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Exercise in Pregnancy

dwright@tallycreative.com (Dana Wright) — Tue, 21 Sep 2021 16:52:33 GMT

Dr. Molly Johnson

Exercise in Pregnancy

Staying active during your pregnancy is key to feeling your best as your pregnancy progresses and is something I feel very strongly about! In general, you can continue any exercise that you were doing prior to pregnancy at your usual level of intensity. Often fatigue and nausea limit exercise in the first trimester so jump back in to your routine whenever you feel good enough to do so.

The recommendation for exercise in pregnancy is 30 minutes of moderate intensity exercise 5 days a week. I usually advise that when exercising, don’t exert past the point of being able to have a conversation with someone. The most important thing is to listen to your body and stop or modify whenever you feel like you need to. Drink plenty of water before, during, and after exercising and avoid getting overheated.

BENEFITS OF EXERCISE IN PREGNANCY

Staying active during the pregnancy helps to maintain healthy weight gain, avoid constipation, and can help you sleep more soundly. Staying active can help with energy level and improved mood. Exercise such as yoga can help with posture and back pain in pregnancy.

Labor itself can be like running a marathon and so being in good physical condition usually helps labor and the hard work of pushing go better.

Studies show exercise in pregnancy to be associated with higher incidence of vaginal delivery and lower incidence of excessive weight gain, gestational diabetes, high blood pressure in pregnancy, preterm birth, Cesarean birth and low birth weight.

Staying in shape during pregnancy helps with postpartum recovery and weight loss after delivery as well.

WHAT IF YOU HAVE NOT BEEN EXERCISING BEFORE PREGNANCY?

Doing some type of physical activity 30 minutes most days of the week is the general recommendation for exercise during pregnancy, even if you were not active prior to getting pregnant. Walking is ideal because it is free, can be done anywhere, and is not too difficult to start even if you are not used to exercising. You can start with 10 minutes a day and work up from there!

ARE THERE ANY TYPES OF EXERCISE TO AVOID?

Avoid any exercise that could cause trauma to the abdomen/uterus or put you at risk of falling. Examples are snow skiing or water skiing, horseback riding, basketball, volleyball, and softball.

If you have high risk conditions such as placenta previa or preterm labor, make sure you talk to your doctor about exercise recommendations. Otherwise, if you are healthy and your pregnancy is normal, make sure you make it a habit to move your body throughout your pregnancy!

Doctors on Vaccines

Fri, 10 Sep 2021 22:42:14 GMT

Dr. Libby Crocket

Doctors on Vaccines Video Series

There are many questions about the COVID-19 vaccine and local physicians are working to answer those questions. In this video, OBGYN Libby Crockett discusses what she's hearing from her patients, what she's seeing in the research and more. This is part of a series by the CDHD called "Doctors on Vaccines" where local physicians share their experiences with the vaccine

Nutrition in Pregnancy

dwright@tallycreative.com (Dana Wright) — Wed, 01 Sep 2021 16:30:18 GMT

Dr. Molly Johnson

Nutrition in Pregnancy

NUTRITION IN PREGNANCY

Every expecting mom wants to do her best to take care of her baby, even before it is born. One way to do that is to consider what are the best foods to nourish you and your baby! We want you to get plenty of nutrients to support the development of your baby and at the same time maintain a healthy weight gain. A good way to make sure you are getting a variety of nutrients is to make sure at least half of your plate is filled with vegetables and fruits and then the rest lean meats and whole grains.

EATING FOR TWO?

You will definitely have well-meaning friends and relatives that give you an extra helping or an extra cookie for the baby. But really you only need about an extra 300 calories a day – one healthy snack in the afternoon or evening in addition to your usual diet. Examples of that would be Greek yogurt with fruit or crackers and cheese.

WHAT SUPPLEMENTS ARE IMPORTANT?

Prenatal vitamin - It is recommended to take a prenatal vitamin ideally at least one month before getting pregnant and during the pregnancy – this provides extra folic acid, iron and other vitamins and minerals that are important to get during pregnancy. If you take one prenatal vitamin daily and have a healthy diet, you should get the recommended amount of most of these nutrients.

Iron - Besides a prenatal vitamin, you may need extra iron supplements to prevent or treat anemia. Your body needs extra red blood cells during pregnancy and iron is an important in making these cells. Foods with iron include beef, turkey, beans, and spinach.

Omega-3 fatty acids – this helps with brain development before and after birth. Eating 2 servings of fish per week while pregnant or breastfeeding supplies this nutrient. In Nebraska, we often don’t eat this much fish and so other sources are flaxseed (put it in your smoothies!), spinach, cantaloupe and broccoli.

Calcium – helps with development of bones and teeth. The best way to get calcium is through dairy products in the diet like milk, cheese and yogurt, but if you don’t get about 1000mg per day in your diet, you may want to consider taking a supplement (or an extra TUMS ).

STAYING HYDRATED

We recommend drinking 80-100 oz of water per day in pregnancy. Get a large water bottle so you can track how much you are getting throughout the day. This will help prevent constipation, muscle cramps, and headaches and will make you feel much better overall!

WHAT TO AVOID

Lunch meats or deli meats have risk of listeria bacteria so avoid these unless reheated.

Soft cheeses that are unpasteurized and raw fish also have risk of bacterial contamination. No amount of alcohol is technically safe in pregnancy so avoid all alcoholic beverages.

Some fish have high amounts of mercury so avoid eating more than 6oz per week.

This chart gives best choices and fish to avoid

www.fda.gov/media/102331/download

Eating well, limiting junk food and staying well hydrated will help to make you feel great throughout your pregnancy! Using the foods you eat to help with your baby’s development is one of the first steps you can take in being a great mom too!

Weight Loss

dwright@tallycreative.com (Dana Wright) — Thu, 29 Jul 2021 18:23:26 GMT

Dr. Lindsey Mettenbrink

Summertime is here! Let's talk healthy weight loss.

Summer is here which means it’s time to pull out the swim suits! If you are like me, the thought of swim suit season brings out more anxiety than it does excitement. The year 2020 was rough, with many people putting on “The COVID 15”, or more. Before you run out to the store to purchase an over the counter weight loss supplement, consider the following healthy lifestyle changes you can make not only to help your waistline for the summer, but for years to come.

Diets

Fad diets are just that, a fad. You can’t eat diet bars and salads forever. We need to start eating the way that we want to feel. If you want to feel like a greasy pepperoni pizza…go for it. Instead, avoid putting the processed junk in your cart. If it comes in a box or a bag, it is likely loaded with salt, sugar and preservatives. All of this stuff stimulates your appetite, spikes your blood sugar and makes you feel sluggish and fatigued. Instead, reach for the WHOLE foods. Items like fresh fruits (or frozen with no added sugar), fresh veggies, unsalted nuts, lean proteins and dairy products in their most natural forms. If you need to buy a few things in packages, look for whole grain products or items with 5 or fewer ingredients that you can actually pronounce. A diet high in processed foods leads to obesity, diabetes, hypertension and hyperlipidemia. These diagnoses often require several medications to treat and put you at risk for long term health consequences. Taking care of your body now, can prevent you from paying hefty medical bills and prescription drug costs later.

Exercise

We need it folks. I don’t care if your job is “physical”, you need to exercise outside of work. The recommended goal is 30 minutes 5 days per week. I’ve heard a lot of people say, “I don’t have time”. Trust me…you do. Did you have time to watch your favorite Netflix show last night? Did you have time to hit the snooze button 3 times this morning? You have time. You need to start treating your body like it belongs to someone that you care about. Exercise is not only good for your heart, lungs and muscles, but also for YOUR MOOD! Exercise releases those “feel good” chemicals and gives you MORE ENERGY to get through your day. Who doesn’t want that?? You don’t need to have a goal of running a marathon (but kudos to you if you do!), but you need to get out there and move. Start small with a 10-15 minute walk in the evenings. Slowly increase the time and distance. You will be glad you did.

Water

I know you drink “a lot”, but you probably don’t drink enough. You should be drinking half of your body weight in ounces of WATER per day. You need more than that if you are exercising or outside sweating. This amount does not include coffee, soda, energy drinks or alcohol. Often times when we feel hungry, we are actually thirsty. Before you grab your next snack, try drinking some water first and see if those hunger pains go away.

With all of this being said, these changes don’t happen overnight. You have spent countless years developing habits that are hard to break. Maybe choose one area that you want to work on (i.e. exercise, decreasing soda intake, cutting back on take-out, etc). Once this habit is changed, move onto the next. The goal is lifestyle change, not rapid weight loss that can’t be maintained. Our goal at the Grand Island Clinic is a “lifetime” of health…not 1 or 2 months. If you are struggling, talk to your PCP! We would love to help begin to live a healthier lifestyle and feel more comfortable in that swim suit this summer and all the summers to follow.

Wellness in Pregnacy

dwright@tallycreative.com (Dana Wright) — Tue, 13 Jul 2021 18:15:10 GMT

Dr. Molly Johnson

Focus on Healthy Sleeping Habits During Pregnancy

SLEEP IN PREGNANCY

Anyone who is or has been pregnant has probably experienced the kind of crushing fatigue that is unique to pregnancy. I remember being pregnant and working ridiculous hours as an OB/GYN resident while also having a toddler at home. In the first trimester, I would get home from work, go directly to the couch and sleep until the alarm went off the next morning. I literally could not do anything besides sleep. Then after the fatigue of the first trimester or so improves, sleep can quickly become more difficult. Discomfort due to aches and pains, getting up to use the restroom several times per night, heartburn, and the snoring that often happens toward the end of pregnancy all make a good night’s sleep harder to achieve as your pregnancy goes on.

GETTING A GOOD NIGHT OF SLEEP

Sleep position – it is usually recommended to try to sleep on one side or the other. Find the position that is most comfortable for you. Use pillows to support your legs and abdomen. There are many pregnancy body pillows that can help to get in the most comfortable position possible. Keep your bedroom very dark, cool, and as free of kids and pets as possible. Stop using anything with a screen (TV, phone, Ipad) at least 30 minutes before bed so that your brain knows it is time to go to sleep. Staying active throughout the day and exercising 30 minutes most days of the week will help you sleep better as well. Gentle stretching or yoga before bed can be helpful as well. There are several apps that have calming meditations to do before bed to help with falling asleep. These include Calm, Headspace, and Deep Sleep.

RESTLESS LEGS AND LEG CRAMPS AT NIGHT

These conditions common especially in the third trimester and can make sleep difficult.

Make sure you are drinking plenty of water throughout the day. Sometimes this can be due to low iron levels (RLS) or not enough magnesium or potassium in the diet. Taking a magnesium supplement at night can help with sleep and prevent cramps.

HEARTBURN AT NIGHT

Sometimes heartburn is the culprit that causes difficulty sleeping. Prevent heartburn by having a smaller meal at night and avoid eating too close to bedtime. Sleeping with your head elevated may also prevent heartburn.

WHAT IF INSOMNIA IS HAPPENING EVERY NIGHT?!

If you have had a few nights in a row of tossing and turning and just not getting any sleep, over the counter sleep aids are safe to use occasionally in pregnancy. These medications are diphenhydramine (the ingredient in Benadryl and Tylenol PM) or doxylamine (Unisom).

The Importance of Sports Physical Exams

dwright@tallycreative.com (Dana Wright) — Thu, 27 May 2021 15:42:53 GMT

Dr. J.D. Law

Summer time means it's time to schedule your sports physical exam season. This type of doctor’s appointment is required for student athletes to participate in athletics in grades 8 trough 12. There are many advantages to scheduling these appointments with your child's primary care physician rather than obtaining them at a high school or an urgent care facility.

The obvious focus for many of these appointments are on the health and stability of the musculoskeletal system and the heart. But when seeing your child's primary care physician we will also address mental health issues such as anxiety and depression. We have discussions about the risks of sexual activity and substance abuse. We also provide guidance on what to expect as their bodies are maturing and changing.

Over the last year the COVID-19 pandemic has caused chaos and change all around us. Our children's lives have often been flipped upside down. Many kids are struggling with anxiety and depression. We perform a depression and anxiety screen on every adolescent patient. These are given to the patient to fill out privately so they can be honest and not afraid of what their parents might think. This allows their doctor to identify any patients who may benefit from further therapy, medication or expert specialty care.

Primary care physicians will make sure that your child is up to date with their vaccinations. Also, we will be able to monitor for chronic health conditions such as diabetes, obesity and hypertension.

Your child's health encompasses so much more than just their joints and heart. Scheduling yearly visits with your primary care physician helps keep their body and mind healthy and thriving.