Planning for Your Healthy Baby: Pregnancy and Diabetes (Amarillo Diagnostic Clinic)

By Rachel Pessah Pollack, MD

Do you have diabetes? Are you thinking about getting pregnant?

If so, there are things you need to do for the health of you and your baby during pregnancy. Your blood sugar control is very important.

Diabetes during pregnancy is on the rise.

healthy pregnancy with diabetes

More and more people are getting diabetes. There are about 1.5 million new cases per year. As a result, many more women with type 2 diabetes are becoming pregnant.

Elevated blood sugar (glucose) levels during pregnancy are bad. They can cause a higher risk of birth defects, miscarriage, birth injury, preterm delivery and certain complications such as pre-eclampsia. By being careful with blood sugar levels before becoming pregnant and during the early weeks of pregnancy, these potential problems can be prevented.

Here is what you can do to optimize your care and ensure a successful outcome.

Tips for Diabetics During Pregnancy

  • Schedule your doctors’ visits.
    • Your doctor may send you to a specialist before you get pregnant to help you with your diabetes control.
    • Obstetrical [ob-steh-trih-kal] care – some patients with diabetes may see obstetricians [ob-steh-TRIH-shen] who specialize in high-risk pregnancies. Your doctor will help you make this decision based on how long you have had diabetes and how well your diabetes is controlled.
    • Eye disease – every woman with diabetes should see an eye doctor for an eye examination before getting pregnant. You may be counseled on the risk of getting diabetic eye disease (retinopathy [reh-tin-AH-pah-thee]). Eye exams are also recommended in the first trimester, during pregnancy, and after birth. Sometimes the eye disease may become worse with pregnancy; however, this risk can be prevented with laser surgery.
    • Kidney disease – all women with diabetes who want to get pregnant should be checked for diabetic kidney disease (nephropathy [neh-FRA-pah-thee]). A urine test is used for this test.
    • High blood pressure – your doctor will want to make sure that your blood pressure is under good control before you get pregnant. You may have to switch or add blood pressure medications.
    • Nerve disease – your doctor may suggest you see a foot specialist (podiatrist [poe-DYE-ah-trist]) to determine if you have diabetic nerve disease. This is also known as peripheral neuropathy [per-IH-fer-al noor-AH-puh-thee]. It is important to take good care of your feet before and during pregnancy and to check your feet each day to keep infections at bay.
  • Focus on healthy eating now
    • Before pregnancy, it is a good time to pay close attention to what you eat. Eating properly is important to achieve and maintain normal sugar levels throughout pregnancy. You are hopefully already following a healthy diabetes diet, including fruits, vegetables, and fiber. You can continue to eat the same foods as you plan for pregnancy. However, be aware that, during pregnancy, how many carbohydrates there are in each meal is the most important factor affecting your blood sugar control, both before and after your meals. It may be useful to meet with a registered dietician or diabetes educator before you get pregnant. This will help you learn how to count calories and choose healthy foods. In addition to watching your diet, all women who want to become pregnant should take a daily prenatal multivitamin containing at least 400 micrograms of folic acid. Folic acid prevents neural tube defects, such as spina bifida [spine-a BIH-fid-a] in babies.
  • Target normal blood sugar levels
    • Studies have shown that poor blood sugar control during pregnancy can lead to poor pregnancy outcomes and risk for birth defects. During the first trimester, the baby’s organs are forming and normal sugar levels can decrease the risk of any problems during this period. For this reason, it is very important to wait to conceive until blood sugars are under excellent control.
    • Hemoglobin A1C, which is a measurement of your blood glucose control over the prior two to three months, should be checked before you get pregnant to help with your overall diabetes treatment plan. Talk with your health care provider about what your blood sugar range and A1C level should be both before pregnancy and during pregnancy to reach your goal of a normal blood sugar. Blood glucose self-monitoring is recommended by many different diabetes organizations (each has different target levels). During pregnancy you will be asked to check blood sugar levels one to two hours after the first bite of your meal. This is different from when you weren’t pregnant.
  • Review your medications for safety
    • Before you get pregnant, have your doctor review your medications and determine if you need to switch them to ones that are safe in pregnancy. Some examples are listed below:
      • Diabetes medications – Many of the diabetes pills that are taken when not pregnant cannot be taken when pregnant. Before you get pregnant discuss with your doctor whether you may need to start insulin before or during pregnancy. Or, you might find out that diet and carbohydrate monitoring are all you need. In general, if insulin is needed, you will likely need to use more insulin the further you get into your pregnancy, especially during the third trimester. Although there is some good data with certain pills for diabetes, it is not known how safe and effective they are, and insulin is often recommended to control blood sugar.
      • Blood pressure medications: ACE inhibitors and ARBs used for blood pressure control and kidney disease are not advised during pregnancy, since they are likely to harm the baby. Before you get pregnant, consult your health care team about changing your blood pressure medications.
      • High-cholesterol medications: “Statins,” a class of medication used for its cholesterol-lowering effects, should be stopped before you get pregnant.
  • Evaluate your pre-pregnancy weight
    • Women with diabetes who are overweight or obese have a higher chance of having problems during pregnancy. These problems include higher rates of cesarean section, high blood pressure, birth defects, and premature infants. The good news is that if you are overweight and are able to reduce or normalize your body weight before you get pregnant, you can prevent many of these poor outcomes from occurring. Losing just a few pounds can help you maintain better control of your sugars and lower your blood pressure.
  • Plan to exercise
    • Once your doctor has decided that you are healthy for physical activity, add exercise to your daily regimen. Choose activities that you enjoy and are most likely to continue with and have a goal of 30 minutes of aerobic exercise most days of the week. Keeping fit will help with both weight loss and control of your blood sugar. Check your sugar level before and after exercising because you may need to eat a snack to prevent low blood sugar during physical activity. Continue your exercise routine during pregnancy unless your doctor advises against it.
  • Avoid bad habits
    • It is very important to get counseling from your doctor before you become pregnant so that you have a healthy pregnancy. Women with diabetes should be screened for depression, tobacco and alcohol use, drug abuse, weight management, and exercise.
    • If you are a smoker or are still drinking alcohol, the perfect time to stop is before you get pregnant.
    • If you are abusing drugs (prescription/non-prescription), now is the time to stop and get help if necessary.
    • If you have missed doses of insulin or if you don’t take your medications as prescribed, focus on taking the best care of your body as you prepare for pregnancy and avoid missing doses.
  • Know when you need to wait
  • It is important for each woman with diabetes to know when a pregnancy is not safe. If your diabetes is not under good control, you should wait to become pregnant. By working with your health care team and making adjustments to your treatment, you can improve control of your blood sugar and ensure a healthy outcome for you and your baby.

There is a lot of planning to be done. However, you must remember that the patience and additional work is worth the end result: your healthy baby!

Dr. Rachel Pessah Pollack has a special interest in pregnancy-related endocrine disorders. She has published articles and given presentations on gestational diabetes, Cushing’s disease during pregnancy, and iodine deficiency during pregnancy.

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Surefire Ways to Relieve Work Stress With a Vacation

Understand the benefits of taking time off from work, and heed these tips for a successful, stress-free break from the office.

Take a stress-free vacation

Vacations are important to your mental health. Stay organized at work so you can enjoy your time away from the office.

While it’s hard to fit into our busy schedules, taking some time off work is healthy. The many health benefits of taking a vacation include reduced blood pressure, relieved stress, reduced exhaustion and better-quality sleep. In other words, experts recommend the occasional break from work. 

More stress relieving benefits of taking a true break away from work include a boost of creativity, more time to spend on healthy habits and increased productivity.

But just the thought of taking a vacation stresses some people out. Many people chose to skip vacations because of the stress of being away from the office. It’s all about pre-vacation planning and a smooth transition out of the office.

What steps can I take before vacation to make sure my tasks get done without me?

  • Ensure that all project calendars are updated, and make sure the appropriate teammates are tagged in the calendars
  • Complete work as far in advance as possible before leaving, and update your teammates of the status
  • Set up an auto-email response and voicemail. It’s helpful to include an out-of-office message such as, “I’m on vacation through March 17. Please allow a delay in my response. If you need immediate assistance, please contact my colleague, jim@company.com.”
  • Delegate projects/responsibilities to your colleagues
  • Organize and clean your office space for a pleasant return
  • Have a plan in place in case of work emergencies, including points of contact and protocols
  • Plan a post-vacation debriefing with a trusted colleague

How do I destress during vacation?

While on vacation, stay disconnected! So much planning and preparation have gone into being away, so don’t worry about checking your phone/laptop to see what you’re missing. Turn off all notifications, leave work technology behind, and silence your personal cell phone. Give yourself permission to stay disconnected and have a great time.

How do I get back into work mode after vacation?

Once you’ve enjoyed your time away, getting back to work can be nerve-wracking. Of course, you wonder what you missed. To prevent this feeling, don’t overload your schedule for the day you get back. Spread out meetings for the week, meet with a colleague to review what you missed and spend time organizing and responding to emails.

Vacation doesn’t have to be stressful. Be strategic with your vacation planning, and follow through with your work responsibilities. Enjoy your vacation and all the health benefits it brings!

How Do I Take a Mini Vacation at Work?

  • Move! Set an alarm to get pull away from your desk, get out of your chair and stretch with a quick walk or a couple sets of stairs. Movement breaks are especially important for those who work desk jobs.
  • Take one day off! Even short interval breaks between long work days are necessary to keep your brain stimulated to produce better work.

Sleep Study Findings: Why Do We Sleep, Anyway?

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Hunger and Eating/Sleepiness and Sleep: Powerful Internal Drives

A resource from the Division of Sleep Medicine at Harvard Medical School


While we might not often think about why we sleep, most of us acknowledge at some level that sleep makes us feel better. We feel more alert, more energetic, happier and better able to function following a good night of sleep. However, the fact that sleep makes us feel better and that going without sleep makes us feel worse only begins to explain why sleep might be necessary.

One way to think about the function of sleep is to compare it to another of our life-sustaining activities: eating. Hunger is a protective mechanism that has evolved to ensure that we consume the nutrients our bodies require to grow, repair tissues, and function properly. And although it is relatively easy to grasp the role that eating serves— given that it involves physically consuming the substances our bodies need—eating and sleeping are not as different as they might seem.

Both eating and sleeping are regulated by powerful internal drives. Going without food produces the uncomfortable sensation of hunger, while going without sleep makes us feel overwhelmingly sleepy. And just as eating relieves hunger and ensures that we obtain the nutrients we need, sleeping relieves sleepiness and ensures that we obtain the sleep we need. Still, the question remains: Why do we need sleep at all? Is there a single primary function of sleep, or does sleep serve many functions?

An Unanswerable Question?

Scientists have explored the question of why we sleep from many different angles. They have examined, for example, what happens when humans or other animals are deprived of sleep. In other studies, they have looked at sleep patterns in a variety of organisms to see if similarities or differences among species might reveal something about sleep’s functions. Yet, despite decades of research and many discoveries about other aspects of sleep, the question of why we sleep has been difficult to answer.

The lack of a clear answer to this challenging question does not mean that this research has been a waste of time. In fact, we now know much more about the function of sleep, and scientists have developed several promising theories to explain why we sleep. In light of the evidence they have gathered, it seems likely that no single theory will ever be proven correct. Instead, we may find that sleep is explained by two or more of these explanations. The hope is that by better understanding why we sleep, we will learn to respect sleep’s functions more and enjoy the health benefits it affords.

This essay outlines several current theories of why we sleep. To learn more about them, be sure to check out the “Bookshelf” feature at the end of this essay. There you’ll find links to articles by researchers who are studying this fascinating question.

What are Some Theories for Why We Sleep?

Inactivity Theory

One of the earliest theories of sleep, sometimes called the adaptive or evolutionary theory, suggests that inactivity at night is an adaptation that served a survival function by keeping organisms out of harm’s way at times when they would be particularly vulnerable. The theory suggests that animals that were able to stay still and quiet during these periods of vulnerability had an advantage over other animals that remained active. These animals did not have accidents during activities in the dark, for example, and were not killed by predators. Through natural selection, this behavioral strategy presumably evolved to become what we now recognize as sleep.

A simple counter-argument to this theory is that it is always safer to remain conscious in order to be able to react to an emergency (even if lying still in the dark at night). Thus, there does not seem to be any advantage of being unconscious and asleep if safety is paramount.

Energy Conservation Theory

Although it may be less apparent to people living in societies in which food sources are plentiful, one of the strongest factors in natural selection is competition for and effective utilization of energy resources. The energy conservation theory suggests that the primary function of sleep is to reduce an individual’s energy demand and expenditure during part of the day or night, especially at times when it is least efficient to search for food.

Research has shown that energy metabolism is significantly reduced during sleep (by as much as 10 percent in humans and even more in other species). For example, both body temperature and caloric demand decrease during sleep, as compared to wakefulness. Such evidence supports the proposition that one of the primary functions of sleep is to help organisms conserve their energy resources. Many scientists consider this theory to be related to, and part of, the inactivity theory.

Restorative Theories

Another explanation for why we sleep is based on the long-held belief that sleep in some way serves to “restore” what is lost in the body while we are awake. Sleep provides an opportunity for the body to repair and rejuvenate itself. In recent years, these ideas have gained support from empirical evidence collected in human and animal studies. The most striking of these is that animals deprived entirely of sleep lose all immune function and die in just a matter of weeks. This is further supported by findings that many of the major restorative functions in the body like muscle growth, tissue repair, protein synthesis, and growth hormone release occur mostly, or in some cases only, during sleep.

Other rejuvenating aspects of sleep are specific to the brain and cognitive function. For example, while we are awake, neurons in the brain produce adenosine, a by-product of the cells’ activities. The build-up of adenosine in the brain is thought to be one factor that leads to our perception of being tired. (Incidentally, this feeling is counteracted by the use of caffeine, which blocks the actions of adenosine in the brain and keeps us alert.) Scientists think that this build-up of adenosine during wakefulness may promote the “drive to sleep.” As long as we are awake, adenosine accumulates and remains high. During sleep, the body has a chance to clear adenosine from the system, and, as a result, we feel more alert when we wake.

Brain Plasticity Theory

One of the most recent and compelling explanations for why we sleep is based on findings that sleep is correlated to changes in the structure and organization of the brain. This phenomenon, known as brain plasticity, is not entirely understood, but its connection to sleep has several critical implications. It is becoming clear, for example, that sleep plays a critical role in brain development in infants and young children. Infants spend about 13 to 14 hours per day sleeping, and about half of that time is spent in REM sleep, the stage in which most dreams occur. A link between sleep and brain plasticity is becoming clear in adults as well. This is seen in the effect that sleep and sleep deprivation have on people’s ability to learn and perform a variety of tasks.

This theory and the role of sleep in learning are covered in greater detail in Sleep, Learning, and Memory.
Although these theories remain unproven, science has made tremendous strides in discovering what happens during sleep and what mechanisms in the body control the cycles of sleep and wakefulness that help define our lives. While this research does not directly answer the question, “Why do we sleep?” it does set the stage for putting that question in a new context and generating new knowledge about this essential part of life.

For more about why we sleep, watch the video Why Sleep Matters and explore Consequences of Insufficient Sleep.


Amarillo Diagnostic Clinic is the only Sleep Center in the Panhandle area accredited by the American Academy of Sleep Medicine. Give us a call at 806-358-0200 to set up your sleep study.

Making the Most of Your Checkup

For some people, the doctor’s office is a stressful place. Sometimes patients are so stressed, they forget their physician’s instructions! The best way to prevent this from happening to you is to have a plan when you visit your doctor.

A productive checkup increases the potential for a more effective outcome. Before you visit your doctor, check out these seven simple tips:

Preparing for Your Doctor’s Visit

1. Your Symptoms

Your physician can help you most if he or she knows exactly how you are feeling. When you go to see the doctor for a specific reason, write down in advance how you feel. Your physician needs to know who, what, where, when, why and how much – just like a middle school word problem.

Take 15 minutes to write down:

  • What your symptoms feel or look like. Be specific with your descriptors. Here’s a quick list, but use your own words: achy, stabbing, dull, burning, tingly, stiff, sore.
  • Where your symptoms affect you. Do they start in one place or all over?
  • When your symptoms began.
  • Why your symptoms act up. What seems to trigger them.
  • Also write down what reduces or eases your symptoms. Don’t be afraid to include anything that helps. Alcohol, nicotine or other substances can help, and that information will help your doctor.
  • How often do you experience your symptoms and for how long. Are they annoying or crushing?

2. Your Homework

Believe it or not, it helps doctors when you have already looked up your symptoms and have done a bit of research about your condition. This isn’t like your uncle who gets on WebMD and then posts on Facebook that he now has the rarest form of cancer ever.

Researching in advance helps a physician because you can now better understand medical terms they might use. If your throat hurts, glance over the different parts of the throat so you can be specific about your pain and where in the throat you feel discomfort. That helps improve diagnoses than starting with, “It hurts when I swallow.”

Right Before You See the Doctor

3. What Do You Want?

Once you’ve prepared for the doctor, it’s important to prepare for yourself. Write down what you want to know, because – believe it or not – some people get stressed in the doctor’s office and forget what they want to ask. Your checkup is your time. Make sure you get the answers you want. And leave space so you can write down your doctor’s answers (see No. 6).

  • What is wrong with me? What is the name of my disease?
  • Do I need a diagnostic test? Which ones?
  • What are my treatment options? What drugs are you prescribing, and what do I need to know about them?
  • Can the doctor detail their prognosis: What can I expect to happen to me? How long can we expect this to last?
  • Should you reach out for help? Will you experience fatigue, depression or other negative feelings?

4. Where’s Your Medical Information?

  • Did you doctor order tests before your meeting? Make sure you’ve picked up your results in advance. (Nowadays, many imaging results can be sent digitally.)
  • Your doctor is going to ask you what medication you are already taking. Make a list of all your prescriptions and any over-the-counter medication you’ve been taking to alleviate your symptoms. Please add medicines like Tylenol or NyQuil, any natural supplements you’ve been using, or herbal remedies. If they’ve been working well, please let the doctor know that, too.
  • For most appointments, you should bring along a detailed medical history. If your symptoms are especially problematic, make sure to include the health history of your immediate blood relatives.

5. Who Should Your Doctor Contact?

  • Your intake form will ask for emergency contacts.
  • List other doctors who treat you and for what conditions. This should even include chiropractors and holistic healers.
  • Include your preferred pharmacy name, phone and address.

Listening

6. Document New Information

  • Nothing beats an old pen and paper when it comes to learning new information. Write down your doctor’s answers to your questions so you can fully understand them.
  • Take notes on other information the doctor gives you.
  • If a caregiver, spouse or friend joins you on your visit, ask them to take notes for you, so that you can focus on what the doctor is saying.

7. Next Steps

  • Talk to your insurance company about the doctor’s suggestions to make sure you can follow their orders in-network.
  • Ask for authorizations for specialists or other procedures.
  • Make sure you have the phone number of the doctor’s office to follow-up or to ask further questions. Ask for the best person to contact and the best times to call.

Being prepared for a doctor’s appointment will help ensure a more productive office visit. When you are ready to see the doctor, contact us here. We look forward to serving you and will do the very best we can to answer all of your health questions.

Do you have other tips you’d like to share with us? Comment below, please!

There Could Be a Reason Behind Your Headache

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Some information provided by Medline Plus.

The most common type of headache is a tension headache. Tension headaches are due to tight muscles in your shoulders, neck, scalp and jaw. They are often related to stress, depression or anxiety. You are more likely to get tension headaches if you work too much, don’t get enough sleep, miss meals or use alcohol.

Types of Headaches

  • Migraine headaches
    • Pain may be generalized or on one side or both sides of the head
    • Can cause mood swings, fatigue, food craving, nausea, vomiting or vertigo
    • May also cause visual disturbances or sensitivity to light and sound, flashing lights or floaters
    • Usually last 4-72 hours
  • Tension headaches
    • Usually occur at the base of your head and usually on both sides of your head
    • Dull, vice-like pressure around the head
    • Can be triggered by stress or muscle tension, poor ergonomics or body mechanics
    • Can be intermittent and lasting throughout the day
  • Cluster headaches
    • Pain may affect the eye, temple, face and/or neck areas
    • Sudden and excruciating pain that can happen at night, waking you up from sleep
    • May be accompanied with a runny nose on one side or nasal stuffiness
    • May cause watering in one eye
    • Can occur at the same time for several days
  • Chronic daily headaches
    • Daily or nearly daily headache for more than three months
  • Medication overuse headaches
    • Use of an analgesic more than three times weekly for more than three months
  • Sinus headaches
    • Pain or pressure occurring behind the brow bone or cheek bone
    • Often accompanied with nasal or sinus congestion
    • Ear fullness

Other Less Common Types of Headaches

Some headaches originate from the neurological system:

  • Post traumatic headaches
    • Concussion
    • Brain injury
    • Tumors and other causes of increased intracranial pressure
    • Pseudotumor cerebral (too much fluid in the brain compartment)
    • Subdural hematoma (blood outside the brain but putting pressure on the brain)
    • Cervical spine disorders

Some headaches originate from causes outside the neurological system such as:

  • Fever
  • Hypertension
  • Sinusitis
  • Sleep apnea

When to Seek Treatment

  • Sudden onset of excruciating pain
  • First or worst headache of your life
  • Worsening pattern of headaches
  • Fever associated with a headache
  • Rapid onset of headache with strenuous exercise
  • Any change in mental status or level of consciousness
  • New headache in patients under 5 or over 50

Clinical Services Available

  • MRI
  • Lab

Treatment Options

  • Medication to prevent or relieve the pain
  • Physical therapy referrals
  • Botox therapy
  • Occipital nerve blocks

Not all headaches require a doctor’s attention. But sometimes headaches warn of a more serious disorder. Let us know if you have sudden, severe headaches. Get medical help right away if you have a headache after a blow to your head, or if you have a headache along with a stiff neck, fever, confusion, loss of consciousness or pain in the eye or ear. Contact us if you have any questions or to set up an appointment.

3 Fascinating Facts about Bacteria

1. Humans are 99.9% bacterial

Nearly everything that happens in our body is a result of something happening with bacteria in our bodies. Even though we are a “germ crazy” society, it’s interesting to note that our bodies are, in fact, bacterial. The term “mutualism” refers to the study of how different kinds of bacteria work together to perform functions that help support things like attaining nutrients from food, sophisticated immune systems and balancing of emotions and cognition.

2. Breast milk: The original probiotic

Breast milk contains more than 600 types of bacteria, all of which are beneficial for newborn babies to develop important functions in the body. The milk also contains a rich amount of saccharides, or “milk sugars,” that break down in the baby’s colon to provide nutrients and food to the growing baby.

3. Nutrients can only be absorbed with the help of healthy bacteria

Bacteria of many kinds will clump around by the thousands in your colon. Why? Because much of what we eat cannot be absorbed without the help of these thousands of kinds of bacteria. It’s an interesting part of who we are. Theoretically, a germ-free human would, be by, definition malnourished because bacteria is required.

What You Can Do About the Flu

It’s already time to start preparing for the flu season. Don’t delay, get your flu shot today!

A young person in Florida has already died from the flu, and another woman in Kentucky passed away in mid-October from flu-related illness. These aren’t cold weather states; the flu is already starting this year and will be pervasive in the Panhandle before we know it.

Last year marked the highest level of hospitalization for influenza ever recorded. After such a staggering season, the CDC looked back at 2017 to report on the direct costs – such as doctor’s visits and hospital stays as a result of the flu. The annual cost for treating influenza in the United States in 2017 was $4.6 billion.

You Can Make 2018 a Better Flu Season

There are some positive signs for this flu season. The CDC forecasts the H3N2 influenza virus to have a weaker year than 2017 since, unfortunately, so many people were infected with that particular strain last year. Also, Australia’s recent flu cases (their flu season peaks around our Labor Day) were primarily of the H1N1 strain, which is milder than other strains. We are all hopeful this trend will continue.

Signals of a milder flu strain shouldn’t mean it is time to relax against the disease. Last year, 80,000 Americans died from the flu – most of them over the age of 65. If you are a senior citizen, or come into contact with seniors – at church, in restaurants or theaters, or over the holidays – the flu can be deadly. Everyone should get a flu shot, but especially if you are in contact with Amarillo’s more vulnerable citizens.

Flu shots are still the single most effective way to prevent infection and to stay healthy.

From the time a person is exposed to the flu virus, to the time when symptoms begin is an average of about 2 days. Even so, symptoms may begin as early as the very next day or may not appear for as many as 4 days. At that time, most adults are able to infect others from the day before their symptoms develop, up to 5 to 7 days after becoming ill.

The lengthy and unclear time of being contagious is why many people infect others. They may not “feel sick” and still be contagious. Or they may feel they’ve already beaten the disease after their own illness – and may yet still be contagious to others who haven’t been vaccinated. A flu shot is not only the best way to keep yourself healthy, it is the best way you can keep from infecting others.

5 Tips to Combat Flu Season

  1. If you have flu-like symptoms you should always separate yourself from others and go to bed. A good rule of thumb is to assume that you are contagious for 24 hours after your fever goes away. Stay away from others until that time period has passed.

    2. Wash your hands often with soap and water. Use alcohol-based hand sanitizers and don’t touch your eyes, nose or mouth. If you do, wash your hands again.

    3. We’ve all been told to cover our coughs and sneezes. Since a sneeze travels at speeds of 100 miles per hour, they need to be covered. Grab a tissue and use them. And wash your hands.

    4. Clean surfaces and items that have frequent hand contact with anti-bacterial cleaner or wipes.

    5. Get enough sleep. Proper sleep helps keep bodies running at their best, and helps recovery happen quicker. At any stage of the disease, and before infection, sleep is one of the best things you can do to remain healthy.

We are here to care for you! Contact BSA ADC today for a flu shot.

If You Do Become Ill…

We hope that you don’t, but if you do, it’s okay – we can still help you. Prescription antiviral drugs can make illness milder and shorten the time you are sick. They may also prevent serious flu complications. For people with high risk factors, treatment with an antiviral drug can mean the difference between having a milder illness versus a very serious illness that could result in a hospital stay.

Studies show that flu antiviral drugs work best for treatment when they are started within 2 days of getting sick. Starting medication treatments later can still be helpful, especially if the sick person has a high-risk health or is very sick from the flu.

Follow your doctor’s instructions when taking any prescription medication.

Diabetes is Not a Death Sentence

Together with ADC, people can live normal lives even with diabetes.

Over 400 million people worldwide have diabetes, and the disease causes over 1 million deaths every year. The disease also damages the body, amplifying other health concerns and is a secondary cause for even more deaths. It also causes blindness and amputations – it’s a very serious disease which, as of yet, has no cure.

But, there is some good news.

When managed properly, people with diabetes can lead long and productive lives. The Endocrinology Department at ADC deals daily with people managing the disease. Today, let’s learn more about the disease and what is necessary to manage it.

How Diabetes Affects the Body


After eating, carbohydrates in food are broken down into sugars to be carried throughout the body via the bloodstream. The body uses those sugars as energy for regular, daily function. The condition of diabetes disrupts this cycle – creating severe, damaging imbalances in blood sugar levels. There are two ways this imbalance occurs.

In Type I Diabetes, the body’s immune system damages the pancreatic cells responsible for producing insulin. The body’s naturally-produced insulin can no longer aid in breaking down blood sugars. With the body is incapable of producing enough of its own insulin, Type I Diabetes is treated with injections of an insulin replacement.

The second type, Type II Diabetes, is a more common form and is also a progressive form of the disease. This form of diabetes causes insulin resistance over time. The body still produces insulin, but has difficulty utilizing it effectively. There are various medications in pill form to treat Type II Diabetes. As a result of the nature of Type II diabetes, however, the pancreas often wears out due to late detection of the disease or from years of medication. At that point, insulin replacement by injection is – again – necessary.

When caught early, diabetes can easily be treated. The longer someone lives undiagnosed, the worse their health outcome is likely to be. Patients should visit their doctor every three to six months so that the efficacy of their treatment can be re-evaluated.

Good glucose control is essential to prevent the onset of diabetic complications that can can lead to blindness, heart attack or stroke, dialysis, and amputation. But with proper self-care and medical expertise people with diabetes can avoid these complications.

4 Ways To Effectively Manage Diabetes Symptoms

1. Exercise


If diagnosed, one of the best things a person can do for themselves is to exercise on a regular basis. Guidelines recommend a daily exercise regimen for at least 45 minutes that is initiated slowly and built up gradually to avoid injury and to build stamina. Clearance from a physician is imperative for any patient before starting an exercise regimen.

Every person that is overweight significantly increases their chances of contracting diabetes. The Amarillo Diagnostic Clinic has a patient education specialist to assist you in the care and management of diabetes through diet and exercise.

2. Check Your Blood Sugar

People living with this disease check their blood sugar levels regularly with a home glucose monitor. A physician or diabetic educator will prescribe a routine and frequency that best suits a patient’s needs. Most recommend checks before breakfast and before supper.

Not only is checking levels necessary for day-to-day health but recording those numbers daily is another necessary step. At doctor visits, a physician will need those readings to understand the full scope of how the patient is managing their disease.

3. Periodic Checks


Glycohemoglobin: This is a test developed for information about average blood sugar level over the course of two or three months. These checks may occur two to four times a year – varying between patients. The American Diabetes Association recommends that the patient’s diabetic regimen achieves a glycohemoglobin level of less than 7%. Any contributing risk factor for vascular disease should be aggressively assessed and treated.

Cholesterol, triglycerides, low HDL, high blood pressure, and smoking would all be considered factors of risk.

Some medications used to treat elevated blood pressure also have a protective effect in preventing kidney complications of diabetes. Any medication prescribed by a physician should be taken only as directed. Before adding or deleting any medication – including over the counter medications. Patients should consult their doctor about any changes to their prescriptions.

Microalbumin: This urine test is performed yearly to evaluate the likelihood of diabetic kidney involvement.

Ophthalmologist: A visit should be scheduled annually as well. The doctor can evaluate any diabetic retinopathy, cataracts, or other conditions and plan treatment accordingly.

Finally, patients should have an annual comprehensive medical exam – including a treadmill exercise test. Underlying coronary artery disease is often more common in an individual with diabetes and needs early intervention.

4. Sick Days

Living with this disease means that some days are simply going to be worse than others. We refer to them at ADC as “sick days” and they require special consideration. Anything a body perceives as stress has the ability increase blood sugar levels. This stress can be physical or emotional in nature. If a person with diabetes is ill their blood glucose will likely rise – even if they cannot eat.

Sick Day Best Practices for Diabetics

  • Stick to meal plans if able to eat.
  • Continue diabetes medication unless a physician says otherwise.
  • Check with a doctor before taking any new medication.
  • Drink at least one large glass of liquid each hour. If eating, these liquids should be sugar-free.
  • Take a blood sugar test every 4 hours.
  • It is recommended to have someone check on the ill person every few hours, in case the illness progresses.

If in doubt, consult a physician. Early and effective management of these sick days will reduce chances of falling into a diabetic coma.

It Will Be Okay


Taking steps to prevent and control diabetes doesn’t mean life is over. It means eating a tasty, balanced diet, exercising and taking the necessary steps to stay healthy. With these tips, anyone can still take pleasure in life – with diabetes – without feeling deprived.

The Endocrinologists at Amarillo Diagnostic Clinic are thoroughly trained in the management of hormonal and metabolic disorders. Patient education services are available for patients in the care and management of these disorders. We also provide dietary counsel for lowering cholesterol and triglyceride levels.

We are here to help, please contact us if you have any questions or to schedule an appointment.

Having Trouble Sleeping? Hit the Gym!

Photo by bruce mars on Unsplash

Try adding exercise to your daily routine to enjoy better sleep.

Do you toss and turn? Do you wake up after a few hours and find it impossible to fall back asleep? First, the bad news: so are 60 million other Americans. 60 million Americans will experience some form of insomnia this year.

The Good News

Sleep disorders are treatable, and you can find help at Amarillo Diagnostic Clinic Sleep Disorders Center. The center specializes in the diagnoses and treatment of patients who have sleep difficulties.

There may be personal changes that can also help that don’t require a physician. Putting your smartphone away an hour before bedtime helps your mind and body “power down.” Caffeine stays in your body for 6 – 8 hours after drinking a cup of joe, and your liver needs an hour to break down alcohol. So try having your beverage of choice earlier in the day.

Researchers have found sleep quality improves with exercise.

If you’ve been tossing and turning for twenty minutes, you often become anxious about not falling asleep. Getting out of bed and distracting yourself for a few minutes can help – reading, watching a relaxing show, meditating. But one study shows “a bout of moderate-intensity aerobic exercise (e.g., walking) reduced the time it took to fall asleep and increased the length of sleep of people with chronic insomnia compared to a night in which they did not exercise.”

People who regularly hit the gym sleep better and feel more alert during the day than those who are not as active. An Oregon State University sleep study showed that participants who exercised 150 minutes a week slept better and felt less drowsy during the daytime.

Regular physical activity may help those suffering from insomnia without medication.

Why Does Exercise Help?

Oddly, not all exercise seems to assist in battling insomnia. Running, lifting weights and other vigorous aerobic exercise does not immediately improve sleep. After a period of daily exercise, (a few months) adults following vigorous workout routines reported better sleep quality. They reported falling asleep more quickly than they did before starting their exercise regimen, and also sleeping for longer periods of time.

Exercise causes the body to elevate its temperature. This increase in body temperature can last for up to four hours after your workout. The post-exercise drop in temperature promotes falling asleep, so get that workout in before dinner. After that, a little light yoga or an after-dinner stroll is helpful – but don’t take a late HIIT workout.

If you don’t have problems falling asleep, but you wake up after a few hours, a morning jog may be the most beneficial. Beginning the day with exercise will help the body remain in its rested state longer. Make sure that you stretch and warm up if you go this route – your body needs time to adjust from sleep to activity.

Exercise Helps in Other Ways

Insomnia is often linked to depression and anxiety, ranging from mild to severe cases. The release of endorphins as a result of exercise plays a large part in reducing those symptoms.

Circadian rhythm also plays a part in some types of insomnia, and exercise can help to “reset” that natural cycle. Adding exercise early in the day sets the body cycle naturally to rest after a period of time. If your body clock is broken, a quick exercise regimen may be just the thing you need to fix it.

Beyond Exercise

If you have difficulties falling asleep or staying asleep at night or excessive daytime sleepiness, we are here for you. If it seems like nothing works, don’t worry. We have you covered – read this, and learn more about our Sleep Disorders Center here.

Staying Healthy on Vacation in a Foreign Country

Photo by Mysaell Armendariz

How You Can Stay Away From the Summertime Blues

Summertime means vacation time. Beaches and drinks with umbrellas in them and lots of photos for Facebook and Instagram. For many travelers, however, vacations can also lead to sickness. Drinking bottled water helps reduce the chances of “Delhi Belly” and “Montezuma’s Revenge;” getting appropriate vaccinations are always recommended.

The chances of contracting Hepatitis A also increases when you travel outside of the American borders. This highly contagious viral disease is hardest on seniors with weaker immune systems. The disease attacks mainly the liver. At its peak, it can leave you feeling weak for an extended period of time – in some cases, even months. The symptoms begin several weeks after contracting the disease, so Hepatitis A won’t likely ruin your vacation – but it can put a damper on the rest of your summer.

How To Know If You’re At-Risk

Traveling with reputable companies to first-class accommodations does not eliminate contracting contagious diseases. In fact, quite the opposite is true. According to the World Health Organization, most cases of hepatitis A in travelers occur in those who stick to higher-level hotels and resorts. A gourmet meal or a pristine bathroom can still harbor disease – and the rigors of traveling can weaken your natural defenses. Assume you are at risk whenever you travel abroad, regardless of the level of cleanliness and service.

If you’re traveling in regions where hepatitis A outbreaks occur, avoid raw or undercooked meat and fish. If you buy fresh fruits or vegetables at a local market, wash them with bottled water before eating. Very hot coffees and teas are typically safe, but ask for a disposable cup, not a hand-washed mug.

While you’re on vacation, you may be substituting drinking water for other beverages, but dehydration can leave you vulnerable. Alcoholic drinks tend to be safe (use your straw, and – even on vacation – always drink in moderation). Drinking water is historically less so. Quench your thirst with bottled water instead of local “tap” water – and use bottled water when brushing your teeth. Skip the ice, and don’t drink beverages of unknown purity. If bottled water isn’t available, boil tap water before using it.

Wondering If You Have Hepatitis A?

Don’t panic. Most cases of hepatitis A are mild cases don’t require treatment. Nearly everyone who becomes infected recovers without permanent liver damage. But vigilance is always a better choice than treatment. Vaccines are available for people most at risk. Contact us if you have any questions or to schedule an appointment.

Hepatitis A can last from a mild case of several weeks to a severe case lasting a few months. Again, age often plays a factor in the severity of the symptoms. Hepatitis A signs and symptoms appear most often four weeks after exposure and develop over several days. Symptoms may also start abruptly in as few as two weeks or as many as seven, and include:

  • Fatigue
  • Nausea and vomiting
  • Abdominal pain or discomfort, especially in the area of your liver on your right side beneath your lower ribs
  • Clay-colored bowel movements
  • Loss of appetite
  • Low-grade fever
  • Dark urine
  • Joint pain
  • Yellowing of the skin and eyes (jaundice)

Finally, not everyone with hepatitis A develops signs or symptoms. For this reason it is important to be diligent upon returning home from an area prone to the disease. Immediately, wash your clothing, bathe, and clean personal items with disinfectant.

Should You See the Doctor?

Exposure to hepatitis A can be treated before the first signs of symptoms. You can receive the hepatitis A vaccine within two weeks of exposure to thwart possible infection. Likewise, immunoglobulin therapy is also available before the beginning of symptoms. Ask your doctor – or your local health department – about receiving treatment for hepatitis A if:

  • You’ve traveled internationally recently, particularly to Mexico or to South or Central America, or to any area with poor sanitation
  • A restaurant where you recently ate reports a hepatitis A outbreak
  • Someone close to you, such as someone you live with or your caregiver, is diagnosed with hepatitis A
  • You recently had sexual contact with someone who has hepatitis A

Hepatitis A is not a living bacterial infection, it is a viral disease. As is the case with most viruses, there is no specific treatment or cure once infected. At this point, the only thing you can do is get a lot of rest.

How You Can Stay Healthy

To avoid getting hepatitis A you have to know how you can get infected in the first place. For all illnesses that commonly affect travelers, follow these simple instructions:

  • Do NOT eat food handled by someone who has not properly washed his or her hands.
  • Do NOT eat food that comes from contaminated water. Shellfish (like mussels, clams) or any local fish where there is an outbreak of disease.
  • Do NOT eat food that is washed in contaminated water. Eating even a healthful salad can make you sick in a month. Stick to cooked vegetables for your diet.
  • Hepatitis A is most often found on your hands (by shaking hands with someone who is infected, for example). The disease is then transferred to your mouth, where it enters your system. Be sure to wash your hands as often as possible.
  • Again, contaminated drinking water can put you at risk for Hepatitis A and other illnesses. Avoid ice and brush your teeth with safe, bottled water.

You can have a great vacation and not worry about contracting a disease if you practice good hygiene. Those most likely to contract hepatitis A will do so from contaminated food or water. But don’t forget that the disease can also spread from close contact with someone who’s infected. Wash your hands frequently, and any older travelers should look into the two-part Hepatitis A vaccine.