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Spring is a beautiful time of year that brings renewed life to our environment and often sparks new well-being motivations. Exercise is one of our most potent and beneficial medicines. May is National Physical Fitness and Sports Month, another reminder of how movement gives us life and rejuvenation.

Exercise has many benefits. It strengthens our bones and muscles. It reduces our risk of certain cancers, helps us maintain healthy body weight, reduces our risk of heart disease, and increases our chances of living longer with a better quality of life. Exercise helps our bodies release substances such as endorphins and endocannabinoids that improve our mood and overall mental health, help us sleep well, improve our sexual health, and decrease widespread pain in our bodies. Exercise helps our brains stay sharp and enhances our learning and judgment skills. Exercising with others can be fun and have many social benefits as well.

Motivation to exercise comes like the waves of the ocean. Sometimes we catch a surf wave and ride it for quite some time before getting knocked down, and other times, we might get excited as the perfect wave approaches, only to faceplant several seconds later. Do not worry; it is uncommon to be an ideal exerciser.

The important thing is to reorient ourselves and keep riding those waves of motivation. Focus on your successes and not your faults. Shame is a tactic used by many well-meaning people and organizations to try and implement change. Still, we learn that shame cannot create long-term healthy change without psychological damage. Please don’t allow yourself or others to shame you regarding how your life is lived. Celebrate your successes and find ways to enjoy the fantastic benefits of exercise.

Why Am I Developing Allergies, and How Can I Prevent Them?

Two to Three hundred years ago, very few people suffered from allergies. Nowadays, it’s common for people to be allergic to multiple things. What has changed? Why are people becoming more and more allergic to chemicals, foods, animals, and our natural environment? There are numerous reasons:

1. We have fewer bacteria in our intestines. We are exposed to cleaner water and more soap and hand sanitizer. C-section delivers more of us, so we are not exposed to our mother’s natural vaginal bacteria (1). We are exposed to more antibiotics, especially as children. Fewer bacteria diversity in the intestines has been shown to increase the risk of developing allergies.

2. For decades, doctors recommended waiting to introduce certain foods till later in childhood. We now know this increases the chance of developing a food allergy (4).

3. We are exposed to more acid-reflux medicines, which reduce stomach acid. Lower stomach acid affects food digestion and how our immune system is exposed to food (3).

4. We spend less time outdoors, especially as children and fewer of us grow up on farms, having less exposure to farm animals (5).

5. We have been exposed to more pollution and 1st or 2nd hand smoking. These have altered how our immune system interacts with our environment (5).

6. Our children wear shoes more when they play outside. When children’s feet have less exposure to bacteria and worms, the risk for allergies goes up (5).

We can control some of these risk factors now, some of them we can modify, and some we cannot. To decrease your and your children’s risk of developing allergies, you can do the following:

1. Eat various foods in your home, including milk, nuts, eggs, and soy. Expose your children to them starting at six months (see your allergist first if there is a family history of life-threatening food allergy). Eat these foods when you are pregnant. If your infant was born via C-section, give them a few different probiotic supplements in their first five years (2).

2. Keep your infant off acid reflux medicine unless necessary. Eat healthily and lose weight to avoid having to take acid-reflux medicine.

3. Avoid taking and giving your children antibiotics unless necessary.

4. Let your kids go outside in the backyard barefoot (within reason).

5. Limit kids’ screen time, and get them outside as much as possible, as young as possible.

6. If you have an opportunity to live on a farm in a less polluted area, take it.

7. Limit hand sanitizer and soap use (within reason) in your home.

8. Stop smoking/vaping.

9. Consider taking a daily probiotic with various strains in it.

By David Beckstead, MD

Sources:
1. Koplin J, et al. Is cesarean delivery associated with sensitization to food allergens and IgE-mediated food allergy: a systematic review. Pediatr Allergy Immunol. 2008;19(8):682.
2. Kuitunen M, et al. Probiotics prevent IgE-associated allergy until age five years in cesarean-delivered children but not in the total cohort. J Allergy Clin Immunol. 2009;123(2):335.
3. Mitre E, et al. Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy and Allergic Diseases in Early Childhood. JAMA Pediatr. 2018;172(6):e180315. Epub 2018 Jun 4.
4. Commins S. Food intolerance and food allergy in adults: An overview. UpToDate. Accessed 3/9/22.
5. Platt-Mills T, Commins S. Increasing prevalence of asthma and allergic rhinitis and the role of environmental factors. UpToDate. Accessed 3/9/22.

Inspired by Heroes – Bennion Veterans Home

Hiking is one of the favorite recreational activities for my family and me. The scenic vistas and the peace of the trail are always refreshing. A few years ago, we ventured to the Redwood Forest and hiked amongst the giants of the forest. I marveled at the size of the redwood trees as they stretched toward the sky. You cannot help but feel that you are amid greatness.

In 2013, I had the opportunity to become the medical director of the Bennion Veterans Home in Payson and continue to serve in that capacity. The veterans home is a skilled nursing and rehabilitation facility for veterans and spouses of veterans.

There is a similar feeling of inspiration as I care for the veterans there. These veterans have been and continue to be heroes to freedom.

Many have visible signs of their sacrifice made in service to others. I am among giants as I walk those halls. I appreciate the chance to work with the veterans and their families. Their service and dedication inspire me.

Pathway to a Healthier Heart

Heart disease is the leading cause of death in the United States (causing one in four deaths each year) and is much more likely to affect our health than any infectious disease. Although both heart disease and infections are mostly preventable, there’s a lot we can do every day to live a heart-healthy life. In the past couple of years, with our focus on COVID, have we neglected some other basic lifestyle and wellness principles? 

Exercise: Exercise can be intimidating, and you can always think up a lot of reasons why you shouldn’t exercise—it’s hard, you don’t have time, you’ll get sweaty, people will laugh at you if you do it wrong, it’s boring, the gym is expensive, you don’t have the right shoes or clothing…the list goes on and on. Exercise is and should be challenging, which is why it benefits you. But work on making it fun and find the activity that’s right for you. Anything is better than nothing. Start small and work towards 30 minutes of physical activity at least five days a week with two days of strength training. If you can’t do 30 minutes in one block, do five minutes here and there throughout the day. Be fun and creative with your exercise. Organize a pickleball tournament with your co-workers, dance with your family, walk with a friend. You’ll get the most out of physical activities that you enjoy, and you’ll keep coming back for more. 

Eat better: As with exercise, start small. Work on improving your diet a little at a time. Planning is key. Plan a healthy menu and write a shopping list to take to the store. It’s easier to stick to your nutrition goals when you have healthy choices on hand and only buy what you need. Write it down. Keeping a food journal helps you focus on what you’re doing—good and bad. Be forgiving. You can’t change what you’ve eaten, but you can make better choices moving forward. Incorporate vegetables, fruits, and whole grains into your diet. Eat fish, poultry, beans, nuts, vegetable oils, and fat-free or low-fat dairy products. Try to cut down on foods high in saturated fat, sodium, sugar, and other sweeteners. Make better fast food choices—salads, smaller “meal deals.”

Strive for a healthy weight: Your best bodyweight range is one that promotes optimal physical and mental health. You should feel strong, energized, and confident at a healthy body weight. Being overweight taxes your heart and increases your risk of having heart disease, a stroke, high cholesterol, high blood pressure, and diabetes. Choose healthy foods and exercise regularly to achieve and maintain a healthy weight. Weight fluctuates with body size, so there’s no “ideal” body weight for all people. Everyone has a different body frame, body fat distribution, and height, all of which determine your healthiest weight range.

Quit smoking: Smoking harms your heart and blood vessels in many ways. Quitting is hard but possible and worth it. There is no single quit smoking plan that will work for everyone. Be honest about your needs. Set a quit date and ask your people for support. Stay busy. Avoid triggers. Stay positive. Consider starting a new hobby to keep your hands busy and connect you to others like sewing, knitting, woodworking, art, or music.

Reduce stress: Stress can contribute to heart risks. Practice meditation. Be physically active. Do relaxation therapy. Talk with someone you trust who might help you cope with stress. While smartphones, computers, and tablets are an unavoidable part of everyday life for many people, using them too often may increase stress levels. Cut down on caffeine. Consuming caffeine may increase your anxiety and stress if you’re sensitive to caffeine. Taking time for yourself is essential to living a less stressful, healthy life. Self-care doesn’t have to be elaborate or complicated. It simply means tending to your well-being and happiness. A sound social support system is essential for overall mental health. If you’re feeling alone and don’t have friends or family to lean on, social support groups may help. Consider joining a club or sports team or volunteering for a cause important to you. 

Improve sleep: Not getting enough sleep or regularly getting poor quality sleep increases the risk of heart disease and other medical conditions. Aim for 7 to 8 hours of sleep a night. Keep a routine—have a regular bedtime and don’t eat late at night. Stay active during the day. Optimize your sleeping place by minimizing external noise, light, and artificial lights from devices like alarm clocks or cell phones. Test different temperatures for your bedroom to find out which is most comfortable for you. Around 70°F (20°C) is best for most people. Your bed, mattress, and pillow can significantly affect sleep quality, so try to obtain high-quality bedding, including a mattress. Make sure your bedroom is a quiet, relaxing, clean, and enjoyable place. In general, the bedroom should only be used for sleep and intimacy. Relaxation techniques before bed, including hot baths and meditation, may help you fall asleep.

Know where you stand: Meet your goals by tracking how much you exercise, blood pressure, and cholesterol numbers. Seeing where you are and tracking progress is motivating.

Connect with others: These goals are more fun and achievable if families and friends work together. We tend to eat and play like our friends and family, so your healthy choices may inspire those around you. People who are connected with others in a plan are more successful. 

John Manwaring, PA-C

Canyon View Medical Group

References and Resources

https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/index.html

https://www.everydayhealth.com/hs/family-nutrition-guide/motivation-to-eat-healthy/

https://www.healthline.com/health/how-much-should-i-weigh#understanding-body-weight

https://www.healthline.com/nutrition/17-tips-to-sleep-better

https://www.healthline.com/nutrition/16-ways-relieve-stress-anxiety

https://www.health.qld.gov.au/news-events/news/30-ways-to-get-active-exercise-fun

https://www.nhlbi.nih.gov/sites/default/files/publications/HM-2022-TakingCare-of-OurHeartsTogether-508.pdf

https://www.verywellfit.com/creative-at-home-workouts-you-can-do-today-86023

Tabitha’s Way – Making a Difference

My name is Hailey Wayland. I am a Medical Assistant and MA Supervisor in our Santaquin Family Medicine Office.

Outside of work, I volunteer at Tabitha’s Way, our local food pantry here in Spanish Fork. While I was there, I had the opportunity to pack meals for families and individuals in need throughout Southern Utah County.

This experience made me realize to be more grateful for the little things. The feeling of making a difference in someone else’s life is a feeling you can never forget! Also, we all need to go and experience this at least once in our lives.

By Hailey Wayland
Medical Assistant Supervisor

Preventing Cervical Cancer

Today, cervical cancer remains a significant cause of cancer morbidity and mortality among women. In fact, in 2020, cervical cancer was the fourth most common cancer in women worldwide. Fortunately, due to access to cervical cancer screening and prevention programs, the U.S experienced a significant decrease in cervical cancer deaths compared to the rest of the world. In the past 50 years, there has been a 75% decrease in cervical cancer incidence and mortality in countries that have implemented screening and prevention programs. For this reason, Canyon View highly encourages regular screening and vaccination against cervical cancer. 

You may be wondering, what exactly is cervical cancer? Cervical cancer is cancer of the uterine cervix and thus, occurs only in women. Cervical cancer is almost always caused by human papillomavirus (HPV) infection. On rare occasions, it can be due to other non-HPV causes such as genetics, cigarette smoking, and even oral contraceptive use. Because cervical cancer is so frequently caused by HPV infection, it is essential to understand HPV. HPV is the most common sexually transmitted infection in the United States and is spread by vaginal, anal, or oral intercourse with someone who has HPV. It can cause cervical cancer and cancer of the vulva, vagina, penis, anus, and oropharynx. Different strains of HPV can cause genital warts as well. Because cancer from HPV takes years to develop after getting infected, it is difficult to know when someone got infected if they have had multiple sexual partners over the years.  

You may now be wondering, how can I avoid contracting HPV and developing cervical cancer? You can do several things to protect yourself from developing cervical cancer. The first thing you can do is get the HPV vaccine. The CDC and American College of Obstetrics and Gynecology recommend HPV vaccination at age 11-12 and for everyone through the age of 26 if they have not yet been vaccinated. The HPV vaccine is recommended not only for females but also males since they can be carriers of the virus. HPV vaccination has been shown to work exceptionally well, as it is estimated to prevent more than 90% of HPV-attributable cancers.

The second thing you can do to protect yourself is to get screened for cervical cancer. Screening for cervical cancer is recommended for all women ages 21 to 65 years old. Early screening for cervical cancer helps prevent the disease altogether. This can be done by getting a Pap test and/or HPV test. A Pap test checks for precancerous cells or changes of the cells in the cervix that might develop into cervical cancer, while the HPV test checks for the human papillomavirus that often causes those cells to change. Both of these tests can be done in your healthcare provider’s office. An instrument called a speculum is inserted through the vagina so your provider can examine your cervix and collect some cells and mucus from that area. 

Screening with a Pap test is recommended every three years from age 21 to 29 years old. From ages 30 to 65, HPV testing is recommended every five years and a Pap test every three years. When both tests are done together, it is called “co-testing.” If your test results are typical for this test, your medical provider may recommend that you wait five years until your next screening. After the age of 65 or for women who have had a hysterectomy with removal of the cervix, screening is not recommended anymore if you have had normal previous results. 

Screening for cervical cancer is an effective way to detect precancerous lesions and cancer. Because early cervical cancer is often asymptomatic, regular screening and HPV vaccination are critical aspects of one’s comprehensive reproductive health. Talk to your provider about your recommended screenings and vaccination schedule today. 

Erin Tyrrell, FNP

Canyon View Family Medicine

Cervical Cancer: What should I know about screening? (2021). CDC. https://www.cdc.gov/cancer/cervical/basic_info/screening.htm

Invasive cervical cancer: Epidemiology, risk factors, clinical manifestations, and diagnosis. (2021). UpToDate. https://www.uptodate.com/contents/invasive-cervical-cancer-epidemiology-risk-factors-clinical-manifestations-and-diagnosis?search=cervical%20cancer%20&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H1

Updated Cervical Cancer Screening Guidelines. (2021). The American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/04/updated-cervical-cancer-screening-guidelines

Creating Holiday Cheer

The holidays can be the most wonderful time of the year; they can also be very stressful. As we hustle from holiday activity to holiday activity, it’s essential that we remember to slow down, manage stress, and take time to care for ourselves. Here are some helpful hints to manage stress during the holiday season as we head into the new year

  • Don’t lose sight of what really counts. What matters most differs from person to person. Identify your priorities and goals and focus on the things that help you fulfill those goals.
  • Respond with kindness. It is no secret that the world has been under a lot of stress these last two years. It is easy to get wrapped up in our own lives and forget the struggles others may be going through. Even when you feel stressed or encounter individuals who may be grumpy, try to take a step back and respond with kindness. Kind words and a genuine smile go a long way.
  • Remember, it’s OK to do less. It is OK if you don’t cross everything off your “to do” list. Everything will be OK! Taking time to breathe and relax is very important and should be at the top of your “to-do” list.
  • Accept imperfections. Find the beauty in the imperfection and chaos of the holiday season. Always remember the wise words of Bob Ross “There are no mistakes, only happy accidents.”
  • Set healthy boundaries. It’s OK to say “no.”
  • Maintain your healthy habits. Try not to overdo it on the sweets, continue to get daily exercise, and ensure you get adequate sleep each night.
  • Reach out. The holidays are a time to connect with those we love deeply. It can also be a time that triggers depression and anxiety in some people. If you are struggling, please make sure you reach out for help.
  • Rethink your resolutions. Be gentle with yourself. Break down your goals into smaller steps that are easier to accomplish. 

We wish you a happy and healthy holiday season!

With love from our Canyon View Medical Group family to yours.

Latinos In Action

My name is Daeli Mendoza. I am a lab tech in our Springville Family Medicine office. Outside of work, I am involved in Latinos in Action, a community organization dedicated to bridging Latino students’ graduation and opportunity gap, working from within the educational system to create positive change.

One of the many ways we serve in our community is through tutoring; we go to elementary schools and help kids with their homework, reading, and projects. Another aspect of tutoring isn’t in our “job description” but is a more significant part of what we do – it is about being someone for these kids to whom they can look up. 

These schools are diverse, and we have to show the students that anything is possible no matter their background or skin color. It is about being someone these children can confide in about things that have little to do with homework or school, but we are there to listen to them. It is about being their friend when they otherwise don’t have any. Although we do this for an hour a day, once a week, which is nothing for most people, it is everything for these kids. Their eyes light up every time they see us walk through the doors, and that is something I will never forget, and I’m hoping that neither will they.

What’s best for your breast?

October is breast cancer awareness month. It’s a great time to go over a few common questions women have regarding breast health and breast cancer detection. 

The first step in breast health is breast self-awareness, which means that you are aware of what is normal for your breast and can detect small changes. Self-detection results in almost one-half of all cases of breast cancer being found in women aged 50 years and older. A woman herself often finds breast cancer. In women younger than 50 years, more than 70% of breast cancer cases are self-detected.

Are there signs and symptoms related to breast cancer?

The most common symptom of breast cancer is a new lump or mass. A painless, hard mass with irregular edges is more likely to be cancer, but breast cancers can be tender, soft, or round. They can even be painful. For this reason, it’s essential to have any new breast mass, lump, or breast change checked by experienced healthcare professionals. 

Other symptoms can include –  

  • Swelling of all or part of a breast (even if no lump is detected).
  • Skin dimpling (sometimes looking like an orange peel).
  • Breast or nipple pain.
  • Nipple retraction (turning inward).
  • Nipple or breast skin that is red, dry, flaking, or thickened.
  • Nipple discharge (other than breast milk).
  • Swollen lymph nodes (sometimes breast cancer can spread to lymph nodes under the arm or around the collar bone and cause a lump or swelling there, even before the original tumor in the breast is large enough to be felt).

Should I have a clinical breast exam?

Yes! A healthcare provider should perform a clinical breast exam and can help find lumps that may need further testing and evaluation. The exam should be done every 1-3 years for women aged 25-39 and women aged 40 and older should have an exam every year.

How do I know I am at an average or higher risk for breast cancer?

A woman is considered at higher risk if there is a family history of breast cancer, ovarian cancer, or other inherited types of cancer; BRCA1 and BRCA2 mutations; chest radiation treatments at a young age; and history of high-risk breast biopsy results. Women without these risk factors are at average risk. If you meet the criteria for higher risk, you should speak with a healthcare professional to develop a plan that may include earlier mammograms and/or genetic testing.

When should I start having mammograms?

The American College of Obstetricians and Gynecology recommends that a woman of average risk start at age 40 and have mammograms every 1-2 years. For more information regarding mammograms, click on the link in the reference section below or speak to your healthcare provider.

Early detection of breast cancer is an essential factor in survival rates. Having yearly wellness exams is a great way to stay on top of your health. We would love to answer any questions you have regarding breast health or any part of your wellbeing.    

Learn more about Crystal at:

https://canyonviewfamilymedicine.com/providers/crystal-kolling-fnp/

References:

https://www.acog.org/en/womens-health/faqs/mammography-and-other-screening-tests-for-breast-problems

https://www.cancer.org/cancer/breast-cancer

Recognizing the Signs of Depression

One of the more common conditions we see in Family Medicine is depression. Depression is the most common mental health condition experienced in the general population. About 15% of the adult population will experience depression at some point in their lifetime. 

Symptoms of depression can include feeling low, down, sad, or blue. However, there are many mental as well as physical complaints that can be signs of depression. Other common symptoms may include apathy, disinterest, inability to feel anything, problems with sleep, appetite, concentration, motivation, and social withdrawal. 

Most people feel low and sad at times. These feelings are normal reactions to life and are experienced when going through different life stressors such as losing a loved one, getting fired from a job, divorce, and other difficult situations. However, prolonged feelings of sadness, hopelessness, and despair that persist can signify depression.

I often find depression, and symptoms of depression are much more subtle and difficult to spot in oneself and those close to us; thus, symptoms may be missed and treatment not started. Currently, the American Academy of Pediatrics now recommends regular depression screening for all adolescents 12 and over, given that adults often overlook the symptoms of depression. Similar screening recommendations exist for adults. 

A tool called PHQ-2 can be an easy and quick screening for depression. This tool consists of two simple questions that one can ask themselves or a loved one. The questions are:

  • Have you often been bothered by feeling down, depressed, or hopeless during the past two weeks?
  • Have you often been bothered by having little interest or pleasure in doing things during the past two weeks?

A single “yes” answer of more than half or every day indicates possible significant depression, and one should seek further evaluation and care. Thoughts of death necessitate medical attention, and a plan to self-harm requires emergent care.

The good news is there are many effective treatments if you or a loved one is struggling. Effective treatments for depression may include medications, working closely with mental health professionals, and learning different coping mechanisms. Working closely with one’s healthcare provider is a great starting place to help determine the best course of treatments.

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