EXPERT WOUND CARE
GUARD YOUR HEALTH IN EVERY DECADE
GET TO KNOW OUR SPECIALISTS
SERVING THE OXFORD COMMUNITY FOR OVER 60 YEARS
HAVE MORE ENERGY IN 2025
GET TO KNOW OUR SPECIALISTS
THESE EXPERTS PROVIDE HIGHLY-SPECIALIZED CARE TO OUR COMMUNITY.
M c CULLOUGH-HYDE MEMORIAL HOSPITAL | TRIHEALTH (MHMH) is known for its exceptional level of patient care and for the skilled providers and other professionals who deliver it. Here, four talented TriHealth specialists give us a glimpse into their lives and careers.
JOSEPH CHRISTOPHER EASTON, MD
Plastic Surgery, Reconstructive Plastic Surgery
Dr. Easton is a plastic surgeon who joined TriHealth in August 2024. He grew up in Akron, Ohio, where, as a teen, he worked at a pharmacy and became intrigued by how medications work. This led him to a premed track in college. He completed his undergraduate education at the University of Notre Dame before attending medical school at Indiana University.
“My mom was diagnosed with breast cancer during my second year of medical school,” says Dr. Easton, noting that she subsequently had reconstructive surgery. “At that time, I decided to specialize in plastic surgery and reconstructive plastic surgery.”
After graduating medical school in 2018, Dr. Easton completed a residency in plastic surgery at the University of Cincinnati before joining TriHealth.
“My plastic surgery practice is almost entirely reconstructive surgery for patients with cancer or other wounds,” says Dr. Easton. “The most rewarding part of my job is helping patients through difficult reconstructive surgeries for cancer or wounds developed in accidents or from other injuries.”
Dr. Easton currently lives in the Hyde Park neighborhood of Cincinnati with his dog and enjoys spending time with family and friends, going to parks and restaurants, and exploring the city. “I grew up a Cleveland Browns football fan, but I don’t tell that to many people on this side of the state because they are usually pretty serious Bengals fans, but we have fun joking about it and watching football together,” he says.
ANA ELISA PANTEL, MD
Obstetrics and Gynecology
Dr. Pantel is an obstetrician and gynecologist who joined TriHealth in August 2017. She grew up in the south of Brazil and has lived in the United States for the past 22 years. She completed her undergraduate education at the University of Cincinnati and went to medical school at the University of Toledo, from which she graduated in 2013. After completing her residency in Connecticut, she joined TriHealth.
Dr. Pantel was inspired by watching her father and grandfather take care of people in her native Brazil, where she realized that being a doctor was a privilege that allowed her to connect, bring comfort and hope, and take care of people in need.
“During my OB-GYN rotation, I realized how much I enjoyed taking care of women, and that I often could find common ground with my patients,” says Dr. Pantel. “During my first night on my OB rotation, I got to deliver a baby and fell in love with that experience. Delivering babies and watching the parents’ emotions during that moment is the most rewarding part of my job. I also enjoy finding the first heartbeat and sharing it with the new parents.”
Dr. Pantel lives with her husband and two children in Cincinnati. She enjoys spending time with her family, bicycling, cooking, gardening and traveling.
ALZIRA B. LEQUES, MD
Obstetrics and Gynecology
Dr. Leques grew up in Scott Depot, West Virginia, and graduated from Marshall University in Huntington, West Virginia, with a degree in biology. She attended medical school at the West Virginia School of Medicine, graduating in 2006. She completed her residency training in obstetrics and gynecology at TriHealth in 2010 before joining a private practice (Seven Hills Women’s Health Centers), where she worked until joining TriHealth in July 2024.
“I decided to become an OB-GYN in my third year of medical school during my OB-GYN rotation,” says Dr. Leques. “I had not considered it before that exposure. The hours are long in medical school rotations, but they seemed to pass quickly during that rotation for me because I was very enthusiastic about what I was learning. I loved the hands-on aspect of the professionthe deliveries and the surgeries. I also loved learning the medical conditions specific to my field. It is a special privilege to help women with their healthcare.”
Dr. Leques currently lives in Loveland, Ohio, with her husband, son and daughter. “As a family, we love to see FC Cincinnati games,” she says. “I love to read, travel and try new restaurants. I also enjoy exercising and I am a big Orange Theory fitness enthusiast.”
ABUBAKER HASSAN, MD Pulmonology
Dr. Hassan joined TriHealth in July 2024. “Before joining TriHealth, I completed my training in pulmonary and critical care at the University of Cincinnati,” he says. “Before that, I did my internal medicine residency in Detroit—a place I hold dear and where I proudly became a Michigander.” A board-certified critical care and lung physician who has practiced medicine on three continents—Africa, where he was born and trained; Asia, where he refined his skills; and North America, where he lives in Wyoming, Ohio—Dr. Hassan brings a holistic approach to patient care. “Holistic care is about seeing the patient as a whole person, not just a collection of symptoms or diseases,” he says. “People are complex, and their health is shaped by more than just physical factors. In addition to addressing their disease, we look at social determinants of health, like their living environments, habits, and even stressors in their daily lives.”
Dr. Hassan’s career path to medicine was largely inspired by his mother, who nurtured his interest in biology and the human body from a young age. “Pulmonary medicine became my passion because of my endless fascination with lung physiology—the complexities of how we breathe and how integral the lungs are to our overall health,” he says.
Dr. Hassan says the most rewarding part of his job is seeing people with chronic lung diseases live healthy, active lives. “There’s often a misconception that these patients can’t enjoy a long, fulfilling life, but I love being part of the journey that proves otherwise,” he says.
STATE-OF-THE-ART WOUND CARE
AT OUR WOUND CENTER, COMPLEX, SLOW-TO-HEAL AND NON-HEALING WOUNDS ARE TREATED BY SPECIALLY TRAINED EXPERTS.
SOME WOUNDS are harder to heal than others. While simple wounds can sometimes be treated by a primary care provider (PCP), complex, non-healing or slow-to-heal wounds, sores or ulcers can be the result of a variety of health problems, including diabetes, vascular conditions, or previous radiation therapy for cancer. These wounds generally require specialized treatment, and that’s exactly what’s offered at the Wound Center at McCullough-Hyde Memorial Hospital | TriHealth (MHMH).
‘A ONE-STOP SHOP’
According to Clinical Program Director Kristin Fightmaster, the center is “a one-stop shop for wound care. If there is a wound, we will treat it. Typically, if a wound is not healing, there is an underlying issue. Our goal is to find that issue.”
The MHMH wound center is led by Louis Thibodeaux, MD, the center’s medical director who is also head of TriHealth’s inpatient wound program. Read on to learn more about the types of wounds the center treats.
• Chronic and Non-Healing Wounds
These include persistent wounds that haven’t healed within an expected timeframe; pressure injuries, which are damaged skin and tissue caused by prolonged pressure or friction; and neuropathic ulcers, which commonly occur due to nerve damage and are sometimes seen in people with diabetes, peripheral neuropathy, or spinal cord injuries.
• Trauma-Related Wounds These include burns; skin tears, which are wounds resulting from weak, thin or fragile skin separating from underlying tissues; and traumatic wounds, such as abrasions, lacerations, crush wounds, puncture wounds and penetration wounds, caused by accidents or external forces.
• Post-Surgical and Medical Procedure Wounds Post-surgical wounds include incisions and other wounds resulting from surgical procedures. Osteoradionecrosis is the death of bone, and soft-tissue radionecrosis is the death of soft tissue due to radiation exposure, which can develop months or even years after radiation treatment for cancer.
• Infection-Related Wounds These include necrotizing infections, which cause tissue death, are extremely serious and require immediate treatment; and chronic refractory osteomyelitis, which is an infection of the bone or marrow that is caused by bacteria or microbacteria and has not responded to standard treatment.
HELP FOR SKIN DISORDERS
The center also treats dermatological disorders, atypical skin disorders, arterial/ischemic ulcers and cellulitis, and has recently started a lymphedema program (see box on this page).
“The most common wounds we treat are diabetic ulcers, which occur on the feet,” says Director of Nursing Nathanial (Nate) Chaney, MSOL, BSN, RN. “We have podiatrists, and patients come in for dressing changes, debridement, cleaning of the wound, antibiotics, skin
substitutes that cover and help heal the wounds, and wound vacs.”
While patients are often referred to the center by a primary care doctor or other provider, a referral is not always necessary.
“Patients can simply call us, and we will schedule them,” says Fightmaster. “Some insurances do require authorization for procedures, but they are typically approved.”
ADVANCED WOUND CARE
The center offers advanced wound care treatments, including:
• Pressure relief or offloading, including total contact casting, which reduces the pressure on the wound and increases the probability and speed of healing. Interventions to prevent weight-bearing include boots, crutches and wheelchairs.
• Tissue-growing therapies, which help new skin cells develop by delivering living tissue directly to the wound, activating the body’s own ability to repair and regenerate through new cell growth.
• Negative pressure wound therapy, in which a vacuum is placed over a dressed wound to draw fluid from the body through the wound and stimulate blood flow to the wound.
• Wound debridement , the removal of dead or infected tissue from wounds. Debridement is essential for healing because dead tissue prevents new tissue from growing and can trap bacteria or hide pockets of pus, which can lead to a life-threatening infection or even amputation, if a limb is involved.
• Hyperbaric oxygen therapy, which stimulates the growth of new blood vessels and tissue via a pressurized, oxygen-rich environment that allows blood plasma to carry up to 20 times the normal amount of oxygen.
A COMMUNITY NEED, FILLED
In addition to Fightmaster, the center, which opened in December 2021, currently has three RNs, one LPN, a
SPECIALIZED TREATMENT FOR LYMPHEDEMA
Lymphedema is tissue swelling caused by an accumulation of fluid that’s usually drained through the body’s lymphatic system. Any problem that blocks the drainage of lymph fluid can cause lymphedema. “It most commonly affects the upper and lower extremities,” says Fightmaster. “It can be caused by many different factors, including lymph node damage or removal and chronic venous insufficiency.”
Patients with lymphedema who are treated at the center are seen weekly for treatment. “We generally put them in a compression wrap for three to four weeks to get the swelling down to the patient’s baseline or where there is no fluid affecting the limb,” says Fightmaster. “We order compression garments for the patient to wear daily, as well as lymphedema pumps that they will use for one to three hours a day. These pumps massage fluid out of the limb and help it recirculate.” Patients are included in the center’s secondary prevention program and follow up at the center every six months.
patient navigator/scheduler, and five providers. According to Chaney, the number of patients treated at the center has increased exponentially since its opening and more staff members will be brought onboard in the near future.
“The center saw 15 patients in its first month,” he says. “Since then, we see more than 300 patients a month with 25 new patients every month. It’s been a real success.”
DRIVEN BY SCIENCE AND EMPATHY
WHEN IT COMES TO PATIENT CARE, DR. MUFTI AHMAD HAS IT ALL—A BRILLIANT MIND AND A COMPASSIONATE HEART.
MUFTI NAEEM AHMAD, MD, a hematologist, medical oncologist and attending physician at McCulloughHyde Memorial Hospital | TriHealth (MHMH), knew that medicine was his calling from an early age.
MD
As a young child growing up in Pakistan, Dr. Ahmad, who joined TriHealth in August 2023, aspired to go to
medical school and become a doctor. “I’ve always held physicians, and the medical profession, in high regard,” he says. “My two sisters are doctors, my mother was a Lady Health Visitor, which is very much like a midwife, and my grandfather was a naturopathic doctor. So you might say I grew up in a medical household.”
Dr. Ahmad attended medical school in Pakistan before coming to the United States, where he completed his residency at the University of Buffalo. He worked in primary care
for four years in Indianapolis and Dayton, Ohio, before completing his fellowship training at the Levine Cancer Institute in Charlotte, North Carolina.
“While working in Indianapolis, I volunteered at a breast cancer research lab at Indiana University,” says Dr. Ahmad. “I enjoyed the people I worked with, and I found that the work they were doing was important and very cutting edge.” It was this experience that led to his interest in hematology and oncology.
Mufti Naeem Ahmad,
A TEAM APPROACH
Dr. Ahmad specializes in the diagnosis and treatment of blood disorders and cancers. He treats hematology patients with iron deficiency, blood count and clotting disorders, and other blood-related conditions. “As a medical oncologist, I specialize in chemotherapy as well as novel biological therapies and immunotherapies for cancer,” he says. “I also do bone marrow transplants.” According to Dr. Ahmad, hematology and medical oncology frequently
overlap, though there are many blood disorders that have nothing to do with cancer.
Dr. Ahmad enjoys collaborating with other doctors in developing treatment plans for patients. “At TriHealth, we have something unique called MDC, multi-disciplinary care, which allows patients with cancer to be seen on the same day by surgical, medical and radiation oncology,” he says. “In addition to being a team approach, it helps patients more clearly understand the various aspects of their disease and treatment. This can alleviate stress and anxiety, which is very important.”
PRIORITIZING EMPATHY
In addition to his medical training and knowledge, Dr. Ahmad believes he has the right personal attributes for his chosen specialties. “Oncology is a great fit for me, both as a physician and as a person,” says Dr. Ahmad. “It’s very science driven, data based and data heavy, so it’s intellectually stimulating. At the same time, it allows me to interact with patients and their families in a compassionate way, which helps ease their fears and anxiety, and this is both personally and professionally rewarding.”
Dr. Ahmad believes that a good bedside manner is not just helpful, it’s essential. Communicating in a sincere and honest way and allowing patients to talk and ask questions helps build a rapport based on trust. “Patients who are coping with cancer are vulnerable,” he says. “Being able to communicate calmly and compassionately with them helps them relax. When they see that I am nonjudgmental, that I am not rushing them, that I am honest with them about their condition and their treatment, they’re more likely to share their goals and priorities, thoughts and feelings, maybe even their belief system. This helps me deliver truly personalized care because no two cancers, treatments or people are the same.”
Dr. Ahmad sees his job as helping to solve a problem. “First, I have to clearly identify the problem,” he says. “My knowledge and experience help me determine the most effective and efficient strategy for solving the problem. I often must go outside of my specialized area to do this because a human body doesn’t function in a fragmented way; everything is connected. So I try to be ‘the doctor,’ not the hematologist or oncologist, and I treat them as a whole person, rather than just focusing on that one specific area.”
REWARDS AND CHALLENGES
Dr. Ahmad’s job offers many rewards. “Of course, when a patient has trusted me with their treatment and they get better, that is extremely rewarding,” he says. “Sometimes, though, a cancer is not curable, but if patients are confident in their treatment team, a lot of their anxiety over the diagnosis goes away, and they feel more empowered.”
In some cases, treatment options have been exhausted. “If I tell someone their best treatment option is hospice, sometimes they break down and they are relieved,” says Dr. Ahmad. “It’s counterintuitive, but it’s a relief to know that they’ve tried everything, and that this is the best option.”
Dr. Ahmad says one of the greatest challenges of his work is knowing that even the best medicine and the best care has limitations. “As physicians, we want to help people get better,” he says. “Though there have been great advances in treatment options, such as immunotherapy and biological therapies, we still don’t have enough therapies to cure cancer and feeling helpless after all options have been tried is difficult.”
Dr. Ahmad lives in Cincinnati with his wife and two young children. He enjoys spending time with his family, traveling, experiencing different cultures, eating good food and playing pickleball.
RX FOR SAFE MEDICATION DISPOSAL
HERE’S HOW TO GET RID OF UNUSED, UNWANTED OR EXPIRED MEDICATIONS.
SCENARIO 1: Your doctor prescribes a 30-day supply of a sleep aid, a benzodiazepine receptor agonist, for insomnia. You take a pill just one night and find that it does not agree with you—you wake up with a headache and are groggy all day at work. You decide to try non-medicinal options instead. You have schoolaged children and don’t want to keep
the remaining pills in your medicine cabinet.
SCENARIO 2: Two years ago, you had an arthritis flare-up that lasted for a couple of months. Your doctor prescribed anti-inflammatory medication to help you through the flare. Soon, the pain subsided, and you no longer needed the meds, but
now you’re having another flare. You reach for the medication and see that it’s expired.
You know you need to dispose of the medication, but how can you do it safely?
It is often a knee-jerk reaction to flush unwanted medications down the toilet, but that isn’t safe. “Medication that is flushed down the
one of the best ways to safely dispose of unused, unwanted or expired prescription and over-thecounter medication is via a drug take-back option. There are several kinds of drug takeback options, including national and local events and programs; permanent or temporary locations, drop boxes or kiosks; mail-back programs; and recommended in-home disposal methods. Authorized drug take-back locations may be retail stores, hospital or clinic pharmacies, or law enforcement facilities.
DRUG DISPOSAL POUCHES
toilet can hurt the environment when the active ingredients contaminate the water system,” says Ohio Certified Prevention Specialist Amy L. Macechko, health and wellness coordinator for the Talawanda School District. “Throwing them in the garbage could lead to accidental poisoning if individuals find and misuse them and may also allow harmful substances to seep into the soil, impacting the environment.”
So what to do? According to the U.S. Food & Drug Administration (FDA),
TAKE-BACK PROGRAMS AND EVENTS
The U.S. Drug Enforcement Administration (DEA) hosts periodic National Prescription Drug Take-Back Days during which temporary drug take-back locations are set up in communities across the country. But there are other programs closer to home.
According to Macechko, another great alternative is to use a Deterra Drug Deactivation and Disposal Pouch. “People can put pills, patches or liquids in the pouch, add water, seal it, shake and then put it in the trash,” she says. “The active ingredients in the medicine are deactivated and therefore it is safe for the environment. We have these bags throughout the community, and they can be accessed through the office of the Coalition for a Healthy Community—Oxford Area. Residents can also call 513.273.3390 or contact us through our website at www.healthyoxfordarea.org.”
“A drug take-back program is a wonderful community resource,” says Macechko. “It requires a partnership with local law enforcement agencies and can include other prescribing entities. Here in the Oxford area, we have permanent medication drop boxes at the Oxford Police Department, Oxford Township Police Department, Miami University Police Department and, most recently, McCullough-Hyde Memorial Hospital | TriHealth.” The boxes are secured and allow people to drop off medicines at their convenience.
“Thanks to our local law enforcement agencies and partners, we also participate in the DEA National Take-Back Day every October and April,” says Macechko. “On these designated days, the community is invited to stop by specified locations to drop off their unused or expired medications from 10 a.m. to 2 p.m., with no questions asked.”
MAIL-BACK PROGRAMS
According to the FDA, you can buy drug mailback envelopes at various outlets, including pharmacies and websites. Pharmacies may offer them at no cost as a convenient way to safely dispose of your unused or expired medicines. If you cannot readily get to a drug take-back location or use a pre-paid drug mail-back envelope, you can still safely dispose of unwanted, unused or expired medication by following a few simple steps recommended by both the FDA and the Centers for Disease Control and Prevention. First, check to see if the medication has its original package insert or attached disposal instructions. If it does not, do the following:
• Mix medicines (do not crush tablets or capsules) you want to dispose of with an inedible substance such as dirt or cat litter.
• Place the mixture in a sealed plastic bag or other sealed container.
• Throw the container in your household trash.
• Scratch out personal information on the prescription label and then dispose of the empty container.
9 WAYS TO HAVE MORE ENERGY IN 2025
IMPROVE YOUR PHYSICAL, MENTAL, AND HEART HEALTH WITH A FEW SIMPLE CHANGES.
FORGET NEW Year’s resolutions— they often fail within a month. 2025 will be the year you get out of your rut (and out of your own way) and create new, healthier habits because you want to feel better. To do this, you’ll need two key tools: movement and food. Exercise improves cardiovascular health and boosts energy. Food is fuel, and the right kinds of foods—those that are rich in nutrients, vitamins and minerals— give the body the energy it requires to repair, heal and stay strong. Nutrition and exercise experts at TriHealth offer the following steps to kick-start your journey.
1. START SMALL AND BE SMART
Generally, the people who see the best results are those who take small steps. Trying to do a major health and fitness overhaul is almost guaranteed to fail. Instead, look to achieve goals that are SMART: specific, measurable, actionable, realistic and timely. “I want to lose a lot of weight” is too vague. This goal is much more specific and workable: “I want to lose six pounds in January, and I will do that by cutting out white sugar, eating smaller portions at each meal and taking a daily 20-minute walk.”
2. MAKE EXERCISE ENJOYABLE. The word “exercise” can instill fear in those who aren’t used to it. That’s because most people equate exercise with work and specific (usually difficult) fitness regimens done at a gym. While exercise can be a gym workout, it certainly doesn’t have to be. Dancing is exercise. Swimming is exercise. Walking is exercise and, it’s one of the easiest exercises you can incorporate into your daily life. The key is to get your body moving in a way you enjoy.
3. CREATE A SUPPORT
SYSTEM.
Exercising with a friend makes it easier and more fun, whether you’re walking, dancing, swimming, cycling or going to the gym. If you opt to work with a trainer, whether one-on-one or in a small group, find one who will develop a program based on your current health needs, goals and fitness level. For instance, there are exercise groups for people
with diabetes, arthritis, cardiac issues and other conditions.
4. TRY HABIT STACKING.
While the name may be fairly new, the process behind it has been around for a long time. It works by attaching a new habit to an existing habit or routine that’s already second nature. For instance, you brush your teeth every morning, no matter what. You want to start stretching for 10 minutes every day, but you keep forgetting. If you “stack” teeth brushing and stretching—meaning you will now stretch daily after you brush your teeth— it will be easier to remember and, hopefully, become automatic.
5. READ THE LABEL.
When purchasing packaged foods, look for those that are higher in fiber and lower in sugar and fat. High-fiber foods make you feel more satisfied, so you eat less.
6. CHOOSE “GOOD” SUGAR.
Sugar from an orange is beneficial; sugar from orange candy or soda, is not. Sugar is the body’s first fuel, and our bodies are made to burn fuel. Consuming naturally occurring sugars, such as those found in fruits, is how our bodies expect to receive sugar. Processed sugar, on the other hand, tends to hang around in the body and turn to fat.
7. GO NUTS.
Nuts, as well as seeds like pumpkin and sunflower seeds, are great sources of protein and healthy fats, which are vital for cellular turnover, hormone synthesis and bowel health. Eat them on their own or add them to oatmeal, yogurt or salads.
8. EMBRACE YOUR ROOTS.
Root vegetables, such as yams, beets, carrots, turnips, rutabagas and parsnips, are versatile, nutritious, delicious and filling. They’re perfect as side dishes and for soups, stews and frittatas.
9. EAT THE RAINBOW.
Every color of fruit or vegetable has a different nutrient profile. The more you mix it up, the more your body will thank you.
EATING FOR ENERGY
The recipes below check all the boxes for improving heart health and energy. “This black bean and quinoa recipe is quick to make, has healthy carbs and protein to sustain energy levels and is full of satisfying flavor,” says Diane Weeks, RD, who gives healthy cooking demonstrations at RWJ Rahway Fitness & Wellness Center in Scotch Plains (see Community Calendar 22). “The chai drink satisfies sweet cravings while providing immune-boosting compounds.”
BLACK BEANS AND QUINOA WITH ROASTED PEPPERS
Ingredients:
• 2 red or yellow bell peppers
• 1 poblano or green bell pepper
• 3 tablespoons extra-virgin olive oil
• 1 tablespoon lemon juice
• ½ teaspoon kosher salt
• ¼ teaspoon dried oregano
• 1 cup cooked quinoa
• 1 15-ounce can no-saltadded black beans, drained and rinsed
Directions:
• Cut peppers in half lengthwise. Place them skin side up on a lined baking sheet. Broil until blistered and charred in places, 10–12 minutes. When cool enough to handle, peel off the skin and dice the peppers.
• In a large bowl, whisk together the oil, lemon juice, salt and oregano. Mix in the peppers and all the remaining ingredients.
Recipe from www.NutritionAction.com
Ingredients:
• 4 cardamom pods, cracked
• 1 (4-inch) piece cinnamon stick
• 4 whole cloves
• ¼ tsp. anise seed
• 2–4 slices (approx. ¼ inch) fresh ginger, peeled*
• 2 cups water
• 2 black tea bags
• 2 tablespoons unsweetened natural cocoa powder
• ¼ teaspoon vanilla extract
• 2 cups unsweetened almond or soy milk
• 3 tablespoons agave syrup or honey, or to taste
*Note: Ginger root varies in thickness. If you have a fat piece, 2 slices may be enough.
Directions:
• Place cardamom, cinnamon, cloves, anise seed and ginger in medium saucepan, add 2 cups water and place over medium-high heat. When water simmers, cover and simmer over medium-low heat for 3 minutes. Remove from heat. Add tea bags, cover and steep for 4 minutes. Remove tea bags, cover and steep brewed tea with spices for 20 minutes. Strain to remove spices, and return spiced tea to saucepan.
• In small bowl, whisk cocoa with ¼ cup of hot tea until dissolved, then add to tea. Mix in vanilla, and almond or soy milk. Heat chai over medium-high heat until steaming.
• Sweeten to taste, then pour into mugs, or divide chai among 4 mugs and sweeten it to taste individually.
Reprinted with permission from the American Institute for Cancer Research, www.aicr.org
CHAI HOT CHOCOLATE
BRINGING URINARY INCONTINENCE OUT OF THE SHADOWS
HELP IS AVAILABLE TO CORRECT OR TREAT THIS EMBARRASSING— BUT EXTREMELY COMMON—PROBLEM.
WHEN IT comes to health conditions no one wants to talk about, few sit higher on the list than urinary incontinence (UI), which is the uncontrolled leakage of urine. Stigmatized though it may be, UI is extremely common. Accurate data is difficult to obtain—partly because there are different types of UI and partly because many people are reluctant to report it—but it’s
estimated that roughly 423 million adults worldwide experience some form of the condition.
One thing is certain: UI can dramatically affect a person’s quality of life. Not only is it physically annoying and frustrating, sometimes requiring frequent clothing changes and/or the use of pads or special garments for bladder leakage, but it also makes people reluctant to go out in public or
socialize for fear they might have an “accident.”
The good news is that help for UI is readily available. Discuss your symptoms with a urologist and remember that every patient the doctor sees has a urinary problem, so don’t be embarrassed. TriHealth has several experienced urologists who understand what you’re experiencing, both physically and psychologically,
and they offer a number of treatment options.
TYPES OF UI
• Stress incontinence occurs when a patient loses urine during movement or activity, such as lifting, sneezing, coughing or laughing. This type of UI is caused by the weakening of certain tissues and muscles associated with urination, including the urinary sphincter, which controls the release of urine, and the pelvic floor muscles that support the urethra, the short tube that carries urine out of the body.
In men, this condition commonly occurs after surgical removal of the prostate gland, which weakens muscles around the urethra. In women, it is often caused by pregnancy and one or more vaginal deliveries, which stretch the muscles of the pelvic floor.
• Urge incontinence involves the sudden, intense need to urinate, followed by involuntary urine loss. (An overactive bladder is urgency, usually experienced frequently, with or without urge incontinence.) Urge incontinence may be caused by an infection or by a condition such as stroke, Parkinson’s, multiple sclerosis or spinal cord injuries.
When an individual suffers from both stress and urge symptoms, he or she is diagnosed with mixed incontinence
• Overflow incontinence happens when small amounts of urine leak from a bladder that can’t be emptied sufficiently. Diabetes and spinal injuries can cause this, as can an enlarged prostate blocking the urethra.
• Functional incontinence occurs in many older people. A person may have normal bladder control but may be unable to get to the toilet fast enough because of arthritis or other conditions that make them unable to move quickly.
TOOLS FOR TREATMENT
Options for managing UI include restricting fluids, especially before exercise and sleep, and using products like absorbent pads or undergarments. Other techniques include:
• Kegel exercises, which address both stress and urge incontinence by
FRONT VIEW OF URINARY TRACT
strengthening pelvic floor muscles. Kegels, which can be done with the guidance of a physical therapist who specializes in pelvic floor disorders, are done by lifting and holding and then relaxing your pelvic floor muscles. These exercises benefit both men and women.
• Oral medications can be used to treat urge incontinence. They work by relaxing the bladder, which allows it to store more urine.
• Botox injections are used to treat overactive bladder and urgency incontinence and work by relaxing the bladder muscle and decreasing spasms. It is generally not a first treatment but is used if exercises and medications fail. Results typical last for six to 12 months.
• Tibial nerve stimulation is an in-office procedure that involves a practitioner providing temporary electrical impulses, via an electrode placed near the tibial nerve at the ankle, to the nerves responsible for
HOW THE BLADDER WORKS
About every 10 to 15 seconds, small amounts of urine travel from the kidneys to the bladder by way of two thin, eight-to-10inch tubes called ureters The bladder swells into a round shape when it is full. Circular muscles called sphincters operate like rubber bands to keep urine from leaking into the urethra , the tube that allows urine to pass outside the body. Nerves in the bladder signal that it’s full and needs to be emptied. When you go to the bathroom, the brain signals the bladder muscles to tighten, squeezing urine out, and the sphincter muscles to relax, allowing urine to exit the bladder.
Source: Kidney and Urology Foundation of America
bladder and pelvic floor function.
• InterStim is a kind of pacemaker for the bladder that calms down erroneous messages from the bladder to the brain. It is used for urge incontinence and involves the implantation of a quarter-sized device under the skin. It lasts for about 10 years.
• The urethral sling, used to treat stress UI, is a piece of synthetic mesh material that is surgically placed under the urethra to support and compress it to prevent leakage.
• An artificial urinary sphincter, a surgical option for men only, involves a cuff placed around the urethra. When a button is pressed, the cuff inflates and squeezes the urethra so no urine can pass.
UI can affect both men and women of any age. If you are experiencing symptoms of UI, see a urologist, or ask your primary care provider for a referral.
KIDNEYS
URETER BLADDER URETHRA
GUARD YOUR HEALTH IN EVERY DECADE
A WOMAN’S GUIDE TO KEY SCREENINGS AND OTHER STEPS THAT CAN IMPROVE WELLBEING THROUGHOUT LIFE
WOMEN’S HEALTH often focuses on milestones such as pregnancy, childbirth and menopause. But day-to-day and year-to-year health maintenance and preventive measures are also critical to wellbeing throughout life.
Getting recommended exams, screenings and immunizations are some of the most important things you can do to prevent problems or catch them earlier—and stay healthier longer. Here are some things women can do to stay healthy at every age and in every stage of life.
IN EACH DECADE
Regardless of your age, it’s important to be proactive about your health and to work with your healthcare provider to keep on top of regular tests. As the
saying goes, an ounce of prevention is worth a pound of cure.
General Health
• Full checkup: See your primary care provider yearly.
• Sleep habits: Discuss at your annual exam.
• Thyroid (TSH) test: Discuss with your healthcare provider.
• HIV screening: Get tested if you are at risk for HIV infection (due to, for example, unprotected sex, sexually transmitted disease or use of unprescribed drugs with needles).
Heart Health
• Blood pressure test: Get one at least every two years if not at your annual checkup.
• Cholesterol panel: Establish your
total, LDL, HDL and triglycerides in your 20s. Discuss follow-up with your provider in subsequent years.
Diabetes
• Blood glucose or A1c test: Get screened if you have sustained blood pressure greater than 135/80, take medicine for high blood pressure or are at risk for developing diabetes.
Skin Health
• Skin exam: Do a monthly self-exam of skin and moles and as part of a routine full checkup.
Oral Health
• Dental cleaning and exam: Frequency depends on a variety of personal factors. Discuss with your dentist.
Mental Health
• Behavioral health screening: Talk with your provider about whether this would be helpful.
IN YOUR 20S AND 30S
Early adulthood is the time to establish a baseline of regular self-checks, exams and screenings that you can build on in the decades to come. You’ll continue many of these practices as you age.
Breast Health
• Breast self-exam: Regularly examine your breasts and become familiar with them so you can identify any changes and discuss them with your provider.
• Clinical breast exam: Have your provider check your breasts at least every three years.
Reproductive Health
• Pap test: Undergo screening for cervical cancer at least every three years.
• Pelvic exam: See your obstetriciangynecologist yearly beginning at age 21.
• Sexually transmitted infection (STI) tests: Both partners should get tested for STIs, including HIV, before initiating a sexual relationship. Get a chlamydia test yearly until age 24 if you are sexually active. After age 25, continue getting this test yearly if you have new or multiple partners.
Immunizations
• Seasonal influenza vaccine: Get your shot yearly.
• COVID-19: Keep up to date with boosters.
• Tetanus-diphtheria-pertussis booster vaccine: Update every 10 years.
• Human papillomavirus (HPV) vaccine: Protect against HVP with a single two- dose series up to age 26; if your vaccine series is incomplete, talk with your provider.
• Meningococcal vaccine: Discuss with your provider if you are in college or in the military.
IN YOUR 40S AND 50S
Continue following recommendations from your 20s and 30s for breast and reproductive health or discuss with your doctor, and keep up with recommended immunizations. Add the following:
Bone Health
• Bone density screening: Talk with your provider about guarding against bone conditions such as osteoporosis.
Breast Health
• Mammogram: Get screened for breast cancer every one to two years. Official recommendations vary, so talk with your provider about the schedule that is right for you.
Eye and Ear Health
• Comprehensive eye exam: See an eye doctor for a baseline exam at age 40, then every two to four years as your doctor advises. At age 55, start getting eye exams every one to two years.
• Hearing test: Have your hearing tested in your 40s. Retest after
10 years, then every three years from your 50s on.
Colorectal Health
• Fecal occult blood test, flexible sigmoidoscopy, colonoscopy: Starting at age 45, get screened for colorectal cancer. Talk with your provider about which screening test is best for you and how often you need it.
IN YOUR 60S, 70S AND
BEYOND
Continue following recommendations from your 40s and 50s for breast, reproductive, colorectal and eye/ear health, and keep receiving scheduled immunizations. Address the following considerations:
General Health
• Hepatitis C (HCV) screening: If you haven’t already been screened for hepatitis C and were born between 1945 and 1965, get your test.
Breast Health
• Mammogram: Talk with your provider about how often to receive mammograms from age 75 on.
Reproductive Health
• Pap test: Discuss the value of continued testing with your provider.
Bone Health
• Bone density screening: If you haven’t yet had a bone mineral test, get it at least once, ideally by around age 65. Talk with your provider about repeat testing.
Immunizations
• Pneumococcal vaccine: Get this onetime vaccine to protect against pneumococcal disease.
• Herpes zoster vaccine: Talk with your provider about preventing shingles and painful complications with a one-time, two-shot series.
• RSV vaccine: This one-time immunization is recommended for adults 75 and older and for those 60-74 years who are at increased risk of severe RSV disease. Talk to your doctor about whether this vaccine is recommended for you.
