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      Colorectal Cancer Screening Saves Lives

      When my patients turn 50, I tell them it is time to begin colorectal cancer screening. Many of my patients dislike the idea of “that test.” The idea of a colonoscopy makes many patients uneasy. I think I have heard every excuse in the book why they can’t get screened. Each year, colorectal cancer affects 140,000 people in the United States and more than 50,000 people die of it. It is the second leading cancer killer in the U.S. Colorectal cancer is preventable, if you get screened!

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      When my patients turn 50, I tell them it is time to begin colorectal cancer screening. Many of my patients dislike the idea of “that test.” The idea of a colonoscopy makes many patients uneasy. I think I have heard every excuse in the book why they can’t get screened. Each year, colorectal cancer affects 140,000 people in the United States and more than 50,000 people die of it. It is the second leading cancer killer in the U.S. Colorectal cancer is preventable, if you get screened!

      Colorectal cancer is a type of cancer that occurs in the colon or rectum. Abnormal growths, called polyps, can develop in the colon and rectum and can become cancerous. Screen tests such as a colonoscopy can find and remove these polyps before they turn into cancer. During a colonoscopy, a long, thin, flexible, lighted tube is inserted through the rectum and is used to check the rectum and colon. Most polyps and some cancers can be found and removed during the procedure.

      For most of my patients, screening for colorectal cancer should begin when they turn 50 and be repeated every 10 years. Screening should begin early and should be repeated more frequently if they are at increased risk for colorectal cancer. Talk with your doctor to determine if you are a candidate for early screening.

      March is Colorectal Cancer Awareness Month, a time to remind everyone of the importance of getting screened. Here are some additional facts on Colorectal Cancer Screening from the CDC.

      • If you are age 50 to 75 years old, you should get screened for colorectal cancer.
      • The U.S. Preventative Services Task Force recommends screening beginning at age 50. Some groups, including the American Cancer Society recommend starting earlier, at age 45.
      • The vast majority of new cases of colorectal cancer (about 90%) occur in people who are 50 or older.
      • Millions of people in the United States are not getting screened as recommended. They are missing the chance to prevent colorectal cancer or find it early, when treatment often leads to a cure.
      • If you think you may be at increased risk for colorectal cancer, learn your family health history and ask your doctor if you should begin screening before age 50.

      Source – www.cdc.gov/cancer/colorectal/basic_info/screening/

      Dr. Broomfield has been practicing medicine in rural settings for over 25 years. Like the country doctors before him, Dr. Broomfield is committed to providing quality family health care to his patients, no matter where they are. He even makes the occasional house call. Board-certified in family medicine, he joined the Kimball Health Services medical staff as our medical director and chief of staff in September, 2013. He sees patients in the Kimball Health Services Clinic and Pine Bluffs Health Clinic. He also offers a skin care specialty clinic at each facility twice a month.

      What is Heart Failure?

      Heart failure is a chronic, progressive condition that starts slowly and gets worse over time. Many people don’t realize they are experiencing heart failure because the symptoms can be similar to normal aging.

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      Heart failure is a chronic, progressive condition that starts slowly and gets worse over time. Many people don’t realize they are experiencing heart failure because the symptoms can be similar to normal aging. Heart failure is the result of the heart’s muscle gradually losing the ability to pump enough blood to supply the body’s needs. This can happen for a variety of reasons including injury to the heart muscle from a heart attack or high blood pressure. Generally, the heart either becomes weak and unable to pump blood or it may become stiff and unable to fill with blood. Both conditions ultimately lead to retention of extra fluid which is referred to as congestion. This is why a person’s experiencing the symptoms of heart failure are referred to as having congestive heart failure.

      How Common is Heart Failure?

      Heart failure is a growing problem in the United States. It is estimated that there are nearly 6.5 million Americans over the age of 20 who are dealing with heart failure. A major killer, heart failure can directly account for about 8.5% of all heart disease deaths in the United States and is a contributor in about 36% of all cardiovascular disease deaths.

      Risk Factors

      Having read thus far, you may be asking yourself, am I at risk for heart failure? Heart failure can occur at any age, but most people are at a greater risk as they get older.

      Here are some other risk factors to be aware of:

      • High blood pressure
      • coronary artery disease
      • Heart attack
      • Damage to the heart valves of history of a heart murmur
      • Enlarged heart
      • Congenital heart disease
      • Family history of enlarged heart
      • Diabetes
      • Obesity
      • Sleep apnea
      • Severe lung disease

      Symptoms

      The symptoms of heart failure are often dismissed as part of the normal aging process. Extra fluid or congestion is the primary factor in the symptoms of heart failure. Symptoms can occur over a period of time or they may all occur at once.

      • Shortness of breath with simple activities
      • Trouble breathing when resting or lying down
      • Waking up breathless at night
      • Needing more than two pillows to sleep
      • Tiring easy
      • Frequent coughing
      • Coughing that produces a pink or bloody mucus
      • Dry, hacking cough when lying flat in bed
      • Swelling of feet, ankles or legs
      • Increased need to urinate at night
      • Swelling of the abdomen
      • Lack of appetite and nausea
      • Fatigue
      • Cold legs and arms
      • Difficulty concentrating

      Diagnosis

      Heart failure is diagnosed by your healthcare provider based on your signs and symptoms, a physical examination and through special tests designed to measure heart function. Your provider may order an echocardiogram, or “echo”, which is an ultrasound of the heart to measure ejection fraction, the thickness of the heart wall and the flow of blood through your heart valves.

      Treatment

      If heart failure is detected and treated early, you can continue to live an active lifestyle. Your healthcare provider will work with you to determine your best course of treatments. Treatments can include medication, devices and lifestyle changes such as quitting smoking, changing your diet and increasing exercise.

      Living with Heart Failure

      Heart failure is a very serious and life-changing disease, but with appropriate management and lifestyle changes, you can maintain quality of life for a long period of time. The key is to educate yourself on your condition. Knowledge is power! It is also important for you to meet regularly with your healthcare provider, take your medications as directed, adhere to dietary recommendations and exercise as directed. Finally, you will weigh yourself daily. Large changes in weight may be an indication that you may need to adjust your treatment plan. Following these step and the advice of your healthcare provider gives you the best chance possible to stay one step ahead of heart failure.

      Ann has been caring for heart failure patients since starting in cardiology in 2001, assisting patients with diagnosis and treatment in both outpatient, inpatient and infusion clinic settings. Ann was also a co-author of a book chapter on heart failure and has spoken nationally on this topic to other healthcare providers and patients. Ann offers cardiology clinics at both the Kimball and Pine Bluffs clinics.

       

      The Basics of Breast Reduction

      Having excessively large breasts is a serious medical issue for many women. I frequently meet with patients who come to me with back and neck pain, complaining of difficulty performing common physical activities and emotional distress due to their large breasts.  Making the decision to have breast reduction surgery is a serious one, but many of my patients they tell me it “was the best decision I have ever made”.

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      Having excessively large breasts is a serious medical issue for many women. I frequently meet with patients who come to me with back and neck pain, complaining of difficulty performing common physical activities and emotional distress due to their large breasts. Making the decision to have breast reduction surgery is a serious one, but many of my patients they tell me it “was the best decision I have ever made”.

      What is breast reduction surgery?

      Breast reduction is a surgical procedure to remove excess fat, granular tissue, breast tissue and skin to achieve a breast size more in proportion with a patient’s body and to alleviate the discomfort associated with excessively large breasts.

      What are the risks of breast reduction?

      As with any surgery, there are risks of complication such as infection, bleeding, blood clots, skin loss, loss of nipple sensation and unfavorable scarring. Patients considering a breast reduction surgery should discuss possible complications and concerns with their plastic surgeon before having breast reduction surgery.

      Who is a candidate for breast reduction?

      Patients who may be a candidate for breast reduction surgery:

      • Are physically healthy
      • Have realistic expectations
      • Don’t smoke
      • Are bothered by feeling that their breasts are too large
      • Have breasts that limit their physical activity
      • Experience back, neck and shoulder pain caused by the weight of their breasts
      • Have shoulder indentions from bra straps
      • Have skin irritation beneath the breast crease
      • Have failed other conservative treatment measures such as physical therapy, chiropractic care, support bras and NSAIDs

      What should be expected during recovery from breast reduction?

      Breast reduction surgery is most often preformed as an outpatient procedure at a hospital or surgical center. When the procedure is completed, dressings or bandages are applied to the incisions. An elastic bandage or support bra may be worn to minimize swelling and support the breasts as they heal. The physician and their staff will provide all post-operative wound care and answer any questions that arise. Patients are sore and tired for a few days after surgery and should plan on 1-2 weeks down time before gradually returning to full activity levels. A full recovery can take up to 6 to 8 weeks.

      Next steps?

      If you are considering breast reduction surgery, it is worth your time to discuss your issues with a board-certified plastic surgeon.

      Dr. Wyatt is a board-certified plastic and reconstructive surgeon, board-certified hand surgeon and board-certified general surgeon with over 30 years of experience. He is affiliated with Kimball Health Services and sees patients in Kimball, Nebraska and Pine Bluffs, Wyoming. For an appointment at either location, call (308) 235-1953.

      References

      American Society of Plastic Surgeons - Reconstructive Procedure/Breast Reduction. https://www.plasticsurgery.org/reconstructive-procedures/breast-reduction


      Do I Really Need an Antibiotic to Get Well?

      Many people this time of year get sore throats, ear aches, coughs, and other various symptoms and seek medical care. Unfortunately, according to the CDC (Centers for Disease Control and Prevention) at least 2.8 million people get an antibiotic-resistant infection, and more than 35,000 people die from them each year.

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      Many people this time of year get sore throats, ear aches, coughs, and other various symptoms and seek medical care. Unfortunately, according to the CDC (Centers for Disease Control and Prevention) at least 2.8 million people get an antibiotic-resistant infection, and more than 35,000 people die from them each year. We are going to briefly discuss ways as a patient you can help in the fight against resistant bacteria and help protect yourself and your family.

      Antibiotic resistance does NOT mean that one’s body is resistant to antibiotics, but instead means that the bacteria (or microbe in case of fungus) has changed in a way that it is no longer going to be killed by an antibiotic (or antifungal in the case of fungus).

      There are many examples of ways that antibiotic resistance threatens modern medicine and our current abilities to care for patients. According to the CDC, at least 1.7 million adults develop sepsis each year and need emergently treated with effective antibiotics in order to save their lives. Many surgical patients also require antibiotics before and after surgery to prevent or treat infections. There are also chronic conditions, like diabetes, kidney failure and dialysis patients, organ transplant patients, and cancer patients on chemotherapy, that predispose patients to developing infections that require antibiotics or they could die. This is millions of people across the US that have needs that warrant the use of effective antibiotics every day (CDC, 2019)

      Healthy habits can help protect you from infections and stop germs from spreading. These habits include keeping current on all recommended vaccinations, keeping your hands washed and clean, keeping any wounds clean, and keeping your chronic health conditions, like diabetes, under good control.

      Antibiotics save lives daily for both animals and humans, however, they don’t always come without side effects and as mentioned, resistance the more they are used. Antibiotics do NOT work on viruses (like colds or flu). If you or your animals become ill, talk to your health care provider or veterinarian regarding the need for antibiotics. Do not assume that just because there is a sore throat or sinus congestion, that you NEED an antibiotic or that you will be given one. Also know that antibiotic resistance is a worldwide issue. Make sure you report to your health care provider if you have traveled out of the country or received care in another country (CDC, 2019)

      8 ways to be antibiotic aware

      • Antibiotics save lives, but are not always the answer when you are sick.
      • Antibiotics do NOT work on viruses.
      • Antibiotics are only needed for treating certain infections caused by bacteria.
      • An antibiotic will NOT make you feel better if you have a virus
      • Anytime antibiotics are used, they can cause side effects.
      • Taking antibiotics creates resistant bacteria.
      • If you need antibiotics, take them exactly as prescribed (and finish them, no left overs).
      • Stay healthy: cover coughs, wash hands, and get vaccinated.

      Click to view tip sheets on determining if you really need an antibiotic or not and how to protect yourself. When in doubt, check with your health care provider. We are always willing to help!

      Holly Dobrinski is a family nurse practitioner and primary health provider at the Kimball Health Services Clinic in Kimball. For an appointment, call (308) 235-1966.

      References

      Centers for Disease Control and Prevention (CDC) Antibiotic/Antimicrobial Resistance. November 5, 2019. https://www.cdc.gov/drugresistance/index.html

      Centers for Disease Control and Prevention (CDC) Antibiotic Resistance: 5 Things to know. July 2, 2019. https://www.cdc.gov/drugresistance/about/5-things-to-know.html

      Centers for Disease Control and Prevention (CDC) About Antibiotic Resistance. November 4, 2019.

      Silent Killer

      Blood Pressure Readings Chart

      High blood pressure affects nearly half of all American adults. Many people with high blood pressure don’t even know they have it because it is often a symptomless “silent killer.” When left untreated, the damage that high blood pressure does to the circulatory system is a significant contributing factor to heart attack, stroke and other health threats.

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      High blood pressure affects nearly half of all American adults. Many people with high blood pressure don’t even know they have it because it is often a symptomless “silent killer.” When left untreated, the damage that high blood pressure does to the circulatory system is a significant contributing factor to heart attack, stroke and other health threats.

      High blood pressure occurs when the force of blood flowing through your blood vessels is consistently too high. Blood pressure is recorded as two numbers:

      • Systolic blood pressure – (the first number) – how much pressure your blood is exerting against your artery walls when your heart beats
      • Diastolic blood pressure (the second number) – how much pressure your blood is exerting against your artery walls while the heart is resting between beats

      There are five blood pressure ranges as recognized by the American Heart Association. They are:

      • Normal – 120/80 mm Hg or less
      • Elevated – Readings consistently range from 120-129 systolic and less than 80 mm
      • Hypertension Stage 1 – Readings consistently ranges from 130-139 systolic or 80-89 mm Hg diastolic
      • Hypertension Stage 2 – Readings consistently ranges at 140/90 mm Hg or higher
      • Hypertensive crisis – Blood pressure readings that exceed 180/120 mm Hg require medical attention*

      High blood pressure develops slowly over time and can be related to many causes. The only sure way to know if you have high blood pressure is to have your blood pressure checked regularly. If you have been diagnosed with high blood pressure, here are some solutions to help you work with your provider to get your blood pressure under control.

      • Ask about your blood pressure at your annual check up
      • Know your numbers – know what your blood pressure should be
      • Become a tracker – keep a log of your blood pressure levels
      • Be flexible – it may take time to get to your blood pressure goal
      • Know yourself – be aware of barriers to better health and talk to your provider about them

      Dr. Broomfield has been practicing medicine in rural settings for over 25 years. Like the country doctors before him, Dr. Broomfield is committed to providing quality family health care to his patients, no matter where they are. He even makes the occasional house call. Board-certified in family medicine, he joined the Kimball Health Services medical staff as our medical director and chief of staff in September, 2013. He sees patients in the Kimball Health Services Clinic and Pine Bluffs Health Clinic. He also offers a skin care specialty clinic at each facility twice a month.

      *If your blood pressure is higher than 180/120 mm Hg and you are experiencing signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision or difficulty speaking, do not wait to see if your pressure comes down on its own. Call 911.

       


      Your Heart Skips a Beat, is it Love or Atrial Fibrillation?

      Your Heart Skips a Beat– Is it Love?

      It is once again that time of the year---Valentine’s Day. It’s a time when our hearts flutter or skip a beat because of the love we have for somebody…but what if that skipped, irregular heart beat is a sign of something more serious...atrial fibrillation?

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      It is once again that time of the year---Valentine’s Day. It’s a time when our hearts flutter or skip a beat because of the love we have for somebody…but what if that skipped, irregular heart beat is a sign of something more serious...atrial fibrillation?

      What is atrial fibrillation?

      Normally, your heart contracts and relaxes to a regular beat. Certain cells in your heart make electric signals that cause the heart to contract and pump blood. In atrial fibrillation (AFib), the heart’s two small upper chambers (atria) don’t beat the way they should. Instead of beating in a normal pattern, the atria beat irregularly and too fast, quivering like a bowl of gelatin. It is estimated that at least 2.7 million Americans are living with atrial fibrillation, or AFib.

      The cause of atrial fibrillation is not always known, however it can be the result of uncontrolled high blood pressure, coronary artery disease or a complication from heart surgery. No matter the cause, the most serious risk is that it can lead to other medical problems including:

      • Stroke
      • Heart failure
      • Chronic fatigue
      • Additional heart rhythm problems
      • Inconsistent blood supply

      Who is at risk for atrial fibrillation?

      Anyone can develop atrial fibrillation, but typically people who have one or more of the following conditions are at greater risk of AFib:

      • Advanced age
      • High blood pressure
      • Underlying heart disease
      • Drinking alcohol
      • Family history
      • Sleep apnea
      • Athletes
      • Other chronic conditions – thyroid problems, diabetes, asthma

      What are the symptoms of atrial fibrillation?

      People with atrial fibrillation may not have any symptoms and their condition is only detectable upon physical examination. Still others may experience one or more of the following symptoms:

      • General fatigue
      • Rapid and irregular heartbeat
      • Fluttering or “thumping” in the chest
      • Dizziness
      • Shortness of breath and anxiety
      • Weakness
      • Faintness or confusion
      • Fatigue when exercising
      • Sweating
      • Chest pain or pressure*

      How is atrial fibrillation treated?

      Treatment of atrial fibrillation begins with a proper diagnosis through an in-depth examination from your healthcare provider. After a diagnosis, treatment goals will include restoring normal heart rhythms, reducing heart rate, preventing blood clots, managing stroke risk factors and preventing heart failure.

      You can live with AFib. While nothing in life is guaranteed, you and your healthcare provider can work together to reduce your risk of stroke and other complications from AFib.

      For more detailed information on atrial fibrillation, visit the American Heart Association website. https://www.heart.org/en/health-topics/atrial-fibrillation

      Ann Anderson, FNP has focused on the practice of general cardiology for nearly 20 years. She is a board-certified ANCC family nurse practitioner and is a certified cardiac device specialist with the International Board of Heart Rhythm Examinations. Joining the Kimball Health Services team in 2016, Ann sees family practice patients at the Pine Bluffs Health Clinic and offers cardiology clinics at both the Kimball and Pine Bluffs clinics.

      *Chest pain or pressure is a medical emergency. You may be having a heart attack. Call 911 immediately.

       

      What is a Board-Certified Hand Surgeon?

      Hand Surgeon

      Take a look at your hands.  They are a marvel of nature; made up of bones, joints, ligament, tendons, muscles, nerves, skin and blood vessels which all must work together to do the most delicate of tasks.   So much of what you do every day depends on your ability to use your hands – opening a door, drinking your morning coffee, tying your child’s shoes, working at a computer, driving and so much more.

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      Take a look at your hands.  They are a marvel of nature; made up of bones, joints, ligament, tendons, muscles, nerves, skin and blood vessels which all must work together to do the most delicate of tasks.   So much of what you do every day depends on your ability to use your hands – opening a door, drinking your morning coffee, tying your child’s shoes, working at a computer, driving and so much more.

      Just like other parts of your body your hands can be affected by disease, birth defects and traumatic injury, and when something goes wrong, it can be debilitating. Physicians who treat problems of the hand are known as hand surgeons. A board-certified hand surgeon receives specialized training in treatment of the hand. This training is above and beyond the training they receive as a plastic surgeon, orthopedic surgeon or in general surgery. Physicians spend a full year in this specialized additional training in the area of hand surgery and must pass a rigorous certification examination in order to receive board certification from the American Society of Surgery of the Hand.

      Conditions treated by a board-certified hand surgeon can include problems of the elbow, arm and shoulder. Other conditions include:

      • Carpal tunnel syndrome
      • Tennis elbow
      • Wrist pain
      • Traumatic injuries to the hand, wrist and forearm
      • Trigger finger
      • Arthritis
      • Nerve and tendon injury
      • Birth defects

      Hand surgeons do not have to treat all problems with surgery. They often recommend non-surgical treatments such as medication, splints, therapy and injections.

      If you are experiencing any sort of pain or discomfort or have suffered an injury to your hands, wrists or arms, it is worth your time to discuss your issues with a board-certified hand surgeon.

      Dr. Wyatt is a board-certified plastic and reconstructive surgeon, board-certified hand surgeon and board-certified general surgeon with over 30 years of experience. He is affiliated with Kimball Health Services and sees patients in Kimball, Nebraska and Pine Bluffs, Wyoming. For an appointment at either location, call (308) 235-1953.

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