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Ebola and Breast Cancer

Dr. George Linhardt Teton Valley Health Care

Dr. George Linhardt
Teton Valley Health Care

That caught your attention. To be clear, breast cancer does not lead to an Ebola infection nor does Ebola put you at increased risk for breast cancer. However, they share the importance of monitoring yourself and being vigilant to stay well.

With Ebola, if one has traveled to certain countries and develops symptoms, they need to seek medical attention to save their life.

With breast disease, if one detects a lump or a change, it is imperative to seek medical attention to save one’s life.

Men as well as women can develop breast cancer, so men should not ignore changes.

You know your body better than anyone else, so you will be the best to detect subtle changes or irregularities. These changes will not be detectable overnight, but may arise over a period of a month. It is recommended that a particular day of the month; 1st, 15th or last day of the month be your day for self-examination. For women, it is best to schedule your self-exam several days after the last day of your menstrual cycle. It will be easiest to detect changes at that time.

Breast self-examination is easily performed by you in the shower with a liquid soap. It is important to include the entire breast, the area beneath the breast and the armpit. One should be one alert for a bloody discharge, or a different discharge and changes in the skin of the nipple. These nipple changes may be a rash, scaling or an unusual skin tag. You can visit Teton Valley Health Care’s breast health information webpage for more information about self exams and general breast health. Teton Valley Hospital can also provide you additional information with diagrams to assist you.

Mammograms are an excellent partner for breast self-examination. This partnership is critical as approximately 15% of all breast cancers are not detectable by mammography. Current recommendations for mammograms begin at age 40 and at intervals of one to two years. If one waits until that age or the next mammogram to have a lump evaluated valuable time is lost, and options may radically change. Unfortunately, many are fearful of finding a lump or that if a lump is detected a biopsy will be necessary. The sooner one finds a cancer, the more options are available. Biopsies should not be feared. Today, most biopsies are performed under local anesthesia through a nick in the skin, with minimal discomfort and a tiny scar.

It is imperative that you do not ignore a potential change you may detect during a  self-exam, and that your provider listens to your concerns.

In breast cancer: earlier is better than later, smaller is better than larger, know and trust what you body tells you.

Dr. George Linhardt is a general surgeon at Teton Valley Health Care. He sees patients at Driggs and Victor Health Clinics. To make an appointment call (208) 354-2302.

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Doc Talk: Hydrate, hydrate, hydrate!

Doc Talk: Hydrate, hydrate, hydrate!

By Dr. Nathan Levanger, DO

Outdoor adventure season is in full swing here in the valley. Whether it’s a day trip to the Wind Cave up Darby Canyon or an overnight camp-out in the Alaska Basin, our options are seemingly endless when it comes to hitting the trails.

Our high elevation, combined with long sunny days and stretches of temperatures in the 70s, 80s and 90s can pose some risk for unprepared adventure seekers.

Regardless if you plan to go for an hour or a day, it’s important to make a few key preparations.

First, always bring water on your trips. In warm months, hikers/bikers/climbers/runners should drink approximately one gallon of water per day, but that can vary based on your individual needs. In direct sunlight and with physical exertion, your fluid/electrolyte loss can happen faster than under cooler conditions. Sweat evaporates instantly in dry climates like ours, so it’s important to pay attention to any signs your body might need hydration. If hiking with children, pay attention to the water in their water bottles to make sure they are drinking enough and at an appropriate frequency. Ditto for dogs.  Don’t plan on finding sufficient watering holes for dogs to lap up; bring water for the pooches and remember that dogs are exerting energy while wearing fur coats. Also be aware that dogs may not stop to drink water at a creek or pond if their human partner is bike riding or running at a steady pace. You may have to stop and relax before your dog feels that he can take a break and lap up some water.

Second, dress in layers and loose-fitting, lightweight clothing to avoid heat exhaustion. Seek out shaded areas when hiking, and avoid sunburns. Also, if you are taking any medications, ask your doctor whether the medications could make you more susceptible to heat exhaustion or sunburn.

Third, bring a friend or family member along for the trip and avoid strenuous activity in the middle of the day, when the sun and heat are at their highest points.

Generally, by the time you are thirsty, you’re already somewhat dehydrated. To avoid this, drink 1/2 to 1 quart of water or electrolyte drink for every hour you hike.

Although most instances of dehydration are mild or moderate and can be easily resolved by drinking fluids, severe dehydration can also occur.  Signs of a serious problem include little or no urination, extreme dry mouth and skin, confusion, rapid heart-beat and unconsciousness.  Severe dehydration is a medical emergency.

Like any good Scout, you need to be prepared.  Water, sunscreen, good shoes, weather outlooks, and good directions should form the basis of every summer outing.

Dr. Nathan Levanger is a family practice physician offering patient care at Driggs Health Clinic located in Driggs Idaho.

This article originally appeared in the Teton Valley News.

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Doc Talk: What is hantavirus and how can you avoid it?

Dr. Nathan Levanger

Dr. Nathan Levanger

With the weather warm and the sun shining, now is the time of year for cleaning up the yard, decluttering the house, and digging into old boxes and attics to make space.

While this summer cleaning is music to garage sale lovers’ ears, you can sometimes get more than you bargained for when you finally get to that corner of boxes in your basement or barn.


In Teton Valley, it’s common to find evidence of rodents taking up residence in your long-forgotten possessions, and this can put you at risk for a very serious illness: Hantavirus Pulmonary Syndrome (HPS).


As of April, 639 cases of HPS had been reported throughout the U.S. this year, with Idaho, Wyoming and Utah reporting 21, 11 and 33 incidences respectively. HPS is more common in rural areas, and it can be fatal.

Transmission
The virus is transmitted to humans most commonly when we breathe in air contaminated by the virus, which is carried by mice, including deer mice common to this area as well as white-footed mice, cotton rats, and rice rats. We are susceptible to breathing in tiny droplets of the virus when we disturb droppings, urine or nesting materials of infected mice. We can also contract HPS if we are bitten by an infected rodent or by eating food contaminated in some way by the virus. It is important to note, however, that not every mouse is infected with HPS.

Risk factors

  • People are more likely to contract HPS if they:
  • Open and clean long unused buildings or sheds
  • Houseclean, particularly in attics and other low-traffic areas
  • Have a home or work space infested by rodents
  • Have a job that involves exposure to rodents
  • Camp, hike or hunt in the wilderness

Symptoms
The Centers for Disease Control reports that symptoms of HPS can develop between 1 and 5 weeks after exposure to fresh urine, droppings or saliva of infected rodents. Early symptoms include:

  • Fatigue, fever and muscle aches, especially in the larger muscle groups such as the thighs, hips and back
  • Headaches, dizziness, chills, nausea, vomiting, diarrhea and abdominal pain

Late symptoms, which can occur 4 to 10 days after the initial phase of the illness, include coughing and shortness of breath.


The loss of breath is caused by the lungs filling with fluid, which can be fatal. As well, blood pressure will begin to drop and ultimately organs will begin to fail. The Mayo Clinic reports the mortality rate for the North American variety of HPS at more than 30 percent.

See your provider if you experience any of the symptoms above or if you suspect you may have contracted hantavirus.

Treatment
Treatment can include hospitalization and assisted respiration through intubation or mechanical ventilation. In rare cases, blood oxygenation may also be used.

Prevention
The best way to stay free of hantavirus is to minimize contact with rodents in your home, workplace or campsite. You can do this by sealing up holes inside and outside of your home to keep rodents out, trapping rodents around your home to reduce their population and taking precautions when cleaning rodent-infested areas.
These precautions are:

  • Wear disposable gloves
  • Wet down dead rodents and areas where they have been with alcohol, household disinfectants or bleach.
  • Follow that by disinfecting the area with a mop or sponge
  • Wear a respirator if you are cleaning heavily infested areas

For more information on HPS visit http://www.cdc.gov/hantavirus/hps/index.html

Dr. Nathan Levanger is the Chief of Medical Staff at Teton Valley Health Care. He specializes in family medicine and sees patients at Driggs Health Clinic and Teton Valley Hospital. Call (208) 354-2302 to make an appointment.

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