to assist you.

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Exercise Myths, Busted DON’T LET THESE FALSEHOODS DOOM YOUR FITNESS PROGRAM. AT THE BEGINNING of every year, knowing that exercise is critical to good health, millions of people resolve to live a fitter life. Why do so many well-intentioned exercisers fail to persevere? Often, it’s due to mistaken beliefs about how best to get in shape and what it takes to see results. Here, we debunk three common exercise myths.

“No pain, no gain.” Most fitness

visible muscle, you need two things: lots of calories and testosterone.

Females typically don’t have enough of either. So unless they’re taking testosterone supplements and consuming 3,000 calories a day, women simply cannot build muscle mass the way men can. That’s not to say heavy workouts won’t make a noticeable difference in how you look. Exercise, particularly cardiovascular training, will help you work off excess fat. Strength training will add tone and definition. It will also make you stronger, but being stronger is different from having bigger muscles.

Resistance training strengthens both muscle and bone, and has been proven to fight osteoporosis.

“Exercise is a bore.” This is the myth with a kernel of truth. If you do exactly the same things every time you work out, it can become boring.

That’s one reason you should change your routine at least every four to six weeks. Even changing the sequence of your exercises can fight monotony.

But bigger adjustments—adding a new exercise, for instance—can help in another way. By keeping your body off guard, such changes help you avoid plateaus and continue progressing. Our bodies can adapt to almost anything, including an exercise routine. We need to “surprise” our muscles to keep them from getting too comfortable. Check out the machines you haven’t used yet, sign up for a personal training session to get fresh ideas, or take up a new activity.

FLORIDA HOSPITAL (844) 804-9378 | SPRING 2017

experts agree on the foolishness of this old saying. Pain is an inflammation response that means your body is trying to heal an injury.

But soreness is not the measure of a good workout.

Instead, judge your success by whether you’ve met your exercise goals. If you feel less stressed, more fit, more energetic and more flexible, then it’s a quality workout. Post-exercise soreness should be gone in 24 to 48 hours. If it lasts longer, scale back on exercise for now—and see your doctor. If you feel pain during your workout, that’s your cue to stop that particular exertion. Once you reach ‘Ouch!’ you’ve gone too far.

“Lifting weights bulks up women too much.” To build

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4 steps to Better

HeaRt HealtH Anything that gets your body moving and burning calories is good for your heart, as is being careful what you put into your body.

Here are 4 simple ways to keep your heart healthy.

• Be vigorously active for 30 minutes most days.

• Don’t smoke.

• Eat fewer fatty and salty foods, and more fruits and vegetables, whole grains, fish and poultry.

SPRING 2017 | inspiredtampabay.com

• See your doctor for regular physical exams— and if you experience chest pain, a rapid heartbeat or other troubling symptoms.

For more inFormation or to Find a physician, visit floridaheartexperts.org

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SecretS of the Female Heart For women, both diagnosis and treatment oF heart disease can pose special challenges.

E x p E r t s s a y women tend to fear breast cancer personally but think—even if they have heartdisease risk factors—that a heart attack will happen to someone else. In reality, heart disease is the leading cause of death for women in the United States, followed by all cancers.

Many women don’t realize that heart disease can show itself differently in women than in men.

While some experience classic angina—chest pain—just as men do, others have nausea or flu-like symptoms instead. That can make it difficult to diagnose.

There’s also a difference in the way male and female

For these symptoms,

Studies show women are less likely than men to have the classic chest pain and more apt to have other symptoms, such as those listed in the last two bullet points.

During the childbearing years women get some protection from natural hormones, so on average they’re a little older when heart disease is diagnosed. And they’re more likely to have additional conditions, such as diabetes and hypertension.

Researchers are still learning about these differences between men and women. But what is clear is that women—especially those with known risk factors such as excess weight, high cholesterol, high blood pressure or a history of smoking—should consult their doctors to make sure they’re doing all they can to protect themselves against heart disease.

Chest discomfort that lasts more than a few minutes, or goes away and then returns. It may be pressure, squeezing, fullness or pain.

Shortness of breath, often accompanying chest discomfort, but sometimes preceding it.

Discomfort in other upper-body areas, including the back, neck, jaw or stomach.

Other signs, such as nausea, vomiting, lightheadedness or breaking out in a cold sweat.

florida hospital (844) 804-9378 | SPRING 2017

Call 911

bodies handle plaque, which accumulates in arteries and can lead to blockages in blood flow to the heart. Doctors say that instead of a major blockage in one spot, women sometimes develop more diffuse buildups all along the artery wall. These elongated deposits can sometimes make angioplasty or coronary artery bypass graft surgery less effective.

Studies also show that women are more likely than men to develop dangerous conditions in the smaller byways of the arterial system, where they are more difficult to treat, rather than the major arteries leading directly to the heart.

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EMERGENCY?

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THIS LIST OF ER-WORTHY SITUATIONS CAN HELP YOU KNOW WHEN A SICK CHILD NEEDS IMMEDIATE CARE.

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FIND YOUR CLOSEST FLORIDA HOSPITAL ER AT PEDIATRICCARETAMPABAY.COM.

T h e r e ’ s n o T h i n g more frightening than a child who appears to be severely ill. And in those first moments of concern, it’s hard to know whether the youngster needs to be rushed to a hospital emergency room or whether an urgent care facility or the child’s pediatrician may be a wiser choice.

Dr. Heidi-Marie Kellock, a pediatric emergency physician at Florida Hospital Tampa, understands this. “It can be difficult to know how sick your child is and whether you should go to the ER,” she says. “But there are signs and symptoms you can look for that will help you decide.”

Below, in three categories, Dr. Kellock offers examples of conditions that should be promptly treated in the ER. When you’re in doubt about how to transport your child, or if your child appears to be in significant distress, it’s always best to call 9-1-1 for an ambulance.

Breathing Problems There are many causes of labored breathing in children, says Dr. Kellock, including asthma, allergies and illnesses like croup and pneumonia. An ER visit is recommended if you notice any of these symptoms and, in the case of asthma, if rescue medications do not bring immediate improvement: • Your child’s breathing seems faster than normal.

• You can see your child’s ribs or collarbone outlined by skin during inhalation.

• The belly moves outward with every inward breath.

• The nostrils flare outward on inhaling.

• The tongue or lips are blue.

• There’s a high-pitched or squeaking noise when the child inhales.

Vomiting Vomiting is usually caused by gastroenteritis, a virus infecting the gastrointestinal tract, says Dr. Kellock. This “stomach flu” also can cause nausea and diarrhea. “These infections usually don’t last long and are more disruptive than dangerous,” she says. But come to the ER right away if: • You observe projectile or forceful vomiting in an infant, particularly a baby who’s less than 3 months old.

• Your infant is under 2 months old and is vomiting, not just spitting up.

“The vast majority of children who have a fever are not in danger,” says Dr. Kellock.

“However, fever may be a marker of a more serious condition, such as meningitis, pneumonia or a severe urinary tract infection.” You should bring your feverish child to the ER if he or she:

• Your child vomits after taking an oral electrolyte solution for close to 24 hours.

• Is 3 months old or younger and has a rectal temperature of 100.4 degrees F or higher.

• Has a fever-related stiff neck.

• Is dehydrated. Signs include dry mouth, no wet diapers in eight to 12 hours, sunken eyes and sunken soft spot, or fontanelle, in newborns.

• Is having difficulty breathing.

• Vomiting that has eased starts again as soon as you try to resume your child’s normal diet.

• Vomiting begins after a head injury.

• Vomiting is accompanied by fever.

• Your child vomits bright green or yellowgreen fluid, blood or material resembling coffee grounds.

• Your child’s belly feels hard or bloated, and/or is painful between vomiting episodes.

• Your child is lethargic.

• Your child’s vomiting is accompanied by swelling, redness or pain in the scrotum.

florida hospital (844) 804-9378 | SPRING 2017

Fever

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DecoDe These

Coughs

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Want relief from your rattle, rumble or hack? here’s help determining its cause.

F o r t u n a t e l y , m o s t c o u g h s are benign and self-limiting. They run their course and go away on their own. If you have what medicine calls an acute cough—one that’s been going on for three weeks or less—you don’t have to book it to the doctor unless the cough is very thickly productive or accompanied by other worrisome symptoms, such as fever and sore throat. If your cough lasts more than three weeks, it’s time to see your physician.

Coughing can be caused by several conditions, some of which—colds and viral flu, for example— don’t have quick cures and must be waited out. That

doesn’t mean you can’t find some relief from your cough.

Drink plenty of fluids to stay hydrated and use an overthe-counter expectorant, which thins out mucus and makes it easier to cough up.

Determining the cause behind a cough can be tricky. There’s not always an obvious match-up between characteristics and causes. Still, it’s good to know what you’re up against, so read up on these likely suspects.

T find a florida HospiTal To pHysician, call (844) 804-9378 or visiT FloridaHospital.com.

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Postnasal drip

Asthma

Acid reflux

This most common cough usually produces phlegm. But contrary to folk wisdom, that phlegm’s color isn’t a reliable indicator of illness.

This cough, the second most prevalent, tends to be dry and is often accompanied by wheezing and chest tightness.

What to do: If over-

rescue inhaler may help calm the cough, and your physician may suggest anti-allergy therapy.

Roughly one-fourth of chronic coughs are linked to gastroesophageal reflux disease (GERD), which develops when acid backs up into the esophagus.

The acid can irritate nerve endings, triggering a nagging cough. This cough could be the culprit if you find you’re coughing more after meals, if your voice is sometimes hoarse or if your cough gets worse when you lie down.

the-counter medicines don’t bring relief, your physician may prescribe a nasal steroid along with decongestant and antihistamine medications.

What to do: An asthma

What to do: Your physician may prescribe a medication that reduces the amount of acid produced by the stomach’s lining. Raising the head of your bed at night may help too.

Pneumonia

suspect pneumonia, see your physician right away.

Antibiotics can knock out bacterial pneumonia, while viral pneumonia can be treated with medications to combat symptoms and keep the infection from spreading in the body.

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What to do: There’s no specific treatment regimen here. Take it easy and try home and over-thecounter remedies—and get lots of rest.

florida hospital (844) 804-9378 | SPRING 2017

What to do: If you

This cough can show up when you’re recovering from an upper respiratory infection.

It develops when the nerves in the airway become hyperresponsive.

Human coughs can expel air at speeds of up to 500 miles per hour.

500

If you’re acutely ill (high fever, chills) with a brandnew cough, and it’s very productive with a thick pus, you may have pneumonia.

Other indications: feeling like you can’t catch your breath or blue-tinged lips or fingernails.

Post-respiratory infection

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UNDERSTANDING RSTA

Endometriosis WHEN UTERINE-LINING TISSUE SHOWS UP WHERE IT ISN’T WANTED, PAIN CAN RESULT.

DOCTORS DON’T KNOW what

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causes endometriosis, a painful condition in which the endometrium, or uterine lining, grows outside of the uterus. But they do know that several effective treatments are available to bring relief.

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When endometrial tissue grows outside the uterus, it continues to act as it would in the uterus: During menstruation, it thickens, breaks down and bleeds. Outside the uterus, however, the tissue being shed has no way to exit the body. Over time, nearby tissue can become irritated and scar tissue can develop.

Estrogen plays a role, so symptoms of endometriosis disappear during pregnancy and after menopause (unless you take estrogen).

Dr. Marian Sampson, a boardcertified Ob/Gyn at Florida Hospital Zephyrhills, explains that endometriosis can be difficult to diagnose. “Its symptoms can have other causes, such as irritable bowel

syndrome and interstitial cystitis,” she says. “For a firm diagnosis, endometriosis must be seen during surgery or proven with a biopsy.”

Diagnosis and treatment are sometimes combined during laparoscopy, in which a surgeon inserts a scope through a small incision near the navel and uses fiber-optic lights to examine the pelvic organs. If endometrial tissue is located outside the uterus, it is removed or destroyed using a laser, electrocautery or other small surgical instruments.

Other treatments for endometriosis include pain medication and hormone therapy.

“The best treatment for each patient depends on individual clinical circumstances,” says Dr. Sampson.

Almighty ASPARAGUS

LOADED WITH NUTRIENTS, THESE SPIRITED SPEARS ARE PACKED WITH POWERFUL HEALTH BENEFITS. This springtime green vegetable is tender, tasty, easy to prepare and packed with nutritional benefits. So maybe it’s time to make these succulent stalks a menu regular.

Power Up

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Growth rate: up to 10 inches in 24 hours.

3

Time from seed to harvest: 3 years.

Choose stalks that are round and neither fat nor twisted. The stems should be firm and thin with deep green or purplish closed tips. To store your spears, wrap a damp paper towel or cloth around the ends and place in your fridge. Try to consume asparagus within 48 hours of purchase, when it’s at its best both in taste and nutritional value. Pre-cooking prep is minimal.

Use a vegetable peeler to remove the outer skin of the stem’s thicker bottom portion, which tends to be tough and stringy. Don’t cut the tips off! Wash asparagus under cold water to remove any grit and then cook stalks whole to maintain nutrients. Serve asparagus as a side dish by sautéing in your choice of vegetable broth, chicken broth or olive oil, or by roasting in the oven, lightly sprinkled with Parmesan cheese. In the mood for a breakfast with a difference? Asparagus makes a flavorful addition to any omelet. Or liven up that lunchtime salad by chopping up asparagus spears—raw or cooked—and tossing them into the mix.

15-20

A perennial vegetable that produces for 15-20 years.

20

Of 300 varieties, only 20 are edible.

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Asparagus helps the heart in several ways. It’s rich in fiber, which can reduce risk of cardiovascular disease, and full of inflammation-fighting antioxidants. It also packs plenty of B vitamins, which help regulate the amino acid homocysteine, high levels of which can be a danger to your arteries. What’s more, one ½-cup serving of this powerhouse vegetable provides 57 percent of your daily requirement of vitamin K (which helps blood clotting and strengthens bones), and 34 percent of the daily requirement for folate (needed to produce DNA and to help the body’s cells divide properly). Asparagus also contains a type of soluble fiber that helps us absorb nutrients by supporting the colon’s probiotic bacteria. You get all that—and distinctive taste too—for only 20 calories!

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