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Health Q&A

Posted November 14, 2012 in Advice Column, Ankeny

Q: My child is being treated for ADHD but is still struggling. Could it be a vision problem?

A: ADD and ADHD have become a common terms in the past 20 years. Whether this is due to better training to find and diagnosis cases or due to a perceived notion that a child or person who is hard to control at times or has a hard time focusing thus resulting in overdiagnosis is a different story and up for debate. What is not debatable is the side effects of the medications used to treat ADD/ADHD, or how similar the signs of ADD/ADHD are to signs of vision issues.

First, a known side effect of the medications is an impact on the ability of the human eye to properly focus itself to keep things clear when reading or doing near work. This results in variable blurry vision for the patient, which can impact the clarity of both near and far vision. In addition, a long-term government-funded study that has investigated the most common learning-related vision issue in children, called the Convergence Insufficiency Treatment Trial, has recently concluded that children with convergence insufficiency exhibit more behaviors and symptoms of ADHD as reported by teachers and parents than children without convergence insufficiency, and that after office-based vision therapy, those behaviors and symptoms improved significantly. This long-term study had already shown the office-based vision therapy was the single-most effective way to treat convergence insufficiency. If this sounds like you or someone you know, please call us at 515-964-7541 to schedule an comprehensive vision exam.

Information provided by Erik Romsdahl, Child and Family Vision Center, 2525 N. Ankeny Blvd., Suite 109, Ankeny, 964-7541.

Q: I have diabetes but seem to be managing it well. How often should I see my doctor?

A: Everyone should visit his or her healthcare providers at least once a year. This ensures that you stay up to date on vaccinations and makes sure your body is still working the way it should. If you have diabetes, a yearly visit to a primary healthcare physician is not enough. Ideally, you should see the following healthcare providers to help manage your diabetes and hopefully avoid further complications:
• Primary care physician for an annual physical including blood pressure check.
• Endocrinologist as needed, until blood glucose is under control, then every three to six months to have Hemoglobin A1C tested
• Podiatrist at least yearly to have feet examined for sores, ulcers and signs of diabetic neuropathy (loss of feeling in feet that can lead to amputation).
• Ophthalmologist yearly to have eyes examined for diabetic retinopathy (can lead to blindness)
• Dietitian upon first diagnosis of diabetes and regularly if weight not at goal.
• Dentist at least twice a year to maintain healthy teeth and gums.
November is Diabetes Awareness Month, so it’s a good time to schedule appointments with these healthcare professionals if you have not done so recently. Once you set up these appointments, you should also record them in a daily planner or on your mobile calendar. Doing this will help you remember future visits as well as have documentation for past diabetes care visits.

Information provided by Jennifer Meurer, PharmD., Medicap Pharmacy, 107 N.E. Delaware, Suite 6, 964-8550.

Q: What are some tips for cooking winter squash?

A: Fall brings the new crop of hard-shelled squash to the grocery store. These winter squash add an abundance of super nutrients to the table. Orange-fleshed squashes are high in beta-carotene, important for healthy skin, immune system and night vision. A half-cup of cooked orange-flesh winter squash provides about 50 calories. Follow the cooking tips below:

Bake: Cut in half, remove seeds and place cut-side down in a baking dish. Bake at 350° F or microwave on high until tender. Scoop flesh for recipes using cooked squash. Roast: Cut into chunks, peel cut off, toss with olive oil and seasonings. Place on a foil-lined shallow baking pan and roast at 475° F for 35 to 45 minutes, stirring every 15 minutes. Roast until they’re fork-tender. Steam or boil: Cook peeled chunks in a small amount of simmering water or in a steamer until tender. Season and serve.

Winter Squash Primer:

Butternut: Tan shell makes these easy to spot. Similar in flavor and texture to sweet potatoes. Acorn: Looks like a large green acorn. Sweet buttery yellow-orange flesh. Buttercup: Dark green shell with lighter green spots.  Deep-yellow flesh with slightly nutty flavor. Spaghetti: Stringy flesh resembles cooked spaghetti. Use as a very low-calorie alternate to pasta dishes.

This information is not intended as medical advice. Please consult a medical professional for individual advice.

Information provided by Jenny Norgaard, RD, LD, registered dietitian, Ankeny Hy-Vee, jnorgaard@hy-vee.com, 515-964-0900.

Q: What is medical home?

A: A medical home is a model of healthcare that utilizes a team-based approach to care. Led by a physician, the team includes nurses, pharmacists, dieticians and therapists in addition to other clinical staff. The goal of the team is to improve coordination of your care. There are several key concepts:

Access. Access to same-day appointments is offered through blocked open scheduling at your medical home. Also, a patient portal is designed to provide you with confidential electronic access to test results, email access to the clinic and online access to your health record.

Self-management support. Self-management support enables the medical home to work with you individually to give you the best tools and resources you need to take control of your own healthcare.

Test tracking and follow-up. The medical team has established systems in your electronic health record to track and follow-up on test results. They work to improve effectiveness of care by managing the timely receipt and communication of information on all tests and results.

Referral tracking. Referral tracking systems in the electronic medical record are designed to ensure timely coordination of care by following through on critical consultations with other physicians.

Outcome measures of performance. The team measures and monitors performance data at a provider level regarding: clinical process, clinical outcomes, service data, patient satisfaction and patient safety.  Many offices are undergoing this “care redesign” process and believe that it will improve the quality of care that is delivered to you, the patient.  When the redesign is complete, you will find your care more efficient and effective, yet personable and comforting. Just as it should be.

Information provided Dr. Doug Layton, D.O., Family Physicians at Prairie Trail, 2515 S.W. State St., 964-6999.

Q: Is there a link between breast cancer and gum disease?

A: Statistics can be confusing, but here’s a simple one to wrap your mind around: Nearly 80 percent of Americans have some form of gum disease. The World Health Organization studied the link between periodontal disease and breast cancer from 1985 to 2001. Of the 3273 subjects between age 30 and 40, there was a significantly higher incidence of breast cancer in patients who were missing molars as a result of chronic periodontal disease. There are no guarantees against getting cancer, but there are plenty of compelling reasons to take care of yourself, including maintaining oral hygiene and going to the dentist twice a year.
Patients undergoing chemotherapy may experience side effects involving their oral health. Toothaches, dry mouth, sore throats, inflammation and infection in the mouth, difficulty swallowing, strange tastes and thrush (a yeast infection in the mouth) are often reported. You may not feel much like going to the dentist when you’re battling cancer, but try to maintain regular checkups, if at all possible. A strong and healthy mouth will make it easier for you to focus on the fight at hand. You’ll be dealing with enough without having to be concerned with fillings,root canal therapy or extractions from severe tooth decay.

Our team at Peddicord Family Dentistry offers our support to anyone battling cancer. We can help if you are experiencing dental issues from chemotherapy. Visit our website at www.peddicordfamilydentistry.com  or call to schedule an appointment.

Information provided by Dr. Erika Peddicord, Peddicord Family Dentistry, 121 N.E. 18th St., Suite C, 963-3339.

Q: What are some of the most common issues facing the elderly?

A: Thanks to new medications and surgical techniques, people are living longer and healthier lives. However, the body we had at 55 will be a very different body than the one we have at 75. Many issues, both genetic and environmental, affect how we age.

The most widespread condition affecting those 65 and older is coronary heart disease, followed by stroke, cancer, pneumonia and the flu. Accidents, especially falls that result in hip fractures, are also unfortunately common in the elderly.

As the body changes, other things to be aware of are:
• A slowed reaction time, which is especially important when judging if a person can drive.
• Eyesight can diminish, which can also be a factor whether driving is safe and can make daily tasks hard to do.
• Thinner skin, which can lead to breakdowns, skin tears and wounds that don’t heal quickly
• A weakened immune system, which can make fighting off viruses, bacteria and diseases difficult and sometimes deadly.
• Diminished sense of taste or smell, especially for smokers, which can lead to diminished appetite and dehydration
• The list can seem daunting. However, with proper care, elders have a life filled with joy.

Information retrieved from Susan Levy, M.D., provided by Chelsea Spear, At-Home Care Company Ankeny.

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