Recommended Resources
Presbyterian Healthcare Services is committed to the health of its patients, members and communities. At Presbyterian, you have access to a wide range of medical services and treatment options to help you stay healthy. You can also manage your health plan through myPRES. We encourage you to take an active role in understanding your health, your disease and your treatment, and have compiled these resources to help you.
Suggestions from Presbyterian Physicians for Finding Reliable Health Information
In the digital age, the challenge we all face isn’t a lack of health information but an overwhelming amount of it. When you are just beginning to research a health condition or disease, it can be difficult to know where to turn for reliable information. While we recommend that you always engage your healthcare provider in conversations about your health, we recognize that supplemental resources can be a great help - and comfort, too. To help you find those resources, we asked some of our physicians to offer suggestions for where to turn for accurate health information, with a special emphasis on our Presbyterian Medical Group areas of expertise
General Health & Wellness
Lifestyle practices and health habits play a large part in determining our health. Many studies show that not smoking, being active, eating a healthy diet with an abundance of fruits and vegetables, maintaining a normal weight, and drinking alcohol only in moderation can significantly decrease (up to 90%) your risk of heart disease, stroke, diabetes and some cancers. If you are overweight, even weight loss of 5-10% can significantly improve your health.
Unfortunately, we are surrounded by foods and activities that are aren’t good for us in many ways. It is very empowering for you to recognize this and choose a different path. Additionally, positive lifestyle change has an “infectious” component—I hear about patients’ children, parents and spouses adopting changes as well. While it is impactful to change lifestyle at any age, this is especially significant for children, as we know many diseases start early in life. Teaching your children to make positive lifestyle choices helps them maintain these choices into adulthood and sets them up for a long and healthy life. I encourage you to consider a short-term commitment to a trial of significant change, so you can judge for yourself how powerful lifestyle change is – this will give you the motivation to sustain these changes into the future.
While the preventive power of lifestyle is well known, a new and fascinating development is the creation of the field of “lifestyle medicine,” which is the use of lifestyle intervention in the treatment and management of disease. Lifestyle interventions can include diet (nutrition), exercise, stress management and smoking cessation, among others. A growing body of scientific evidence has shown that lifestyle intervention is an important part of the treatment of chronic disease and can often be as effective as medication. This is an extremely hopeful message in the face of a new diagnosis.
Many aspects of our modern lifestyle affect our health in huge ways. There are many things that can influence your health, like nutrition, poor sleep, sitting too much, physical inactivity, and stress. For example, studies have shown that the levels of hormones that regulate your appetite are greatly influenced by how much sleep you get. When you don’t get enough sleep, you have an increased appetite, causing you to eat more calories than you need for the hours you’re awake during the day. In the evening your cortisol levels (a stress hormone that should decrease in the evening as we prepare for sleep) are elevated with chronic sleep loss, which is likely to promote the development of insulin resistance, a risk factor for obesity and diabetes. There are many things you can do to get better sleep. Try turning off all of your electronic devices about half an hour before bedtime every night and do something that relaxes you, like taking a warm bath, reading or listening to music. If you are still struggling, ask your doctor for help.
One tidbit I like to share with my patients is that it is healthy to cultivate “mindfulness” – this means you are living in the present as much as possible. Many philosophical and religious traditions teach that happiness can be found by living in the moment and it appears that this affects our health at the most basic level – in our cells. Humans naturally spend a lot of time thinking about what isn’t going on around them and instead think about what happened in the past, what might happen in the future or what may never happen at all. A recent study that appeared in a prestigious scientific journal showed that people spend almost half of their time thinking about something other than what they’re doing. A mind that is present in the moment indicates well-being and promotes health at the cellular level -- a follow-up study showed a connection between mind wandering and a measure of aging in the DNA of cells.
I believe working on your general health at each of these levels is rewarding and empowering. If you search for wellness or any other health topic on the internet, make sure you use websites that have reliable, medical-based information. There are also a lot of great resources on the internet for ideas for outdoor family activities, new recipes and tips for improving your overall well-being.
RECOMMENDED RESOURCES:
By Dr. Sally Fisher, preventive and integrated medicine and physician nutrition specialist at Presbyterian
Healthy Eating
The American Heart Association has looked at the areas that affect cardiovascular health and the one that is the most disastrous for Americans is our diet. While we have added more unhealthy foods to our diets, such as oil, meat, cheese and soda, we have seen a decrease in healthy foods, like fruits, vegetables, beans and whole grains. Plant-based foods have complex mixtures of thousands of active compounds that are beneficial to our health, so it’s not just the presence of unhealthy foods, but the absence of healthy ones too that create nutritional difficulties. Most of the chronic diseases that plague us (diabetes, heart disease, obesity, high blood pressure, most cancers, gout, and many more) are related to nutrition.
As a Physician Nutrition Specialist, I recognize, along with others in the field, that recommending a diet based on fruits, vegetables, beans and whole grains is the strongest evidence-based advice for dietary change we have. Not only is there the very well established benefit of a diet with decreased calories and unhealthy saturated and trans fats and increased fiber and healthy mono and polyunsaturated fats, you are getting a daily infusion of many beneficial compounds including vitamins, minerals, antioxidants and thousands of other plant compounds which are being actively studied by scientists. With these foods, there is no need for calorie-counting and portion control, which has been very difficult for most people, since you can eat as much as you want and it will still be low in calories. Choosing this kind of diet can help you lose weight, reduce the risk of heart disease, Type 2 diabetes and certain types of cancer, as well as lower your blood pressure.
The time we spend cooking has plunged over the past 40 years (although the amount of time we watch TV shows about cooking has increased!). Cooking at home, when possible, using whole, natural foods (vegetables, fruits, legumes, whole grains, perhaps from a farmers market in town) can decrease your family’s food costs while increasing health and happiness for you and everyone you live with. There are many easy to make, quick and healthy meals. Try new recipes often and encourage your family to participate in meal preparation.
An active lifestyle along with changes to your diet is important to maintaining a healthy weight and for good health in general on many, many levels. Go to the gym, ride your bike, or walk the dog for an hour a day. Take the stairs or park a little further from the entrance to work or the grocery store. These websites are great for finding more information on healthy eating plans, heart health and weight loss.
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By Dr. Sally Fisher, preventive and integrated medicine and physician nutrition specialist at Presbyterian
Diabetes
While diabetes is skyrocketing due to unhealthy lifestyle changes occurring worldwide, the great news is this disease is highly preventable. For people who are at high risk for diabetes because they have increased glucose levels, lifestyle changes work better than medication at preventing the onset of diabetes. Even very modest weight loss along with two and a half hours of moderate exercise a week (which includes walking) helps prevent or delay the onset of diabetes for high-risk individuals.
If you or a family member has already been diagnosed with diabetes, lifestyle change can powerfully affect the course of your disease, which is a really hopeful message! Everyone with diabetes should have the opportunity to discuss his or her diet with somebody trained to do so, such as a dietician or physician. According to the American Diabetes Association Standards of Care 2013, “A variety of dietary meal patterns are likely effective in managing diabetes including Mediterranean-style, plant-based (vegan or vegetarian), low-fat and lower-carbohydrate eating patterns.” There are alternatives to the standard ‘diabetes diet’ that I love to explore with patients. I particularly encourage patients to adopt a plant-based diet because health improvements are greater in diabetics with this type of diet and many people find this way of eating highly acceptable and easy to follow. This diet also has the advantage of not requiring any weighing or measuring of portions.
RECOMMENDED RESOURCES:
Eating and Diabetes (National Diabetes Information Clearinghouse)
Diabetes Diet: Create your healthy-eating plan (Mayo Clinic)
Regular exercise helps lower your blood sugar (glucose). Walking your dog around the block, riding your bike, shooting hoops and even dancing are great ways to help you gain energy, relieve stress, and lower your risk for heart disease and stroke. Be sure to check your blood sugar regularly and take medications you’re prescribed as directed. This can include medicines for diabetes, blood pressure or cholesterol.
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By Dr. Sally Fisher, preventive and integrated medicine and physician nutrition specialist at Presbyterian
Smoking Cessation
People with tobacco dependence should not feel alone. There is medical help available, which for most people is essential to quitting. According to the American College of Chest Physicians (the national group of lung specialists) tobacco dependence is a severe illness that may improve or get worse for people over the course of time and is an illness that people should have their physicians actively engaged in helping them with.
Besides cigarettes, tobacco dependence can include using chewing tobacco or snuff, pipes, hookahs, or e-cigarettes (often called vapes or vape pens). While conventional cigarette smoking has declined in recent years, e-cigarettes have gained popularity, with many users being middle or high school aged. E-cigarettes should never be used by youth, young adults, or those who are pregnant, as they can cause significant lung injury and damage to the brain. The brains of adolescents and young adults are still developing up until age 25, and nicotine exposure can harm the parts of the brain that control attention, learning, mood and impulse control. Although rare, e-cigarettes can also explode, causing serious injury to people.
Approaching tobacco dependence as a disease acknowledges that the brain has altered chemistry in tobacco-dependent patients. The goal of therapy in tobacco dependence is to normalize brain function so that the patient has very minor or no symptoms of nicotine withdrawal. Common nicotine withdrawal symptoms can include:
Dysphoric or depressed mood
Insomnia
Irritability, frustration, or anger
Anxiety
Difficulty concentrating
Restlessness
Decreased heart rate
Increased appetite or weight gain
The goal of tobacco-dependence therapy is to control and minimize these withdrawal symptoms through individualized treatment, which allows the patient to feel as normal as possible while not using tobacco. The intensity of treatment should match the severity level of nicotine dependence.
Smokers have more tools than ever to help them stop smoking -- support groups, help hotlines, counseling services and even mobile apps. You can visit the following websites for more information about the effects of smoking on your body, tips for quitting and a variety of tools and resources that can help you stop smoking for good.
RECOMMENDED RESOURCES:
Women’s Health
Congratulations on your pregnancy! It’s an exciting time for you and your family and you can expect many changes to your body in the coming months. There are many things to learn and adjustments you’ll need to make to your routine and diet to help make sure you have a healthy pregnancy and birth experience. During your pregnancy, it’s important to make sure you stop smoking and drinking, eat a healthy diet and follow a low intensity exercise plan based on your fitness level.
Regular prenatal care is essential to a healthy pregnancy and a healthy baby! You’ll have a visit with your doctor once every four weeks for the first seven months of your pregnancy, once every two weeks during the eighth month and once a week until your baby is born. During prenatal visits, your doctor will ask you questions about your lifestyle and medical history, check your weight and blood pressure, screen for potential problems and monitor your baby’s growth and progress. Take the opportunity to talk about how you are feeling and ask your doctor any questions you may have.
Skin-to-skin contact immediately after birth helps you form an amazing bond with your baby, calms both mom and baby and helps regulate baby’s temperature, breathing and heart rate. Skin-to-skin contact also helps you produce more breast milk and makes latching easier when you are preparing to breastfeed.
Breastfeeding is one of the best things you can do for your baby! Breast milk has protein and vitamins that are easier for your baby to digest, as well as antibodies, enzymes and hormones that you can’t get in formulas. Breast milk helps your baby’s brain grow and lowers the risk for asthma, obesity, diabetes and some cancers. Breastfeeding is good for mom, too! It lowers the risk of Type 2 diabetes, breast cancer, ovarian cancer, osteoporosis and postpartum depression. Breastfeeding also saves you time and money. Just think – no expensive formula and no more measuring, mixing or cleaning bottles!
There are a lot of websites where you can find information about how your baby is developing every week, what kind of foods you should eat and vitamins you should be taking and information about how to prepare yourself and your family for your new addition. Here are a few I suggest:
RECOMMENDED RESOURCES:
By Janelle Wolfe, manager of Women's Health Education and Resources at Presbyterian
Children's Health
If you are a parent, you’re used to getting lots of questions from your kids. You probably have plenty of questions yourself! One of the concerns we hear most often from parents is about the safety of childhood vaccinations. Internet rumors that vaccinations can cause autism and other developmental disorders have caused many parents to decide against immunizations, but there is no scientific evidence that vaccinations contribute to these issues. The vaccines your child can receive at any Presbyterian clinic are mercury free, purified and have been tested for safety. Immunizations are still the best way to protect children (and the general public) from preventable disease!
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Parents often ask us how they can help their kids be more active. Part of helping your kids develop healthy habits is adopting those habits yourself! Eat breakfast every day, limit snacks and sugared drinks and practice portion control. Encourage your kids to help with meal preparation. Make sure to fit in an active family activity for 60 minutes a day, like walking the dog or taking a bike ride. Limit screen time (including TV, computer, game time and homework) to less than two hours a day. Staying active and developing healthy eating habits will help you and your kids maintain a healthy weight and lower the risk for diabetes, high cholesterol and high blood pressure.
RECOMMENDED RESOURCES:
Provide Healthy Meals and Snacks (Centers for Disease Control and Prevention)
Keep Your Kids Active (Centers for Disease Control and Prevention)
Helping your child develop confidence and self-esteem is an important part of helping them develop a happy, healthy lifestyle. Keep the lines of communication open and talk with your children every day about their schoolwork, their friends and any potential problems, such as bullying or peer pressure. When your kids feel good about themselves, they can do anything!
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There are many trusted websites available to research children’s health issues, but be cautious about the information and websites you trust. KidsHealth has doctor-approved information and advice on everything from the common cold to exercise and fitness to family activities. Visit KidsHealth.org
By Dr. Sylvia Crago, pediatrician at The Children’s Center at Presbyterian
Cancer Care
You’ve just been told, “You have cancer.” As scary as this is to hear, you have many resources to help you learn about and cope with your diagnosis, along with the support of your doctor, your family and your friends.
There are over 100 different types of cancer that can affect many parts of your body, but all cancers start because abnormal cells start to grow and get out of control. Your body is made up of many different kinds of cells, all of which grow and divide to produce new cells as they are needed to keep your body healthy or to repair injuries. If your body produces cells that don’t die as they should and new cells continually form, these extra cells clump together and cause a mass of tissue called a tumor.
Depending on the type of cancer you have been diagnosed with, your symptoms, treatment options and recovery times will vary. I encourage you to learn as much as you can about your cancer and make sure to ask your doctor any questions you may have about your options. Don’t let your diagnosis keep you from doing the things you love! Staying active, eating healthy and spending time with friends and family doing the things you enjoy are the best things you can do to help yourself cope with your symptoms, stay motivated and help relieve some of the stress, anger and other emotions you may feel.
Amidst the myriad cancer resources on the internet, the following websites are credible, accurate and continually updated. Each of these sites contain a robust array of information on everything from basic skills for coping with cancer to communicating with your doctor, to understanding your tumor type and identifying treatment recommendations for an internationally recognized expert panel (NCCN). You can also find information about survivorship and living well.
RECOMMENDED RESOURCES:
Heart Health
If you have heart disease or it runs in your family, you know how important it is to take care of your health. Even if you don’t have heart disease, it’s good to know what changes you can make to your diet and lifestyle so that you can reduce your risk of heart attack, stroke and high blood pressure.
We all know that diet and exercise play a key role in heart health. Find a healthy eating plan that works for you. Reduce saturated and trans fats (found in butter and margarine) and avoid fried and processed foods as much as possible. Introduce more fresh fruits and vegetables into your diet, aiming for 5-9 servings a day. Stick to food to get the nutrients and vitamins your body needs, not supplements. I recommend Centrum Silver or a similar generic multivitamin for my patients who don’t get enough nutrients from the food they eat. Read the package labels on the foods you eat regularly and become aware of what you’re eating!
Exercise five days a week – aim for relatively vigorous activity for 30 minutes a day or less vigorous activity for 45 minutes each day. Whether you are just starting or you are continuing an exercise plan, it’s important to find an activity that you enjoy and that works for you and your day. We all have busy schedules, but there is plenty of opportunity to fit in half an hour of exercise before work, during your lunch break or before bed. Walking is the easiest form of exercise to achieve heart health. The Institute of Medicine recommends that you aim for 10,000 steps a day.
Research shows that exercise is an excellent way to lower blood pressure and cholesterol, help reach weight loss goals and improve circulation, all of which reduce the risk of heart attack and stroke.
Exercise has great physical benefits, but did you know that there are also huge benefits to your emotional health? Physical activity helps reduce and relieve stress and depression and releases endorphins that help you feel more relaxed and rested. I tell my patients that they should recognize that the world is fast-paced and stressful and they should find techniques that work for them to reduce this stress. Breathing exercises, biofeedback, tai chi and yoga can all help you calm down and control your stress.
If you have a family history of heart disease, make sure you have regular general screenings to check your cholesterol, blood pressure and risk of diabetes. If someone in your family has had a heart attack or stroke, your chances of heart disease are much more likely. You can’t change your genetics but you can make changes to your lifestyle to help you reduce your risk, including weight loss, quitting smoking, eating healthy and getting plenty of exercise.
There are plenty of resources online to learn more about how you can improve your heart health and lower your risk of heart disease, high blood pressure and stroke. Here are some sites I recommend:
RECOMMENDED RESOURCES:
By Dr. Daniel Friedman, cardiologist at Presbyterian Heart and Vascular Care
Behavioral Health
There are a lot of things we can do to look after our physical health (like healthy eating and exercise) but we also need to think about the things we can do to improve our emotional health! People who manage their stress and other emotions well and avoid abusing drugs or alcohol live happier, healthier lives.
One of the biggest health problems in America today is stress. We have stress for a variety of reasons, including chronic health issues, family or personal relationships, work issues and major life changes. Short-term stress is normal but chronic stress, or stressful situations or events that last longer periods of time, can lead to health problems such as high blood pressure, heart disease, obesity and diabetes. Stress affects everyone differently, so if you need help managing it, don’t forget how many resources you have for help! Talking with trusted friends and family members, staying active and participating in self-help groups and individual or group therapy are all great ideas. While no one can avoid all stress, one key way to reduce stress is to take good care of yourself! Make sure you get enough sleep, eat healthy foods and make time for exercise and other activities that help you relax.
Most of us feel blue or a little down once in a while, but if you are sad and feel hopeless and it interferes with your daily activities, you might be depressed. There are many ways to treat your depression so you can get back to feeling your best. If you aren’t sure where to start, ask your primary care doctor for a referral to a psychiatrist or a counselor. He or she can discuss your symptoms and review your history with you and recommend group or individual therapies, medications and other changes, like exercise and participating in activities that can affect your mood. The earlier you start treatment, the more effective it can be!
There are many online resources that you can review for more information about behavioral health disorders and issues, tips for reducing stress and managing your emotions and identifying support groups and behavioral health services in your area. If you research behavioral health or any other type of health issue on the internet, make sure that you use credible, up to date websites that are based on medical facts. Remember to be wary of symptom checklists you find online – rely on a behavioral health professional for any questions you may have or an official diagnosis.
RECOMMENDED RESOURCES:
Substance Abuse and Behavioral Health (Substance Abuse and Mental Health Services Administration)
Mental Health Support, Education and Advocacy (National Alliance on Mental Illness)
By Dr. Steven Jenkusky, psychiatrist
Surgery
Millions of people have surgery every year for a variety of health issues. Whether you are having emergency surgery or elective surgery, one of the best ways to improve your outcome and recovery is to ask questions and learn about your surgical treatment options. Don't feel embarrassed about asking lots of questions — the more informed you are, the more comfortable you'll feel about having surgery.
If you research surgery online, make sure to use websites that are up to date and are backed by medical experts. If you have any questions about your surgery, pre or post-operative symptoms or would just like to know more about your surgical options, there are many websites that you can access that use plain English to describe disease processes and feature illustrations that are easy to understand. Researching your surgery options online will also help you make choices about whether you should consider a complete workup or if you should seek out a second opinion. These sites are full of great information and searching is easy!
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Patient discussion forums and message boards are good for a sense of community and are an excellent place to find people who have similar problems and questions, but these sites can have a lot of incorrect information or links to disreputable products, such as gallbladder cleanses, that can be dangerous to your health. Make sure you discuss anything you learn on message boards and forums with your doctor so you can be sure this information is true and is right for you.
By Dr. Kevin Hudenko, general surgeon, Surgical Services at Presbyterian
