H. pylori – Who should be tested?

by Ramalinga Kedika


As seen in the Odessa American’s Medical Matters:



Did you know there is a stomach infection present in approximately half of the world’s population? That infection is a bacteria called Helicobacter pylori, or H. pylori for short.

Signs and symptoms of H. pylori

Most people with H. pylori will never have signs and symptoms and therefore routine screening is not needed in the United States. Some people will have stomach symptoms including pain, nausea, poor appetite, burping/belching, bloating and/or weight loss. It is these patients that should be tested for H. pylori infection by their healthcare provider.

Long-term complications

Some of the long-term complications of infection include stomach and intestinal ulcers, irritation of the stomach lining (gastritis) and stomach cancer. It should be noted that the presence of H. pylori infection combined with excess over-the-counter NSAID (Motrin, Advil, etc.) use will significantly increase your risk of developing ulcers. It is a common misconception that stress alone is a cause of ulcers!

How do people get infected with H. pylori?

The exact way is not known, but most people acquire the infection in their childhood. What we do know are the risk factors for infection. These include living in crowded conditions, lack of clean water, living in a developing country and living with someone who has the infection.

How is H. pylori diagnosed?

  1. pylori can be diagnosed in multiple ways. The easiest way for patients is often a breath test that can be done at most laboratories. Other ways include a stool test or upper endoscopy (scope test into the stomach) with biopsy. If diagnosed, H. pylori should be treated with a 10 to 14 day regimen of antibiotics and acid reducers.

One interesting historical tidbit. In 1984, scientist Barry Marshall drank a Petri dish containing H. pylori to help show that the infection caused gastritis and ulcers. For this, Marshall and his colleague Robin Warren earned the Nobel Prize in 2005!


RSV and the Nose Goblins

By Dr. Bonnie Carter, Board Certified in Family Medicine


As seen in OA Medical Matters:



RSV … three simple letters that strike fear into the hearts of parents everywhere. Probably everyone knows someone whose child has been hospitalized due to the respiratory syncytial virus (RSV). We’ve all heard the horror stories and, if diseases had a Most Wanted List, RSV would definitely be on it. According to the CDC, RSV accounts for approximately 2.1 million office visits, 57,000 hospitalizations in children under five, 177,000 hospitalizations for adults over 65 and 14,000 deaths in adults over 65.

The peak season for RSV is late fall to early spring, with January and February seeing the highest numbers. It is estimated that by the age of two, 90 percent of children will have had RSV at least once. RSV is the leading cause of bronchiolitis and pneumonia in children under the age of one. There are multiple strains of the virus, which means you can get it more than once. At this time, there is no vaccine available.

The symptoms of RSV are similar to the common cold: fever, cough, congestion and runny nose. What distinguishes RSV from other upper respiratory infections is the diffuse wheezing and difficulty breathing. For most healthy children over the age of two and healthy adults, RSV is just a bad cold. While uncomfortable, it does not present a danger to most in this age group. However, for children under the age of two, and especially those under six months, RSV can be a ticket to the hospital.

So why is RSV so bad for babies? One of the main reasons babies have so much trouble with RSV is that they don’t know how to breathe out of their mouth until they are older. When a baby’s nose is congested, they can’t breathe. This is why it’s important to use the bulb syringe and suck out any of those nasty nose goblins and boogies that get in there. And there are a lot of nose goblins with RSV! It creates an excessive amount of nasal drainage and secretions. It also causes inflammation of the air tubes, or bronchioles, causing bronchiolitis.

Signs that are concerning for respiratory distress in an infant or small child are tachypnea (rapid breathing), nasal flaring, retractions (caving in between the ribs with inspirations), use of accessory muscles (arm muscles and abdominal muscles) to breathe and perioral cyanosis (turning blue around the mouth).

One question I’m often asked is, “How do I know whether to take my baby to the doctor’s office or the emergency room?” Obviously, our goal is to keep you out of the ER as much as possible. They are busy and don’t need to be bogged down with non-emergent visits. But if your child is having respiratory distress with any of the signs listed above, that is where they need to be. If your kiddo has a runny nose, cough, fever, sore throat or earache, then call your physician and bring them into the office.

Treatment of RSV is symptomatic and it requires the tincture of time to resolve. RSV is a virus and therefore does not respond to antibiotics. Likewise, antibiotics do not prevent the illness from worsening. Like the commercial says, “That’s not how this works…that’s not how any of this works!” Parents often pressure physicians to prescribe antibiotics, especially when the child appears moderately ill. When we tell you antibiotics are not necessary, it’s not that we don’t believe your child is sick, or that we want your child to suffer longer. Trust me, if I had the magic wand to wave and make it all better, I would do it in an instant. Unfortunately, I never got my letter to Hogwarts, so I went to medical school instead. Also, we do not recommend cold medication such as cough medicine, decongestants and antihistamines for small children because studies have not shown an improvement of symptoms with their use and they often cause adverse side effects. The one therapy that has shown any consistent improvement is bronchodilator therapy (nebulized breathing treatments). I do recommend frequent nasal suctioning to help keep their nose clear and Tylenol to help fever. On average, an infection with RSV lasts about a week, with the worst symptoms being in the first three to four days.

As the old saying goes, “An ounce of prevention is equal to a pound of cure.” Preventing RSV infection is always the best plan, but sometimes the best laid plans go astray. Do not take your baby out to stores, church or anywhere there is a group of people who could be sick. If you do have to take your baby out, keep their carrier covered with a blanket to protect them from respiratory droplets. I know that everyone wants to see and hold the new baby, but it is safer to keep away from Grandpa Bill and his germs if he is sick. If someone in the house gets sick, try to keep them isolated in a separate room, especially at night. Cover your mouth and nose when you cough or sneeze and wash your hands. You can use Lysol to spray surfaces such as countertops, door knobs, or toys that might be contaminated with respiratory droplets. As tempting as it is, don’t Lysol the baby (or the dog, or your sibling, or your husband …)!

Soup and Salad for Cold and Flu?

by Deborah McPherson MS,RD, LD, CDE and Mia Gibson RDN, LD, CDE

As seen in the Odessa American Medical Matters: http://www.oaoa.com/people/health/medical_matters/article_7651392c-e298-11e7-9893-2b7b151c4e84.html

We may have all heard that chicken soup is good for what ails you, but can it actually cure a cold?

The answer is, of course, no. However, it has been proven to help relieve congestion, act as an anti-inflammatory and prevent dehydration … which may come in handy when you have a cold or flu.

How can salad help? 

A salad, especially a dark green leafy salad with spinach, contains beta-carotene and vitamin C that both enhance immunity … which might help prevent us from getting sick in the first place. Add some grilled salmon to the salad, which contains omega-3 fatty acids, for additional anti-inflammatory properties.

A healthy diet, getting enough exercise and rest … and keeping stress levels down … may be our best defense against cold and flu this season. A well-nourished body may more easily ward off infections. Other nutrients that may help increase our immunity are:

  • B-6 in fortified cereals, poultry, seafood and a variety of fruits and vegetables
  • Vitamin E in nuts, protein in dairy, meat, poultry, fish, beans and peas
  • Selenium and zinc in seafood and beef

So why can’t we just take a vitamin or herbal supplements instead of eating these foods? 

Whole foods offer several benefits over dietary supplements. Whole foods provide more than one nutrient, dietary fiber and other protective substances such as phytochemicals and antioxidants that may also help protect us against disease.

Before taking dietary supplements, other than those prescribed by your doctor, remember that dietary supplements don’t undergo the same testing and quality control that prescription medications do. Just because the bottle says “all natural” does not mean that it will not interact with your current medications or cause side effects. Use caution and remember that supplements such as Echinacea and Ginseng, when taken longer than a few weeks, may actually lower immunity.

Some people may benefit from supplements, but ask your doctor before jumping on the supplement band wagon.

Dietary guidelines do recommend doctor-prescribed supplements or fortified foods during pregnancy and for adults over 50. In addition, we might need supplementation if we have a medical condition or surgery that leads to a deficiency in certain nutrients, consume less than 1,600 calories daily or follow a special diet (vegan or vegetarian) that may limit the variety of foods consumed.

Just remember:

  • Too much of a good thing (vitamins, herbs) may not be good.
  • Too many of those “candy-gummy” vitamins could be toxic.
  • Eat whole foods first and discuss dietary supplements and vitamins with your doctor.


Consult your doctor before making changes in your diet. If you have a medical condition, certain items may need to be reduced or eliminated. Seek the advice of your physician and Registered Dietitian before making any changes in your diet or lifestyle.

NUTRITION TIP OF THE DAY: Hot drinks with lemon or lime may help relieve sore throat or cough symptoms. And try spicy, hot soups to help clear nasal passages and possibly help an inflamed throat.


(Sources: Mayo Clinic, Nutrition Action, CSPI, JADA, Eatright.org, Web MD and MCHS Dietitians)


Serves Eight



1 small onion, chopped

1 tsp. cumin

1 (4-5 oz.) can chopped green chilies

½ tsp. black pepper

2 cloves garlic, minced

1 (14.5 oz.) can beef broth

2 Tbs. water

1 tsp. chili powder

1 (14.5 oz.) can no salt stewed tomatoes

2 tsp. Worcestershire sauce

1 ½ c. water

8-10 corn tortillas, cut in strips (bake in oven to crisp)

1 (14.5 oz) can fat free reduced sodium

1 c. diced cooked chicken breast

chicken broth

1 c. fat-free or low fat shredded cheese

1 (13.5 oz) can tomato juice



In large soup pan, soften onion, chilies and garlic in 2 Tbs. water. Add liquids, tomatoes and seasonings. Bring to a boil and simmer one hour, covered. During last ten minutes, add chicken. Top with cheese and tortilla strips before serving. Add one or two slices of avocado before serving, if desired.



Calories – 130

Carbohydrate – 24 gms

Protein – 8 gms

Fat – 0.5 gm

Saturated Fat – trace

Percent calories from fat – 3 percent

Sodium (w/o cheese) – 650 mg






Urinary Incontinence

by Dr. Avelino Garcia

As seen in the Odessa American Medical Matters: http://www.oaoa.com/people/health/medical_matters/article_5e237dea-dd36-11e7-b864-efb69ed2f589.html

Though many are embarrassed to discuss it, urinary incontinence is very common among women. Urinary incontinence is leakage of urine. It can range from leaking just a few drops of urine to complete bladder emptying. Other accompanying symptoms include having the strong urge to urinate, urinating frequently, waking up several times during the night to urinate, burning with urination or leaking urine while sleeping.

There are three main types of urinary incontinence in women.

  • Stress Urinary Incontinence (SUI) is leakage of urine when laughing, coughing, sneezing or exercising.
  • Urgency Urinary Incontinence (UUI) is a sudden urge to urinate that cannot be stopped. Many women leak urine before they can make it to the restroom.
  • Mixed incontinence combines the symptoms of both SUI and UUI.

Several things can cause or worsen urinary incontinence. Urinary tract infections can cause leakage of urine. Certain types of medications, like diuretics, caffeine and alcohol, can contribute to urinary incontinence, as these are substances that cause your body to create more urine and/or are bladder irritants. Different disorders caused by weakening of the muscles of the pelvic floor can cause problems controlling urination. Long term constipation is often a trigger for urinary incontinence, especially in older women. Neuromuscular or anatomical problems can also cause problems controlling urinary leakage.

Urinary incontinence is diagnosed by medical history and a physical exam. A pelvic exam is necessary to determine if there is pelvic organ prolapse. Certain tests may be done during the physical examination to see if there is complete emptying of the bladder after urination. In some cases, imaging and bladder function tests can be ordered for further information.

The first line of treatment for urinary incontinence is nonsurgical. This may include lifestyle changes, like discontinuing caffeine and alcohol, and managing fluid intake during the day. Weight loss in overweight patients is beneficial for reducing leakage of urine. Bladder training may be discussed by your provider. According to the American College of Obstetricians and Gynecologists (ACOG), “the goal of bladder training is the learn how to control the urge to empty the bladder and increase the time span between urinating to normal intervals (every three to four hours during the day and every four to eight hours at night).”

Performing Kegel exercises helps strengthen pelvic muscles and can improve all types of urinary incontinence. There are many medications that help improve UUI by controlling bladder spasms, manage to relieve the urge to urinate and urinary frequency.

A pessary may be recommended for nonsurgical management of SUI and to improve pelvic support. A pessary is a small device that helps to support the walls of the vagina, thereby lifting the bladder and urethra. These devices come in many shapes and sizes and can be fitted by the provider during the pelvic exam. Pessaries can easily be removed for cleaning and re-inserted by the patient at home, making them a very convenient alternative to surgery for many women.

There are several surgeries that can be completed by the provider in a hospital setting to improve SUI. There are many different slings are available for the treatment of urinary leakage. A sling is a narrow strap made of synthetic materials that is placed under the urethra to lift and provide extra support. Other surgical procedures include lifting and securing the bladder neck to nearby supporting structures using stitches.


If you are suffering from urinary incontinence, call ProCare Women’s Clinic today and make an appointment at (432) 640-2491.

Winter Weather Safety

by Amanda Everett, MCHS Emergency Management Coordinator

Vehicle Preparedness and Safety:

  • Plan your travel and check the latest forecasts.
  • If you encounter snow, sleet or freezing rain, drive extremely cautiously. Even four-wheel drive vehicles will have difficulty on icy roads.

Dressing for the Weather:

  • Wear loose-fitting, lightweight clothing in several layers.
  • Outer garments should be tightly-woven and water-repellant.
  • Wear a hat. Nearly half of your body heat loss is from the top of your head.
  • Wear gloves or mittens. Mittens snug at the wrist are better than gloves.

Preparing Your Home:

  • Bring your pets inside.
  • Have a flashlight and extra batteries available. Do not use candles if the electricity goes out.
  • Use a battery-powered NOAA Weather Radio and a portable radio to receive emergency information.
  • Be sure to wrap any exposed pipes.

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!