Sep
2
Adults Need Regular Checkups, Too. Dr. Maleeha Basha and Dr. Judith Bressler Remind Adults to Make and Keep Annual Medical Exams
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Back to school is a busy time for all. Parents have focused on their children and have made sure they are up-to-date with school supplies as well as their school physicals and vaccines. However, National Adult Immunization Week occurs September 20-26 and serves to remind those parents and other adults to stay current on annual checkups and necessary vaccines.
DuPage Medical Group’s Dr. Maleeha Basha, a board certified internist, was quoted in Naperville Magazine’s September issue. “Tetanus is the most common vaccine for adults. You need to make sure your tetanus is updated every ten years.” Dr. Basha recommends all adults see their physician once a year to check cholesterol levels and screen for diabetes and thyroid problems. An annual checkup should include various tests specific to the patient’s age and risk factors.
Board certified obstetrician and gynecologist Dr. Judith Bressler of DuPage Medical Group also stresses the need for women to have a “female exam” once a year - whether from a gynecologist, family physician, or internist. Dr. Bressler says, “It’s mainly about maintenance of health and early detection of cancer.” She noted that annual Pap smears are now recommended for any woman who has been sexually active for three years. Dr. Bressler also points out that there is no point at which women can safely stop receiving gynecological exams, including mammograms.
Click here to read the entire article. Maintaining good health by scheduling annual physical exams and talking to their doctor is something every adult needs to do on a regular basis. To schedule an appointment with Dr. Maleeha Basha, please call 630-961-2710. Her office is located at 640 S. Washington Street, Suite 268 in Naperville.
To schedule an appointment with Dr. Judith Bressler, please call 630-893-8585 . Her office is located at 120 Spalding Drive, Suite 309 in Naperville and 7 Blanchard Circle, Suite 100 in Wheaton.
Aug
25
Dr. Nasir Shahab, DuPage Medical Group Oncology, Featured in Recent News Report
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One of the largest reports ever published about cancer awareness was distributed within the Chicago Tribune on August 21, 2009. Leaders in Oncology, such as our own Dr. Nasir Shahab, hope to raise awareness about preventing, detecting, and treating cancer. “Finding a Cure, Your Guide to Cancer Awareness” includes almost all of the leading treatments within the world of Oncology, including preventative measures and early detection. It has become the largest report in the United States on cancer awareness in any mass publication.
Please click here to read “Finding a Cure“. “Better Results with Less Pain” is on page 8 and features Dr. Shahab.
Dr. Nasir Shahab works at our Naperville office on E. Ogden Avenue. Please call 630-364-7850 for more information or to schedule an appointment.
Aug
21
You and Your Baby - The First Few Weeks by Todd Koffler, M.D.
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Part 1; 1st day of life
Your baby’s first few weeks of life will be a time of constant transition and change. By the end of this tumultuous time of adjustment both you and your baby should end up being in a good routine. But during the first couple of weeks, do not expect any two days to be exactly the same. Knowing that change is the norm will help you to feel more at ease during this exciting time, I hope this brief outline of these changes will help as a guide of what to expect during this exciting time.
This 1st part below will focus on the first day of life. First, we will outline what to expect during the first few hours after your baby is born. Then we will go over the goals we have for your baby in its first day. These first day’s goals are basic, ensuring your baby is breathing, swallowing, urinating and passing stools normally. We will outline some common first day issues and some basic treatments and evaluations your baby will receive. Then we will talk about getting breastfeeding established. There will be an additional 2nd part to this article that will discuss our goals for the remainder of your baby’s first few weeks of life.
Keep in mind every baby is unique, and particularly in the first couple of weeks each experience will be a bit different. Your baby’s gestational age, weight, type of deliver and initial adjustment to feeding all play a part in this variability. That said, there are general trends that you can follow, and will help you and your pediatrician (or family practitioner) successfully navigate through these first few weeks and get you to the next stage where your routine will be much more regular (and likely easier too!)
Delivery Room
Every delivery is different, which is good to keep in mind when you talk to friends about their experiences. Once your baby is born medical staff will help make sure they transition well to their new environment outside the womb. During this time, your baby will receive antibiotic eye ointment to prevent infection and an injection of vitamin K to prevent bleeding problems in the newborn period. Also, your baby will be checked to see that it is breathing well and can maintain its temperature. This sometimes involves a little bit of extra support and stimulation (and if needed a neonatologist can be involved to provide additional care). As soon as possible your baby will be in your arms for bonding time and its first feeding. Often your baby’s first time at the breast goes well due to nature’s instincts.
Next your baby will go to the nursery were it will be assessed and get its first bath. Also all babies get a hearing screen while in the hospital. The hearing screen does not diagnose hearing problems nor does passing guarantee normal hearing. It simply detects which babies will need further testing to rule out significant hearing problems. It is common for babies to fail their initial hearing screening but go on to pass subsequent tests.
1st day of life and your baby’s health
Your pediatrician will thoroughly evaluate your baby during its first 24 hours of life and each day thereafter until you leave the hospital. (If your pediatrician is not on staff at the hospital another pediatrician will see your baby during this time.) Since you will be talking to your doctor once a day, it is helpful to write down any questions you have when you think of them. That way you won’t have to remember everything when we come to see you (which could be early in the morning.) Keep in mind that you don’t have to remember everything you doctor and nurses tell you the first time. We will make sure you are comfortable with the basics before you go home.
Our goals for your baby’s first day of life are pretty simple: breathing, swallowing, urinating and passing stools. A baby’s first major transition is breathing comfortably. There are times when this goes slowly and involves observation in the nursery or NICU. Because your baby is particularly vulnerable to infections and breathing issues around the time of delivery we are cautious and in some cases need to order blood tests or start an antibiotic. Because of this caution babies tend to do very well. Most babies that require testing do not end up developing any infection or serious complication. Additionally, there are routine tests performed if your baby is very small or large or if you had problems with gestational diabetes.
During the first day of life we expect to see at least one wet diaper and bowel movement. Each day after that we would like to see at least one additional wet diaper (so 2 on day 2, 3 on day 3, and eventually more than 6 wet diapers per day.) In terms of bowel movements, your baby will first pass dark tarry stools called meconium stools. These take up to 20 minutes to come out and are a bit of a challenge to clean (so you might want to wait a bit before changing if your baby has only just started passing a dark stool.) As your baby feeds more we expect the stools to transition to green and then yellow. We will discuss this more later in part 2.
Our initial goals for feeding are basic. We like to see your baby attempt feeding without swallowing difficulties. However, it is common for your baby to spit up mucous and be a bit gaggy the first day. Because of this we typically have babies feed only 4-6 times on day 1. Your baby is born with mucus and amniotic fluid in its belly and it has to be either passed with stool or spit up during the first few days. Sometimes your baby may need extra suctioning the first day to help clear these secretions- this is normal.
Breastfeeding
Getting breastfeeding established can be a challenge for many moms. We do not expect all babies to breastfeed well in the first few days of life. Some babies do great from day one, but this is often not the case. Most babies who eventually turn out to be great at breast feeding have some ups and downs over the first few days of life. It can come as a bit of a surprise to many moms that after that initial first good breastfeeding at birth, their baby struggles a bit the next several days. This is not only common, it is normal.
These struggles during the first few days do not predict problems later on with breastfeeding and typically do not represent a problem with your body or your baby. Until your milk is fully in babies often struggle with mastering the complex latch, suck and swallow needed to breastfeed effectively. Also your body needs to adapt to lactation. During the first day your milk will not be in (there will be colostrum which is still good for your baby.) Your milk will come in after day 2 or 3 (and don’t worry, you will know when it’s in).
Some moms may need to work extra with a lactation consultant. This may involve using a breast pump and sometimes even giving your baby some supplementary formula if your baby is losing too much weight. But try and remember that breastfeeding gets much easier after a few days, and typically initial struggles are only temporary. Take advantage of the support at the hospital to help you work through any initial problems with breastfeeding. Your nurses and lactation consultants are great resources. And remember that lots of babies who turn out to be great breastfeeders initially struggled to get the hang of it during their first week of life.
Recovery time
Another thing to remember during your baby’s first day is to try and let yourself recover. Just as your baby is making a major transition to the world, your body has to transition from the stress of delivery to the needs of caring for your baby. Sleep will be fragmented for a couple of weeks, so take advantage of time you have to sleep. A hospital can be chaotic at times, but remember all of these people are there to help care for you and your baby. It is good to request times to sleep and to take advantage of the help you have available. You don’t have to master everything at once, and taking care of yourself goes a long way in taking good care of your baby.
Summary
So that’s about it for the first day: breathing, swallowing, urinating and passing stools… just the basics. We don’t expect you or your baby to be any kind of settled routine after the first day. In fact each of the next few days will likely be different, with the goal of getting into a good routine by the time your baby is 2-3 weeks old. I hope this helps prepare you for what to expect immediately after your baby is born, and Part 2 will cover the remainder of your hospital stay and your babies first few days at home.
Note: This article is meant as a brief overview. You can learn a lot more by reading and talking with your doctor.
There are lots of great books and web resources out there, as well as local parenting and new mom classes at your local hospital.
Most notably books:
What to Expect the First Year, by Dr. Murkoff (I trained under Dr. Mark Widome, who wrote the forward. He remains my role model as a pediatrician.)
Your Baby’s First Year, by American Academy of Pediatrics, edited by Dr. Shelov
Heading Home with Your Newborn: From Birth to Reality, By Dr. Sears
The Baby Book: Everything You Need to Know About Your Baby from Birth to Age Two, by Drs. Jana and Shu
On the Web:
http://aap.org/parents.html (American Academy of Pediatrics)
http://www.webmd.com/parenting/baby/
Vaccination links:
The Facts About Childhood Vaccines
Also, many parents chose to meet with their pediatrician before they have their baby, this helps you learn about the office and is also helpful if you have any specific questions or concerns about your baby.
Dr. Todd Koffler is a pediatrician at West Suburban Pediatrics of DuPage Medical Group. To schedule an appointment, please call 630-620-6322.
Meet Dr. Koffler at the DuPage Women’s Fair on Wednesday, September 16 from 10:00 am to 3:00 pm at Yorktown Shopping Center.
May
27
Dr. Julio Gonzalez, Orthopaedics/Sports Medicine, Discusses Rotator Cuff Tendinitis
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Rotator cuff tendinitis is one of the most common problems seen in the shoulder. It is usually a result of overuse activity, and is seen frequently in overhead athletes like swimmers, baseball and volleyball players.
The rotator cuff is a set of four small muscles that helps to stabilize the shoulder. The muscles are called the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles are working overtime to maintain the shoulder joint in proper position when it is subjected to unstable forces, such as during the repetitive overhead motion of swimming. As a result, the tendons can get inflamed. This inflammation then causes pain and, sometimes, limited motion. The pain is often difficult to localize and commonly radiates into the upper arm. It can be made worse by raising the arm overhead and frequently causes problems sleeping.
The diagnosis can be made by history and physical exam. X-rays are often taken, but are usually normal. An MRI may be done if there is concern for other problems, such as a rotator cuff tear or cartilage damage.
Treatment is initially aimed at decreasing the inflammation. This is usually done with ice, anti-inflammatory medications, and relative rest. Physical therapy is also often prescribed and can help reduce inflammation and pain, as well as strengthen the rotator cuff and other muscles around the shoulder. This can be done by seeing a physical therapist or by doing exercises at home.
Sometimes when these treatments fail, or don’t give complete relief, injections can be considered. These injections are typically a combination of a numbing medicine, like lidocaine, and a steroid anti-inflammatory, like cortisone. This injection is done in the space where the rotator cuff is, not in the shoulder joint itself. It may take a few days to notice any relief from the injection. Even if the injection helps, it is still recommended to continue with the rehabilitation exercises so as to prevent a re-occurrence.
Prevention for rotator cuff injuries involves balancing one’s workouts. Shoulder strengthening exercises should be part of the triathlete’s program so as to limit the chances for developing overuse tendinitis.
Dr. Julio Gonzalez works out of our Glen Ellyn and Naperville offices. For more information or to make an appointment with Dr. Gonzalez, please call 630-790-1872.
Dr. Gonzalez will be a featured speaker and on-hand course physician for the U.S. Women’s Triathlon Serieskicking off in Naperville, Illinois on June 13 and 14, 2009.
May
21
Dr. Keith Monson Offers Single-Incision Laparoscopic Surgery
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Minimally invasive surgery keeps getting less invasive and the latest development uses a single small incision hidden in the belly-button to complete major operations with almost no scarring. Dr. Keith Monson, a board certified surgeon with DuPage Medical Group, is the only surgeon in the area who currently offers this option. At this time, the technique is done primarily for cholecystectomy (removal of the gallbladder), but Dr. Monson hopes to expand this to encompass additional procedures in the near future.
The advantage of this technique is primarily cosmetic, as the single incision can be essentially hidden in the umbilicus (belly-button). There is also some evidence that this procedure may be associated with less post-operative pain.
Dr. Monson has found that many patients, but especially those with cosmetic concerns, are quite enthusiastic about the prospect of this approach. Referring physicians are encouraged to keep this option in mind for their patients with gallbladder disease.
Dr. Keith Monson has consult locations available in Hinsdale - Lombard -Naperville.