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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

Pregnancy Planning and Birth Defects Prevention

If you are planning to become pregnant, there are certain things you can do to increase the odds of good health for you and your baby. Some actions you take in advance can also significantly decrease the risk of certain birth defects. While some birth defects cannot be prevented, others are linked to the mom’s health and actions before and during pregnancy.

Folic acid supplementation

Every woman who might become pregnant should take a prenatal vitamin with 400 mcg of folic acid. Folic acid, also called vitamin B9, is an essential nutrient that helps develop the baby’s brain and spinal cord. This development usually happens early in pregnancy before a woman knows she is pregnant, so planning is essential. Some foods are also enriched with folic acid, such as fortified bread, pasta, and cereals. Eating a healthy, varied diet in addition to taking a prenatal vitamin will ensure that your body is getting the nutrients it needs for a healthy pregnancy.

Avoid alcohol, smoking, and drugs

There is no known safe level of alcohol, tobacco, or drugs like marijuana to consume during pregnancy. These substances can be harmful at all stages of pregnancy, including in the very early stages. It is best to avoid these substances altogether if you plan to become pregnant. If you need help to stop smoking or using a drug, please reach out to your healthcare provider.

Prevent infections

Some infections can cause pregnancy complications and birth defects if the mother has them during pregnancy. These infections include rubella, cytomegalovirus (CMV), toxoplasmosis, mosquito-borne illnesses like Zika and West Nile viruses, and many sexually transmitted diseases. If you are pregnant or planning to become pregnant, you should protect yourself from these diseases. Ensure you are up to date on your immunizations and talk to your healthcare provider to see if you need additional vaccines. Avoid travel to places where high-risk diseases like Zika are common. If you have a cat, you should avoid changing the litter box, which is a potential source of toxoplasmosis infection. And of course, it is a good idea to practice basic sanitation and infection prevention techniques like frequent handwashing and avoiding sick people. 

Check-in with your healthcare provider

Stay in close contact with your healthcare providers before and during pregnancy. If you have any chronic health conditions, you should make sure these are well controlled before becoming pregnant. For example, diabetes is a common health condition that can affect a baby’s growth and development if not controlled. Blood pressure problems, bleeding and clotting disorders, mental health conditions, and many other health problems can also affect pregnancy. Some prescription medications can cause birth defects and are unsafe to take during pregnancy. If you take any prescription medications and might become pregnant, you should make an appointment with your healthcare provider to discuss a plan for these medications.

Take care of yourself

Finally, take care of yourself! Pregnancy is an exciting time, but it can also be quite stressful. It may seem like everyone has an opinion about what pregnant women should and shouldn’t do. Make sure you get your information from trusted sources. Remember that some aspects of pregnancy are simply out of your control, and trying the best you can to care for yourself and your baby is enough. At Canyon View Women’s Care, our goal is to help women have happy, healthy babies. We would love to take care of you before, during, and after your pregnancy and answer any questions you have. Call us at 801-465-2559 for a preconception consult or pregnancy-related visit.

Alyssa Heath, PA

Canyon View Women’s Care

What Your Pediatrician Has in Her Medicine Cabinet (For the Kids)

Is your medicine cabinet a jumble of bottles, with some expired medications drying up in the back? Have you ever had a child sick in the middle of the night and had to send someone out in the cold to pick up something for a bit of relief? Pediatricians often call the winter months “respiratory season” because of the seasonal spikes in viral illnesses, so consider doing a quick check on your medicine cabinet so you can be prepared. Here is what I have in my home, regardless of the time of year.


Even with a varied diet, it can be hard to get all the recommended nutrients every day. The AAP recommends breastfed babies receive 400 IU of vitamin D supplementation, and all children and adolescents 1 year and older receive 600 IU of vitamin D. This is especially important for Utahns because while many Americans are vitamin D deficient, we are at even higher risk in the high latitudes of Utah. Bone density increases fastest during growth in childhood and adolescence, so take advantage of that by adding calcium too–especially during puberty! Consider providing these nutrients through a multivitamin, especially if your child has picky eating habits.

Acetaminophen (Tylenol)

Acetaminophen is great at reducing fevers and pain. Children as young as 3 months of age can safely take acetaminophen for teething, fevers with illnesses, or other fussiness you may think may be pain-related. Under 3 months of age, you should talk to your pediatrician first. A fever in this age group should be evaluated immediately. Also talk to your doctor first if your child has a history of liver disease or injury.

Ibuprofen (Motrin)

I am a fan of acetaminophen and an even BIGGER fan of ibuprofen. For children 6 months and older, I usually grab this one first. Ibuprofen also treats fevers and pain, and at higher doses has anti-inflammatory effects too. When kids have pain in their bones or muscles, I usually recommend this as the first-line medication offered. Talk to your doctor first if your child has a history of kidney disease or if you are concerned about them being severely dehydrated.

Diphenhydramine (Benadryl)

Diphenhydramine is a powerhouse medication with many uses. While I hope you don’t need it often, I have it in my medicine cabinet just in case. It can be used for allergies, itching, allergic reactions, motion sickness, severe sleep issues (clear this one with your doctor first), and even helps treat migraines.


Ok, this is not a medication, but have you ever had a bad cold and been soothed by a spoonful of honey either swallowed straight or mixed into warm tea? When prescription medications are not needed, it is so great to have other options, so try this for a cough or sore throat. Just remember, infants under 1 year of age should never be given any honey or honey products because of their risk for botulism.

Bonus: Nasal Aspirator

Another non-medication, but WOW, these are great for all of our sick and snotty babies! The Nose Frida and NeilMed Naspira are some of my favorites because you control the strength of the suction, and they disassemble easily for thorough cleaning between uses. A good nasal suction can sometimes keep a baby out of the doctor’s office, and while we love to see you, your sweet baby may rather stay at home. Pair its use with nasal saline drops or saline spray to break up that snot and increase your suction superhero powers. Nasal saline can also be very effective on its own for children who are older or do not tolerate suction.

For your child’s dosing of the medications listed, check out our Dosage Charts. And if you ever have questions or concerns about your child’s illness, the pediatricians at Canyon View Pediatrics are here for you. We can clarify your child’s appropriate dosing for medications, provide recommendations on how to use them, and determine if other treatments, such as antibiotics, are needed as well. And remember to always keep your medications (including those vitamins) in a safe and secure place away from your child’s reach. If you have a concern about accidental consumption, call us right away, or call Poison Control at 1-800-222-1222.

Sarah Tang, MD

Canyon View Pediatrics

Spanish Fork, UT

Giving Back to Education

In 1984, Carl Nielson was my high school counselor at Spanish Fork High School. He called me into his office, which made me a bit nervous. I thought Mr. Nielson would yell at me for some things that may or may not have happened on the previous Saturday night. Instead, Mr. Nielson congratulated me on my academic achievement and told me, “if you wanted, I think you could make it to medical school.” Fifteen years later, Carl Nielson became the Nebo School District Superintendent, the same year that I joined Canyon View Medical Group as a young physician. His belief in me and his devotion to education made me what I am today.

I strongly feel that K-12 education is vital to our community and recently decided to dedicate some of my time and energy to making sure that other kids can be inspired and allowed to excel. I was elected in 2020 to the Nebo School District Board of Education, and now I spend time each month reviewing and developing policies, working with district administrative staff, and overseeing the finances of our local school district.

I am excited to be part of the Nebo District and particularly look forward to rebuilding Springville, Spanish Fork, and Payson High Schools. I am amazed at the quality of our staff and the dedication they have to educate our children. While I love practicing medicine, I also love learning about how schools are run and financed and helping the district teach our children and inspire another generation.

Newborn Diaper Care

What is in my baby’s diaper…?

When babies are born, we spend a lot of time loving their beautiful faces, but a lot of their care seems to be for their bottoms! A newborn baby typically has 8 to 12 diaper changes in a day—while a person might know a lot about what happens down there, as a parent of a newborn, you may be surprised by what you find. Hearing about it early may help calm some of those middle-of-the-night panic moments. Here are some common findings, questions, and even surprises that may come up during your baby’s diaper change.


How often should your baby pee? Your baby should work up to at least 5 to 6 wet diapers per day. A good rule of thumb is Days of Life = Number of Diapers. So 1st day of life, have 1 wet diaper; 2nd day of life, 2 wet diapers; and so on until he reaches 5-6 wet diapers per day from then on. Decreased wet diapers may be the first sign of dehydration, so if you see that your baby isn’t peeing as much as usual, consider shortening those feeding intervals and feeding her more often. If it is a big or persistent drop, she isn’t acting well, or you have other concerns, seek medical attention right away.

Sometimes, in a baby’s urine, you’ll see an orange tinge or even a little pile of orange dust! This is caused by urate crystals. Urate crystals occur because newborn urine is more concentrated in the first few days of life. If you see these, it will likely be in the first week of life. Sometimes, this is referred to as “brick dust” because it often sits on top of the diaper.


Ahh, poop. I never thought poop would be so important in my medical or parenting career, but the newborn phase is the new parent’s inauguration into the poop obsession club.

Your newborn’s poop will start out as sticky, black/dark green meconium, which will go away by his 4th day of life. After that, diaper changes will be less sticky and tricky. His poop may then be various shades of green, yellow, or brown. Talk to your pediatrician if your baby’s meconium has not transitioned by the 4th or 5th day of life.

Unlike wet diapers, we worry less about how many dirty diapers each baby has. He may poop with every feeding or just every few days. Pooping might even take a bit of effort, accompanied by a red face and a little cry. (It is hard to bear down and relax at the same time!) But if your little one is otherwise happy and gaining weight appropriately, we will be happy too.

So when will your pediatrician REALLY worry about poop? If it is red or black like new blood or old blood, or chalky white, which means it could be missing bile. If there are tiny drops of blood in your baby’s poop, schedule an appointment with your pediatrician. But if you see lots of blood or white-colored stool in your baby’s diaper, he should be seen by a medical professional immediately.

Is that blood down there??

Occasionally, a parent is put in shock from seeing blood in the front of the diaper. Where does this come from?

In baby girls, blood may come from the vagina. Your little girl is born with functioning reproductive organs, so as her mother’s hormones decrease in her body outside of the womb, it may stimulate a “mini period” in her. It can also cause a little bit of clear, white, or yellow vaginal discharge that has a mucus consistency. But no need to worry if either of these things does not occur—though it can happen, it will not necessarily happen in all baby girls.

A baby boy may have small amounts of blood in his diaper after a circumcision. Otherwise, he should not bleed. Normal bleeding from a circumcision site is spotting, less than the size of a quarter. If you see continued dripping or oozing when you are home, try applying pressure for at least 30 seconds. If it does not stop, he should be seen right away by a doctor. Not sure if it’s blood, or is your baby uncircumcised? Consider the possibility of urate crystals. If you think it could be blood, call your doctor right away.

While the rest of us have a #1 and #2, maybe babies should have a #3, #4, or more! Now that we have reviewed what some of those things are, you can be assured when your baby makes the normal transition from being inside the womb to outside. If you have other questions, consider taking a photo of the diaper to share at your appointment when you come to see your pediatrician at Canyon View Pediatrics. Happy diaper changing!

And remember, if your baby is acting ill, excessively sleepy or fussy, has a temperature of 100.4 F or higher, or if you have any other immediate concerns, you should always take your baby in to be seen right away.

Preventing Heat Stroke

Summer is just around the corner, and with the promise of summer break approaching, you may find that you are planning more outdoor activities for you and your family. The goal of this week’s blog is to discuss the importance of preventing heat stress in children and infants. For more information on sun protection and sunscreen, please see Dr. Paxton’s blog post on this topic from March 2016.

In Utah, we are no stranger to intensely hot, dry weather. In this climate, children and infants can become quickly dehydrated if not adequately prepared. While it’s important to ensure that your children remain active and play outside during the summer months, keep in mind that when the temperature rises too high levels, or if you are traveling somewhere with very high humidity, intense activities such as hiking, running, riding a bike, etc. that last longer than 15 minutes should be minimized to prevent heat stress and heat stroke. Limiting the time spent outside between the hours of 10:00 am and 3:00 pm will also protect against the most intense UV light that can cause sunburns.

Dehydration is the major concern when participating in any prolonged activity outside in high heat and/or humidity. This can be easily prevented by providing adequate rest and hydration to children. Children are at a higher risk of becoming dehydrated compared to adults because, for their weight, children’s body surface area is larger.

Spotting dehydration can be tricky if you’re not sure what to look for. Early on, children may complain of fatigue, thirst, lack of energy, and feeling hot. You may notice that their lips and/or tongue are dry. If a child is complaining of thirst, they are already slightly dehydrated. Children should be given plenty of opportunities to drink water and remain hydrated before, during, and after activities outside. When remaining active outside for less than one hour, drinking water is sufficient. Breaks should be provided every 20 minutes to allow children to have water and/or sports drinks to ensure adequate hydration. They should be drinking 5 to 9 ounces during these breaks. Be sure to dress your active child in lightweight, light-colored clothing when outdoors, and that they change any sweaty clothing with dry clothing as soon as possible. Any child who is feeling dizzy, lightheaded, or nauseated should be removed from the activity promptly and brought somewhere cool and allowed to drink water.

Prompt recognition and treatment of dehydration are important so as to prevent progression to heat cramps, heat exhaustion, and heatstroke. Heat cramps are characterized by painful cramping of the muscles, usually in the abdomen, arms, or legs. Heat exhaustion presents with dizziness, nausea, vomiting, headache, weakness, and muscle pains. Rarely, children can become unconscious when suffering from heat exhaustion. Heatstroke occurs when the core temperature rises to 104 or higher and the child has symptoms of nausea, vomiting, seizures, disorientation, lack of sweating, and shortness of breath. Children suffering from heatstroke may become unconsciousness, and rarely comatose if not treated promptly. Heatstroke is a medical emergency and can result in death if left untreated.

For infants and small children, the focus of preventing heat stress and heat-related illness is different. Most people have heard of the sad event of an infant or toddler who was left in the car during the summer months and suffered heat illness, heatstroke, and even death. Infants and younger children are unique from older children as they lack the ability to regulate their body temperature in the same manner. For this reason, it’s especially important to pay close attention to the comfort of your infants and small children in hot environments, especially in the car during the summer months.

When traveling with infants and young children, make sure that you ALWAYS check the back seat to make sure everyone is out of the car when you reach your destination. For those families who have older children who help take care of infants and toddlers, NEVER entrust this responsibility to them. As a parent, it is your responsibility to make sure that everyone is safely out of the car. Too often have infants and children been left in the car unintentionally because an older sibling was responsible for getting them out and, for whatever reason, forgot. Because the temperature inside the car can reach dangerously high levels quickly, you must NEVER leave a child alone in the car, even if it’s just for a quick trip into the store. If your infant or small child is accidentally left inside a hot car for a prolonged period of time, seek immediate medical attention for observation to ensure that they are OK.


Haley Pledger, PA
Women’s Care
Matthew Walton, DO
Austin Bills, DO
Family Medicine
Aaron Fausett, PA
Family Medicine
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