Monday, June 27, 2011

Ask Us Anything: Why Do I Feel Cold?

"I am frequently cold and am wondering if it could be a sign of a vascular problem. I've been sensitive to air conditioning and fans for as long as I can remember and wear sweaters whenever they are present. Is this something that I should be concerned about? Or that I can correct?"

Nurse Practitioner Lana Pasek Responds:

Nurse Practitioner Lana PasekThe general feeling of being cold most of the time is not a symptom of a vascular disorder. It could be a symptom of a thyroid disorder, such as hypothyroidism, which indicates an underactive thyroid.

In addition to feeling cold, hypothyroidism can cause tiredness or depression, dry skin, heavy periods, constipation and memory issues, such as trouble with recall. A blood test can detect a thyroid disorder (you will need a prescription from your doctor for the blood work).

Other causes of feeling cold are a low body weight, as muscles and fat keep us warm, and consuming too few calories (the body conserves energy by producing less heat). As for vascular disorders, you may be associating cold and a vascular problem with the vascular disorder called Raynaud’s syndrome.

Raynaud’s affects the arms and hands. It is episodic ischemia (or decreased blood flow) to the fingers which causes a change in the color of the fingers. The fingers turn white then blue or purple and then red after re-warming them. This happens mostly in the cold and/or when there is emotional stress. An underlying autoimmune disorder, such as lupus or rheumatoid arthritis, may cause these episodes.

If you have such response to cold, then an evaluation by a vascular surgeon is useful. Tests can be administered (there is no single test to diagnose Raynaud's syndrome). If you are diagnosed with the disorder, the initial therapy is cold avoidance (avoidance of cold environments). There are also medications that can be tried.

Most patients with Raynaud's do not lose function of their hands or need surgery.

— 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, June 20, 2011

Ask Us Anything: How Can I Add Protein to a Vegetarian Diet?

"Whenever I tell people that I am a vegetarian, they ask me how I get my protein. There seems to be a perception that eating meat is healthier than abstaining from meat products and I'm wondering if this is true."

Registered Dietitian Deborah Richter Responds:

Registered Dietitian Deborah RichterVegetarian diets can contain ample protein, particularly if dairy products and eggs are consumed.

There are many protein choices that will provide sufficient nutrients. Dried beans, nuts and cooked legumes are good sources of protein, fiber, B vitamins and trace minerals.

However, several nutrients are either lacking or very low in meatless diets. These include iron, zinc, vitamins B12 and D, and possibly calcium. Thus, vegetarians are advised to consume specific foods on a daily basis to ensure adequate intakes of these nutrients.

Good choices include:
  • Dried fruits and fortified breakfast cereals (for iron)
  • Nuts (for iron, zinc, and essential fatty acids)
  • Fortified non-dairy soy beverages (for vitamin B12, calcium and D) 
  • Green leafy vegetables (for calcium)
Vegan vegetarians (those who do not eat dairy or eggs) are advised to supplement their diets with vitamins B12, D and the mineral calcium if they choose to omit fortified foods from the diet.

The health benefits of vegetarian diets include a reduced risk of:
  • heart disease,
  • high blood pressure,
  • diabetes,
  • certain cancers, and
  • obesity.
Vegetarians usually consume more fiber-rich foods such as dried beans, nuts, whole grains and more vegetables and fruits. These foods provide excellent sources of vitamins C and E and beta-carotene, and are rich sources of phytochemicals (plant chemicals). These nutrients help to protect blood and tissues from oxidative stress resulting from normal metabolism. They also protect from exposure to environmental irritants such as pollution, UV light, chemicals, and cigarette smoke.

It is important to choose a variety of foods and to maintain a balance with the portions and to practice moderation. This message is good for everyone, vegetarian or meat eater.

Enjoy those crunchy vegetables and the benefits of a healthy diet!

Resources for more information include:
— Deborah Richter, RD

Deborah Richter is a registered dietitian at Sisters of Charity Hospital, St. Joseph Campus in Cheektowaga. She teaches diabetes education classes and provides outpatient nutrition counseling. She has helped her clients to lose weight, reduce their blood pressure and feel better about themselves through healthy eating choices.

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

Monday, June 13, 2011

Ask Us Anything: Can I Predict or Influence My Baby's Gender?

"My husband and I are thinking about starting a family. Is there a way to increase our chances of having a girl naturally (without medical intervention)? Also, I have heard people say that if a woman carries low, that she is having a boy. Is there any truth to this?"

Dr. Scott Zuccala Responds:

Dr. Scott ZuccalaIn response to your question about gender selection, it is difficult to select a boy or girl.

A baby's gender is determined by the sperm that fertilizes the egg.

There are two types of sperm: sperm that carry an X chromosome and sperm that carry a Y chromosome. Two X chromosomes are needed to produce a girl.

The mother's egg always carries an X, so the father's sperm is the determining factor. From a purely academic point of view, the male sperm is lighter; thus one can use the technique of separating the sperm based upon weight to increase the chances of a boy or girl. This is known as sex selection.

But, there is no way from a non-medical point of view to increase the chances of one versus the other.

Some people have said there is a way to time the cycle, but I have seen no literature to support this.

One of the most popular theories regarding gender selection is known as the Shettles Method, which was developed in the 1960s. It hypothesizes that a couple can time intercourse to increase the odds of an X-carrying sperm fertilizing the egg.

There has been no conclusive evidence that the Shettles Method is effective. In fact, a 1995 study in the New England Journal of Medicine stated that, "the timing of sexual intercourse in relation to ovulation has no bearing on the sex of the baby."

In terms of carrying low, this does not indicate boy or girl.

Ultrasounds or genetic testing are the most accurate methods of predicting gender. However, neither are 100% accurate, and there are pros and cons to each.

 — Dr. Scott Zuccala

Dr. Zuccala is a gynecologic surgeon at Mercy Hospital of Buffalo. He practices obstetrics and gynecology, including minimally invasive surgery, and vaginal and pelvic reconstruction for prolapse and urologic incontinence surgery. He was one of the first surgeons in the Buffalo area to perform minimally invasive gynecological surgery for non-cancerous conditions using the da Vinci® Robotic Surgical System.

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

Monday, June 6, 2011

Ask Us Anything: How Can I Get a Better Night's Sleep?

"How can I improve my quality of sleep? No matter whether I get 4 hours of sleep or 10 hours, I'm always tired. Is coffee or other caffeinated beverages a good pick-me-up? Are energy drinks safe to consume?"

Registered Nurse Robert Mages Responds:

Sleep can be a tricky subject, to say the least.

Our sleep is primarily effected by a few things: our circadian rhythm, or 24-hour cycle, aging, psychological stressors (those factors can cause difficulty falling asleep and disturb the quality of your sleep), and common social or recreational drugs like nicotine, caffeine, and alcohol.

These are just the tip of the iceberg when it comes to the proper rest.

My first suggestion to you would be to stay away from all stimulants for at least 4 hours before bed, including caffeinated or sugary beverages, nicotine and alcohol. All of these things can impair your ability to sleep. Reduce stress by listening to relaxing music or taking a warm bath or shower. Or, enjoy some quiet time with your feet up to help your body relax and become ready for sleep.

You may wish to consult your primary care doctor, as sleep disorders not only hinder your daily life but can lead to health problems down the road. A sleep study may be suggested by your doctor, which can be done both at home as well as in a sleep lab, and can be an important tool in your present situation.

As far as energy drinks go, I suggest staying away from them as much as possible. They contain a good amount of caffeine as well as other ingredients that can have side effects down the road. The excessive caffeine can cause your heart to race and cause overall general illness. A recent study found that these beverages can have dangerous effects on blood pressure, heart rate and brain function.

Please try to avoid these products for your safety.

— 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.
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