Author Archive

Endoscopic Ultrasound (EUS)

Monday, February 19th, 2018

Endoscopic Ultrasound (EUS)

Advances in endoscopic technology have led to a variety of new and exciting applications. Endoscopic Ultrasound (EUS) is now the most accurate imaging technology for staging tumors of the gastrointestinal (GI) tract. With traditional endoscopy, we were able to view the innermost lining of the digestive tract. However, with the addition of ultrasound technology, we can visualize and see your internal organs and examine your esophageal and stomach linings as well as the walls of your upper and lower gastrointestinal tract.

For patients, it offers a far less invasive approach to cancer staging. EUS allows for fine-needle aspiration capabilities, which has led to increased diagnostic accuracy in cancer staging. It is a less invasive option that may eliminate the need for staging surgery and/or CT guided biopsies. The ability to obtain tissue samples allows us to further assess digestive and lung diseases.

Because we are able to take an ultrasound picture of organs and tissues beyond the lining of the GI tract, EUS has been shown to have better accuracy in diagnosing pancreatic tumors than a CT scan and a more comprehensive evaluation can be made when a patient presents with one of the more common problems in the GI system, like abdominal pain: we can see small stones/ debris in the bile duct, not detected with other imaging studies. We can find and biopsy abnormal lymph nodes close to the GI tract.

Under mild sedation, this outpatient procedure is very safe and takes about 20-40 minutes. During the procedure, a small, flexible ultrasound device is mounted on the tip of an endoscope. An endoscope is a small, lighted, flexible tube with a camera attached. When the endoscope enters the upper or the lower digestive tract, we are able to see high-quality ultrasound images of organs. With high quality pictures, we can then determine the size and location of a tumor and whether it has spread to the lymph nodes, blood vessels or other structures.

When it comes to your digestive system, we are experienced and expertly trained to care for you. Please feel free to schedule a consultation. I can be reached at Portneuf Medical Group Gastroenterology at 208-232-6616.

 

The Health Benefits of Dark Chocolate

Friday, February 16th, 2018

The Health Benefits of Dark Chocolate

By: Jennifer Hill

chocolate heart

For decades, chocolates have been given to that special someone as a sincere gesture of appreciation.  On Valentine’s Day, chocolate is shared as a sign of love or friendship. While the gesture and gifts of sweets are wonderful, rich milk chocolate is also considered to be junk food – high in calories, fat and sugar.

However, if you choose to indulge in dark chocolate, it is a somewhat healthier option. Milk chocolate is very processed, contains a lot of added sugar and does not come with many health benefits. On the other hand, dark chocolate, being 70% or higher cacao, is not as processed, will never have sugar listed as a first ingredient, and has several health benefits.

Dark chocolate contains fiber, iron, potassium, and other important minerals the body needs. It also contains antioxidants; it can improve blood flow through the body and brain and it may help lower blood pressure. Some studies suggest it may help raise HDL (the good cholesterol), and overtime may help prevent plaque from clogging arteries.

While perhaps a bit healthier than milk chocolate, dark chocolate is still high in calories and should be consumed in moderation.

During Valentine’s Week try making an easy, sweet treat to share with those you love.

 

Valentines Day Dark Chocolate Recipe

By: Lee Hayward

  1. Melt dark chocolate (70% or higher) in a saucepan over medium heat
  2. Pour into a heart shaped baking tray (or any shaped baking tray)
  3. Place a few almonds (your preference of nut) in each tray
  4. Place in the refrigerator until cooled and hard
  5. Drizzle with honey (optional) before serving

Gunnars, K., BSc. (2017, May 30). 7 Proven Health Benefits of Dark Chocolate. Retrieved February 10, 2018, from https://www.healthline.com/nutrition/7-health-benefits- darkchocolate#modal-close

Hayward, L. (n.d.). Valentine’s Day Dark Chocolate Recipe – Lee Hayward’s Total Fitness Bodybuilding Tips. Retrieved February 10, 2018, from http://leehayward.com/blog/valentines-day-dark-chocolate-recipe

Weight Bias and the Impact on Individuals

Friday, February 16th, 2018

Weight Bias and the Impact on Individuals

by: Alyssa Lynott RDN, LD

 

An image of a person holding up a larger pair of pantsWeight discrimination affects as many as 40% of the United States population and is one of the most common types of discrimination in our country today. Rebecca Pearl, Ph.D., states that “as obesity rates have risen over the past few decades, so have rates of weight-based discrimination.”  Weight bias or weight discrimination is any negative attitude towards an individual based on their weight status whether in the act of bullying or unfair treatment. The act of weight bias was once thought to encourage behavior changes, for example, using the term ‘fat’ was thought to encourage the individual to lose weight. However, as more research is completed, it has been found how weight bias can negatively affect an individuals’ health.

Where and how does weight bias occur?

Weight bias occurs in our society today where those with obesity or extra weight are looked at differently. Though research has recently revealed that obesity can be brought on by many different factors including genetics, biological factors, and environment; society tends to blame the individual’s lifestyle, disregarding any consideration of the biological or genetic factors at play.

What are the impacts on health?

Weight bias has a large effect on an individual’s mental health, especially when they accept these weight-based stereotypes to be true about themselves. Conditions such as depression, anxiety, and eating disorders are common among individuals who have experienced weight bias. Some research has also shown evidence of increased disease and mortality risk with those who experience weight-based discrimination. Pearl states, “Obesity and weight-related health outcomes are complex… stigma is one factor that impacts obesity-related health problems.”

What can we do?

The first step in correcting a bias is recognizing your own. A test created at Harvard University titled Project Implicit (follow the link below and select the tab Weight IAT) can help an individual recognize their own personal bias. We all need to mindful of our bias and treat every individual with respect regardless of the size of their body.  A powerful movement that focuses on just this is called, Health at Every Size. This movement focuses on celebrating body diversity and honors the differences between all humans. Every individual can change the way they view weight in our society, after all, it is just a number. Let us all take one step forward in living in a world free from weight bias!

Project Implicit Link

Health at Every Size Link

Health Impact of Weight Stigma Full Article

Free Seminar on Obstructive Sleep Apnea

Monday, February 12th, 2018

Free Seminar on Obstructive Sleep Apnea

community seminar information card for Dr. Fort Sleep Apnea SeminarThe word apnea literally means ‘without breath.’ Statistics indicate that more than 18 million American adults suffer from sleep apnea, a potentially serious sleep disorder. Common symptoms may include chronic snoring, walking up abruptly to the sensation of choking and/or gasping, excessive daytime sleepiness and fatigue, dry mouth, morning headaches and/or irritability. It is extremely difficult to get a restful night of sleep when you are gasping for air.

People with sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night. Despite the high prevalence of this disease, many people do not seek medical care. In part, because the sleeper may be unaware of these breath stoppages or perhaps due to the mistaken belief that those who suffer snore. While chronic snoring is a strong indicator of sleep apnea, it is important to know that just because you or your partner snores at night does not automatically equal apnea, in fact, a number of apnea patients don’t snore at all.

If you or a loved one is experiencing symptoms, this seminar is for you. Topics will include an overview of the types of apnea, but will focus specifically on obstructive sleep apnea. It will also cover when to seek medical care, risk factors, symptoms, diagnostic testing, long-term effects as well as treatment options. One of the more common methods used to diagnose sleep apnea is a sleep study so there will be a conversation about that diagnostic tool and well as lifestyle changes that can help mitigate symptoms.

This free community seminar will be held in the Pebble Creek Conference Room at the Portneuf Medical Center on Thursday, Feb 15, 2018. Doors open at 6:00 pm; the presentation begins at 6:30 pm. Light refreshments will be served. To reserve a seat, click here. To learn more about Portneuf’s upcoming seminars be sure to like Portneuf Medical Center on Facebook.

Untreated sleep apnea can have serious and life-shortening consequences: high blood pressure, heart disease, stroke, automobile accidents caused by falling asleep at the wheel, diabetes, depression, and other ailments. Many individuals continue to struggle with the ill effects and health concerns that often come hand in hand with poor sleep and inconsistent breathing.

Medically reviewed by Peter Fort, MD

Red Hot Mamas and Overactive Bladder

Tuesday, February 6th, 2018

Red Hot Mamas and Overactive Bladder

Red Hot Mama Ad for February 2018Millions of women and men suffer from an overactive bladder (OAB). The symptoms of OAB are usually characterized by frequent, sudden and compelling urges to run to the bathroom. Sometimes there is even leakage of urine. My patients often say things like, “when I’ve got to, I’ve got to go” or “I have to hurry, because I don’t want to wet myself.”
Sound familiar? It is estimated that approximately 10-16% of adults have OAB – that’s roughly 30-50 million people!

While OAB affects women and men about equally, women are twice as likely compared to men to experience leakage of urine. This obviously creates a highly negative impact on the quality of life for these women. A number of clinical factors increase a woman’s risk for overactive bladder and urinary incontinence; these include, increasing age, post-menopausal status, weight gain, history of childbirth, neurological disease, and diabetes.

Overactive bladder is not a disease, but rather a symptom complex resulting from a variety of factors. Other conditions such as urinary tract infection, malignancy, or stones can mimic the symptoms of OAB, therefore these should be ruled out before one is formally diagnosed with OAB.

Despite the high prevalence of OAB and urinary incontinence among women, many do not seek treatment – as high as 80%. Many women are simply not aware of the treatment choices that are available to them. Or, they may assume that invasive surgery is their only option, which they understandably would prefer to avoid.

If you or a loved one would like more information about overactive bladder and the treatment options that are available, please join me for a special seminar in the Red Hot Mamas® lecture series titled “Women and Overactive Bladder: taking back bladder control.”

The Red Hot Mamas® organization is a leading provider of information and support programs to women to help optimize their health at menopause and beyond.

This seminar will be held in the Pebble Creek Conference Room at the Portneuf Medical Center on Tuesday, January 6, 2018. Doors open at 6:00 pm; the presentation begins at 6:30 pm. Light refreshments will be served. To reserve a seat, visit www.portneuf.org/event/rhm or call 208-239-2033. To learn more about Portneuf’s upcoming seminars, including Red Hot Mamas®, be sure to like Portneuf Medical Center on Facebook.

Ready, Set, Go Red

Monday, January 29th, 2018

Go Red Portneuf Logo 2018Ready, Set, Go Red

One out of every three deaths among women in the US each year is attributed to cardiovascular diseases making it the No 1 killer of women in this country. In fact, heart disease and stroke cause more fatalities than all forms of cancer combined, according to the American Heart Association. The National Wear Red Day is a countrywide campaign geared toward creating awareness surrounding heart and stroke prevention. Celebrated on the first Friday of February each year, we would like to encourage everyone to wear red on Friday, February 2nd in support of this worthy cause.

We use this opportunity to reach out to women in our community and alert them to their personal risk factors for heart disease. Statistics indicate there is an estimated 43 million women in the US who are affected by cardiovascular disease and many do not know they are at risk. You may look and feel healthy, but a person can still have an underlying heart issue and still feel fine.

As with men, women’s most common heart attack symptom is chest pain or discomfort, but women are more likely to experience other symptoms such as shortness of breath, back pain, nausea, and sweating. These less obvious and more ‘silent’ symptoms are often discounted or brushed aside because there is a mistaken belief that chest pain or discomfort are the only signs of a heart attack.

During February, our goal is to share educational information and provide opportunities that may just save a life. Primarily, we want everyone to know that women’s symptoms are not as predictable as men’s in matters of the heart. It is so important to learn all you can about symptoms and how to lead a healthier lifestyle.

Second, we highly encourage women to schedule their annual well-women visit. Heart disease is referred to as the silent killer because symptoms, especially for women, can be more subtle. During an annual visit, your primary care provider will assess your health, check your blood pressure, discuss family history, review risks factors, share ways to live a healthier lifestyle and talk about any additional health concerns. During your visit, providers typically order routine blood test to further look at the numbers.

And that brings us to the final thing I want to share with you in this article. Heart Healthy Numbers are important! To help in prevention and early detection, Portneuf Lab will offer reduced fee heart healthy labs during the month of February. The reduced fee labs are open to everyone. To learn more, visit Portneuf Lab. You can print the form, fast for 12 hours, and come to the main entrance of the hospital, by the waterfall. From there, we will get you in the system, collect the fee and get your labs drawn promptly – no appointment necessary.

Liquid Meal Replacements

Friday, January 26th, 2018

Liquid Meal Replacements

By: Jessy Griffel, RD, LD

a wall of drinks at a grocery storeIn light of “diet month,” I am sure you have heard of millions of weight loss strategies. But have you heard anything about meal replacements? A meal replacement is defined as any food that’s eaten or drunk as a substitute for a meal or part of a meal. You can use a meal replacement to supplement or replace breakfast (easy option for breakfast on the go) or use them as the sole source of nutrition to help promote weight loss or weight gain. There are several types of meal replacements, but we are going to focus on liquid meal replacements.

Advantages
Liquid meal replacements can offer a premeasured amount of food with specific calorie, protein and nutrient levels, eliminating the need to weight, measure, or estimate portion size. Another benefit is that these products transport easily. They come in a can or bottle, and require little to no preparation or clean-up! This is very convent for individuals on the go.

Some research suggests that the monotony of consuming the same type of meal replacement with a similar texture each day leads to “sensory-specific satiety,” i.e., the decreasing pleasure of tasting, smelling, or eating a food until full or satisfied. The result of this monotony can be reduced appetite and fewer calories consumed.

Jessica Crandall, RDN, CDE, AFAA, a spokesperson for the Academy of Nutrition and Dietetics and wellness center director at Denver Wellness & Nutrition by Sodexo, agrees. “For clients who have had their brains fixated on food for so long, these liquid meal replacements can work.”

Disadvantages
Obviously, like any product on the market, liquid meal replacements come with some disadvantages. They often don’t provide enough phytochemicals; which are found in plant-based food, i.e. fruits and vegetables. Additionally, a strong support system is required for individuals who have been on liquid meal replacements as sole nutrition when they are reintroducing real foods back into their diet.

Prepackaged liquid meals do not help you learn how to effectively estimate portion size of real foods. Knowing how to best manage your food intake is a critical aspect of long-term weight management.

Additionally, some of the liquid meal replacements that are marketed as low calorie often contain sugar alcohols, which commonly cause gastrointestinal distress such as bloating and diarrhea. Lastly, adding liquid meal replacements to your daily routine can be costly, ranging anywhere from $1.25 to more than $4 per serving.

Consult a Professional
As you look for ways to lose weight and make healthy lifestyle choices, it is important to contact your primary care provider or meet with a Registered Dietitian to find the tools that are unique to your activity level, health and taste buds.

 

New Technique for Diagnosing Lung Cancer

Monday, January 22nd, 2018

New Technique for Diagnosing Lung Cancer

lung cancer screening image

This is the navigational bronchoscopy image. The Computer guides the catheter to the spot as seen on the CT chest images.

Lung cancer is the leading cause of cancer death in both men and women in the United States. According to the American Lung Association, “the disease has been closely associated with smoking since 1964, when the first Surgeon General’s report concluded that tobacco smoke was a cause of lung cancer. Today, smoking is thought to cause up to 80-90 percent of lung cancer cases.”

Statistically, the five-year survival rate for a person diagnosed with lung cancer currently stands at around 16 percent as compared to an over 90 percent survival rate for breast, colon and prostate cancers. In the past few decades, screening for breast, colon and prostate cancers has proven to be instrumental in early detection, diagnosis and subsequently successful treatment of those cancers.

Now, there is a test that can reduce death from lung cancer through early detection. The test is not recommended for everyone. You may be eligible for early screening if you:
• Are a current smoker or if you have quit within the past 15 years
• Have no current symptoms of a lung condition or a history of lung cancer
• In the age group from 55 to 74 years old
• And have smoked a minimum of 30 “pack years”

We believe we can reduce the number of deaths caused by lung cancer by offering improved detection at earlier stages, when lung cancer is much more easily treated. Results of the National Lung Screening Trial (NLST) released in August of 2011 show that screening with a low-dose spiral computed tomography (CT) scans as compared to chest X-rays reduced lung cancer deaths among heavy smokers by 20 percent.

If a spot on your lung is found, a new non-invasive technique called electromagnetic navigational bronchoscopy (ENB) is one of the tools we now use to diagnose lung cancer. ENB, an exciting technique, promises accurate navigation to identify lesions; it uses technology similar to a car’s GPS to locate areas of concern.

If you or a loved one is interested in learning more about the screening or would like to schedule an appointment, please contact our Lung and Sleep Specialists.

Newborn Nutrition

Thursday, January 18th, 2018

Newborn Nutrition

By: Margaret Larson, RD

According to the American Academy of Pediatrics, exclusive breastfeeding for 6 months can decrease (1):

  • Respiratory tract infections during the first year of life
  • Gastrointestinal tract infections
  • Necrotizing enterocolitis (NEC) in preterm infants
  • Sudden Infant Death Syndrome (SIDS)
  • Obesity
  • Diabetes
  • Childhood leukemia and lymphoma

baby bottle and ice packs in a bag

Along with these health benefits, breastfeeding provides balanced nutrition for the growing baby. A woman’s body is truly amazing; it can customize the breastmilk composition to meet the unique needs of her baby. For example, if a baby is born premature, mother’s milk adjusts to provide additional protein and nutrients. As the baby grows, the composition of the breastmilk changes and adapts to better fit the needs of the growing baby. And, if the baby or mother is sick, once again, the cellular composition of breastmilk changes to provide added protection and healing for the baby. The unique changes that occur in breast milk suggest an immunological link between mother and child. Breastmilk truly is important! (2)

When infants are born early, some with a birth weight of less than 2 pounds, they may be transferred into a Neonatal Intensive Care Unit (NICU). Simultaneously, when labor and delivery happen well before the due day, a mother’s body may not be ready to start producing milk or the mother may be sick and milk production is slowed. When a mom is not able to produce milk or, for some other reason, mom’s milk is not available, we have a beautiful alternative to ensure babies get the nutrition they need to grow and stay healthy.

Portneuf Medical Center’s NICU, as well as numerous NICU’s across the country, purchase milk through accredited milk banks. At present, we work with the Mothers’ Milk Bank of Denver, Colorado. All potential milk donors go through a thorough screening process before being approved as a donor. Once approved, mother’s milk is frozen, collected and sent to the Mothers’ Milk Bank to be pasteurized and tested.

In situations where a mother is unable to produce milk, struggling due to preterm birth or unable to provide milk for her child, moms can rest assured that their babies can receive the nutrition they need to grow and be healthy while they are in our NICU.

Portneuf Medical Center also serves as a donation collection site for the Mothers’ Milk Bank of Denver, Colorado. Mothers who have additional milk production, beyond what their little one may need, may apply to be a donor and help infants in need. To learn more how you can become a donor, please visit www.portneuf.org/service/women-children/mothers-milk-bank-donation-and-collection-site/ or at www.rmchildren.org.

1. American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved April 27, 2012, from http://pediatrics.aappublications.org/content/129/3/e827.full.pdf+html
2. Clinical & Translational Immunology (2013) 2, e3; doi:10.1038/cti.2013.1
Published online 12 April 2013

New Hope to Patients with Metastatic Liver Tumors

Monday, January 15th, 2018

New Hope to Patients with Metastatic Liver Tumors

bottle of y90 SIR-Spheres® microspheresUp to 70 percent of the some 140,000 Americans diagnosed with colorectal cancer every year will see their cancer spread to the liver, and most liver tumors cannot be surgically removed. Metastatic liver cancer is often fatal, with up to 90 percent of patients dying from liver failure. Selective Internal Radiation Therapy (SIRT) has emerged as a treatment option for patients with colorectal cancer that has spread to the liver.

SIR-Spheres® microspheres or SIRT therapy has proved to be an excellent option for multiple types of cancer patients whose disease has spread to the liver and who are not candidates for surgery. SIR-Spheres microspheres are microscopic radioactive spheres that can be delivered by the millions directly to the tumor site. The microspheres contain the radioactive isotope yttrium-90 (Y-90), which delivers beta radiation to the tumor. The microspheres selectively target liver tumors with a dose of internal radiation up to 40 times higher than conventional radiotherapy while sparing healthy tissue.

“This is a powerful weapon against a very common place for cancer to spread,” says Jared Bailey, MD “In the past, in patients who can’t get surgery, we were able to offer patients few, if any, targeted treatment options. In the correct patient, SIR-Spheres microspheres have been proven to extend patient survival and, just as importantly, the treatment allows patients to maintain a good quality of life.”

Ongoing research continues to showcase the effectiveness of SIR-Spheres microspheres in treating patients with metastatic colorectal cancer, neuroendrocrine cancer, and hepatocellular cancer. Clinical studies have confirmed that certain patients with metastatic colorectal cancer treated with SIR-Spheres microspheres have response rates higher than with other forms of treatment, resulting in increased life expectancy, greater periods without tumor activity and improved quality of life. SIRT has been found to shrink liver tumors more than chemotherapy alone.

Under the direction of Dr. Jared Bailey, we began offering SIRT using SIR-Spheres® microspheres at Portneuf Medical Center in late 2017.The treatment is performed as an outpatient procedure by specially trained Interventional Radiologists and requires the placement of a catheter into the hepatic artery. Using the liver’s unique blood supply, millions of radioactive microspheres are selectively implanted into the tumor where they become trapped, killing tumor cells and sparing the surrounding healthy liver tissue.

If you or a loved one has been diagnosed with colorectal, neuroendocrine, or hepatocelluar cancer, you may want to speak to your provider about this treatment option.

Medically reviewed by: Jared Bailey, MD