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Ways to Avoid Holiday Weight Gain

Ways to Avoid Holiday Weight Gain

The holidays are upon us again, and for many of us, this is our most favorite time of the year. Is there anything that can stand in the way of our visions of sugarplums, white fluffy snow, or Jolly Old St. Nick? Sure…the fear of holiday weight gain!!! A 2011 Consumer Report Survey on what Americans dread most about the holiday season, 37% said the thought of gaining weight over the holiday season was what they dreaded the most! But how much weight do we actually gain over the holiday season? The answer to this question is not really known. The best answer we can find is anywhere from 1-10 pounds. What is most consistent about the findings of holiday weight gain, however, is that many Americans fail to lose what they gain over a holiday season. So as the years go on, our weight continues to creep up.

So can you have the best of both worlds? Can you truly enjoy the holiday season and prevent weight gain? Yes! This article includes a variety of tips to prevent holiday weight gain.

  • Plan, plan, plan.  It is the holidays after all!  More than likely, you are going to eat foods that you normally don’t, but you must have a plan in place.  It is important to plan to eat the healthy foods, but it is just as important to plan out the unhealthy foods as well.  This will help you keep the portions of your favorite holiday foods under control.
  • Change your holiday traditions.
    • Find more ways to add physical activity to your holidays.  Play games, the Wii, or take a walk with friends or family members.
    • Change up the menu.  Add healthier items to the menu this year.  Find lower-calorie sweet treats too.
  • Eat before you go.  Eat a small meal or hearty snack before attending your holiday gatherings.  Being satisfied, as opposed to hungry, will help you control your portion sizes and help you make healthier food choices.
  • If dining at a buffet or potluck, keep these rules in mind.  Walk through the buffet line with no plate in hand and make a game plan of what you are going to eat.  Strive to create a balanced meal.  Then, make 1 trip through the buffet with plate in hand, making sure that none of the food touches on your plate (to keep your portions sizes under control).
  • Beware of liquid calories.  Holiday beverages can be an easy way to pack in a lot of extra calories.  Opt for lower calorie versions of eggnog, flavored coffees, and your favorite holiday cocktail.
  • If all else fails, remember to eat higher-calorie foods in moderation.  You can do this by following the 3 Bite Rule:  the first bite tastes the best, the second bite confirms just how good the food really is, and the third bite is your last so savor it as much as possible.

Happy Holidays!

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Quick, Easy, and Healthy Lunch Ideas

Quick, Easy, and Healthy Lunch Ideas

Remember the days when your mother packed you a nice, healthy lunch everyday to take to school?  In today’s world, it is not uncommon for us to be rushed to get out the door in the morning leaving little to no time to eat breakfast, let alone pack a healthy lunch.  This handout is going to give you ideas and strategies for creating quick, easy, and healthy lunches all week long.  

Before we get to the meal ideas themselves, let’s back up and talk about planning.  Planning is essential for creating healthy meals.  If you do not have healthy foods in your environment, it makes it really hard to make healthy meals.

  1. Think ahead and plan what you will be doing for lunch each day
  2. Make a list of healthy foods that you would like to eat for the week
  3. From that list, create a grocery list that includes these foods in the appropriate quantities
  4. Each day, think about what you will be having the next day
  5. Pack these foods the night before so that they are ready to go in the morning

* TIP:  If you are a person that doesn’t mind leftovers, plan to make extra at certain dinner meals so that you can take them to work with you the next day.

Remember when making your lunch to try and focus on balance and choose from the following food groups:

myplate_white

The USDA’s My Plate does a great job illustrating how your healthy plate should look at every meal.

  • Lean meats
  • Low-fat dairy products
  • Whole grains
  • Vegetables
  • Fruits

 

If you do eat out during the week, keep the following tips in mind:

  • Research the restaurant before you go
  • Pick restaurants that have a variety of veggies and fruits on the menu
  • Ask how the food is prepared and also to have the sauces on the side
  • Portion sizes in restaurants are generally double or triple the actual amount we should eat.  Ask for a take home box right when you get your meal so that you can put some of the meal away to save as leftovers.
  • If lunch is catered in to the workplace, still pack healthy sides like fruits, vegetables, and low fat dairy products to supplement the meal.
    • If you have a say in the type of foods that are catered in, request healthier options.
  • Baked potato bars, salad bars, build your own taco bars, sandwiches or wraps with fruit, leaner protein options like chicken breasts or pork loin with steamed veggies, etc.
  • Meal Ideas

    • Sandwich on whole wheat bread with lean deli meats such as turkey, ham, or roast beef; add 2% cheese, your favorite veggies, and low-fat condiments such as spicy mustard or light mayo.  Couple the sandwich with baked chips, low-fat yogurt, and any kind of fruit.
    • Wraps or pita pockets are something you can make with deli meats or even left over meats from dinner the night before.  Try grilled chicken or steak Greek-style by adding lettuce, tomatoes, onion, cucumber, low-fat feta cheese, and Greek vinaigrette.  You could also use the same meats and make them Mexican-style by adding lettuce, tomato, black olives, low-fat cheddar cheese, salsa, and low-fat sour cream.  (Feel free to add any other veggies in that you like and to keep your wraps or pitas from getting soggy, add the sauces to them right before you eat.)  Baked tortilla chips and salsa or fresh veggies with hummus/refried bean dip (see recipe below) pair nicely with either one of these ideas.
    • Salad with all sorts of your favorite veggies and lean protein such as chicken, salmon, steak, deli meats, shrimp, leftover taco meat, black beans, chickpeas, etc.  Add low fat cheeses and salad dressing to top it off.  Nuts are also high in protein and taste great in a salad, but can be very high in calories so make sure to use in moderation.
    • Pre-packaged frozen meals.  Check the Nutrition Facts Label to make sure the food is low in calories and moderate in sodium (< 600 mg).  To this meal add a salad or fruit and 1% cottage cheese or low-fat yogurt.
      • Some preferred brands include Smart Ones, Lean Cuisine, and Healthy Choice

 

Turkey and Vegetable Tostada
270 calories

What You Need
6 flour tortillas (6 inch)
1 pkg.  (1-1/4 oz.) Taco seasoning mix, divided
1 lb. ground turkey breast or 93% lean ground beef
4 tomatoes, chopped, divided
1 cup chopped zucchini
½ cup water
1 cup 2% shredded Colby & Monterey Jack cheeses
1-1/2 cups shredded lettuce
3 Tbsp. chopped fresh cilantro

Make It
Heat oven to 400°F.
Place tortillas in single layer on baking sheet; spray with cooking spray. Sprinkle with about 1 tsp. taco seasoning. Bake 6 min. or until crisp and lightly browned.
Meanwhile, cook turkey/beef in large nonstick skillet sprayed with cooking spray on medium-high heat 4 min. or until done, stirring frequently. Add 1 cup of tomatoes, zucchini, water and remaining taco seasoning; simmer 5 min., stirring occasionally.
Spoon turkey mixture onto tortillas; top with cheese, lettuce, remaining tomatoes and cilantro.

Caesar Pleaser
250 calories

What You Need
½ cup torn romaine lettuce
1 thin red onion slice, separated into rings
1Tbsp. shredded Parmesan cheese
1 Tbsp.  Light Creamy Caesar dressing
1 ciabatta sandwich roll, partially split
2 oz. Oven Roasted Chicken Breast, leftover steak or salmon, or deli meats like turkey, chicken, or roast beef
2 tomato slices

Make It
Toss lettuce with onions, cheese and dressing.
Fill roll with lettuce mixture, chicken and tomatoes.

Bean Dip
2 cans fat free refried beans
½ cup fat free sour cream
½ cup salsa
½ packet taco seasoning
1 can green chilis
Mix all of the ingredients together and bake at 350 for 30-45 minutes.

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Dr. Paul Johnson achieves recertification

Dr. Paul Johnson achieves recertification

Dr. Paul Johnson, a general surgeon at Midlands Clinic P.C. in Dakota Dunes, has received recertification from the American Board of Surgery. His certification is now active until 2026.

The American Board of Surgery is an independent, nonprofit organization founded in 1937.

Johnson, who sees patients at Dakota Dunes, Oakland, Neb. and the Advanced Mercy Wound Care Center at Mercy Medical Center in Sioux City, has a strong professional interest in general, laparoscopic and trauma surgery and wound medicine.

See article on the Sioux City Journal website here: http://bit.ly/1pouSt9

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Midlands Clinic now offers Laparoscopic Sleeve Gastrectomy

Tired of feeling like you’ve tried every diet and failed? Do you worry about how your weight is impacting your health? Are you experiencing joint pain, diabetes, high blood pressure, high cholesterol, sleep apnea or other conditions? Is your weight affecting your family relationships – or the ability to have one? Do you feel discriminated against at work and in public?

If you answer yes to all of these questions, you may be a candidate for a new bariatric surgery being performed by Drs. William Rizk and Keith Vollstedt at Midlands Clinic in Dakota Dunes.

Starting mid-May, Midlands Clinic will be offering Laparoscopic Sleeve Gastrectomy, a procedure that limits the amount of food you can eat by reducing the size of your stomach.

Like other metabolic surgeries, it also helps to establish a lower, healthier body-fat set point by changing the signals between the stomach, brain and liver.

Here’s how it works: The surgeon creates a small stomach “sleeve” using a stapling device. This sleeve will typically hold 50 mL to 150 mL and is about the size of a banana. The rest of the stomach is removed.

Dr. William Rizk, general surgeon with Midlands Clinic, said 80 percent to 85 percent of the stomach is removed, dramatically reducing its size.

This procedure induces weight loss in part by restricting the amount of food (and therefore calories) that can be eaten, and therefore absorbed, without bypassing the intestines.

Laparascopic Sleeve Gastrectomy is the latest option that Midlands Clinic will be able to offer patients who come to them with co-morbid conditions, lack of mobility and a low quality of life.

In addition to the Laparoscopic Sleeve Gastrectomy, Midlands Clinic offers two other weight loss surgeries to fit with patients’ lifestyles: Laparoscopic Gastric Bypass and Laparoscopic Lap-Band.

Because all three procedures are laparoscopic, they only require five or six small incisions – all 1-2 centimeters – and are performed under general anesthesia. The surgeries are between 45 minutes to 1 1/2 hours long.

“There is no perfect surgery for weight loss or no magic bullet. Each surgery has a certain level of invasiveness, starting with Lap-Band surgery, which is the least invasive and offers the least amount of weight loss, to gastric bypass surgery, which is the most invasive with the most weight loss potential. All three surgeries work by diminishing the capacity of the stomach and restricting how much a patient can eat. They just do it in different ways,” Rizk said.

During the Lap-Band surgery, a silicone band is placed around the upper part of the stomach, and a small pouch is created. As a result, the stomach holds less food and the patient feels full faster and longer. The size of the restriction can be adjusted after surgery.

During gastric bypass surgery, six small incisions are made to hold laparoscopic instruments, then the stomach is separated through the use of staples to create a small pouch. The smaller stomach is attached to the middle of the small intestine, bypassing the section of the small intestine (duodenum) that absorbs the most calories. Patients eat less because the stomach is reduced from the size of a football to the size of a golf ball and they absorb fewer calories because food does not travel through the duodenum.

During the sleeve gastrectomy, the surgeon uses a spiral stapling device that divides the stomach and seals it off. The procedure causes hormonal changes to disrupt hunger.

“The Laparoscopic Sleeve Gastrectomy has been popular over the past five years. It has overtaken the Lap-Band surgery. It’s very effective with less nutritional complications than gastric bypass. It’s also relatively easy to perform. In bariatric literature, it’s more popular and studies to support its effectiveness are being done across the U.S,” he said.

The key to any surgery is to eat smaller meals, eat less between meals, and feel less hungry, he said.

“It’s important to change your lifestyle, drink more water between meals, and increase exercise. We’re available to counsel patients and teach them how to eat with the dramatic change. Portion sizes are a lot smaller. It can be done,” said Rizk.

Oftentimes, not only do patients lose a significant amount of weight, they also are able to reduce and/or eliminate medications while positively impacting their overall health with bariatric surgery.

“Behavior modification is very important,” said Megan Cleveland, registered dietitian at Midlands Clinic. “Weight loss surgery is a tool, not a quick fix or an easy way out. It’s a way to be successful.”

When you choose bariatric surgery at Midlands Clinic, you will receive all the support you need to positively take control of your health and your future.

“We’re here to help people. We know what they’re going through,” Cleveland said. “We’re here to listen to them and let them know the options that are available.”

Midlands Clinic offers:

  • A highly trained team of doctors, nurses, psychologist and a dietitian who specialize in weight loss surgery. This multidisciplinary team helps patients make lasting changes to their lifestyles, in conjunction with their weight loss surgery, to promote long-term success.
  • A facility geared toward the bariatric patient, with chairs and scales that accommodate the bariatric patient.
  • All staff have been trained in bariatric sensitivity – meaning, they understand your struggle, they don’t judge it.
  • Proven experience. Midlands Clinic has been performing weight loss surgery continuously since 1976. Since 2002, they have performed more than 1,000 laparoscopic weight loss surgeries, with complication rates well below the national average.
  • Real life, lasting results.
  • Excellent safety record.
  • Personal support – They will be with you for every stage of your weight loss journey, including all the years after your journey.

If you would like to explore your options or have questions about bariatric surgery, call Midlands Clinic at 605-217-5511.

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Evaluation and Management of Multiple Osteoma Cutis

Evaluation and Management of Multiple Osteoma Cutis

Osteoma cutis is the formation of bone in the dermis or subcutis. Depending on the context, these de novo ectopic bone lesions may be classified as primary or secondary osteoma cutis. Primary osteoma cutis is the idiopathic formation of bone. In contrast, secondary osteoma cutis, which is much more common, is bone formation as a potential complication of several acquired disorders, such as severe acne; connective tissue disease; or inherited disorders such as Albright’s hereditary osteodystrophy.

Read the rest of this article featuring Dr. Chabra here.

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Gouty Tophi on the Ear: A Review

Gouty Tophi on the Ear: A Review

Although the classic location of gouty tophi is the great toe (podagra), gouty tophi of the ear also is common and is worth including in the differential diagnosis in patients presenting with ear lesions. Other entities presenting as papules or nodules on the ear include chondrodermatitis nodularis helicis (CNH), actinic keratosis, basal cell carcinoma, squamous cell carcinoma, verruca vulgaris, amyloids, rheumatoid nodules, and elastotic nodules. If tophaceous gout is suspected, alcohol fixation of the biopsy specimen is preferable, as it enables visualization of characteristic needle-shaped urate crystals.

Read the rest of this article featuring Dr. Chabra here.

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Driving without sunscreen can cause cancer

Driving without sunscreen can cause cancer

Do you ever think about wearing sunscreen while you are driving? A local Siouxland dermatologist says its time to because two out of three skin cancer cases are related to driving.

Skin cancer, the most common cancer diagnosis, is responsible for three and a half million cases each year.

A Siouxland dermatologist at the Midlands Clinic decided to dive into the numbers and found something that caught his eye.

Read the rest of this article featuring Dr. Chabra here.

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The sun is finally here. What about sunscreen?

The sun is finally here. What about sunscreen?

How does sunscreen prevent skin cancer?

By protecting the skin from sunlight, sunscreen prevents the development of skin cancer. Skin cancers will require surgeries to treat, and may even kill you.

Sunlight contains ultraviolet (UV) light, which can be divided into 3 sub-types – UV-C (100-290 nm), UV-B (290-320 nm), and UV-A (320-400). Almost all of the deadly UV-C, and most of UV-B light are blocked by the Earth’s ozone layer. However, some UV-B and most of the UV-A penetrate the atmosphere and reach us.

Read the rest of this article featuring Dr. Chabra here.

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New Faces at Midlands Clinic

Midlands Clinic, a multispecialty clinic in Dakota Dunes, has recently undergone an expansion and remodel to accommodate the addition of two physicians and a nurse practitioner to its staff.

“Midlands Clinic has been growing steadily every year, and to meet the demand of our expanding patient base, new providers have been added to the clinic,” said Clinic Administrator Stacy Harmelink, MBA. “Consequently, we had to add multiple exam and procedure rooms as well as expand our patient waiting area.”

The newest additions to the Midlands Clinic staff are Drs. Indy Chabra, dermatologist; Craig Nemechek, general surgeon; and Allie Nettleton, a nurse practitioner in endocrinology.

Dr. Indy Chabra, M.D., Ph.D., is an addition to the Dermatology department. He specializes in medical, surgical and cosmetic dermatology.

“It was not uncommon for a new patient to wait months for an appointment with Dr. Michelle Daffer, our current dermatologist. With the addition of Dr. Chabra, our patient demand can be handled in a more timely manner,” said Harmelink.

Chabra, a native of India who moved to Long Island, N.Y. with his family when he was 12, received his undergraduate degree at Stanford University in California. He completed his medical degree and Ph.D. in Molecular Microbiology and Genetics at the State University of New York. He performed his internship and residency in dermatology at the University of Pittsburgh Medical Center, the second largest training program in the United States.

Board eligible in dermatology, Chabra is also a member of the American Academy of Dermatology and a member of the American Society for Dermatologic Surgery.

“My goal is to make sure people in this community know they can get the best diagnosis and treatment of any skin, hair or nail problem – medical or cosmetic – here at Midlands Clinic. They don’t have to go to Omaha or Sioux Falls, or Mayo Clinic in Rochester. Between Michelle and I we are highly trained and up to date. We also use the latest technology,” Chabra said.
Chabra said patients who have had dermatological conditions for months or years and have been treating it on their own or going from doctor to doctor and not getting the right treatment don’t need to continue that way.

“We’re the specialists in the area, and patients should be aware of that. With three providers, including a physician’s assistant, we can easily accommodate new patients,” he said. “One of the challenges is patients not being able to see a dermatologist when they actually have the problem. Our goal is when someone has a problem, we will try to accommodate them. We want to diagnose and treat it while it’s happening.”

One such condition is actinic keratosis, which is a small, rough, raised area found on skin that has been in the sun for a long period of time.

Some actinic keratoses may develop into a type of skin cancer. He attributes actinic keratosis to our climate and the lack of sunlight during certain months of the year.

“During the winter time, we’re inside all of the time. In the summer time we get hit with sun. The climate changes dramatically. The average skin doesn’t get melanin and can quickly get sunburns.

“We’re experts here,” said Chabra. “Use us. We have a a lot of experience with that. Patients are very pleased with the results.”
Chabra said Midlands Clinic is also the go-to place for cosmetic procedures, such as chemical peels, neurotoxins, fillers, lasers and electrodessication.

“There are a lot of different modalities and there is ultrasound technology. None do everything. You should go somewhere you can get the right treatments for the right problems. We’re seeing that family doctors or aestheticians are associated with those types of procedures. Patients are associating us with medical dermatology. We’re not associated with cosmetic dermatology. It’s something I want to change.”

Midlands Clinic performs a lot of skin cancer surgery, and has recently added a new modality, photodynamic therapy, for patients who have many difficult to treat skin cancer lesions.

“We’re one of the only places in this area that offers this to patients,” he said. “It allows for treatment of multiple lesions in one setting. It has been used in Europe for years. It is covered by all insurances including Medicare.”

Harmelink said the addition of photodynamic therapy has increased patient volume because the therapy is faster and more convenient than other therapies available.

Dr. Craig Nemechek recently became board-certified in general surgery. His emphasis is in laparoscopic surgery.

Nemechek, a McCook, Neb. native, came to Midlands Clinic from Altoona, Iowa. He completed his general surgery residency at Iowa Methodist Medical Center in Des Moines in June. He earned his undergraduate degree in natural science from Midland Lutheran College in Fremont, Neb., in 2001 and his medical degree from the University of Nebraska Medical Center in Omaha in 2006.

He developed an interest in complex hernia repair during his residency at Iowa Methodist Medical Center, where he focused on performing open or laparoscopic hernia repair procedures.

Nemechek said he joined Midlands Clinic because it is a good fit.

“Dr. (William) Rizk and Dr. (Robert) Anderson came from the same training program. Midlands Clinic offers a unique opportunity in a unique place. I have great partners. It’s a unique job in a nice Siouxland town. I can take on larger, more complex cases and Midlands Clinic has the facilities to take care of them,” he said.

For the past year, Nemechek has been using his experience and expertise at Midlands Clinic to treat hernias. Another condition that is a prominent part of his practice is Gastroesophageal Acid Reflux surgery. People who have certain types of hernias can be more prone to acid reflux.

“Many people suffer from acid reflux,” said Nemechek. “The vast majority do well with medications. Some people don’t get relief. They have other symptoms not relieved by medications or don’t want to take medications. In those cases we recreate and correct the one way valve. Patients with acid reflux usually have leaking of gastric acid into the swallowing tube or esophagus. Surgery helps prevent leaking of acid into the esophagus.”

To obtain objective information regarding the nature and severity of the reflux, esophageal motility and complications of GERD, Nemechek peforms studies that include a 24 hour monitoring of the pH (acidity) in the esophagus. A small Bravo probe is placed into the esophagus with a scope at very specific points, and the number of acid exposures as well as the quantity of acid exposure is recorded.

If the patient is a good candidate for surgery, the procedure can be done laparoscopically.

“Most people who have had the surgery have a very high satisfaction score,” he said.

Allie Nettleton, B.S.N., NP-C, started at Midlands Clinic in August. She is assisting Dr. Tareq Khairalla with his caseload in the Endocrinology department. Nettleton graduated from Briar Cliff University’s nurse practitioner program in May and received her certification in July. She brings 17 years of nursing experience to Midlands Clinic.

“Dr. Khairalla has a very busy practice,” said Nettleton, a 1990 graduate of Woodbury Central High School in Moville. “Some patients waited 3-4 months to get into see him. I hope to lighten his load and allow patients to be seen quickly. We can diagnose, treat and manage endocrine diseases, such as diabetes and osteoporosis. We also help with thyroid management.”

Nettleton said she decided to become an advanced practical nurse because she sought new challenges.

“I had the desire to be an advanced practical nurse for the past 10 years. In 2009 I made the decision to pursue my goals in life. I feel fortunate to have been chosen for this position. I have a great mentor and teacher in Dr. Khairalla,” said Nettleton, who had worked at the Mercy Weight Loss Center clinic for six months in 2008.

The most common condition she and Dr. Khairalla have been seeing in the clinic is diabetes.

“I didn’t realize there was so much diabetes in Siouxland. There are also a lot of thyroid disorders including hypothyroidism and hyperthyroidism, and thyroid cancer, which is easily treatable. Osteoporosis, or bone disease, is affecting younger generations,” she said.

Midlands Clinic also diagnoses and treats adrenal and pituitary disorders.

“We are delighted to welcome these three new providers to our group,” said Harmelink. “The current physicians in our group are confident that these new providers bring skills and increased access to care in the communities we serve.

“These are well-trained providers and they will add to the quality of care Midlands Clinic is known for,” she added.
All three providers are accepting new patients.

Midlands Clinic is located at 705 Sioux Point Road, Suite 100, in Dakota Dunes. For more information or to make an appointment, please call (605) 217-5500.

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Dr. Keith Vollstedt Receives Recertification

Dr. Keith Vollstedt Receives Recertification

Dr. Keith VollstedtDr. Keith Vollstedt, a general surgeon at Midlands Clinic P.C. in Dakota Dunes, received his recertification from the American Board of Surgery.

Dr. Vollstedt has been practicing general surgery since 1992 and has a strong, professional interest in bariatric, general, thoracic, laparoscopic and trauma surgery.

He received his original certification in 1993. The Board, an independent, non-profit organization, was founded in 1937 to certify surgeons who have met a defined standard of education, training and knowledge.

Dr. Vollstedt is a fellow with the American College of Surgeons and the International College of Surgeons.

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