August 2006: Health Briefs from Baylor Health Care System

Today's Technology Gives a Crisp Picture of Your Body's Inner Workings

A decade or two ago, if your doctor had said, "Let's take a peek inside," you would have known you were facing exploratory surgery. But today, more than likely your doctor is referring to one of the scans that can show the inner workings of your body in precise detail. And for most of them, you won't feel a thing. Depending on your symptoms or condition, your doctor might recommend:

CT or computerized tomography layers multiple X-rays in fine detail to display 2-D or 3-D images. Modern scanners, which can take as many as 128 images at once, are fast enough to scan blood vessels and the heart. "We can 'freeze motion' by acquiring many images quickly," explains Mark Fulmer, M.D., a diagnostic radiologist on the medical staff at Baylor University Medical Center at Dallas. "We can see inside the coronary arteries, visualize the plaque, and measure how narrowed they are. And this is just the beginning of a whole explosion of technology." These scans can sometimes replace more invasive techniques such as angiograms and cardiac catheterization.

MRI or magnetic resonance imaging uses high-powered magnets to image the body's tissues. They are often used to view the musculoskeletal system, the brain and abdominal organs, especially before surgery. Breast MRIs can help screen women at high risk of cancer and track the progress of cancer treatment.

Because CTs and MRIs provide different information, your doctor might recommend both tests to evaluate your problem.

The emergency department at Baylor Dallas recently acquired a Statscan, which is a flexible-format digital radiograph system used mainly for trauma and emergency patients. The scanner provides health care providers with a complete head-to-toe image of a patient's injuries. Exceptionally high resolution and low doses of radiation, as well as a quick scan time, make this a good tool for diagnosing many types of injuries.

Digital mammography is to traditional mammography what digital cameras are to their film counterparts. The technique for performing the test is the same, but technicians and radiologists can tweak the image to improve it.

No Time to Work Out? Follow These Tips for a Ten Minute Workout

No time to exercise? No excuse! Phil Tyne, director of the Baylor Tom Landry Fitness Center, says anyone can fit in 10 minutes a day, alternating cardiovascular one day and strength training the next. Always talk to your doctor before beginning any exercise plan.

Cardiovascular Routine: Take a brisk 10-minute walk.

Strength-Training Routine: Choose 10 exercises to work the major muscle groups, and do each until fatigued. In most cases, this will take less than one minute. If the muscle is not fatigued after one minute, add more resistance.

Illustrated examples of proper form are in the Exercise Library on the American College of Exercise Web site at acefitness.org.*

1. Chest-Push-ups
2. Upper back-Upright row with dumbbells
3. Back-Latissimus dorsi pulldowns with a stretch band
4. Lower back-Back extensions
5. Arms-Overhead press with dumbbells
6. Arms-Bicep curls with dumbbells
7. Arms-Triceps kick-backs with dumbbells
8. Legs-Squats with dumbbells or bands
9. Legs-Heel raises
10. Abdominals-Abdominal curls

Back-to-School is Right Around the Corner- Follow these Tips

Healthy kids make happy kids. Here are some tips for starting off the new school year on the right foot.

Back(pack) to school:
Today, a backpack is as much a part of back-to-school gear as new shoes and notebooks. However, overweight backpacks can result in neck, shoulder or back strain.

"Backpacks shouldn't exceed 10 percent to 15 percent of a child's body weight," says Paul Bassel, M.D., a pediatrician on the medical staff at Baylor Medical Center at Garland.

A wheeled backpack is best for heavy-duty use, Dr. Bassel says, since most of the day it can be rolled around instead of carried. Overpacking is still a concern, though, as it will have to be lifted on occasion.

"Also, sometimes even if the school has lockers, kids say there's not enough time between classes to access them," Dr. Bassel says. "So it's important for parents to help children decrease the weight of backpacks by leaving unneeded items at home."

Choosing a well-designed backpack also can help alleviate the strain. The best ones have thick, padded straps and a padded back, as well as a waist belt to keep the backpack close to the body and distribute some of the load to the pelvis. The only challenge is convincing your child to wear it correctly, using both shoulder straps instead of only one.

Car safety:
Are your children's car seats installed properly? Many well-meaning parents install them incorrectly, since the combinations of different seat belts and car seats can be confusing.

Dr. Bassel adds that older children who weigh more than 60 pounds are safest in booster seats, which simply elevate the child to position the seat belt properly. "Your goal is for the lap belt to be positioned over the child's hip bones, rather than the tummy, and for the shoulder belt to be positioned over the collarbone, rather than the neck," he says.

Booster seats, unlike the more elaborate car seats sold in stores, can be difficult to find; ask your pediatrician for manufacturer recommendations.

Shots for school:
Back to school can mean back to the doctor's office for required vaccines. Most schools require proof of immunization for enrollment, unless you have a religious or medical reason for not vaccinating.

Even if your child received all of his or her shots as an infant or toddler, he or she might need a booster. Children typically receive their final doses of the polio vaccine, the diphtheria/tetanus/pertussis (DTaP) vaccine and the measles/mumps/rubella (MMR) vaccine between ages 4 and 6. "It's very important for children to have these vaccines before they start school," Dr. Bassel says.

Also, if your child missed any of the earlier vaccines, such as varicella (chickenpox), which was recently introduced, now would be a good time to catch up. Dr. Bassel says, "The chickenpox vaccine has been tremendously successful-it's reduced the incidence of chickenpox fivefold."

The American Academy of Pediatrics also recommends four vaccines for teenagers, and even college kids are not immune. "The incidence of bacterial meningitis increases from about age 15 into the early 20s, so any student heading off to college should receive the meningococcal vaccine," Dr. Bassel says. Talk to your pediatrician to find out if any of these vaccines are right for your older child.

Fitness focus:
America's obesity epidemic affects kids too. If your children don't get enough exercise, you can help.

"Try to find an activity that your child enjoys, and make it a routine," Dr. Bassel says. You might enroll your child in a sport, either in school or outside school. "It could be gymnastics, basketball-anything he or she likes to do."

Also, encourage your child to unplug. "There is a direct correlation between the number of hours kids watch TV or play video games and the prevalence of obesity," Dr. Bassel says. The idea is to limit time spent on those activities and get kids involved in active play. When it comes to your child's overall health, every little bit of exercise helps.

Infection Control In and Out of the Hospital- Follow These Tip to do Your Part

A hospital is a place for healing. Hospitals take special precautions to reduce the risk of acquiring infection when you are recovering from an illness.

Baylor Medical Center at Irving has a solid set of protocols in place to help patients avoid infection. It starts on the front lines, with health care workers taking care to wash their hands or use liquid hand-sanitizing agent. To keep the environment clean, floors and surfaces are regularly scrubbed with a special antimicrobial cleanser that kills bacteria. And Baylor Irving's infection control nurse, Vanessa Morgan, R.N., monitors infections and cultures to watch for any trends.

If a patient requires a central line or ventilator, specific protocols help to reduce the risk of infection with these devices. For example, when surgeons place central IV lines they wear full surgical garb and they drape the patient in a sterile cover. They use IVs that are coated with antimicrobial substances that help destroy any bacteria.

Even simple changes can help. Patients who need ventilators, for example, now have the head of the bed elevated. That helps reduce the risk of infection from aspiration. And helping patients heal, so they no longer need central lines or ventilators, lowers infection risk.

Studies have shown that the control of blood sugars in a close range after coronary bypass surgeries leads to improved wound healing and less risk for infection. "Even patients who are not diabetic can have elevated sugars after surgery, because of the stress," says Steven Davis, M.D., an infectious disease specialist on the medical staff at Baylor Irving. Monitoring and controlling these blood sugars can help.

You can do your own part to help avoid infection

• Wash your hands and ask family members to do the same.
• Get pneumonia and flu vaccinations if they're recommended. They can help you avoid pneumonia and its complications.
• Aim for good overall health. Complicating infections often strike people with chronic conditions such as diabetes and obesity.

New Procedure Helps Stop Urinary Incontinence

Millions of women, especially moms, suffer from stress urinary incontinence (SUI), a condition where sneezing, coughing or even laughing can lead to urine leakage. "We try to treat patients with conservative therapies, such as learning better bladder habits, doing Kegel exercises, and addressing problems such as chronic coughing, infections and hormone deficiencies-all of which can make leakage worse," says Andrew Sambell, M.D., a urologist on the medical staff at Baylor Waxahachie.

But these methods aren't effective for some women. For them, surgery may be the solution. Baylor Waxahachie is offering a new surgical procedure called tension-free transvaginal tape (TVT). It works by supporting the middle of the urethra-the section most stressed by activities-with a strip of mesh tape.

The minimally invasive procedure typically takes just 30 to 45 minutes, and can be performed with regional or general anesthesia. "The surgery is really well tolerated," says Jason Brown, M.D., an obstetrician/gynecologist on the medical staff at Baylor Waxahachie. "It usually requires just an overnight hospital stay, and recovery time and pain are minimal. Most women are up and about the next day, and back to work in a few days."

The procedure boasts a strong success rate. According to Dr. Brown, the procedure alleviates SUI for 90 percent of all people, and 85 percent are still continent after eight years. It's recommended for women who have finished having children, since the rigors of childbirth can shift the tape.