Handwashing – The “do-it-yourself” vaccine that reduces the spread of germs.

By Veronica Montano, MSN, RN – Bridge Nurse Residency Coordinator, CNE Planner

National Handwashing Awareness Week is Dec. 3 through Dec. 9. According to the Centers for Disease Control and Prevention (CDC), handwashing is like a “do-it-yourself” vaccine that reduces the spread of germs. You can reduce the spread of diarrheal and respiratory illnesses by correctly washing your hands.


The CDC recommends washing hands with soap and clean, running water to avoid getting sick and spreading germs to others. You should wash your hands before eating food, before and after caring for someone who is sick, after using the toilet, after changing diapers or cleaning up a child who has used the toilet, after blowing your nose, coughing or sneezing, after touching your pets and after touching garbage. Washing your hands correctly by using soap and clean water can protect you, your family and others. Hand hygiene is one of the most important measures to take to avoid getting sick and spreading germs.


The CDC recommends washing your hands as follows:

  • Wet your hands with clean, running water (warm or cold) and apply soap.
  • Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers and under your nails.
  • Scrub your hands for at least 20 seconds. (Hum the “Happy Birthday” song from beginning to end twice.)
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel or air-dry them.


When and how to use hand sanitizer:

  • When soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol.
  • Apply the product to the palm of one hand and rub the product all over the surfaces of your hands until your hands are dry.
  • Alcohol-based hand sanitizers can reduce the number of germs on hands in some situations.
  • They do not eliminate all types of germs.
  • If hands are visibly dirty or greasy, hand sanitizers may not be as effective.
  • Swallowing alcohol-based sanitizers can cause alcohol poisoning. Keep out of reach of young children.


Content Sources: Centers for Disease Control and Prevention, 2017 National Health Observances, National Health Information Center, Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Washington, DC.



It’s beginning to look a lot like … Asthma.

By Dr. Kevin Benson

As seen in the Odessa American “Medical Matters”: http://www.oaoa.com/people/health/medical_matters/article_c2285462-a09d-11e7-b46c-cfb9e97cafd1.html


Many of us have enjoyed a wheeze-free summer …and let’s face it, summer in West Texas lasts until at least October. Inevitably, with the change of seasons, along with fall-colored outfits and pumpkin spice flavored everything, we see the shiny yellow, red and blue of inhalers being used on those chilly mornings.

I think of asthma as hyper-reactive airways. Much like seasonal allergies where our noses and eyes react to things in our environments that are really not threatening, those of us with asthma have our lungs react to certain triggers. Triggers for asthma include allergies, changes in the weather, particles in the air like cigarette smoke (or smoke in general, watch those fireplaces!) and exercise. Everyone with asthma is a bit different, both in what they react to and to what extent they react. Asthma is then classified based on the frequency and severity of wheezing a particular person has.

Anyone can have wheezing once. But in general doctors don’t diagnose people with asthma unless there is a pattern of repetitive wheezing or coughing symptoms. In the past, there was a bit of stigma associated with asthma. However, with the invention of medication that improves control of symptoms and flare-ups, the fear of the diagnosis is fading. In fact, denying the fact that you or your child might have asthma can be dangerous. If one had been prescribed an inhaler more than once in the past, the possibility of asthma should be discussed.

When one encounters a trigger and begins wheezing, at least two things are happening in the lungs. Very simply:

  1. Muscles around the tubes in your airways tighten up, making it difficult to pass air through. This happens quickly.
  2. Mucus and inflammation begin to accumulate in your lungs. This happens slowly.

Medications for asthma work on both of these issues. Fast-acting bronchodilators relax the muscles and make breathing easier. Other medications work to slowly, decreasing the inflammation. These medications work in different ways and can be used together to treat and prevent asthma attacks. If you are, or your child is, using their bronchodilators frequently, you should discuss whether a preventative medication might be used to decrease the flare-ups.

Being aware and prepared is the key to a wheeze-free holiday season!


Special Requests during Holiday Meals

by Mia Gibson RDN, LD, CDE

Dietitian at Cardiac and Pulmonary Rehab, Center for Health and Wellness

The holidays are a time to gather for meals with our families and friends. If you are the host or attendee, there are things to consider so the meals will go smoothly to accommodate special requests.

For some, it is just dietary preferences. For others, it may be a life-threatening food allergy to be concerned about.

If you are the host, always ask your guests ahead of time for any special requests. They may have medications that need to be adjusted with meal timing. Providing your guest with the menu and what time the meal will be served will allow them to plan accordingly.

If you have a guest with food allergies:

  • Snap a picture of the label from food items with ingredients listed.
  • Prepare items separately to avoid cross contamination.
  • Be careful with serving utensils and let guests with allergies serve themselves first.

To serve healthy options that will help guests with special requests, try these ideas:

  • Keep food simple by serving dishes that have fewer ingredients.
  • Serve sauces and dressings on the side.
  • Reduce salt as much as possible by not adding salt and by using low sodium options.
  • Provide non-starchy vegetable items. A nice, green salad is a festive healthy option to the buffet.
  • By serving a variety of foods, most guests will be able to select foods that work well for their needs.
  • Always offer non-alcoholic beverages. Sparkling water and water infused with vegetables or fruit offers a nice alternative to plain water.

As a guest, please let you hosts know ahead for special requests. If possible, offer to bring a dish to share.

A little preparation can be the key to a happy healthy holiday gathering!

Source: Tufts University Health and Nutrition Letter, Nov 2017.



So, I have to have a breast biopsy. Now what?

by Dr. Gage Hicks


As seen in Odessa American Medical Matters: http://www.oaoa.com/people/health/medical_matters/article_a5d8b580-d21c-11e7-8f31-9faf6bd0e5e2.html

Maybe an abnormality was detected on your screening mammogram or you were feeling a lump, imaging of your breast most likely showed an abnormality that needs further evaluation with biopsy. This means that additional evaluation of the abnormality is needed in order to determine if cancer cells are present. A biopsy obtains pieces of tissue from the area of concern so that a pathologist can look at it under the microscope and determine if it is (or isn’t) a breast cancer.

A biopsy can be performed in several different ways, and the type of biopsy recommended is often determined by the appearance of the abnormality in question. Most breast biopsies can be performed without surgery, through a tiny incision in the skin (percutaneous biopsy). A small amount of numbing medicine is injected into the skin and below the skin (local anesthesia) so that you don’t feel pain during the biopsy. Some breast biopsies are best performed surgically, and more advanced anesthesia is required in those cases.

The types of biopsies that are performed without surgery (through tiny incisions in the skin and with local anesthesia) are ultrasound-guided biopsies and stereotactic biopsies:

  • An ultrasound-guided biopsy uses ultrasound imaging to visualize the needle as it passes through the area of concern. The doctor is able to watch what is going on inside the breast as the needle takes the small pieces of tissue. In my opinion, these are the easiest biopsies to perform – both for the patient and for the doctor. Most masses can be biopsied in this way.
  • A stereotactic biopsy uses mammogram pictures to guide the biopsy needle to the correct location in the breast. These biopsies tend to be a little bit more difficult for the patient … not because of pain (the numbing medicine takes care of that), but because the breast has to be compressed (like in a mammogram) and because the patient has to be very still during the procedure (just like you have to be still during a mammogram). Stereotactic biopsies are most often used to biopsy calcifications in the breast (these cannot be seen with ultrasound). However, occasionally masses in the breast are not seen with ultrasound and can be biopsied in this manner as well.

Just because a biopsy was recommended, it doesn’t necessarily mean that you have cancer. But the radiologist is concerned enough that a biopsy was recommended for further evaluation. There are several criteria that the radiologist takes into account when recommending biopsy of an abnormality in the breast. Certain abnormalities are highly suggestive for cancer based on their appearance, and a biopsy is needed to determine what type of breast cancer we are dealing with so that the appropriate treatment plan can be put in place prior to surgery. However, this is actually not the most common scenario. More often, a biopsy is recommended for an abnormality that is suspicious for cancer but not necessarily highly suggestive for cancer. This is because there is a lot of overlap between the appearance of abnormalities that are not cancer (called benign) and abnormalities that turn out to be cancer.



You CAN Quit Being Trapped by Tobacco Use!

by Timothy Marquez, BA, RRT – Former MCHS Pulmonary Patient Educator/Cardiopulmonary

Cold Hard Facts from Texas health and Human Services and Center for Disease Control:

  • According to the Texas Department of Health and Human Services, the average age a person first starts using tobacco is 12 to 13 years old.
  • Almost nine out of 10 adults who smoke started before they were 18.
  • A person who smokes one pack a day for a year spends approximately $2,184 on cigarettes.
  • Tobacco is one of the most heavily advertised and promoted products in the U.S. In 2001, the tobacco industry spent a combined $719.2 million advertising tobacco in Texas.
  • Studies show nicotine is more addictive than heroin, cocaine and alcohol.
  • Over 400,000 Americans die each year due to tobacco related diseases.

This is the “heavy of the situation” for the tobacco epidemic. When it comes to smoking, many have attributed it to lung cancer. However, for many years now, the health data has proven its links to many other additional diseases that could lead to death. These include increased risks for stroke, artery disease, blood clots, bladder cancer, COPD, heart disease or heart attack … just to name a few.

HOWEVER, there is good news! For many years, the great State of Texas has been working on a solution for tobacco use prevention, finding funding to support the fight against tobacco use and partnering with local communities’ hospitals, clinics, healthcare organizations and programs to accomplish the goal of tobacco cessation.

STOP Smoking

If you smoke, you still have a fighting chance to STOP smoking. And after you quit, you can stay a non-smoker for as long as you choose. Is this process easy? No, it won’t be easy. But you will be better for it!

There are smoking cessations programs throughout Texas. The program through Medical Center Hospital System is called Smoking Independence Classes and they are held on Thursdays from 6 p.m. to 7 p.m. in the MCH Cardiopulmonary Education Room.

Programs such as these not only help you quit, but provide helpful tips to stay tobacco free. The focus isn’t in replacing the habit or addiction, but turning it around into the focus on dealing with stress, fear, anxiety, negative emotions in a positive manner. There are many reasons why people smoke, and most of them have to do with stress. There are healthier alternatives to relieve stress.

In addition to focusing on coping skills, in the MCHS Smoking Independence Classes, we discuss diet and exercise. According to the Cancer Center for Research at University of South Florida, four out of five people gain weight after quitting smoking. Some of the reason has to do with replacing one bad habit with another bad habit (CCUSF, 2000).

By working with the individual on “why they smoke”, we can provide a supportive and encouraging atmosphere for them. Like most programs, we suggest that the person surround themselves with supporters who want them to quit smoking. The more supporters a person has on board, the better their chances are for success!

For anyone who smokes, please value yourself and realize your worth. You deserve better for yourself than to be trapped by the use of tobacco. You have a fight to win … find your drive and motivation!  YOU CAN DO THIS!




Antibiotic Misuse and YOU!

by Lindsay Rumold PharmD, BCPS, and Erica Wilson PharmD, BCPS

As seen in Odessa American’s Medical Matters:

Do the medications amoxicillin, azithromycin, cephalexin or ciprofloxacin ring any bells? These are among the most prescribed antibiotics in the United States. And, chances are, you or someone you know has received a prescription for one of these before. Antibiotics can be very helpful medications … but there are also risks that exist when antibiotics are used in the wrong way.

Antibiotics are medications used to treat bacterial infections such as strep throat, sinus infections and some pneumonias. Antibiotics should not be used to treat viral infections such as the common cold, most coughs and the flu. When antibiotics are used for viral infections, the infection will not be cured, it will not help you feel better and others can still catch the virus. No harm in trying the antibiotic though right? Wrong! Antibiotics are not always the answer! Remember – there are potential risks when taking any medication, so antibiotics should only be used when the doctor determines they are needed. Antibiotics can cause side effects like nausea or diarrhea, or can result in an allergic reaction. When antibiotics are used in the wrong way, the use may contribute to antibiotic-resistant infections. Antibiotic resistance is when bacteria change and become stronger and harder to kill, usually requiring stronger treatment and possibly a hospital stay. Development of resistance is a real concern, and is why healthcare providers are being more careful when prescribing antibiotics.

Using antibiotics wisely is not just the job of providers. There are things you can do to help prevent resistance as well! First of all is to understand that antibiotics are only useful for bacterial infections. Also, it is important to ask your doctor questions when they prescribe you an antibiotic. Ask questions such as, “What kind of infection do I have?” and “Are these antibiotics necessary?” It is important that you understand your illness and if antibiotics are the correct option. Please do not insist that your doctor give you an antibiotic if it is not appropriate. Never take someone else’s prescribed antibiotics. Do not keep and use past prescriptions as they may not be right for your type of infection, can contribute to resistance and can cause side effects or drug interactions your doctor or pharmacist would not be monitoring. Practicing good hand hygiene can help prevent the spread of germs. Lastly, it is important to always complete the full course of antibiotics, even if you feel better! If the antibiotic prescription is not finished, not all of the illness-causing bacteria are treated and resistance may develop.

Antibiotics have been the first line of defense against infections since the 1940s. They are very powerful in treating bacterial infections when they are used properly … which is the responsibility of healthcare providers and YOU!

Did you know?

  • The Centers for Disease Control estimates that more than half of all antibiotics prescribed are not necessary.
  • Some medications, foods and even alcohol can interact badly with antibiotics. Discuss with your pharmacist all medications you take when filling a new antibiotic prescription and ask whether you should take the antibiotic on a full or empty stomach.
  • Some antibiotic prescriptions require special storage such as in the refrigerator. And most medications should be kept in a cool, dry place. Therefore, keeping them next to the shower may not be ideal.
  • If you have a viral infection, antibiotics will not make you feel better and can have negative effects. So ask your doctor or pharmacist about possible medications that can be used for symptom relief.


  1. Centers for Disease Control; National Center for Immunizations and Respiratory Diseases Division of Bacterial Diseases. Get Smart Know When Antibiotics Work 2012. https://www.cdc.gov/getsmart/community/materials-references/print-materials/parentsyoung-children/answer-b.pdf. Accessed September 27, 2017.
  2. Association for Professionals in Infection Control and Epidemiology. The ABC’s of Antibiotics 2014. http://consumers.site.apic.org/files/2014/09/AntibioticInfographic14-FINAL.pdf. Accessed September 27, 2017.

Mammography: Frequently Asked Questions

by Dr. Mason “Gage” Hicks, Radiologist
As seen in the Odessa American Medical Matters at: http://www.oaoa.com/people/health/medical_matters/article_6a3aea48-b692-11e7-9190-137b296bd2ab.html

Why do women need to have yearly screening mammograms?

It reduces a woman’s risk of dying from breast cancer. Studies have shown that mammography screening cuts the risk of dying from breast cancer nearly in half.

When should a woman start having mammograms?

There are conflicting recommendations from different societies. We follow the American College of Radiology and Society of Breast Imaging guidelines which recommend yearly screening mammograms beginning at age 40 for women at average risk for breast cancer (most women). Studies have shown that this is how we will save the most lives.

Why yearly and not every other year?

It’s simple … yearly screening results in more lives saved than screening every other year.

Should a woman ever start having screening mammograms before age 40?

There are certain situations where a woman should start mammography screening before age 40 … women who are considered high risk. If you are unsure, then talk to your doctor. The American College of Radiology and Society of Breast Imaging never recommend screening mammograms before age 25.

What are some reasons a woman would be considered high risk for breast cancer?

Women with certain genetic mutations (BRCA1 or BRCA2), family history, women who received radiation to the chest at a young age (usually for treatment of Hodgkin’s disease) and women with a personal history of breast or ovarian cancer.

What is 3D mammography?

3D mammography, or breast tomosynthesis, is a breakthrough technology in breast imaging that allows a clearer, more accurate view of the breast (as opposed to the traditional 2D mammogram). It allows the breast radiologist to see through the different layers of tissue in the breast. This improves breast cancer detection.

What are the benefits of 3D mammography?

Earlier detection of small breast cancers

Clearer images of the breast tissue

Fewer additional tests or unnecessary biopsies

Greater accuracy

Greater likelihood of detecting multiple cancers

What does it mean if my doctor says I have dense breasts?

It has to do with the way you are made. It doesn’t mean that anything is wrong with you, though it can increase your breast cancer risk. Every breast has different amounts of fatty tissue versus glandular and connective tissue. When you look at a mammogram, the black/darker parts of the breast are the fatty tissues and the white/lighter parts of the breast are the glandular and connective tissues. When you have dense breasts, it means that there is more of the white/lighter tissues relative to the black/darker tissues.

What is the significance of having dense breasts when it comes to mammograms?

Most cancers also look white on the mammogram. So when you have dense breasts (more of the white/lighter tissues), it sometimes makes it harder for the radiologist to detect cancers. The dense breast tissue can sometimes obscure cancers (particularly smaller cancers) and make them difficult, or even impossible, to see.

What should I do if I have dense breasts?

It’s something to talk to your doctor about. DON’T stop having mammograms. Certain types of cancers, particularly those that present as tiny calcifications in the breast, can easily be detected on mammograms … even in dense breasts. Your doctor may recommend additional screening depending on your overall breast cancer risk. Additional screening with breast MRI can be a valuable tool in certain patients.

Do I need a “screening mammogram” or a “diagnostic mammogram”? What’s the difference?

Generally speaking, if you are not having any breast problems and it’s time for your yearly mammogram, a screening mammogram is recommended. Diagnostic mammograms are generally performed on patients that either had an abnormality detected on their screening mammogram, or are having some kind of breast problem (lump, pain, discharge, etc.)

If the patient had a potential abnormality on a screening mammogram, a diagnostic mammogram is performed for further evaluation. This usually involves specialized mammogram views and possible ultrasound of the area to determine the nature of the abnormality and determine if a biopsy is needed.

The diagnostic mammogram is not better pictures or better image quality than the screening mammogram. It is just performed in a way that allows the problem or potential abnormality to be fully evaluated with the necessary imaging while the patient is in the department. Personally, I like to talk to every patient that has a diagnostic mammogram so that they leave our department with peace of mind and understanding of what my recommendations are.

October is Breast Cancer Awareness Month. Please make your mammogram a priority in your life and encourage your loved ones to do the same. Early detection saves lives.


Hiatal Hernia – A Very Common Condition

by Dr. Ramalinga Kedika

As seen in the Odessa American Medical Matters: http://www.oaoa.com/people/health/medical_matters/article_8245b52a-b163-11e7-9720-079e5674f3e0.html

Patients often come to me very worried after having been told they have a hiatal hernia. A hiatal hernia is very common and often not a cause for alarm.

What is a hiatal hernia?

A hiatal hernia simply means that a part of your stomach is in your chest. Normally your stomach cavity is separated from your chest cavity by a muscle called the diaphragm. Defects in the diaphragm muscle lead to a herniation of the stomach into your chest.

Hiatal hernias are very common.

Up to half of all people in the western world will have a hiatal hernia. Approximately 70 percent of patients older than 70 years old will have one. And most people do not even know they have a hiatal hernia.

Does having a hiatal hernia cause problems? 

Generally it does not. Some patients with hiatal hernia will have acid reflux or heartburn. To this date, we still don’t know exactly what causes acid reflux. There is a sphincter muscle at the connection of the esophagus and stomach and it is thought that abnormal relaxation of this sphincter muscle allows acid to reflux into the esophagus. A hiatal hernia can displace the normal position of this sphincter and may contribute to acid reflux.

When does a hiatal hernia need treatment?

If you experience heartburn regularly, the first thing you should do is modify your dietary and lifestyle habits. If this is ineffective, acid reflux medications could be considered. Surgery to repair a hiatal hernia is an option, but this should be carefully considered with your doctors. Five percent of hiatal hernias are a more problematic para-esophageal hernia that has a small risk of becoming strangulated requiring emergency surgery … but this is rare.

What are the risk factors for a hiatal hernia and how is it diagnosed.

Age is probably the biggest risk factor. Some people may simply be born with a larger opening in the diaphragm muscle. Conditions which increase pressure in the abdomen can also lead to a hiatal hernia. Examples of these conditions include pregnancy, obesity, coughing and straining. Hiatal hernia can be diagnosed on radiology tests or upper endoscopy.

If you feel that you or someone you care about may have a hiatal hernia, visit with your primary care physician or call ProCare Gastroenterology at 432-640-3007.

Pumpkin – More than just decoration!

by Christina Salina, MS, TTU Dietetic Intern


Few people think of pumpkins besides Halloween decorations and carvings or the traditional Thanksgiving pumpkin pie. However, it might be time to rethink this nutritious and delicious orange plant.

Pumpkin is considered a fruit that is rich in nutrients and has a wide range of fantastic health benefits. Beta-carotene is powerful antioxidant that is found in abundance with pumpkins and is also responsible for giving fruits their vibrant orange color. This antioxidant is converted into Vitamin A within the body. Consuming foods rich in beta carotene may prevent the development of certain types of cancer and protect against heart disease.

Another wonderful nutrient found in pumpkins is fiber! On average, an American diet includes about 15 grams of fiber while the daily recommendation is between 25 – 30 grams. Fiber can slow down the rate of sugar being absorbed in the blood and regulate bowel movements.

Here is the complete nutritional breakdown of one cup of cooked pumpkin:

  • 2 g of protein
  • 3 g of fiber
  • 49 calories
  • 200% of vitamin A
  • 19% vitamin C
  • 10% or more of vitamin E, riboflavin, potassium, copper and manganese


Preparing your own pumpkin will deliver most of these health benefits. However, canned pumpkin does retain nutrition well. Steer away from pumpkin pie mix as it contains added sugars and syrups.

REMEMBER: Canned pumpkin should contain only one ingredient: PUMPKIN.


Here are a few creative ways to include pumpkin in your diet:

  • Dice pumpkin into cubes and roast it with other veggies such as Brussel sprouts, red onion, winter squashes etc.
  • Mash boiled pumpkin into puree instead of mashed potatoes
  • Mix pureed pumpkin into oatmeal or smoothies
  • Roast pumpkin seeds for snacking
  • Add cubed pumpkin to chili or soups
  • Stuff mini pumpkins with a veggie rice mix



TRY this easy recipe for a yummy

Pumpkin Breakfast Bowl

that was created by Christina Salina, MS, TTU Dietetic Intern.

Blueberries and Bone Health

Adding blueberries to breakfast cereal or snacks may help your children ward off osteoporosis later in life.

That’s the hypothesis of U.S. Department of Agriculture researchers who fed young, growing rodents a diet with 10 percent freeze dried blueberry powder. The berry eating animals ended up with significantly more bone mass than a comparable group that didn’t eat berries. Blueberries contain polyphenols, compounds that give the fruit its distinctive color and which may also have bone-building benefits.

Studies are still needed to determine whether the berries have the same effect on young human bones. But with their high vitamin C and dietary fiber content, blueberries are already a delicious way to eat healthy.