Exercise seems like the last thing you want to do when you are depressed or feeling blue. But once you get motivated, exercise can make a big difference.  Exercise helps prevent and improve a number of health problems, including high blood pressure, diabetes and arthritis. Research shows that the psychological and physical benefits of exercise can also help  improve mood.

How does exercise help depression? Exercise probably helps ease depression in a number of ways, which may include:

• Releasing feel-good brain chemicals that may ease depression (neurotransmitters and endorphins)
• Reducing immune system chemicals that can worsen depression
• Increasing body temperature, which may have calming effects
• Doing something positive to manage depression is a healthy coping strategy.

What kind of exercise is best?
The word "exercise" may make you think of running laps around the gym. But a wide range of activities that boost your activity level help you feel better. Certainly running, lifting weights, playing basketball and other fitness activities that get your heart pumping can help. But so can gardening, washing your car, or strolling around the block and other less intense activities. Anything that gets you off the couch and moving is exercise that can help improve your mood.

You don't have to do all your exercise at once, either. Add small amounts of physical activity throughout your day. For example, take the stairs instead of the elevator. Park a little farther away at work to fit in a short walk.

Take time to take care of yourself and do activities that you enjoy that will get you moving and make you feel better.

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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. Call 888.777.5959 for more information.

Frequently Asked Questions About Bariatric Surgery

1. Which procedure do you recommend?
   There are three main procedures performed currently in the US. The Lap Band, the gastric sleeve, and the gastric bypass. All three procedures work and have good results when performed by an experienced surgeon and on a patient willing to follow instructions and make lifestyle changes. The most common procedure performed in America is the Lap Band.
2. How much weight can I lose?
   The first order of business is to determine how overweight a patient really is. The average patient will lose about 60-70% of their excess weight after surgery. This means that if someone is 100 pounds overweight, the average patient will lose and keep off about 60-70 pounds. Of course, some patients lose more and some less, depending on their willingness to stick to lifestyle change.
3. Why am I overweight?
   Everyone's weight basically comes down to how much you eat, what you eat, and how much real exercise you do. In general, it has little to do with your job, stress level, family life, etc. Our job is to help educate our patients so that they understand proper portion size, how to eat, prepare, and recognize appropriate foods, and on how to perform proper exercise.
4. Does my insurance cover the surgery?
   Most patients have coverage through their insurance. Look at your policy and see if 'bariatric surgery' or 'treatment of obesity' is a covered benefit. We can help you to figure this out. After an office evaluation we can determine your coverage status and help to get you approved if you are a candidate. Some patients are covered but only after they fulfill certain requirement set forth by their insurance company.
5. How much does surgery cost?
   Most patients are covered under their insurance plans. However, approximately 20% of patients do have to 'pay out of pocket' for their surgery/hospital stay. Surgery is not inexpensive, but when compared to the alternative of paying for the complications of obesity down the road, the cost is reasonable. Because we do a high volume of cases and have good results, the hospital makes every effort to keep the costs as low as possible for our patients. This can be discussed on an individual basis in the office, as each patient has different needs.
6. How long do I stay in the hospital?
   Lap band surgery usually requires a 4-6 hour outpatient hospital visit. The sleeve and bypass procedures usually require about a 2 day hospital stay. Most patients are back to normal activities within 2 weeks, some within 2 days.
7. Why should I have surgery at a Center of Excellence?
   When you make the decision to have bariatric surgery, make sure that it is performed by a surgeon and/or facility that is associated with a Center of Excellence. This is a designation given based on a high volume of cases, good outcomes, and following appropriate protocols that help to optimize good patient outcomes. It has been shown that bariatric surgery performed at lower volume centers have higher rates of complications.

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Dr. George Woodman is a bariatric surgeon and director at MidSouth Bariatrics. Dr. Woodman has performed over 3500 laparoscopic bariatric procedures to help those patients lose over 200,000 pounds. 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. Call 888.777.5959 for more information.

V- is for Vigor: Get out there and exercise three times a week, even if it’s just walking. Get off the couch and start moving. Exercise lowers blood pressure, decreases bad cholesterol, burns calories, adds muscle, and increases bone strength. (See your doctor before beginning a new exercise program)

A - Acceptance: Accept others for who they are. You can’t change them, so change your attitude towards them so that you can learn to be happy around them. Who knows–your acceptance may be all it needs for them to make changes. 

L - is for Laughter:  Spend time laughing with family and friends.  Laughing increases the “feel good” hormone in your brain which improves your overall well-being. It also makes those around you feel better. 

E - Eat breakfast: Breakfast jump starts your day. Breakfast really is the most important meal of the day. It gives you energy to start your day and is linked to many healthy benefits. A good healthy breakfast has been shown to improve weight control, improve concentration in the classroom and the boardroom, provide energy for physical activity, and improve overall intake of nutrients and vitamins.

N - Neatness: Hmmm. Some people don’t like to hear that one, but being organized can help you function better in your home and at work. 

1. You can better manage your time and prioritize your daily chores. These things tend to fall into place when working within deadlines and limits.
2. It will reduce clutter. We can start to get rid of “stuff” and keep the things that are needed and quit accumulating more clutter.
3. It will help you set and achieve personal goals. Make lists of the things you have to do and the things you want to do. As each day passes, you will be closer to your goals.
4. You will learn to focus on the big picture; making sure you have room in your life for the important things that really matter to you.

T - is for Time Management:  Work on finding a balance between your work and home life. In the age of smart phones and laptops, people are working longer hours than ever before often without even realizing it. Do you answer your phone at the dinner table? Check your work email while sitting with your family? Stop that.

I - Interest: Find things that interest you and stimulate your mind. This can be a new hobby such as reading, painting, music, taking a new class, etc…the options are endless. The more interested you become in increasing your thinking power, the more interesting you become.

N - Nurture: Nurture yourself, so you can do the same for others. If you are in the midst of a crisis, take some time out and spend it nurturing yourself. Get a massage, a facial, a manicure, a haircut, relax in the park with a book, meet up with an old friend, or anything that helps you to relax...Remind yourself that underneath all that stress you are a person. Treat yourself. When was the last time you nurtured yourself? It makes a difference in how you are able to nurture others.

E - Enjoy life to the fullest: Make the most of each day. Notice life going on around you. Spend some time in it. Whether you’re headed to work or at home with your family–what can you do to make this the best day possible? If you approach each day with this attitude, it becomes infectious and others want to have the joy that you have.

Make a difference in your own life, become your own best Valentine!

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Gale Dering is the Clinic Manager for the Methodist Minor Medical Center on Hacks Cross Road. 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. Call 888.777.5959 for more information.

What does it really mean to have cultural diversity within an organization? As I pondered this statement, I looked back to my beginnings in northern Mississippi. I grew up in a time of segregation and separation in the south. This was during the 50’s, 60’s, and early 70’s. Surely this term was not invented then. I remembered neighborhoods with only one race in them. Sections of town were racially & culturally divided.

Cultural diversity is the variety of human societies or cultures in a specific region, or in the world as a whole. Cultural diversity within a hospice care program is typically a rarity. However, according to the research information listed below, African American participation in Memphis hospice care is far beyond the national average. During my tenure as a hospice chaplain, the area census listed more African Americans than Euro-Americans (Memphis is over 60% African American), but it also shows a greater number of Caucasians using hospice care.

It would seem that we here in Memphis are truly blessed. Research found that the ratio of African Americans to Caucasians is much lower than the national average. Listed below is a graph of hospice admissions by Methodist Alliance Hospice. It appears that the ratio is much closer here than I had envisioned. Clearly, African Americans lag behind Caucasian hospice usage. However, during the charted period (October 2007 - December 2009), Caucasians led African American hospice usage by only 110 patients. The ratio is nearly one for one. This is a rarity for hospice usage nationally. I think it is also important to note that the graph below includes not only Memphis and Shelby county but other outlying counties in west Tennessee and Northern Mississippi as well. 

Unduplicated Hospice Admissions by Gender and Race/Ethnicity: 

Cultural diversity in the Memphis area is constantly changing. In our hospice program, I have been privileged and blessed to minister to multiple races. I have ministered to Asians, Africans, African Americans, Hispanics, and Caucasians, just to mention some. Our hospice care in Memphis meets individuals where they are regardless of race, religion or national origin. I know we have not reached it yet but I believe that we are ever so slowly moving toward the “Beloved Community” spoken of by Martin Luther King Jr. 

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Chaplain Eddie L. Conner, DMin, BCC is a chaplain with Methodist Hospice in Memphis, Tenn. 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. Call 888.777.5959 for more information.

How many times have you made the same New Year’s Resolution to lose weight and get into shape? If you are like me, I think I have made the same resolution for the last 10 years. Every January I find myself striving for the same outcome, yet the passion only lasts a few weeks before I fall back into my old habits: munching while at the computer, snacking while watching TV, finishing what my kids’ didn’t eat, and making unwise choices because I am always in a rush. Can you relate?

This year while doing some research, I discovered that January 16th-22nd is the 18th Annual National Healthy Weight Week. What a perfect time to reflect on what a healthy weight is for our bodies! We were all made individually with different shapes and metabolisms. This week is the time to really pay attention to what we put into our bodies and be conscious of our eating tendencies.

Some people eat really well most of the time and allow occasional indulgences. For others, unhealthy choices are the majority of their diet. This can wreak havoc on your body. It makes people very susceptible to Heart Disease, Diabetes Mellitus, Stroke, and many other disease processes.

In the fast-paced world that we live in, I understand it is easier running through a drive-thru to pick up dinner versus taking the time to prepare, cook, and clean. I face the same challenges. The less I plan for dinner, the easier it is to find the nearest restaurant. Unfortunately, this makes it all too hard to follow a healthy diet. So many aspects of a healthy diet are sabotaged such as portion control, increased fat intake, too few fruits and vegetables, and less whole grains. Failing to plan really does us no favors.
 
I used to think heart attacks only happened to the elderly, but I have seen more people in their 30's having cardiovascular disease than I ever imagined. This year, I hope I can approach my diet not as a New Year’s Resolution to jump on the latest fad diet to quickly lose the extra pounds, but to really make a lifestyle change that not only improves my health, but impacts my family’s habits as well.

Will you join me in making a resolution to make better food choices that will last a lifetime? Call a friend today and make a plan together that will help each of you to reach your goals. Finally a New Year’s Resolution that can finally be reached!

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Keri Morris, R.N., BSN is a Chest Pain & Stroke Coordinator at Methodist Le Bonheur Germantown Hospital. 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. Call 888.777.5959 for more information.

A New Year: The “Perfect” Time to Consider Too Much of a Good Thing

Most of us strive to do our best in our work and personal lives. We set goals and are pleased when we reach those goals. Sometimes we don’t reach them, and we’re okay with that too. Perfectionists, however, often set unrealistic or unreachable goals then become depressed or frustrated when things don’t proceed “perfectly.”

Give yourself and those around you a break! Accept that we all have limitations and strengths, then begin to change your perspective.  Try some of these techniques to tame those tendencies:

Set realistic goals. By setting attainable goals, ones which have a good chance of being met, you can learn to celebrate your successes instead of cataloging your mistakes.

Avoid “all or nothing” thinking. The sun will rise tomorrow if you’re not perfect. Completing two of the three things on your to-do list is still progress toward your goal.

Be aware of the difference between high standards and perfectionism. Concentrate on personal success instead of avoiding failure.  You may be surprised by the opportunities that arise when seen from a new vantage point.

Take notice of ways in which your perfectionist, critical attitude affects those around you. Others may feel unappreciated for their efforts or feel unable to meet your expectations.

Accept your mistakes. Everyone makes mistakes. This is what makes you part of the human race. Others may see you as more approachable and likable when viewed as human. Plus, the added bonus for you is a reduction of anxiety.

Think positively. Change your thoughts from critical to reasonable ones. Get rid of your “ANTS” (automatic negative thoughts) by changing them into affirmations. Give yourself credit for what goes well in a less than perfect world.

The Memphis EAP team wishes you a healthy and positive New Year. As always, we are here to help you work towards your goal of avoiding the pitfalls of perfectionism or any other New Year’s resolution.

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Author: Colleen Bonadio, LPC, CEAP is a Licensed Professional Counselor and has been in the field of behavioral health at Methodist Healthcare for over 20 years. She has been with the Methodist Healthcare EAP as a counselor since 1997 and received her Masters in Counseling from the University of Memphis.

January is National Birth Defects Prevention Month. Here are 10 Things You Need to Know About Birth Defects. Find out more at nbdpn.org.

1. Did you know that birth defects are common?
   Fact: Birth defects affect 1 in 33 babies every year and cause 1 in 5 infant deaths. For many babies born with a birth defect, there is no family history of the condition.
   
2. Did you know that a woman should take folic acid during her teens and throughout her life?
   Fact: Because half of all pregnancies in the United States are not planned, all women who can become pregnant should take a vitamin with folic acid every day. Folic acid helps a baby’s brain and spine develop very early in the first month of pregnancy when a woman might not know she is pregnant.
   
3. Did you know that many birth defects are diagnosed after a baby leaves the hospital?
   Fact: Many birth defects are not found immediately at birth. A birth defect can affect how the body looks, how it works, or both. Some birth defects like cleft lip or spina bifida are easy to see. Others, like heart defects, are not.
   
4. Did you know that some birth defects can be diagnosed before birth?
   Fact: Tests like an ultrasound and amniocentesis can detect birth defects such as spina bifida, heart defects, or Down syndrome before a baby is born. Prenatal care and screening are important because early diagnosis allows families to make decisions and plan for the future.
   
5. Did you know that birth defects can greatly affect the finances not only of the families involved, but of everyone?
   Fact: In the United States, birth defects have accounted for over 139,000 hospital stays during a single year, resulting in $2.5 billion in hospital costs alone. Families and the government share the burden of these costs. Additional costs due to lost wages or occupational limitations can affect families as well.
   
6. Did you know that birth defects can be caused by many different things, not just genetics?
   Fact: The cause of most birth defects is unknown. Use of cigarettes, alcohol, and other drugs, taking of some medicines; and exposure to chemicals and infectious diseases during pregnancy have been linked to birth defects. Researchers are studying the role of these factors, as well as genetics, as causes of birth defects.
   
7. Did you know that some birth defects can be prevented?
   Fact: A woman can take some important steps before and during pregnancy to help prevent birth defects. She can take folic acid; have regular medical checkups; make sure medical conditions, such as diabetes, are under control; have tests for infectious diseases and get necessary vaccinations; and not use cigarettes, alcohol, or other drugs.
   
8. Did you know there are ways a pregnant woman can keep her unborn baby safe from infections?
   Fact: The best way to keep an unborn baby safe from infections is for a pregnant woman to wash her hands often, especially after using the bathroom; touching raw meat, uncooked eggs, or unwashed vegetables; handling pets; gardening; or caring for small children.
   
9. Did you know there is no known safe amount of alcohol or safe time to drink during pregnancy?
   Fact: Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. These effects can include physical problems and problems with behavior and learning which can last a lifetime. There is no known safe amount, no safe time, and no safe type of alcohol to drink during pregnancy. FASDs are 100% preventable if a woman does not drink alcohol while pregnant.
   
10. Did you know that an unborn child is not always protected from the outside world?
    Fact: The placenta, which attaches a baby to the mother, is not a strong barrier. When a mother uses cigarettes, alcohol, or other drugs, or is exposed to infectious diseases, her baby is exposed also. Healthy habits like taking folic acid daily and eating nutritious foods can help ensure that a child is born healthy.

Methodist Healthcare provides support and resources focusing on Your Healthy Prenancy, including childbirth classes and prenatal education, what to say no to, a trimester checklist, questions for your OB/GYN and prenatal nutrition and exercise. For more information, ask your doctor.

The most common types of Advance Directives are Living Wills and Advance Care Plans. Completing one of these can be one of the best gifts you can give your family and friends. In my practice, I have frequently seen people struggle with making health care decisions for their loved ones. Those charged with making decisions for someone else feel obligated to follow the patients’ wishes, but many times they may not be certain what those wishes may be. Advance Directives can ease the burden by providing direction for those who may be our decision-makers.

A Living Will is a legal document in which a person expresses in advance his or her wishes concerning life support and care, and can designate who is to make decisions. The Living Will is usually written with the assistance of an attorney and can be long and difficult to read.

The Advance Care Plan (ACP) is becoming the most popular way to communicate wishes regarding medical treatment. The ACP allows you to choose a decision maker and to share your perception of acceptable and unacceptable quality of life. Treatment options that can be addressed in the ACP include tube feedings, IV therapy, use of surgery, blood transfusions, and CPR (Cardiopulmonary Resuscitation). There is also an open space on the form where more detailed instructions can be included. The ACP requires either two (2) witnesses or be notarized. An attorney is not required.

Once the Advance Directive is completed, a copy should be given to your physician and to the person designated as the decision-maker. Keep a copy in your personal files. Most importantly, tell your family and/or friends that you have completed an Advance Directive and what decisions you have made.

You can print a copy of an Advance Care Plan and other useful documents from the state of Tennessee website: http://health.state.tn.us/advancedirectives/index.htm

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Cathy Hupf, BSN, CHPN is the Clinical Director for Methodist Hospice in Memphis, Tenn. 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. Call 888.777.5959 for more information.

Methodist Hospice does not just care for the patient we care for the caregiver as well. As healthcare providers throughout the Methodist Hospitals in Memphis, this is true for all of us. The term "caregiver" refers to anyone who provides assistance to someone else who is in some degree, incapacitated and needs help. Learning how to help the caregiver will allow us to also help the patient as well in whatever are we provide care. One way we can help them is by encouraging them to care for themselves so they can better care for the patient and also what to do when they need to relieve the stress brought in their role of being caregiver.

Caregiver Survival Tips

• Plan ahead by setting realistic goals for what you can do physically, emotionally, and financially. 
• Accept that there are things you cannot control.
• Learn about available resources that are available to help you in your role as a caregiver.
• Develop Contingency plans.
• Work to keep your care recipient as independent as possible in order to reduce your stress and maintain dignity for them. 
• Participate in support network for caregivers and get respite care.
• Take one day at a time.
• Practice good communication skills.
• Take care of your own medical needs.
• Get some form of regular exercise.
• Maintain healthy boundaries. Know when to say “No.”
• Learn to ask for help.

Remember that almost everyone is a caregiver for a family member at some point, not just those with someone under hospice care. Plan ahead for those times when you will be stressed as a caregiver. It happens to everyone. If you have a plan of action, you will be better prepared to deal with the stress so that it does not interfere in your life or the care you are providing. No one will be helped if you become sick from too much stress.

Try these stress busters:

• Take a bubble bath.
• Engage in your favorite activity.
• Read a Favorite Book.
• Talk with a friend.
• Take a walk or ride a bike.
• Listen to soothing music.
• Share favorite Memories.
• Watch a favorite movie or go to the movies.
• Write or record memories, poetry, thoughts.
• Try artwork (calligraphy, painting, drawing).
• Do puzzles (jigsaw, crosswords).
• Allow for some quiet personal time.

Remember the little things, for one day you may look back and realize they were the big things.

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Helen Schlessinger is the Director of Clinical Services for Methodist Hospice. 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. Call 888.777.5959 for more information.

How many people have a stroke every year? According to the American Stroke Association – 750,000. A new stroke occurs every 40 seconds. Stroke is the #1 cause of adult disability in the United States. Twice as many women die of a stroke than breast cancer every year. Aren’t these numbers staggering?

If you are like me, you wear many hats every day. I am a wife, mother, friend, sister, employee, housekeeper, chef, organizer, teacher, etc. Basically, I am a multi-tasker extraordinaire. Every woman is. We have lives that demand everything within us and then ask for more. Can you imagine starting your daily routine and suddenly something is not right. You have difficulty picking up your coffee cup, walking across the room, reading the mail, or answering your cell phone? What would you do? Chalk it up to stress or sit down a minute to see if it goes away? You think with a little rest it will go away in a few minutes. Big mistake! Lots of people have symptoms of a stroke and fail to recognize it.

We cannot live to the fullest and take care of those we love if we do not take care of ourselves first. Education is the first step. Learn the sign and symptoms of a stroke and your risk factors. Some risk factors you can change and some you cannot.

Stroke Risk Factors 

Did you know there are time frames in which strokes can be treated to prevent or minimize permanent disability? Any delay in seeking emergency care will decrease your treatment options. In order to maximize treatments, get to the Emergency Room immediately! Do not drive yourself. Call 911 and allow emergency treatment to start even before you get to the hospital.

EMS has been trained to recognize and begin treating stroke symptoms. In Memphis, EMS has a great relationship with all Methodist facilities and will notify us of your symptoms prior to arrival. This way we can start mobilizing our Stroke Team to ensure we maximize your outcome. All Methodist adult hospitals are Certified Stroke Centers. Methodist has a proven process in place to provide the best quality stroke care possible. 

Our lives are too important to neglect taking care of ourselves. Before we start our daily multi-tasking, we have to make ourselves priority.  I know this takes great effort, but we are worth it!

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Keri Morris, R.N., BSN is a Chest Pain & Stroke Coordinator at Methodist Le Bonheur Germantown Hospital. 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. Call 888.777.5959 for more information.

Just ten or twenty years ago it was relatively rare to discover an aneurysm in someone’s brain before it caused a problem. The majority of the aneurysm patients that doctors saw were those whose aneurysms had ruptured. These days patients get CT or MRI scans for a variety of problems like headaches and sinus infections. Some of these scans show aneurysms that have nothing to do with the reason for the scan.

Since I am a neurosurgeon who specializes in the treatment of brain aneurysms, may be sent to see me. Most weeks I see several patients with incidentally discovered aneurysms. These patients are often frightened and in need of information and advice. There are a lot of physicians like me who do research to understand how best to treat you and also spend time on counseling and treating.

Aneurysms are weak spots on the sides of arteries underneath the brain. Imagine that you are buying a garden hose. When the manufacturer made this particular hose, they made a mistake and there is a spot on the side of the hose where the rubber is thinned. On this spot the rubber is as thin as a balloon instead of thick like the rubber on a hose should be. When you get the hose home and start using it, it works fine. Over time, however, as you turn the water pressure on and off repeatedly, that thin spot bulges so that there is a small water balloon on the side of the hose. We think that brain aneurysms form in a similar way. You may have been born with a thin spot on an artery but over time as blood has flown through the artery this spot has become a small, thin-walled sac hanging off of the side of the artery. We know that some drugs, like nicotine, can increase the risk of aneurysms growing or rupturing.

So if you or a friend has had an aneurysm discovered in your brain “incidentally,” or during a scan for something else, then you may be coming to see me or someone like me. I will probably talk to you about how important it is to stop smoking; the last thing you want to do is to increase the risk of the aneurysm growing or rupturing. We will review what factors might make this particular aneurysm more safe or more dangerous together. I might want better pictures of the aneurysm before giving you definitive advice about whether to treat it or not. Whatever you decide, make sure that you get good advice and understand your options so that you can get the best care possible.

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Dr. Adam Arthur is the Director of Cerebrovascular and Endovascular Neurosurgery at the Methodist University Hospital Neuroscience Institute. 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. Call 888.777.5959 for more information.

In today’s busy, 24/7 society, many of us fail to allocate sufficient time or attention to our sleep. Healthy sleep is a fundamental aspect of our physical, emotional and spiritual well-being. When sleep problems occur, the impact on our quality of life is significant and we may experience problems with alertness, productivity, safety, mood regulation, and physical health. 

The following Ten Steps to Better Sleep provide a good place to begin assessing sleep health:

1. Make sleep a priority in your life. Establish a consistent sleep/wake schedule that provides adequate sleep every night. Most adults function best with 7-9 hours of sleep. Teens and young adults generally require 8.5-9.5 hours per night.
2. Avoid activities or habits that work against good sleep: avoid caffeine after 3-4 p.m., avoid strenuous exercise in the evening, and avoid stressful activities such as paying bills or emotional family discussions during the 2 hours prior to bedtime.
3. Maximize your exposure to bright light in the morning and minimize your exposure to bright light in the evening. Bright light has a significant impact on timing and quality of sleep and alertness.
4. Discuss concerns regarding medication side effects that involve sleep with your healthcare provider. Certain medications may cause daytime sleepiness or affect ability to fall asleep or stay asleep at night.
5. Avoid using alcohol to help fall asleep. Alcohol may help hasten sleep onset but it also fragments or disrupts nighttime sleep.
6. Learn how to recognize sleep problems in your life. For example, excessive daytime sleepiness can present with difficulty focusing or completing tasks, irritability, poor memory, and difficulty with brief “lapses” or micro-sleeps.
7. Insomnia (difficulty falling asleep or staying sleep) is a common sleep problem that can occur due to many different factors. Discuss insomnia concerns with your healthcare provider and seek help from a sleep specialist if initial interventions do not help.
8. Breathing problems such as loud habitual snoring, or gasp-like sounds during sleep may signal the presence of a sleep disorder called obstructive sleep apnea (OSA). OSA is an important medical disorder that can be associated with a variety of other chronic health problems such as high blood pressure, diabetes, obesity, stroke, chronic headache, and depression. This problem requires evaluation in a sleep center, followed by development of a treatment plan.
9. Drowsiness while driving is a potentially life-threatening problem. Recognize and acknowledge your drowsiness, and avoid driving when you are sleep deprived or if you are experiencing drowsiness due to medication effects or a sleep disorder.
10. If you or a family member is struggling with a chronic sleep problem, gather information by keeping a calendar or sleep log, and seek help by consulting with your primary care provider or a sleep specialist!

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Merrill S. Wise, M.D. is a neurologist and Board-certified sleep medicine specialist affiliated with 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.

I just finished watching “Meet The Robinsons” for about the fourth time. While watching it this time I noticed a cute part at the end of the movie. It was when Lewis came back to the present, from the past, and went to the Science Fair. This time his invention worked. This was also the first time he realized who his future wife was as a child. She too had entered the Science Fair and was in the early stages of training frogs to sing. She told him that she believed frogs had musical capabilities but everyone else thought she was crazy. She asked him if he thought she was crazy. Lewis had already saw the future and knew she did train the frogs to sing so he said “No, I think you’re right!” Then, she gasped with joy, excitement and was amazed that someone believed in her. And, she goes on to train frogs to sing.

Encouragement can spark momentum and motivate a person to become great. Imagine the good we can do for our friends and family if we took the time out to encourage them? Your encouragement could be what’s needed to give them the strength to get through their situation and propel them to faster healing.

Haven’t you ever had someone in your life that did that for you? Someone who, with sincerity, spoke words of encouragement. I believe that is the kind of person God wants us to be. A lighthouse for the weary, tossed and torn. A beacon of hope!

Paul wrote in Ephesians 4:29 – "Do not let any unwholesome talk come out of your mouths, but only what is helpful for building other up according to their needs, that it may benefit those who listen." Paul knew the power of encouragement.

There are many scriptures that highlight the benefit of encouragement. Proverbs 10:11 tells us that "the mouth of the righteous is a fountain of life." 1 Thessalonians 3:2 tells of the apostles sending Timothy to them to spread the gospel, and to strengthen and encourage. One of my favorite verses about encouragement is Hebrews 10:25 – "Let us not give up meeting together, as some are in the habit of doing, but let us encourage one another-and all the more as you see the Day approaching."

Who better an example for us to follow than God himself?  David wrote in Psalms 10:17 "You hear, O LORD, the desire of the afflicted; you encourage them, and listen to their cry." It is a comfort to know the Lord is looking our for you and me and ready to encourage us when we’re afflicted.

You may be thinking; "I can’t do that. I’m too shy or I’ll feel foolish." Well guess what? If you’re not a natural encourager, you can be.  Everyone can be a light to someone. Everyone can make a choice to make a difference. Life is full of problems, but it is also full of good.  There are a lot of good things about people we can focus on and encourage each other with. You can choose to change the way you think and interact with people. 

So lets make it our daily duty to make a difference in someone’s life. Be the person that helped you when you needed a word of encouragement. I’m going to make it a point to frequently ask God to give me words of encouragement to share with others. There is power in encouragement. And, it is contagious!

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Tasha Leach is the administrator of the Carvel Imaging Center, a Methodist Le Bonheur Healthcare Company. 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. Call 888.777.5959 for more information.

"October is a symphony of permanence and change."

—Bonaro W. Overstreet, author, poet, psychologist

This is my favorite quote about October and the fall season! What a true representation of the world around us and the world within us.

Some examples of permanence and change during the fall season include:

• School is well underway. Students of all ages understand the routine as they are traveling a road of possibilities.
• We hear the familiar sounds of cheering from countless soccer and football fans as they renew their love of the game while hoping their favorite team makes the play-offs.
• The weather begins its’ slow inevitable move towards winter while we enjoy the cooler nights and colorful foliage.
• TV watchers settle down with anticipation to enjoy their familiar shows with new episodes.

This tends to be the time of year when people take inventory of their personal and professional lives. What is going well, what needs to change, what can be better? We refocus our energies in order to finish the year strong.

The Methodist Healthcare EAP along with the dedicated Methodist Healthcare Web Services team have brought permanence and change to the Methodist EAP Web site. There is great content for employees and employers as well as valuable resources for you and your family.

We invite you to explore the new Web site and see the same EAP you have come to rely upon and the wonderful additions that will serve you more effectively in the future. Let us know what you think in the comments section. We'd love to hear your feedback!

It turns out that the Methodist EAP also has a story to tell. We are in this together—with our clients, our businesses, our families and our community. Thank you for being such an important part of our story of permanence and change.

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Donna Tosches, is the Director of the Methodist Healthcare EAP in Memphis, Tenn. To contact Donna 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.