Author: Erin Pearson

Nutrition Corner: Meal planning

Nutrition CounselingMeal prep at home:
Something fancy, something fun, something simple

Meal planning can sometimes be overwhelming, especially if you think you need elaborate plans for each night. One approach for the week ahead is to choose one item from each category below—something fancy, fun and simple—and buy enough for leftovers. You can build in meal variety over several weeks this way.

Still need convincing? See our Extra Meal Planning Tips below the 3 lists.

Something Fancy—Delicious, savory meals

Something Fun—Easy-to-assemble, with a high “wow” factor

  • Taco meat with peppers, cilantro and onion on corn tortillas. (Have extra tortillas? Make quesadillas or these fried egg breakfast tacos)
  • Pizza toppings on store-bought cauliflower crust or flatbread, for fresh-from-the oven pizzazz
  • Black bean salad with corn, peppers, onion and cilantro, spritzed in lime juice and olive oil
  • A delicious peanut sauce on just about any stir-fry
  • Chilled pasta or roasted squash salad with olive oil, chickpeas, chopped kale, peppers, mushrooms, artichokes and chunks of your favorite cheese
  • Mason jar salads for on-the-go ease
  • Sautéed or roasted carrots with oil, salt, pepper, cinnamon and maple syrup

Something Simple—Quick and easy for healthy fridge grazing

  • Pair a ready-to-eat protein with a super-simple salad (ideas below), fresh or frozen veggies
  • Store-bought cold chicken with a sauce for dipping and a summer salad
  • Pre-cooked chicken sausages with condiments and frozen corn
  • Simple open-faced tuna melt with pesto and fresh tomato
  • Avocado toast topped with a hard-boiled egg or hummus, cucumber and arugula toast
  • Fiesta shrimp grain bowl, with frozen or fresh shrimp
  • A French apero dinatoire–style grazing table
  • Super-simple salad ideas:
    • Chopped tomato, avocado and onion dressed with store-bought pesto or simple olive oil and balsamic vinegar mixture
    • Chopped nectarines or pears, bagged greens and goat cheese with store-bought vinaigrette
    • Store-bought Goddess dressing for dipping with carrot sticks, cucumber spears or mini-peppers
    • A store-bought salad kit
  • Super-simple veggie ideas:
    • Fresh asparagus or green beans sautéed for about 10 minutes in olive or sesame oil, and topped with lemon zest, parmesan cheese or balsamic glaze
    • Precooked and packaged beets (or canned) with walnuts, parsley and goat cheese
    • Snap peas or cucumber with dip
    • Sautéed bok choy with spicy chili sauce
  • Super-simple desserts

Still need convincing? Here are 6 Extra Meal Planning Tips:

  1. Build a list throughout the week for meal ideas and groceries to speed up both the planning and shopping steps.
  2. Look at what you have in the fridge and pantry and start from there. This can help eliminate food waste while also saving money!
  3. Don’t overburden yourself by cooking everything at once.
    • Cook the fancy meal for Sunday night—with enough extras for 1-2 meals of leftovers.
    • Cook the fun item either Monday night for variety or, if you’re ambitious, earlier on Sunday to get a jump on things.
    • The simple ideas should be ready from the store with less than 5-10 minutes of prep. Extras stay on hand in the fridge for healthy eating whenever you’re in a pinch.
    • Buy enough for extras in every category, to have options as you go through the rest of the week after cooking just a few times. Be cautious of overbuying however!
  4. Invest in extra storage containers to keep leftovers. Ones that stack well in the fridge are recommended, as well as glass for easier cleaning.
  5. Still don’t have time? Try using a grocery or meal delivery service. These cost more but can be a way to start meal planning with fewer steps.
  6. Keep a list of fancy, fun and simple successes to store for later use. This will come in handy when you draw a blank on the next meal to prepare, or when you are low on motivation to plan a full week of new meals.

Meal planning always takes a little extra time up front, but in the end, it can save you money, food waste, spontaneous meals bought outside the home and even calories if you focus on healthy meals. Try it out and make it work for your schedule and your family.

Happy eating!

Build a home health kit

Home Health KitThis winter, more than ever, preparation is key! Create a home health kit to get the most out of a phone or video visit with your doctor. With just a few items, you can check your vital signs. This important data helps your provider make good clinical decisions. We recommend these items—and extra batteries!

  • Thermometer. Look for a digital model that goes in the mouth. These are more accurate than those placed on the skin. Be sure to read the directions.
  • Oxygen saturation/pulse monitor. You can have alarmingly low oxygen saturation and not feel it! Slip your finger in this small device for a quick reading. This is a key evaluation tool for respiratory illnesses like COVID-19. (Also called a pulse oximeter.)
  • Blood pressure cuff. Get a cuff for the upper arm. Look for an easy-to-read display. For an accurate reading, you must precisely follow all instructions.
  • Scale. No fancy features needed: just one that can measure your weight.

Plus, a few essentials to help you feel better:

  • Tylenol. Unlike ibuprofen or Aleve, Tylenol doesn’t cause GI upset or bleeding, and it’s OK for those 65+. Choose Extra Strength/500 mg. If you are allergic to Tylenol or have liver disease, talk with your provider before taking Tylenol.
  • Nasal rinse. Irrigating the nasal passages helps to relieve congestion. You’ll need a neti pot or a special squeeze bottle, distilled water and a saline mix. Buy saline packets at drug stores, or make your own solution: 8 ounces of distilled water + 1/4 teaspoon non-iodized salt + 1/4 teaspoon baking soda. Distilled or boiled (and then cooled) tap water prevent infections that can occur with other sources of water. Rinse bottle/neti after each use with sterile water and air dry.

Don’t delay! Some items may be on back order.

7 Simple Tips to Get an Accurate Blood Pressure Reading

USE CORRECT CUFF SIZEMeasuring Blood Pressure
Cuff too small adds 2–10 mm Hg

PUT CUFF ON BARE ARM
Cuff over clothing adds 5–50 mm Hg

DON’T HAVE A CONVERSATION
Talking or active listening adds 10 mm Hg

EMPTY BLADDER FIRST
Full bladder adds 10 mm Hg

SUPPORT BACK/FEET
Unsupported back and feet adds 6 mm Hg

KEEP LEGS UNCROSSED
Crossed legs add 2–8 mm Hg

SUPPORT ARM AT HEART LEVEL
Unsupported arm adds 10 mm Hg

Getting the facts on tobacco and quitting

CigaretteEach type of tobacco product carries risks

Are some tobacco products less harmful than others? No, I don’t believe so. Each tobacco product carries its own health risks:

Smoking causes chronic bronchitis, emphysema/COPD and lung cancer. Snuffs, dips, chews and plugs cause head and neck cancers. Vaping causes life-threatening pneumonitis, an inflammation of the lung. All products with nicotine, including gums and patches, may lead to hypertension, heart attacks, strokes and peripheral arterial disease, including erectile dysfunction.

I also want to highlight that all smokers and vape users do poorly if they get COVID-19. They are much more likely to suffer serious complications or death than healthy, non-tobacco users.

The sooner a person quits tobacco use, the sooner they start moving to better health. Evidence suggests that once a person has stopped using tobacco products for 20 years, their risk of heart attack, stroke or cancer becomes equal to the risks of non-smokers.

Take a deep breath and see a new future.

Quitting smoking is very hard, and not restarting is even harder. The physical symptoms of withdrawal—like irritability, shortness of breath, headaches, anxiousness and fatigue—last only three to five days.

Most people can get through the withdrawal symptoms, but later start using tobacco again. So getting tobacco free can take several tries.

If someone is not even contemplating the idea of quitting tobacco products, obviously they won’t quit.

No one is going to wake up tomorrow and forget they dipped or smoked. So contemplating an attempt to quit is definitely the first step.

Make a plan to quit tobacco.

Set a quit date and prepare. Pick a date 7-10 days into the future. Get some sugar-free gum or hard candy as a replacement, to give your mouth something to do. Plan what you’ll do with the free time you have, now that you won’t be taking tobacco breaks. This is important! A smoke break is dedicated “me” time, and your brain will miss that break if you don’t fill it with a satisfying replacement activity.

See your primary care doctor for help. Your doctor can talk with you about various tools and resources. Pharmaceutical products designed to help people quit tobacco use may not work for everyone, but they do help many people.

Enroll in a tobacco-cessation program. Studies on two medications—Chantix (varenicline) and Zyban (bupropion)—show that people are much more likely to succeed if the medications are used in conjunction with an education program. The classes provide important information, and a treatment plan can be customized to you. They also serve as reinforcement. Making time to participate in a class and joining a group requires commitment. This helps you stay committed to your tobacco-cessation efforts.

If you are contemplating a tobacco-free phase of your life, make an appointment to see your doctor. At PacMed, we offer virtual and in-person appointments.

Back to Basics: Getting your child’s health back on track

Child WellnessIt’s understandable this year if your child has gotten behind on immunizations or other care. As a primary care provider, my advice to parents is to start catching up sooner rather than later! Ongoing delay can cause new concerns.

Can we wait on vaccines? Maybe do them later?

As a rule of thumb, the longer you delay immunizations, the greater the risk to your child and others for infection of preventable diseases. Immunizations (also called vaccinations) protect your child and help keep preventable diseases from spreading. Babies and toddlers can be at higher risk of complications. And while babies get helpful antibodies during breastfeeding, this protection wears off over time. This is why we begin protecting children at an early age with vaccines.

Children who get their immunizations on time get earlier protection for these conditions. This is important as they begin interacting with more people. Childhood immunizations and visits are carefully timed to help your child stay healthy.

Your child’s doctor can look at any missed immunizations or well-child visits, and help you get back on track. We will work with you to create a personalized schedule for your family. To keep your child’s risks low, we want to start this process right away! Remember to get flu shots for your family this year—aim to have this done by Halloween.

Is visiting the clinic safe?

We know your healthcare needs are important, even in the middle of a pandemic. PacMed is fully committed to your family’s health and safety. We screen every visitor for COVID-19 symptoms; anyone with symptoms will be moved away from waiting areas for testing. Patients are also screened for symptoms before scheduling appointments. Wearing a mask is required in our clinics. We are offering virtual visits, so you’ll find there are fewer people in the clinics. We also have spaced out appointments to allow for social distancing and rigorous cleaning procedures.

Well-child visits help your child’s primary care provider stay on top of their health and development. Your child’s provider can make a personalized recommendation on how to proceed with routine visits, needed screenings or immunizations. For children 2 and under, we likely will need the child to come in for an in-person visit, but call your primary care provider first to see what is recommended.

When is a virtual visit the right choice?

If you need lab work or a vaccination, then you’ll need to come in. Of course, an injury such as a broken bone needs to be taken care of in person. With other health issues, a good first step is to call your provider’s office and ask if a virtual visit is an option for you.

At PacMed, you can communicate with your care team in MyChart, but if your need is urgent, pick up the phone. We will help you choose the right kind of visit and, if that’s a virtual visit, we’ll make sure you know how to use Zoom to meet us online. If you bring a child in for an appointment, only one parent or guardian may accompany them, due to COVID-19 precautions.

Any tips on how I can help my child feel comfortable and safe?

This is a hard time for most everyone, and especially children who may not fully grasp all that’s going on. It can be helpful to explain to your child several times, and in different ways, the importance of social distancing and handwashing. Leading by example is also very important. For example, when you are washing hands, have your children do the same—and sing a song together to make sure you scrub for 20 seconds.

Also be sure to talk with your child about why we wear a mask, and demonstrate how to do it. The mask should go over the nose and under the chin. Finding a fun print, a comfortable fabric or a good fit for the child can help make this a better experience.

Everyone can work together to keep our community healthy during this time. Thank you for doing your part. At PacMed, our primary care team is here for you.

Flu during COVID-19: Why it is critical to receive a flu shot this year

In an effort to understand the flu and how COVID-19 will impact the virus this season, family medicine provider Dr. Sang Won with Pacific Medical Centers has provided valuable insights on why it’s not only important but critical, to receive a flu shot this year.

Because we predict that both the flu virus and COVID-19 will be spreading this fall and winter, healthcare professionals strongly recommend that everyone who is 6-months and older receive a flu vaccine.
The flu can cause a variety of symptoms, including respiratory syndrome, chest/abdomen pain, body aches, fever, and cough – all of which can lower one’s immune system.
These symptoms, along with a lowered immune system, make COVID-19 infection easier.

While it is always important to get the flu shot – especially this year as we battle COVID-19 – it is also important to note that flu vaccines do not cause the flu. It is made up of the inactivated virus, meaning it is no longer infectious.

While some fraction of recipients may get muscle aches, fever and headaches, you are not getting the flu as a result of the vaccine.

The process of getting a flu shot this year will be slightly different. At Pacific Medical Centers, you will need to make an appointment before you can receive a flu shot.

After you receive a flu shot, you can further decrease your chance of contracting the flu by following these steps:

  • Avoid close contact – continue practicing safe, social distancing
  • Cover your nose and mouth with a tissue when you cough
  • Wash your hands frequently with soap and water for 20 seconds, or use alcohol-based hand sanitizer often
  • Avoid touching your eyes, nose, and mouth
  • If you are sick or have flu-like symptoms, limit your contact with others until you are feeling better or fever-free for 24-hours

Taking care of children’s wellness during back-to-school season

Child WellnessFor many, back-to-school preparation feels quite different than it has in the past. Parents and students are trying to figure out how to navigate the new norms surrounding COVID-19 and remote learning requirements. However, one thing should remain part of the fall routine – standard wellness checks. As a pediatric provider at Pacific Medical Centers in Canyon Park, I would like to help families better understand the importance of regular well-child exams. 

Wellness Checks for Children

Wellness checks provide health supervision during primary growth periods, which is a complex and comprehensive package of services that takes place over each child’s lifetime. Specifically, it includes recommended preventive interventions, such as counseling or screening, and addresses the particular needs of each child in the context of family and community. 

Through this collaborative approach between family, child, and physician, wellness checks offer a versatile approach for the health of the child. 

For example, the benefits of wellness checks include: 

  1. Medical Questions Answered: During these visits, you can ask the pediatrician about nutrition and safety concerns that you’ve been curious about. Even further, you can discuss issues surrounding development, behavior, eating, or other matters.  
  2. Prevention: As a preventive step, your child will stay regularly up to date with immunizations to prohibit future illnesses.
  3. Track Development: Use this time to talk with the pediatrician about your child’s milestones and overall development by tracking growth. 

Immunization Schedules 

Given all of the uncertainty with back-to-school routines, it’s essential to follow the immunization schedule to ensure children receive adequate protection against common childhood illnesses. For example, many of the vaccines given to infants in the first year of life protect against previously common causes of childhood illness such as HiB (Haemophilus influenza type b) and pneumococcal disease, which have decreased in prevalence with the emergence of these vaccines. 

For teens, there are essential immunizations such as Tdap (ages 11-12), meningococcal (ages 11-12 and 16-17) and HPV (starting at age 9). Additionally, especially during the fall, the flu vaccine is particularly important for all children (starting at age six months) and adults. 

What Happens If There Is a Delay

Wellness checks include age-specific screenings and assessments recommended at each well-child visit from infancy to adolescence. Depending on the age, the kinds of things that pediatricians are looking for during these visits may include autism spectrum disorder, depression in adolescents, development (speech and language, gross motor and other developmental screenings), diabetes and more. 

Missing or postponing a wellness visit risks delayed diagnosis and treatment of conditions that we can quickly screen and manage. Many families make the mistake of not coming in for wellness checks when their children are up to date on vaccines, but there is so much more to comprehensive wellness visits than immunizations.

Dr. Nawal Alkharouf is a pediatrician at PacMed.

Becoming better

Becoming BetterPacMed doctor explains how to safely reset and make lasting health-related changes

Now that we’ve officially bid adieu to the holiday season and all of the glorious indulgences that accompany it, many may be looking for ways to reset with a sense of healthy, lasting purpose. For some, incorporating new wellness habits may seem a daunting task at first. Thankfully, Pacific Medical Centers’ Internal Medicine Physician Lesley E. King, MD, is on the scene to address best practices for living a life of overall wellness, beyond the New Year.

Though many people enter the New Year with a newfound sense of dedication to their health and wellness goals, some may find themselves overwhelmed or tempted to cut corners in order to see fast results. What are some suggestions for easing into new healthy regimens safely?

Start small! Many times we are inspired by the New Year to make lofty resolutions to overhaul our lives. While the sentiment is wonderful, it’s not usually realistic and can set us up for failure and frustration. Instead of trying to make drastic changes — like resolving to exercise more by going from not running at all to running five days per week — build up from small changes. So for that inspired runner, they could start by setting aside time to walk or jog one or two days a week and build from there.

And, start off safe! Before making big changes to your health routine, make an appointment with your primary care physician to discuss. Not only can they give guidance on the safest way to making changes in the context of your health as a whole, but they can also be a great ally and sounding board as you make changes.

In your profession, what health concerns do you wish people would prioritize more often?

At Pacific Medical Centers, we often see patients focusing too much on the numbers and less on sustainable behavior change. Things like regular exercise, a healthful diet, sticking to recommended limits for alcohol intake, etc. can have big impacts on our quality and quantity of life which we may not always see in the numbers we can easily measure.

What are some easy ways to incorporate lasting, lifelong changes into daily life?

Be patient and kind with yourself. You didn’t gain the weight or form the habit in one day, one week, or even one month, so it’s unrealistic to expect that you’ll be able to completely change things in a short amount of time. Set small goals for the short term and celebrate your victories along the way. Finally, try and make changes that work for who you are — your interests, your passions, and your goals.

What advice can you offer to individuals who hit plateaus or are suffering from a lack of motivation?

Never underestimate the power of community and accountability. Let your loved ones know what your goals are so that they can support you. Or better yet, find a friend, family member, colleague, or another community member with similar goals. You can work together to motivate. Lots of local gyms, weight loss groups, or other community organizations have programs to connect you to peers for support.

Is there anything else you would like readers to know about incorporating lasting healthful habits into their lifestyle?

Again, your primary care physician is a great ally to have! Consider scheduling appointments at Pacific Medical Centers with their primary care team at regular intervals while you’re working on making a change. This can not only provide a bit of accountability, but can be a great opportunity to track your progress, discuss hurdles, and forge a path forward.

Health Care in the Age of Coronavirus

Healthcare and COVIDThere have been mixed political messages on how COVID-19 is spread but this much is not in dispute by health experts— it is very contagious, and people are advised to limit exposure wherever and whenever possible. No wonder, then, that telehealth is an increasingly popular way to access medical care, especially for the most vulnerable populations.

While non-experts use the words telehealth and telemedicine interchangeably, they are not the same. According to the American Academy of Family Physicians, “telemedicine is the practice of using technology to deliver care at a distance. A physician in one location … to deliver care to a patient at a distant site. Telehealth refers broadly to electronic and telecommunications technologies and services used to provide care and service at a distance.” It’s important to note that during the coronavirus pandemic, the Centers for Medicare & Medicaid Services lifted some limitations on telehealth reimbursements.

Simon Katumu, a primary care provider with Pacific Medical Centers (PacMed), notes a definite rise in this model of care. “During the pandemic, we’ve used telehealth much more, utilizing tools such as telephone consultations, Zoom meetings, and PacMed’s MyChart.” The latter offers online access to a variety of services including test results, prescription renewals, and virtual appointments with a health-care provider.

The benefits of using these tools are clear. “They help reduce exposure in the pandemic and are also convenient,” says Katumu. “We’ve seen great benefits for our patients.”

He says that initially, the thought was that older patients may not warm up to this technology but that hasn’t been the case. “They can do it or get assistance from someone who’s tech-savvy. It hasn’t been much of a problem.”

Katumu acknowledges there are limitations to tech. “We can’t draw blood virtually. We can’t complete physical examinations, like listen to hearts and lungs. So, it’s not a replacement for face-to-face care but it is a great addition to our toolkit.”

Security is also an issue when sharing sensitive medical information remotely. PacMed is partnering with Providence to use a dedicated, secure portal for patient visits through Zoom. The enhanced measures include encryption, meeting identifications, and verification to ensure that the patient’s telehealth visit is a private and secure experience. Even so, patients are advised to have secure systems at home and to find out what security measures are in place with their particular health care providers.

Another model of care that reduces trips to the doctor is mobile urgent care. “We like to say we’re bringing back the house call,” says Valerie Rose, community engagement manager with DispatchHealth, a new company in Washington state that provides advanced medical care for urgent and non-emergency medical needs. “We do an initial risk-assessment by phone,” she explains. “Within 90 minutes a care team arrives, which includes a physician’s assistant or nurse practitioner along with a medical technician.”

DispatchHealth offers a variety of services to all ages, from flu shots to stitches, and is especially appealing to older folks, Rose says. “There is no travel, no exposure, and most services are covered by insurance, Medicare, and Medicaid.”

Plus, there’s the luxury of time. “When was the last time you had 45 minutes of undivided attention with a medical provider?”

In addition, doctor referrals are not needed and it’s not as expensive as a trip to the emergency room. “We are a great adjunct to primary care,” says Rose. DispatchHealth is currently testing and exploring telehealth options in select markets to expand their house call model.

As devastating as COVID-19 is, it has driven innovative ways in which people access medical care. And the genie is unlikely going back in the bottle.

“I do think it’s here to stay,” says PacMed’s Katumu. “I think we’ll maintain what we have at this point and I expect it will grow and expand in the future.”