All Posts tagged idaho health

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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Good Choice, Bad Choice: Fālyər

Failure (fāl yǝr) noun

1. Lack of success synonyms: nonfulfillment, defeat, foundering, debacle

2. Informal: flop, megaflop, dud, ne’er do well, dud, busted flush

I’ve been quiet on the blog lately and usually when I’m quiet, it’s because something has happened that must be processed through my 5 phases of Realization:

  1. Disbelief
  2. Inner scolding
  3. Rationalization aka Flimsy Excuse-making
  4. Acceptance along with inner scolding
  5. Realization = moving forward, along with occasional bursts of inner scolding

The reality is this: I did not meet my wellness goal of lowering my BMI. In fact, I’ve stayed exactly the same in terms of BMI.

  1. Ms. Disbelief says, I can’t believe 12 months have gone by!
  2. If I’d shown some willpower, I’d be in great shape today says the Scolder.
  3. At least my BMI didn’t get worse, according to Rationalizing Ann.
  4. It’s my own fault for not taking this seriously, now I need to commit and try again.
  5. Realization: I have the tools, I know what I need to do, I’ve learned a lot about what motivates me and now I’ll put it all together and succeed. I can’t continue to be a busted flush ne’er do well.

There’s a little trick I play on myself that’s worth about 100,000 calories. (This is top secret information.) This is what happens: Let’s pretend I’ve had a good day of exercising and eating well. I praise myself. I prowl around the kitchen, making a mental list of the locations of all of the high calorie foods. Then, I wait for my husband and teenagers to clear out. When the coast is clear, I quietly pocket a cookie, scarf a spoonful of ice cream, or chug a chocolate milk. Then I scoot off, almost smug in my knowledge that I’ve gotten away with it again!

And what exactly have I gotten away with? NOTHING. While I’ve been able to host secret hoovering sessions, the resulting pounds are visible to everyone. Somehow, eating non-healthy foods in private is similar to the belief that breaking up a cookie into small pieces reduces the caloric intake: No witnesses, no calories. It never happened folks! My capacity for magical thinking is boundless.

Over the past month, I’ve been declining unhealthy foods and replacing them with better choices. I’ve skipped the cinnamon rolls and taken the watermelon slices instead. I’ve made myself get out and walk more, do more yard work and generally be wiser about how I spend my hours. I KNOW what I need to do, I’ve LEARNED how to build and use the tools toward better health, and having that knowledge is simply not enough.

If you’ve been following my blog, you know how much I like quotes. Here’s a good one by Legouvé “To live is not to learn, but to apply.”

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  Disclaimer: This blog discusses my personal wellness goals and is in no way a soapbox to tell anyone else how to eat, exercise and/or live their lives.

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Doc Talk: Don’t get burned — Be kind to your skin

Skin Cancer: The facts
• Skin cancers are common in our community due to our high altitude
• Changes in moles or wounds that do not heal require medical attention
• Prevention is important; if you work or play outside, sunblock is critical and should be reapplied every two hours
• These cancers don’t go away, they only get worse, and are harder to treat when ignored

Q. What is the largest organ in the human body?
A. The skin

Dr. George Linhardt

Dr. George Linhardt

Your skin covers a large surface area and is subject to scrapes, cuts, sun, snow, hot sidewalks and spills of all types. It’s important that we don’t overlook our skin when considering our overall health.

Skin cancer is the most common form of cancer in the United States, and living in a high altitude, sunny environment puts us at a greater risk. Other risk factors include:

  • Sun exposure – spending a lot of time outdoors
  • Blistering sunburns – if you experienced several blistering sunburns as a child or teen
  • Skin color – if you have fair skin, blond, red or light brown hair, blue eyes or freckles
  • Artificial tanning – if you use tanning booths, beds or sunlamps

With all that we know about what can cause skin cancer, gone should be the days of baby oil , a book, and a day in the sun.

While there are several kinds of skin cancer, these can be divided into three common types:

Basal cell cancer – This type of cancer is locally aggressive, meaning if you leave it alone, it will just get bigger. It may not spread to other organs but may be become more and more difficult to treat, becoming unsightly, bleeding and disfiguring. Local excision (conservative surgical removal) is the usual treatment. Depending on the location, other approaches may be used such as medication or freezing with liquid nitrogen. These cancers may appear as chronically flaking skin or a sore that will not heal or constant bleeding.

Squamous cell cancers are more aggressive and can spread to other parts of the body and lymph glands. They can appear as a non-healing or bleeding ulcer. They may have a ridge around the center that is raised. A low volcano may be a good analogy of what these look like. Unlike the basal cells, the surgery needs to be more aggressive with a larger margin clear edges) around the specimen. The skin cancer and the surrounding edges may be checked at the time of the surgery with a frozen section (immediate analysis) or await the final definitive examination. It is important not to ignore these as they can grow in locations that may make treatment very difficult and disfiguring as well as life threatening. Sometimes plastic and reconstructive surgery is required to properly treat these cancers.

Melanoma is the third type of skin cancer and is becoming more prevalent. It is usually dark , and irregular. A crushed black berry on the skin is a good description. It is often raised above the level of the skin, various shades of color. It is can be seen on the palms of the hands and soles of the feet. Any dark moles in these areas are reason for serious concern. Melanomas can be slow growing or rapidly spread and cause death. They can spread to the lymph nodes under the arm or in the groin. They can be found on the trunk as well as the arms and legs. They are categorized as to how thick they measure under the microscope as well as what levels of the skin they penetrate. Deeper and thicker melanomas require the lymph nodes to be evaluated as well.

Dr. Linhardt is a general surgeon offering services weekly at Driggs Health Clinic and Teton Valley Hospital. To learn more about Dr. Linhardt, please click here or www.georgelinhardtmd.com.

 

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