Ask any transplant patient and they will most likely tell you the most important thing they do to protect their transplanted organ is take their medications. These medications are so very vital. The medications that a transplant patient takes range from anti-rejection medications, to anti-virals and antibiotics to prevent opportunistic infections, to different vitamins and minerals that may be lost after transplant. All of the medications work together to keep the transplant patient healthy. However, it is not always easy to remember to take all these different pills. Here are a few tips for all patients to help remember to take the transplant medications on schedule:

1. Take your pills at the same time as an activity you do everyday, such as brushing your teeth, or taking a shower. After a week or two of doing this, you will begin to associate taking your meds as a part of the activity and it should become a habit.
2. Set an alarm as a reminder. Most of us carry our cell phones everywhere these days. You can set a daily alarm as your “pill alarm.” The only caveat to this is remembering to bring your pills with you if the alarm is set for the middle of the day. These alarms can also be set as a start up reminder on your computer for all those who are more tech-savvy.
3. Place reminder cards in various locations. If you take your pills at work, place a reminder on the computer, if you’re at home place a sticker on the refrigerator or on the bathroom mirror. Just make sure the reminders are somewhere you will look every day.
4. Ask a responsible and willing family member, friend or co-worker to support you with daily reminders. This can be especially helpful if the friend or family member also takes daily medications. You can make a pact to remind each other about taking your meds.
5. Use a pillbox. This way you can easily look and see if you have missed a dose. Pillboxes eliminate second-guessing and are easily purchased at any drug store.
6. Keep a chart or calendar. Once you take your medications for the day, place a check on the calendar. If you take multiple doses, divide the calendar squares into as many pieces as necessary to place the checks. This can be especially helpful if you have a pocket calendar, which can go with you everywhere.

These are just some small tips, which may help you remember to take your incredibly important transplant medications. There are many other ways to remember you just have to find what works for you. Once you get into the routine, it should easily become a lifelong habit that you never have to think twice about.

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Amanda Dean is a Nurse Practitioner at the Pre-Transplant Clinic. For more information, contact the Methodist University Hospital Transplant Institute in Memphis, Tennessee at transplant@methodisthealth.org. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Locate a transplant surgeon in Tennessee or call 866.805.7710.

Impact on Performance, Safety and Quality of Life 

Everyone experiences excessive sleepiness at one time or another, but when sleepiness is a chronic problem it can have significant negative effects across many areas of life. Sleepy individuals may exhibit impairment in work efficiency and accuracy, academic performance, social function, and safety. Automobile accidents and falls are examples of potentially life-threatening effects of sleepiness. Individuals with excessive sleepiness may complain of difficulty concentrating, memory problems, and irritability or moodiness.

The presence of sleepiness at inappropriate times signals a problem that requires evaluation and intervention. The most common source of chronic sleepiness in America is sleep deprivation. A variety of social, work, and family pressures may contribute to sleep deprivation. Certain medications and alcohol can cause sleepiness. Primary sleep disorders are often associated with sleepiness including obstructive sleep apnea, restless legs syndrome and periodic limb movement disorder, and narcolepsy.

Obstructive sleep apnea (OSA) consists of repetitive episodes of upper airway obstruction associated with arousals and drops in oxygen levels during sleep. Patients with OSA snore habitually, and bed partners may observe episodes of cessation of breathing followed by a gasp-like sound. Restless legs syndrome involves uncomfortable "creepy crawly sensations" in the feet and legs, with an irresistible urge to move the legs. The patient has difficulty falling asleep and may experience periodic limb jerks (usually involving the legs) that may disturb the patient or bed partner. Narcolepsy is a neurologically based sleep disorder associated with severe sleepiness on a daily basis regardless of the quantity of sleep obtained.

Evaluation of sleepiness begins the process of identifying the underlying cause and initiation of treatment. Treatment of sleep disorders that cause sleepiness may involve lifestyle and schedule changes, changes in medications, or specific therapies to address sleep disorders. Individuals with excessive sleepiness should discuss their concerns with their healthcare provider, and when necessary, seek consultation with a sleep medicine specialist. Appropriate intervention leads to improved alertness, performance, and safety, better emotional regulation, and improved quality of life.

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Merrill S. Wise, M.D. is a neurologist and Board-certified sleep medicine specialist affiliated with the Methodist Healthc are Sleep Disorders Center.  All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Please call the Sleep Disorders Center for more information at 901.683.0044.

A diet high in fiber may reduce the risk for colon cancer by nearly half, according to the American Institute for Cancer Research. Researchers tracked the diets of more than 500,000 people for 4-1/2 years. Good sources of fiber include fruits and vegetables, whole grains and beans. Fiber may not be the only nutrient causing the protective effect. Vitamins and minerals in the plants, as well as other dietary habits of people who eat a high-fiber diet may play a role.

Healthy Memphis Common Table’s magazine, Take Charge for Better Health, lists 4-star physicians in Greater Memphis chosen by over 50,000 people surveyed. Participants were surveyed about their experience as a patient: how well your provider communicates, how long you wait to be seen, and other key factors. 

The survey was part of a pilot program in partnership with Consumers’ CHECKBOOK, a non-profit research firm from Washington, D.C. The business, physician and health insurance communities also joined in this effort. 437 physicians were involved and full results can be found at www.healthymemphis.org

Of the 98 physicians highlighted as 4-star, 78 have privileges at Methodist Le Bonheur Healthcare, including the following:

Milton Addington, M.D.
Cardiovascular Disease

Steve Akins, M.D.
Cardiology

John Albritton, M.D.
Obstetrics/Gynecology

Lanetta Anderson, M.D.
Obstetrics/Gynecology

Melrose Blackett, M.D.
Obstetrics/Gynecology

James Boone, M.D.
Internal Medicine

J. Brantley, M.D.
Internal Medicine

Charles Brown, M.D.
Internal Medicine

Ann Brown, M.D.
Internal Medicine

Charles Burnett, Jr., M.D.
Cardiovascular Disease

John Buttross, M.D.
Internal Medicine

Belvia Carter, M.D.
Obstetrics/Gynecology

Heather Chauhan, M.D.
Obstetrics/Gynecology

George Chu, M.D.
Internal Medicine

Sam Cox, III, M.D.
Obstetrics/Gynecology

Thomas Crenshaw, M.D.
Obstetrics/Gynecology

Charlotte Deflumere, M.D.
Pain and Addiction

Claro Diaz, M.D.
Cardiovascular Disease

Betty Dulaney, M.D.
Obstetrics/Gynecology

Mark Edwards, M.D.
Internal Medicine

E. Arthur Franklin, M.D.
Internal Medicine

Paul Gerlach, M.D.
Cardiology/Internal Medicine

Christopher Green, M.D.
Internal Medicine

Thomas Greenwell, M.D.
Obstetrics/Gynecology

Steve Gubin, M.D.
Cardiovascular Disease

Donald Hamby, M.D.
Obstetrics/Gynecology

Ara Hanissian, M.D.
Internal Medicine and Pediatrics

Julie Harper, M.D.
Obstetrics/Gynecology

Denise Hightower, M.D.
Family Medicine

Stevan Himmelstein, M.D.
Cardiology

David Hollaway, Jr., M.D.
Cardiology

Riad Homsi, M.D.
Obstetrics/Gynecology

David Iansmith, M.D.
Cardiology

Gregory Jenkins, M.D.
Internal Medicine

Penn Joe, M.D.
Obstetrics/Gynecology

Eric Johnson, M.D.
Electrophysiology

Albert Kennedy, M.D.
Obstetrics/Gynecology

Laura Lendermon, M.D.
Family Medicine

Frank Ling, M.D.
Obstetrics/Gynecology and Pelvic Pain

Diane Long, M.D.
Obstetrics/Gynecology

Carol Lynn, M.D.
Gynecology

Daniel Martin, M.D.
Infertility, tubal Surgery & Endometriosis

Frank McGrew, III., M.D.
Cardiology

Christine Mestemacher, M.D.
Obstetrics/Gynecology

Kristin Miller, M.D.
Obstetrics/Gynecology

Marvin Miller, M.D.
Internal Medicine

Olawale Morafa, M.D.
Family Medicine

Garry Murray, M.D.
Cardiology

H. Nease, M.D.
Internal Medicine

Paul Neblett, M.D.
Obstetrics/Gynecology

John Norwood, M.D.
Infectious Disease/Internal Medicine

Debbie O’Cain, M.D.
Internal Medicine

Kingsley Oraedu, M.D.
Obstetrics/Gynecology Consultant

Steven Overby, M.D.
Internal Medicine

Dharmesh Patel, M.D.
Cardiology

Frederick Pelz, M.D.
Internal Medicine

Paula Pilgrim, M.D.
Obstetrics/Gynecology

Beau Pittman, M.D.
Internal Medicine

Jolie Porter, M.D.
Internal Medicine

James Porterfield, M.D.
Cardiology

Michael Pruett, M.D.
Internal Medicine

George Rushing, M.D.
Internal Medicine

William Russo, M.D.
Cardiology

Joseph Samaha, M.D.
Cardiology

Jack Sanford, Jr., M.D.
Obstetrics/Gynecology

James Sikes, M.D.
Internal Medicine

Stacy Smith, M.D.
Cardiology

Henry Sullivant, Jr., M.D.
Obstetrics/Gynecology

Margaret Summitt, M.D.
Gynecology

Louis Talbert, M.D.
Internal Medicine

Herbert Taylor, M.D.
Obstetrics/Gynecology

Ronald Terhune, M.D.
Family Medicine

Cory Tinker, M.D.
Obstetrics/Gynecology

Larry Walker, M.D.
Family Medicine

Angela Watson, M.D.
Internal Medicine

Albert Weeks, M.D.
Oncology/Hematology

Catherine Womack, M.D.
Internal Medicine

David Wright, M.D.
Internal Medicine

Methodist Healthcare is the first hospital in Memphis to make Emergency Room wait times available online for all Methodist adult hospitals. Patients will be able to see approximately how long it will take to see a medical professional, such as a doctor or nurse practitioner, and choose which hospital emergency room best meets their needs.

Patient flow in emergency rooms constantly changes. By posting our wait times online, we’re giving our patients a tool they can use to make an informed decision about where to go for care.

Wait times are accessible online at methodisthealth.org/ER, using a computer or mobile browser or by texting ERwait to 46786* to learn the wait time for Methodist Le Bonheur Germantown Hospital, Methodist North Hospital, Methodist South Hospital, or Methodist University Hospital. Wait times will be updated every two minutes.

Posting emergency room wait times on-line shows our commitment to providing our patients high-quality care and reflects how serious we are about increasing transparency.

A growing number of hospitals across the country are posting ER wait times online. Methodist joins hospitals that are posting wait times to let people know what to expect. The national average wait time to see a doctor or nurse practitioner in the emergency room is 60 minutes. Methodist typically beats that time with an average of 40 minutes.

The ability to post hospital wait times online and other integrated information systems are the result of six years of groundwork to create the electronic medical record that gives Methodist the ability to collect the necessary data. osting emergency room wait times on-line lets patients choose which hospital emergency room best meets their needs.

As always, in case of a life-threatening emergency, patients should go to the closest emergency room where they will be seen immediately, or call 911. *Standard texting rates may apply.

For more information about our Emergency Room wait times, visit methodisthealth.org/ER

Periodic limb movements in sleep are repetitive movements, most typically in the lower limbs, that occur about every 20-40 seconds.  
PLMS is a common sleep disorder affecting approximately one third of adults over the age of 60 years.

The exact cause of PLMS is unknown. PLMS are not considered medically serious. PLMS can be a contributing factor in chronic insomnia and/or daytime fatigue because they may cause awakenings during the night.

Symptoms of PLMS

The most common symptom of PLMS include fragmented sleep, daytime sleepiness, and frequent arousals during sleep. Often, people who have PLMS also have Restless Leg Syndrome. RLS is a disorder that is characterized by the irresistible urge to move the body in an effort to stop uncomfortable or odd sensations, most often in the legs. These sensations or feelings are typically described as creeping, crawling, itching, burning, or tingling feelings. However, research also shows that many individuals have PLMS without experiencing any symptoms. As with several sleep disorders, it’s often the spouse or bed partner that refers the PLMD patient to receive treatment.

Treatment Options

A number of medications have been shown to be effective in treating PLMS, but treatment is only necessary when PLMS are accompanied by restless legs (RLS), insomnia or daytime fatigue.

If you feel that you have PLMS or Restless Leg Syndrome, inform your primary care physician or make an appointment for an evaluation with a Sleep Specialist at the Sleep Disorders Center.

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Jim Donaldson is the supervisor at the Methodist Healthcare Sleep Disorders Center. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Please call the Sleep Disorders Center for more information at 901.683.0044.

(HealthDay News) -- Angina is the term for chest pain that occurs when a portion of the heart isn't getting enough oxygenated blood.

The National Heart Lung and Blood Institute says the following triggers may be behind angina pain:

• Coronary heart disease
• A blood clot
• Extremely hot or cold weather
• Emotional stress
• Smoking or using cocaine
• Medications that cause narrowing of the blood vessels
• Insufficient blood flow to the small arteries feeding the heart

Learn more about about chest pain by asking your doctor. Find a cardiologist in Memphis using our physician locator or call 888.777.5959.

Change in our personal and professional lives can take its toll. There are many events that can increase stress in our lives; even positive events such as marriage, the birth of a child, starting a new job, and having a child leave home. It’s not uncommon for people to become anxious during these times, but if we learn how to build our resilience we can minimize the negative physical and emotional effects. A diversified approach to increasing resilience uses different strategies

Before

• Develop a supportive network of family and friends
• Practice relaxation techniques regularly
• Give yourself permission to have fun and be creative
• Take care of yourself with proper nutrition, regular exercise and adequate rest
• Acknowledge the fact that stress is a normal part of life

During

• Challenge stress-inducing beliefs
• Stop before your thoughts escalate into worst case scenarios
• Identify irrational thoughts, dispute them and reflect objectively on the cause of the stress
• Establish a plan of action
• Use positive self-talk

After

• Continue to take good care of you
• Congratulate yourself for being resilient

We’ve all heard the phrase, “the only thing constant is change,” so start preparing today. You can talk to a counselor about increasing your resilience or any other life challenge, by calling the Methodist Healthcare Employee Assistance Program in Memphis, Tennessee.

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Karole Blake-Shorter, LCSW is a counselor at the Methodist Healthcare Employee Assistance Program. To contact Karole or another EAP counselor, call 901.683.5658 or 800.880.5658. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice.

(HealthDay News) -- Smoke detectors aren't the only devices that should be kept throughout the home in the event of a fire.

Fire extinguishers are equally important. The National Safety Council offers these suggestions for where to keep them:

• Keep an extinguisher that can handle both grease and electrical fires in your kitchen.

• Place another extinguisher next to your furnace, and one in your garage.

• Keep additional extinguishers at other places where a fire could start.

• Make sure everyone in the home who is physically able knows how to work an extinguisher.

An estimated one in five American children is overweight, according to the National Institutes of Health. Serving them healthier meals and exercising as a family can improve their short- and long-term health.

Being obese increases a child's risk for several serious childhood medical problems, including diabetes, heart disease, sleep apnea, and psychological disorders. And, in addition to childhood health risks, studies have found overweight kids are at greater risk of becoming obese adults, with all the health problems associated with obesity lasting through the life span.

Excessive "screen time" has been identified as a direct cause of obesity in children because it replaces physical activity, increases eating, and reduces metabolism.

Get 'em up

Like adults, children should be physically active most, if not all, days of the week. Experts suggest at least 60 minutes of moderate physical activity daily for most children. Running, bicycling, jumping rope, dancing, and playing basketball or soccer are good ways for them to be active.

These strategies can help you help your kids get a move on:

• Don't call it "exercise." Instead, promote "playtime" and encourage activities that are fun and physical, such as hopscotch or jumping rope.

• Find out what your children like to do and make this a focus of your family activities.

• Participate in community fitness events, such as charity walks or fun-runs.

• Use family walks or bike rides as a time to do more than just exercise together. Talk about school and family issues when you're taking a break.

• Relive your childhood by playing the games you loved as a kid. Play tag, Red Rover, hide-and-seek, or any other fast-moving game.

• Plan outings that involve physical activity, such as going to a skating rink, the zoo, or a miniature golf course.

• Turn chores into games. Try raking leaves and jumping in the piles. Have a water fight while washing the car. Pretend you're digging for treasure while gardening.

• Invite neighborhood kids to play games that require more participants, such as capture the flag or kickball.

But the best way for you to help your children get more exercise is to join in.

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All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice.

(HealthDay News) -- Sugar added to foods makes them taste sweeter, but a healthy diet can sour from too much of it.

The American Academy of Family Physicians suggests how you can limit added sugar:

• Cut back on candy, desserts, baked goodies and other sweet treats.

‘It takes a village.’ Our former first lady made her pronouncement regarding the benefits of communal participation in the care of a child, but I often think it could be equally applied to the process of caring for a loved one who is terminally ill. Although many family members I meet are dedicated and committed to seeing their loved one through the process of a dignified death, the task is often a long one, fraught with questions, long nights at the hospital or home, and physical weariness from the mundane duties of caretaking—changing bed linens, bathing or turning the patient, and keeping the vigil to ensure that the patient is not in discomfort. 

Multiple studies have proven what we’ve known instinctively for years--no lone caregiver, however heroic, can succeed day-in and day-out with such challenges. Without adequate support, caregivers suffer increased risks of depression, physical illness, and spiritual distress. That’s when hospice can help in a variety of ways, supporting the caregiver and becoming part of the ‘village’ where good care happens as many give of their varied talents, rather than one or two individuals exhausting all they have and who they are, only to be frustrated. 

There are many Common Misconceptions about Hospice. When many people think of hospice, they picture the continuity nurse visiting the patient within the home, and envision the nurse carrying out doctors’ orders to ensure the patient’s comfort. That’s certainly a core component of the hospice effort, but there’s much more on offer. 

• Social workers can help negotiate the myriad of papers to be filed for family leave, establishment of benefits, and assist with life review for the patient. 
• Home health aides often become a functional part of the family, providing such physically intimate care as bathing or changing the patient.
• Chaplains help the patient and/or family communicate about meaning, and negotiate the difficult but rewarding mental and spiritual work that impending death brings to a family. 
• Volunteers may take the patient out for a drive, help with shopping, give a haircut, or read a story.

I hope that when it’s time for me to quit midnight rounds and busy schedules, and prepare for my own death, my family will take time to be with me, to ensure my comfort and to honor my life with their presence. But I pray they won’t try to go it alone. I’ll probably be a handful. Don’t go for the individual heroics, guys. Get the village—get hospice.

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Dr. Clay Jackson is the medical director for Methodist Hospice & Palliative Services team. For more information about Hospice & Palliative Care Services, call 901.516.1616 or 800.726.2559. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice.

Today’s Wound Clinic spoke with Vickye Hester, APR, Communications Specialist of Methodist Comprehensive Wound Healing Center in Memphis, Tennessee. The following interview provides an in-depth look into the facility as well as the day-to-day operational protocol that must take place. Methodist’s dynamic staff is inevitably the powerhouse behind their ongoing patient success.

1. Go Early running. Morning is good because it is cool and your body's temperature is lower when you wake in the morning. Evening running after 6pm is an option as well. 
2. If you cannot workout in the morning or evening, then start your run with shorter times letting your body adapt to the hot temperatures outside. So start with a 15-20 minute run and add 5 to 10 minutes over the next 2 weeks. 
3. A study was done in New Zealand that researchers found that runners who drank an icy slush drink before a sweltering run lasted an average of 10 minutes longer than runners who gulped a cold drink. 
4. After running you can place ice cubes in a sponge, place under ballcap or place ice cubes in a bandanna and tie it around your neck so cool water can slowly drop your temperature. Some runners take water and dump over their head to cool their body temperature. 
5. Lastly you can take a sweat rate test to see if you know how much to drink during a hard summer run. Weigh yourself naked before and after your run. Each pound lost shows approximately 16 ounces of fluid you lost sweating. This will let you know how much fluid you need to drink per hour. So if you dropped 3lbs then you need to make sure you are drinking 48 ounces of fluid per hour.

It is so important to hydrate. Dehydration can change your running performance up to 20% per a study in Britian. Heat illnesses like cramps, heat exhaustion can begin when your core temperature rises only a few degrees above normal. Recognize the red flags your body is giving you. Do not ignore them when running in the heat. Heat cramps, Heat exhaustion, and Heat stroke are dangerous and can be treated if you will listen to your body's warning signs. Good luck with training and run smart in the heat.

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Dawn Caldwell is a Physical Therapist in Memphis, Tennessee with Methodist Healthcare. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice.

Anger is an emotion that we experience in a variety of situations and sometimes when we least expect it. Learning how to express anger appropriately starts in childhood. However, we have many opportunities along the journey of life to learn how to handle anger.

The Fence
author unknown

There was a little boy with a bad temper. His father gave him a bag of nails and told him that every time he lost his temper, to hammer a nail in the fence. The first day the boy had driven 37 nails into the fence. As each day went by, the number began to gradually dwindle down. He discovered that it was easier to hold his temper than to drive those nails into the fence.

Finally the day came when the boy didn’t lose his temper at all. He told his father about it and the father suggested that the boy now pull out one nail for each day that he was able to hold his temper. The days passed and the young boy was finally able to tell his father that all the nails were gone.

The father took his son by the hand and led him to the fence. He said, “You have done well, son, but look at the holes in the fence. The fence will never be the same. When you say things in anger, they leave a scar just like these scars.”

What is said in seconds can take years to heal from. Protect your relationships by using a kinder language such as “I” talk. (“I wish you wouldn’t do that.”) Avoid name calling and put downs. Apologize sincerely if you do make communication blunders. Verbal wounds will heal over time if new behavior and language patterns are developed and practiced. Never quit trying to treat others better.

If you have difficulty managing your anger, please consider contacting the Methodist Le Bonheur Healthcare Employee Assistance Program at 901.683.5658 or 800.880.5658.

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Brian Long is a Liscensed Professional Counselor with the Methodist Employee Assistance Program. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Counselors are available to you at 901.683.5658.