Monday, May 30, 2011

Ask Us Anything: How Can I Correct My Posture?

"I struggle with my posture, especially with my shoulders hunching forward. What does good posture look like? What are some strategies that I can use to correct my posture? And besides an improved appearance, what are the benefits of good posture?"

Registered Nurse Robert Mages Responds:

When you have good posture, your pelvis is neutral in alignment to support the S-curve of the spine. You don't want to push it forward or back.

Your weight should be evenly distributed from front to back – it should feel like the weight is falling directly through the middle of the foot. To check your posture, stand in front of a mirror and check that your head is straight, your shoulders are level and your knee caps face the front.

Then, turn to the side to evaluate your posture:
  1. Your head should be straight – not jutting forwards or backwards.
  2. Your chin should be parallel to the floor.
  3. You should be able to see a a straight line from your ears down to your shoulders and then to your hips, knees, and ankles.

To sit with good posture:
  • Sit with your back straight and your buttocks touching the back of the chair. If it is difficult to stay against the back of the chair, use a pillow or towel behind you to support your lower back.
  • Your knees should be even with or slightly higher than your hips.
  • Do not cross your legs, and keep your feet flat on the floor.
  • Rest your elbows on your chair or desk to keep your shoulders relaxed.
  • Do not twist at the waist when sitting in a chair that pivots. Rotate your whole body instead.
Try to be aware of your posture throughout the day and correct it when necessary.

You may want to consider pursuing yoga or pilates. These disciplines strengthen your back muscles, upper torso, buttocks and legs to improve posture and stability.

Maintaining a good posture enables you to breath properly. And because you're increasing your oxygen to the brain, you'll experience increased concentration. Good posture also helps you to avoid health complications such as a slipped disc, back aches, back pain and poor blood circulation.

— Robert Mages, RN

Robert Mages is the Nurse Manager of the Open Heart Unit and Critical Care Unit at Mercy Hospital of Buffalo.

If you have a question about your health, click here to ask our experts.

Monday, May 23, 2011

Ask Us Anything: How Can I Prevent and Reduce the Appearance of Spider Veins?

"I have spider veins on my legs, especially near my calves. I am a cashier and am on my feet for eight hours a day. Could this be the cause? What can I do to prevent any further spider veins from developing and how can I reduce their appearance?"

Nurse Practitioner Lana Pasek Responds:

Nurse Practitioner Lana PasekSpider veins are red, blue or purple thread-like lines that are close to the surface of the skin and usually appear in the legs. These veins have dilated (expanded) and can be caused by pressure, trauma or faulty valves.

Long periods of standing can increase your risk of developing dilated veins.

Spider veins are not harmful but you do need to watch for other leg vein symptoms. The cause of spider veins and any other vein problems of the legs that result in swelling, aching, or difficulty walking need to be evaluated by a vascular specialist such as vascular surgeon or at a vein center.

The preferred treatment option for spider veins is sclerotherapy. This involves injecting the veins with a "sclerosing" agent, which results in fading of the vein. The procedure takes about 15 to 30 minutes. The number of veins treated in one session varies. Repeat injections are separated by 1-2 weeks. After a treatment, compression stockings are worn for 2-3 days.

Not everyone is a candidate for this procedure. To determine if sclerotherapy is appropriate for you, you should be evaluated by someone who specializes in veins and/or vascular problems.

To help prevent spider veins in the future, avoid standing or sitting for long periods of time. If you must stand for a long time, shift your weight from one leg to the other every few minutes. You should also consider wearing support hose.

If you're sitting for long periods of time, move around or take a short walk every 30 minutes.

Persons carrying extra weight will want to exercise regularly to improve their leg and vein strength.

— Lana M. Pasek, EdM, MSN, RN, APRN-BC

Lana is a Nurse Practitioner for Vascular and Stroke Services at Sisters of Charity Hospital and has worked in Vascular services for 9 years. She has master's degrees in Education and in Nursing. Lana is a licensed Registered Nurse and is nationally board certified as a Nurse Practitioner in Adult Health.

If you have a question about your health, click here to ask our experts.

Monday, May 16, 2011

Ask Us Anything: Why Do I Have Bumps on My Heels?

"I have a small bump on the back of each heel that may be Haglund's deformity. I am in my 20s and wear heels to work but am rarely on my feet. At home and on the weekends, I wear flats. These bumps do not cause me any pain or discomfort. Should I see a doctor? Will they ever go away?"

Physical Therapist Jeff Castiglione Responds:

Physical Therapist Jeff CastiglioneA Haglunds deformity is an enlargement of the heel bone (Calcaneus) of the foot. The soft tissue of the Achilles tendon may become irritated and painful with pressure on the back of the heel.

An x-ray is needed to confirm this deformity.

Without the presence of the bone deformity, it may also be a simple tenosynovitis due to shoe pressure. If it is not painful, you probably do not need to have it assessed by your doctor.

As far as going away, an enlargement of a tendon is a response to stress, often the type of shoes you wear, such as those with a rigid heel back. You can sometimes help it by avoiding the type of shoes that aggravate it, as well as some massage and stretching of the Achilles tendon.

— Jeff Castiglione, Doctor of Physical Therapy, Certified Strength & Conditioning Specialist

Jeff is the manager of AthletiCare - Amherst, which provides Physical Therapy and Sports Training and Injury Prevention services in Amherst, NY.

If you have a question about your health, click here to ask our experts.

Monday, May 9, 2011

Ask Us Anything: What is the Recovery Time for a Cesarean Section?

"What is the average recovery time for a C-section? What can someone with autoimmune issues, such as lupus, expect? How will lupus affect my pregnancy, both before and during delivery?"

Dr. Ali Ghomi Responds:

The average hospital stay after a cesarean section is 3 to 4 days. Full recovery may take 4 to 6 weeks.

Having said that, mothers are usually able to care for themselves and their newborn with minimal discomfort after a few days. It is recommended to have support at home at least during the first week after delivery.

For the most part, chronic autoimmune conditions should not prolong one's recovery after delivery.

Lupus, a disease in which your immune system attacks healthy cells and tissue, occurs frequently in women of childbearing age.

Generally speaking, pregnancy outcomes are more likely to be complicated in patients with Lupus. The prognosis for mother and the baby is best when the condition has been under control for at least 6 months prior to conception.

The Lupus patient should have pre-conception counseling with her obstetrician to review medications and perform a history and physical examination.

Lupus flare or exacerbation can occur during pregnancy. Pregnant patients with Lupus are at an increased risk of certain conditions such as:
  • toxemia of pregnancy or preeclampsia – a pregnancy-related blood circulation problem that causes high blood pressure and affects the kidneys, liver, brain, and placenta
  • hypertension – high blood pressure
  • fetal loss
  • growth restriction of the fetus – a condition in which a fetus is unable to achieve its potential size
  • pre-term delivery – birth of a baby of less than 37 weeks gestational age
It is very important that pregnant patients with the diagnosis of Lupus be closely monitored by their obstetrician. In addition, co-management with high-risk-pregnancy specialists and/or rheumatologist/nephrologists may be warranted in certain cases.

The delivery should occur in a controlled environment. Mode of delivery may be vaginal or via cesarean section, which is determined by many factors such as the gestational age at the time of delivery and the condition of the mother and the fetus.

— Dr. Ali Ghomi

Dr. Ghomi is the Director of Minimally Invasive Gynecologic Surgery and Chair of The Robotic Surgical Committee at Sisters of Charity Hospital. He is the only physician in Western New York who performs Sacrocolpopexy Prolapse surgery using the da Vinci® robot. Sacrocolpopexy is a proven “gold standard” procedure worldwide to repair severe pelvic prolapse. Click here to learn more about Catholic Health's OBGYN services.

If you have a question about your health, click here to ask our experts.

Monday, May 2, 2011

Ask Us Anything: What Can I Do for a Lonely Parent?

"My father is in his 80s and is in fair health. However, he experiences loneliness but does not live near any relatives. I've recommended that he move or have a companion visit him on a regular basis but he refuses.

He may be more willing to listen to a medical professional. Do physicians make recommendations regarding living arrangements?"

Patricia Weeks O'Connor, Executive Director of the OLV Senior Neighborhood, Responds:

Patricia Weeks O'Connor, Executive Director of the OLV Senior NeighborhoodYou can definitely enlist the help of your father's physician in encouraging him to consider all of his options for increased socialization.

Call your father's physician ahead of his next appointment and share your thoughts and concerns with him or her.

While his physician may not be able to give you feedback unless your father has authorized him/her to do so (due to HIPAA privacy laws), s/he can listen to your concerns and use that information in advising your father. You are wise to be thinking about this for your father, as social isolation can cause depression in the elderly and can lead to more rapid physical decline.

Your father doesn't necessarily need to move. He can take advantage of day programs offered at the senior citizen center in your community (many offer transportation, making outings easier).

Another option may be a church-sponsored day trip program where seniors go on outings. Attending such programs two or three times a week may be just what he needs to stay connected to the outside world!

— Patricia Weeks O'Connor, Executive Director of the OLV Senior Neighborhood and Mercy Nursing Facility

The OLV Neighborhood houses Catholic Health's LIFE program. Its day center offers a place where seniors may engage in recreational and social activities and receive personal care and supervision during the day. Click here for details.

If you have a question about your health, click here to ask our experts.
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