Oxford Health & Life: Winter 2021

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WINTER 2021

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TRIHEALTH.COM

PANDEMIC KINDNESS BOOST YOUR MOOD DIABETES: SHIFTING TO WELLNESS

CARDIAC

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Nancy and Bill Clayton enjoy a very special date night courtesy of the ICU nurses at McCullough-Hyde Memorial Hospital.

PANDEMIC KINDNESS DURING THE HEIGHT OF THE COVID-19 CRISIS LAST SPRING, ONE COUPLE PUT THEIR COOKING TALENTS TO WORK FOR THE ICU TEAM. NEWS COVERAGE about COVID19’s impact on local hospitals inspired Nancy Clayton of Eaton, Ohio, to bake for those on the front lines of the pandemic. “It was a desire to help healthcare workers who were under such incredible pressure,” she says.

She baked to show appreciation and sent her lovingly prepared cookies, treats and breads to the hospital in the care of her friend, Elaine Renner, a nurse in the intensive care unit (ICU) of the hospital.

When Nancy heard how fast the sweets had disappeared, she kept going. Her home-baked appreciation continued sustaining the weekend night shift at the hospital for the next two months. Her husband, Bill, contributed

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to the effort, too. “He was the financial backer!” says Nancy, with a laugh.

“It really boosted morale,” says Renner. “It made people feel like others do care when you’re down in the trenches.” The made-from-scratch comfort Nancy delivered week after week included pumpkin bread, banana muffins, chocolate chip bread and chocolate brownie caramel squares.

Eager to reciprocate the kindness, Renner sent a save-the-date request to the Claytons, then she and her unit planned an unforgettable experience for the couple.

BEST DATE NIGHT EVER Arriving at Renner’s home on the appointed evening, Nancy says, “We

were overcome. It was a shock—we were just so surprised!” A romantic “Claytons’ Best Date Night Ever” had been created.

A waiter greeted them on the porch with champagne, escorting them to their outdoor table. The chefs in the kitchen that night were Renner and her fellow ICU nurses. The beautiful view, embroidered napkins, fine wine and delicious Italian dinner, graciously served, made the evening magical. “It was truly a once-in-a-lifetime memory,” says Nancy.

When Bill suffered complications after knee surgery weeks later, the hospital cooked for the couple. “They turned around and helped us,” says Nancy. “It just came full circle.”

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SHIFTING TO WELLNESS

WITH DIABETES

PATIENTS MOVE FROM FEAR TO HOPE WITH THE HELP OF A SUPPORT PROGRAM THAT DEMYSTIFIES LIFE WITH THIS CHRONIC ILLNESS. IMAGINE SITTING in your physician’s office and being told, “You have type 2 diabetes.” It’s a diagnosis that more than 30 million Americans have confronted. Hanna Thomsen, RD, LD, dietitian for the Diabetes Self-Management Education Program at McCullough-Hyde Memorial Hospital, recognizes how overwhelmed patients feel at the beginning of their diabetic journey. “There’s a lot to this disease,” she says. “It’s a drastic change. It effects every cell in your body.” She and Dana Streight, RN, are educators who equip patients with skills that transform anxiety over a diagnosis into confidence that wellness is still attainable.

“There’s so much for a patient to learn and to consider when having a diagnosis of diabetes,” says Streight, who teaches patients about their medications. “Patient education is one of my favorite responsibilities as a nurse. If I can help someone feel a little more comfortable and confident with diabetes or have that moment where it “clicks,” I feel so lucky to experience that with them.”

LEARNING TO THRIVE The Diabetes Self-Management Education Program is a half-day seminar for patients (four per session) who have received referrals from their doctors. Each patient is invited to bring one support person—a spouse, friend or caregiver.

The program starts with individual assessments of medical history, eating habits, physical activity and medications. Next, key components of life with diabetes— medication, nutrition, monitoring, exercise and the emotional aspect of the disease—are addressed in a group setting. Lifestyle strategies (think travel, dining out, even negotiating relationships) and mindset are also discussed. “The holistic care of a patient is just as important as the medical care,” Hanna Thomsen, RD, LD says Streight.

Patients receive healthy doses of encouragement for months afterward in phone calls, informative emails and an optional followup meeting. Soon, patients realize diabetes is “a drastic change, but a manageable one,” says Thomsen. “They return excited, saying, ‘This has been the catalyst to improve my life and health.’”

DIABETES SNAPSHOT Diabetes is the seventh leading cause of death in the U.S. and a serious concern for the more than 30 million Americans who have it. About 1 in 3 American adults has prediabetes, which puts them at high risk of developing type 2 diabetes, as well as heart disease and stroke. Of those adults, 8 in 10 don’t know they’re prediabetic. So it’s important to understand both the steps you can take to prevent type 2 diabetes and its symptoms.

3 steps to reduce your risk of developing type 2 diabetes: 1. Eat a healthy diet, including lots of fresh fruits and vegetables and lean proteins, like fish, chicken and pork.

2. Be more active, aiming for at least 150 minutes every week of moderate-intensity aerobic activity (for example, 30 minutes a day of brisk walking, five days a week).

3. If you’re overweight, drop excess pounds—eating healthy and exercising more will help with this goal.

If you experience these symptoms, talk to your doctor: • Needing to urinate much more, including at night • Losing weight without trying • Feeling hungry much more often • Blurred vision • Excessively dry skin

• Numb or tingling hands or feet • Feeling tired much of the time • Sores that don’t heal or heal slowly • Becoming suddenly more susceptible to infections.

TO LEARN MORE ABOUT THE DIABETES SELF-MANAGEMENT EDUCATION PROGRAM, CALL 513.524.5555.

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Faisal Adhami, MD, (above, center) receives 2020 Top Doctor recognition with his team by his side.

AN ALLY FOR CANCER PATIENTS DR. FAISAL ADHAMI, KNOWN FOR HIS GREAT KINDNESS AS WELL AS HIS CANCER EXPERTISE, EARNED TOP DOCTOR FOR THE FOURTH YEAR IN A ROW. THE INITIAL WAVE of the pandemic was a dark time for healthcare workers. Yet in the midst of it, there was a bright spot for Faisal Adhami, MD, a hematology-oncology physician at McCullough-Hyde Memorial Hospital. In June, he was awarded a plaque for landing on Cincinnati magazine’s prestigious Top Doctors list for 2020.

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The celebration, held in his clinic during quarantine, was small but tremendously meaningful. “Top Doctors is an award where peers nominate each other and recognize the top physicians in each subfield,” he explains. “The people who work in the clinic with me were all there, giving me recognition.”

Dr. Adhami has been included on the Top Doctors list every year

since 2017. “I’ve been blessed,” he says. Earning such kudos involves more than luck, however; it’s a testament to his remarkable skill and commitment.

As a teen, Dr. Adhami, now 41, realized medicine was his destiny.

“It was during my biology dissection lab—that was one of the most vivid and exciting experiences.

Literally every day, I was waking up

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thinking, ‘I get to see the inside of an organism!’” he says.

FINDING HIS CALLING After graduating as valedictorian from Fairfield High School, he attended Case Western Reserve University in Cleveland, and then entered an MD/PhD program at the University of Cincinnati. Oncology was a natural fit for his talents.

“There’s new research coming out, new fields that really change patient outcomes, and that’s exciting,” he says. “That’s what initially drew me to oncology. Then, when I started interacting with oncology patients and seeing what it is to fight cancer, I realized I couldn’t imagine anything more fulfilling.”

Part of Dr. Adhami’s success lies in excellent patient relationships.

“My philosophy of patient care is to put myself in their position and have empathy. The patients really feel that you care for them,” says Dr. Adhami, who also sees patients with non-cancerous conditions, such as sickle cell anemia.

ally, his despair quickly turned to determination to survive. “He made it easy to understand what was going on, and totally guided me through the avenues of what was best, giving me several options for treatment,” says Marty.

When his cancer caused Marty to develop a blood clot in his lungs and land in the intensive care unit, Dr. Adhami offered reassurance.

“His demeanor made me feel like, ‘Okay, this is something else we can get through,’” Marty recalls.

The crisis is over, and he anticipates full remission. “Dr. Adhami’s staff is fantabulous, and the best way I can describe him is he’s very, very kind,” he says.

Chemotherapy is one of Dr. Adhami’s areas of expertise. “It’s medication that kills cells that divide very fast,” he explains. “Cancer is cells that divide fast, and we need to stop them. Because a lot of your own cells divide fast, they’re impacted by treatment as well, causing side effects. The key is to use chemotherapy in a way that kills the cancer, but controls the harm.”

A PATIENT ALLY Marty Webber can attest to that.

The 47-year-old was referred to Dr. Adhami in February, after being diagnosed with Stage III rectal cancer. With Dr. Adhami as an

THE FUTURE OF CANCER TREATMENT Immunotherapy is another tool that Dr. Adhami uses to treat patients.

“It’s a completely new field of

treatment,” he says. “Basically, we use your immune system to attack your cancer for you. Our bodies have a kind of ‘stop sign’ built into them that stops our immune systems, and cancer tries to hide behind that. Immunotherapy takes away that stop sign, so your immune system can find the cancer and kill it.”

As for what’s exciting in the field, Dr. Adhami says: “The future of cancer is in targeted therapy.

We send a person’s tumor to companies that sequence the genes to discover what are the mutations that made this cancer into cancer. And we’re developing new medications all the time that try to undo what the mutation did.”

While medicine takes up much of Dr. Adhami’s energy, he prioritizes spending time with his wife, Kashifa, an artist and homemaker, and their three children: Raza, 16, Aleesha, 14, and Liyana, 1. During commutes, he listens to audiobooks. He also enjoys going to the movies. But his work is his fascination. “It’s amazing to see what basic science research can bring to change people’s lives, and to take something that used to be a death sentence and give it a completely different outcome,” he says. “It’s just really cool to be involved in that.”

TO MAKE AN APPOINTMENT WITH DR. ADHAMI AT THE INFUSION CENTER AT MCCULLOUGH-HYDE MEMORIAL HOSPITAL, CALL 513.524.5540.

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HEART HEALTH:

IT PAYS TO THINK AHEAD CARDIAC CHECKUPS CAN BE CRITICAL TO PROTECTING YOUR HEALTH. HERE’S A GUIDE TO SOME OF THE MOST COMMON TESTS. HEART DISEASE KILLS one in four Americans and is the nation’s leading cause of death.

Fortunately, many heart conditions can be prevented or treated— especially if you catch them or their warning signs early with appropriate tests.

Getting regular checkups with your primary care physician is the best place to start. He or she can listen to your heart, order screening tests and assess your risks.

If screening tests uncover any reasons for concern, you may be referred to a cardiologist for additional testing to investigate underlying conditions and determine next steps.

LIPID PROFILE BLOOD PRESSURE WHAT IT IS: A measurement of the force that blood exerts on arteries as your heart pumps.

HOW IT’S DONE: A healthcare professional places a cuff around your upper arm, inflates it to compress an artery, then slowly releases it while monitoring your pulse.

WHY IT’S IMPORTANT: High blood pressure triggers no symptoms but greatly increases your risk of heart disease.

WHEN YOU MAY NEED MORE TESTS: Healthy adults should have blood pressure checked at least once a year, but your doctor may check more often if your reading is higher than 120/80 or you have risk factors.

BLOOD GLUCOSE WHAT IT IS: A gauge of blood sugar levels, which reflect the presence or risk of diabetes.

HOW IT’S DONE: A variety of blood tests assess glucose levels; some require fasting.

WHY IT’S IMPORTANT: Untreated diabetes substantially increases your risk of heart disease, but elevated blood glucose that’s caught early can be reversed.

WHEN YOU MAY NEED MORE TESTS: Your blood glucose may be tested more frequently if you’re overweight or have additional cardiac risk factors like high blood pressure or high cholesterol.

WHAT IT IS: A blood test that checks circulating levels of fatty substances such as cholesterol (total, LDL and HDL) and triglycerides.

HOW IT’S DONE: A healthcare professional uses a small needle to draw blood into a vial that’s sent to a lab for analysis. Fasting may be required before the test.

WHY IT’S IMPORTANT: High levels of LDL cholesterol and triglycerides boost your risk of heart disease, while HDL is protective.

WHEN YOU MAY NEED MORE TESTS: Healthy adults should get a lipid profile every four to six years, but your doctor may order screenings more often if your numbers are worrisome or you have risk factors like a family history of heart disease.

ELECTROCARDIOGRAM (EKG OR ECG) WHAT IT IS: A measurement of electrical activity in the heart as it beats.

HOW IT’S DONE: Electrodes affixed to your chest, arms and legs convey your heart’s electrical signals through wires to a computer.

WHY IT’S IMPORTANT: Abnormal electrical activity can indicate conditions such as irregular heartbeat, clogged arteries, heart damage, heart failure or a heart attack.

WHEN YOU MAY NEED MORE TESTS: Cardiac electrical activity can vary throughout the day, but an EKG only offers a minutes-long snapshot.

A portable Holter monitor can record electrical readings over 24 to 48 hours for a more complete picture.

IF YOU HAVE HEART-RELATED CONCERNS OR TEST RESULTS YOU’D LIKE TO DISCUSS WITH A CARDIOLOGIST, CALL THE TRIHEALTH HEART INSTITUTE AT McCULLOUGH-HYDE MEMORIAL HOSPITAL AT 513.246.2400.

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CT SCAN ECHOCARDIOGRAM WHAT IT IS: An ultrasound scan that generates measurements as well as still and moving images of the heart’s interior, including its chambers, blood vessels, valves and blood flow.

HOW IT’S DONE: An instrument called a transducer creates images as it’s moved over the skin of your chest and torso.

WHY IT’S IMPORTANT: Obtaining information about your heart’s size, shape, movement, strength and function can reveal problems including faulty valves, structural abnormalities, heart attack damage, inflammation and heart failure.

WHEN YOU MAY NEED MORE TESTS: If a standard echocardiogram doesn’t provide enough detail, you may need an invasive transesophageal echocardiogram (TEE), in which you’re sedated and a transducer is inserted down your throat to a position closer to the heart.

EXERCISE STRESS TEST WHAT IT IS: A way for your doctor to know how your heart responds to exertion.

HOW IT’S DONE: You walk on a treadmill or pedal a stationary bike while your heart rate, blood pressure and electrical rhythms are tracked.

WHY IT’S IMPORTANT: The stress test allows a doctor to see if enough blood flows to your heart as you get more active, whether your heart rhythms are normal and more.

WHEN YOU MAY NEED MORE TESTS: More tests may be ordered if the results are unclear; if you have other risk factors for heart disease that raise concern; or if your doctor wants to confirm results that indicate coronary artery disease.

CHEST X-RAY WHAT IT IS: A black-and-white, 2D image that shows your bones, lungs and heart.

HOW IT’S DONE: You stand between a machine that generates X-rays and a plate that captures the image.

WHY IT’S IMPORTANT: Chest X-rays can reveal heart-related lung conditions such as fluid resulting from congestive heart failure, problems with blood vessels near the heart and abnormalities in the heart’s size and shape.

WHEN YOU MAY NEED MORE TESTS: If needed, your doctor may order further imaging tests that reveal details not visible on an X-ray, such as internal heart structures.

NUCLEAR STRESS TEST WHAT IT IS: Similar to the exercise stress test, but with images.

HOW IT’S DONE: A small amount of radioactive dye is injected, and then two sets of images are taken with a special camera, one while the patient is at rest and another after exertion.

WHY IT’S IMPORTANT: May be recommended if an exercise stress test doesn’t pinpoint the cause of symptoms.

WHEN YOU MAY NEED MORE TESTS: If results indicate blockages or damage, a coronary angiogram, also known as cardiac catheterization, may be done.

Note: Patients who can’t do exercise for the test may get a pharmacological nuclear stress test, in which a medication is injected to mimic the effects of exercise.

WHAT IT IS: An imaging method called computed tomography (CT) in which X-rays taken from multiple angles produce detailed, 3D images of the heart and its arteries.

HOW IT’S DONE: You lie on a table that slides into a large, tunnel-like machine in which X-ray beams rotate around you.

WHY IT’S IMPORTANT: CT scans can reveal coronary artery plaque buildups that threaten the heart, along with valve problems, inflammation and pumping deficiencies.

WHEN YOU MAY NEED MORE TESTS: If your doctor is concerned about your exposure to X-ray radiation or needs greater accuracy for specific conditions, you may receive a magnetic resonance imaging (MRI) test to take detailed images using magnets and radio waves.

CARDIAC CATHETERIZATION WHAT IT IS: A diagnostic procedure in which a cardiologist inserts a thin tube called a catheter into a blood vessel (typically in the groin) and threads it to your heart to obtain images or samples.

HOW IT’S DONE: The procedure typically takes place in a hospital catheterization (cath) lab under light sedation. You may be injected with a dye that makes blood vessels more visible.

WHY IT’S IMPORTANT: Cath images can show if blood vessels supplying the heart are narrowed or blocked, and a procedure to open them may be done during the same catheterization.

WHEN YOU MAY NEED MORE TESTS: If you need a procedure, such as open-heart surgery, more tests may be required to prepare for your operation.

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MOOD-BOOSTING FOODS THE MOST POWERFUL “MEDICINE” FOR FEELING GOOD MAY BE WHAT YOU PUT ON YOUR PLATE.

WHAT IF YOU WERE OFFERED a tool that would lift your spirits, improve thinking and memory, and give you the energy to do all the things you want to do?

The fact is, you already have this tool at your disposal. Numerous medical studies have found that what we eat on a daily basis is powerful “medicine”—perhaps the most powerful—for fighting depression and fatigue and supporting cognitive performance.

Food can actually trigger chemical reactions in our brains that change how we feel and function. Read on for insights and recipes that include brain-boosting ingredients.

DEPRESSION PREVENTION. Research shows that a higher risk of depression is linked to a diet that includes few fruits and vegetables, but lots of red or processed meat (such as deli meat, bacon and hot dogs), as well as high-fat dairy products like whole milk and butter. Meanwhile, a diet that includes lots of fruits, vegetables, low-fat dairy, whole grains, fish and olive oil is strongly associated with a much lower risk of depression. Certain foods spur the release of the feel-good brain chemicals dopamine and serotonin. This category includes foods rich in the nutrient magnesium, such as leafy greens, nuts, seeds and whole grains;

foods rich in B vitamins, including poultry, fish, avocado and almonds; and foods that contain zinc, such as oysters, cashews, liver and egg yolks.

ENERGY MANAGEMENT. Sugary foods like soda and candy lead to a sharp surge of energy because they trigger the brain to release dopamine. However, this so-called “sugar high” will be brief and will be followed by a slump in mood and energy levels. On the other hand, a well-balanced diet that includes healthy fats, whole grains, lean proteins, fruits and vegetables leads to steady levels of energy.

BRAIN BOOST. A recent large-scale study of 28,000 people in 40 different countries found that people who ate the healthiest diets were 24 percent less likely to have a decline in their thinking skills, compared with people who ate the least healthy diets. Other studies have found a connection between a diet high in refined sugars and impaired brain function.

All of these mental benefits come on top of the physical benefits of a healthy diet—joints that don’t ache, fewer colds, better bowel function, lower cholesterol, reduced risk of heart and kidney disease, and much more.

TILAPIA TACOS This recipe uses lots of fresh peppers, onions, lime and fish combined with corn or rice and seasonings that provide a little heat, such as the jalapeño used here.

INGREDIENTS: • 1 white onion, sliced • 1 red pepper, seeded and sliced • 1 yellow pepper, seeded and sliced • 1 orange pepper, seeded and sliced • 1 teaspoon olive oil • 1 tablespoon fresh chopped cilantro DIRECTIONS: • Preheat skillet on high heat with olive oil.

• Add onions and peppers and sauté on high heat until edges of vegetables begin to brown. Set aside in mixing bowl.

• Spray grill pan with cooking spray and cook fish fillets until translucent, about 3 minutes each side or until fish flakes

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• 4 tilapia fillets, 5 ounces each • Cooking spray • 8 6-inch corn tortillas • 1 small jalapeño • 1 lime, cut in 8 wedges

easily when tested with a fork.

• Add fish to vegetables and toss lightly.

• Warm tortillas according to package directions.

• Divide taco mixture among tortillas and garnish each tortilla with cilantro and wedge of lime.

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COCONUT PUMPKIN SOUP

AFRICAN VEGETABLE STEW

This tasty version of pumpkin soup provides loads of nutrients, including fiber, vitamins A and C, potassium and iron.

Based on a traditional Ethiopian recipe, this hearty dish is packed with nutrients and flavors commonly used in African dishes, including teff, a whole grain with a mild, nutty taste that’s rich in vitamin B6, iron, magnesium and manganese.

INGREDIENTS: • 1 medium orange sweet pepper, seeded and chopped • 2 medium carrots, chopped • 1 medium onion, chopped • 1 tablespoon vegetable oil • 1 14-ounce can reduced-sodium chicken broth

• 1 15-ounce can pumpkin • 1 14-ounce can light coconut milk • ½ teaspoon ginger or pumpkin pie seasoning • 2 tablespoons snipped fresh cilantro (or another seasonal fresh herb, such as sage)

DIRECTIONS: • In a large saucepan, cook sweet pepper, carrots and onion in hot oil over medium heat about 5 minutes, or until tender.

• In a large bowl, combine broth, canned pumpkin and coconut milk. Stir in ginger.

• Add liquid ingredients to saucepan of vegetables.

• Bring to boil, reduce heat. Simmer, uncovered, 10 minutes or until heated through, stirring frequently.

• If you like a thicker soup, simmer longer to desired thickness. Be careful to cook on low heat, checking frequently.

• Add cilantro or other fresh herb as garnish.

INGREDIENTS: • 2 tablespoons olive oil • 2 cups chopped onion • 4 cloves garlic, minced • 1 tablespoon berbere spice blend (purchase online or at an African grocery) • 4 cups vegetable stock, low-sodium or organic • 1 cup water • 1 cup uncooked teff (purchase online, at

Whole Foods or at a health foods store) • 1¼ pounds sweet potato, chopped into small cubes • 4 tomatoes, chopped, or one 14.5-ounce can no-salt-added tomatoes • 8 cups collard greens • ¼ cup natural peanut butter (containing just peanuts and salt, no sugar or added oils)

DIRECTIONS: • Place olive oil in a large stew pot. Add onion and garlic; cook until translucent.

• Add berbere spice and cook 30 seconds, stirring until combined.

• Add stock, water, teff, sweet potatoes and tomatoes. Bring to boil, stirring occasionally.

• Cover and cook 20 minutes, adding a little water if stew is too thick.

• Add collard greens and simmer until wilted.

• Add peanut butter. Mix well and serve.

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PERIPHERAL ARTERY DISEASE: ARE YOU AT RISK? THIS SERIOUS, SOMETIMES SYMPTOMLESS CONDITION INCREASES AN INDIVIDUAL’S RISK OF HEART ATTACK AND STROKE. PERIPHERAL ARTERY DISEASE (PAD) affects one in 20 Americans over the age of 50. It occurs when plaque, a fatty deposit, builds up in the arteries, restricting blood flow to your legs. These fatty deposits put the individual at a greater risk of heart attack and stroke.

The problem is that buildup of plaque may not result in any detectable symptoms.

That’s why it’s important to know not only the potential symptoms, but also the risk factors so you can talk with your doctor.

When assessing your risk for PAD, your doctor will take a personal and family medical history. He or she also will perform a physical exam to check pulses, color and temperature of the legs

and feet, and may perform an anklebrachial index. This test compares the blood pressure in your ankles with that in your arms. If PAD is suspected, your doctor also may order an ultrasound to try to identify the blocked artery.

Treatment options for PAD include lifestyle changes, medication and surgery.

Lifestyle changes that improve PAD include quitting smoking, improving cholesterol and blood glucose levels, eating a healthy diet, exercising and achieving or maintaining a healthy weight.

Medical treatment may include prescriptions to reduce blood pressure and cholesterol, manage diabetes or prevent the formation of blood clots.

You have diabetes

You have high blood pressure You have a history of vascular disease

You are a smoker or former smoker

You are over the age of 50

RISK FACTORS

50+

In addition, surgery or other medical procedures may be used to unclog arteries.

The best thing you can do to decrease your risk for peripheral arterial disease is to make those lifestyle changes now, if necessary, or to maintain your healthy lifestyle into the future.

PAD is one of hundreds of conditions that develop in patients who have high cholesterol, are overweight, don’t exercise, have diabetes or smoke.

Remedying these health issues will help reduce your risk of PAD and countless other conditions as you age. Why not start now? Your future self will thank you for it.

You may be at increased risk for PAD if any of the above is true.

You are AfricanAmerican

IF YOU HAVE HEART-RELATED CONCERNS OR TEST RESULTS YOU’D LIKE TO DISCUSS WITH A CARDIOLOGIST, CALL THE TRIHEALTH HEART INSTITUTE AT MCCULLOUGH-HYDE MEMORIAL HOSPITAL AT 513.246.2400.

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SYMPTOMS TO WATCH FOR

Some people with PAD may not experience any symptoms. For those who do, symptoms may include: • Claudication—heaviness, tiredness or cramping in the leg that occurs during activity and resolves after the activity is stopped • Sores on toes, feet or legs that heal slowly or not at all • Pain in the legs or feet that wakes you up or prevents sleep • Color changes in the feet, particularly blueness • Poor nail growth or decreased hair growth on the legs • A lower temperature in one leg than the other.

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Delivering your birth plan, even if it changes between contractions.

BABY BOUND delivers an individualized plan perfect for you The next chapter of your story is about to begin, and the TriHealth team is by your side. McCullough-Hyde Memorial Hospital delivers more than state-of-the-art facilities, all-private Labor-Delivery-Recovery rooms and a home-like atmosphere, we also deliver a personalized, hands-on experience through our BABY BOUND maternity services. Registered nurses provide individualized plans for each expectant mom that includes pregnancy assessment and birth planning, prenatal education, nutrition counseling, breastfeeding support, follow up visits and more.

BABY BOUND, one more reason why no one else delivers an exceptional maternity experience quite like we do.

Learn more at TriHealth.com/MHMH or call 513 524 5689

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