Weekly View » Dr. Nydia Nunez-Estrada

Begin Your Healthy Diet Now

Dr. Nydia Nunez-Estrada — Thu, 03 Apr 2025 05:09:40 +0000

One of the best ways to prevent chronic diseases is to change your diet. A healthy diet can help prevent diabetes, high blood pressure, cardiovascular disease and many other illnesses from developing. It can also bolster your strength and improve your mood. Simple, smart steps now can set you on the path toward better nutrition. Choose one of these steps to begin and then introduce more:
• Try a new fruit and a new vegetable each week. Too often, we fall into repetitive patterns of eating. Since the U.S. Department of Agriculture recommends half of our plates be filled with fruits and vegetables, it’s important that we keep mixing up what we eat (which also helps us avoid getting tired of healthy food). The American Heart Association recommends a colorful array of vegetables and fruit to ensure we’re meeting nutritional goals: heart.org/en/healthy-living/healthy-eating/add-color/eat-more-color.
• Replace chips with nuts. You may have noticed that your favorite potato chip brand is expensive this year. Substitute a healthier alternative. If nuts are not exciting enough for you, try seasoning them. Some spices that are often used (not necessarily together) include garam masala, rosemary, chili powder, cayenne pepper and cinnamon.
• Eat whole grains. An American Institute for Cancer Research report concluded that just three servings a day of whole grains can result in a 17% lower risk of colorectal cancer. If you are tired of whole wheat and oatmeal, remember that there are numerous other whole grains, including those Johns Hopkins Medicine lists at hopkinsmedicine.org/health/wellness-and-prevention/barley-farro-sorghum-and-more-9-whole-grains-to-try. Some of the nutritional value has been removed from refined grains, such as white bread and white rice, making them less filling and healthy than whole grains.
• Drink more water. It’s not always easy to get the eight glasses a day of water your body craves, but doing so can help you feel better and stay fuller. You can even set an alarm to remind you it’s time to consume more.
• Eat fewer prepared and packaged foods. The U.S. Food and Drug Administration reports that 70% of the salt in American diets originates from packaged and prepared food. In other words, putting away that saltshaker is not enough, especially if you already have high blood pressure. Even supposedly healthy food may be very high in salt, so read all the labels on your food carefully.
• Cut those sugary drinks. If you have been watching what you eat and are still unable to lose weight, the culprit may be a beverage. Americans consume high levels of sugar, including soda and unhealthy fruit juices. Consider mixing sparkling water with a healthy juice (look for 100% juice) instead of drinking soda.
• Introduce more legumes to your diet. Beans, lentils and other legumes are inexpensive, nutritious and easy to add to so many meals. You can toss them into rice dishes, casseroles, stews, salads, soups and even sandwiches. They can be purchased in cans or dry. Since legumes have a longer shelf life than so many other forms of protein, they are easy to keep on hand for when you are low on fresh groceries and unsure what to make for dinner. Consider trying legumes you don’t typically eat, such as cannellini beans, chickpeas, broad beans (fava beans) or lima beans. Handy recipes are included on the Mayo Clinic’s website at mayoclinic.org/healthy-lifestyle/recipes/bean-legume-recipes/rcs-20075988.
• Join Eskenazi Health Healthy Me classes. Free lifestyle medicine groups, taught by medical professionals, can inform you about nutrition and introduce you to easy, healthy recipes. Find out more at eskenazihealth.edu/programs/healthy-me.
Any life change is difficult. Let yourself slip now and then from your new good habits, especially on days you have social gatherings. Once your new routines become the norm, however, you will find yourself feeling better and stronger. If you need advice on any dietary changes, consult with your physician.

Nydia Nunez-Estrada, M.D., family medicine specialist with Eskenazi Health Center Grande

Establish Good Sleep Hygiene to Improve Your Health

Dr. Nydia Nunez-Estrada — Thu, 13 Mar 2025 05:09:08 +0000

Restless or limited hours of sleep do more than just make us feel tired and grumpy. Poor sleep can make it harder to lose weight and can lead to numerous serious health conditions. Your body needs those good hours of sleep to bolster your immune system and repair your cells.
Work toward getting the seven to nine hours of recommended sleep by taking action this National Sleep Awareness Month. Begin practices that lead to better sleep and can have long-lasting effects on your health:
• Make the environment of your bedroom conducive to sleep. Turn the thermostat to the 60s (Fahrenheit). Ensure screen glares are absent and that there is either no or little light and only peaceful noise. Move your devices to another room if possible. Keep them off at least an hour before you sleep.
• Do not lie in bed for hours, tossing and turning. Instead, after twenty minutes or so of restlessness, do something relaxing. Numerous techniques can help. You can try breathing exercises, progressive muscle relaxation, yoga nidra (commonly called yogic sleep) or other soothing techniques before again attempting to sleep.
• Consider the timing of what you eat and drink:
• If you do eat the (often unhealthy) foods that trigger indigestion (fried or fatty food, most fast food, pizza, etc.), make sure it’s earlier in the day.
• Avoid caffeine for several hours before bedtime. Typically, it’s advised to wait eight hours or so, though individual caffeine reactions may vary.
• Do not drink alcohol in the last few hours before you sleep to avoid restless sleep and if you do drink, do so in moderation since greater quantities can worsen sleep quality.
• Exercise regularly to sleep better and to work on reducing your weight if needed since there’s a connection between obesity and sleep. At minimum, leave time for 150 minutes of moderate physical activity weekly, and do strength exercises twice a week.
• Look out for free, recommended apps that are available to help you sleep. The Department of Veterans Affairs offers CBTi-Coach, an app that is meant to accompany cognitive behavioral therapy. This type of therapy, which your doctor may recommend, focuses on changes to your thoughts or actions; it is often used to improve sleep. Even if you never try this treatment, the CBTi-Coach app has useful tips for getting a better quality of sleep.
• Address the stress that is keeping you up at night. Good habits will not help that much if every time you close your eyes, depressing or anxious thoughts are flooding your mind. Reach out for help with these issues to improve your sleep. For example, you can schedule an appointment with the Sandra Eskenazi Mental Health Center (317-880-8491).
• Be aware of conditions or time periods in life that may cause sleep loss. For example, menopause can affect sleep patterns. Your doctor may have remedies attached to the situation or time period you are experiencing.
• Do not ignore signs of obstructive sleep apnea (OSA). If you wake up gasping for air, have periods of no breathing during sleep, snore loudly and/or are having trouble staying awake or alert in daytime hours, you should talk with your doctor. This illness is often left untreated, which can contribute to anything from heart problems to glaucoma. Several treatments are available that can help you avoid the potential negative effects of OSA, including oral appliances, airway pressure devices and changes to your lifestyle.
If you suspect you have a sleeping disorder or need other support in getting high-quality sleep, do not hesitate to contact your doctor or find one at Eskenazi Health Connections (317-880-7666). If your primary care provider thinks you have sleep apnea or another sleep disorder, you may be referred to Eskenazi Health Special Medicine for guidance from a sleep specialist.

Nydia Nunez-Estrada, M.D., family medicine specialist with Eskenazi Health Center Grande

Take Care of Your Heart Health This Winter

Dr. Nydia Nunez-Estrada — Thu, 13 Feb 2025 06:09:00 +0000

February is American Heart Month, meaning it is a great time to take steps to lessen your risk of cardiovascular diseases (CVDs), illnesses affecting your heart and blood vessels. CVDs are not only the leading cause of death in the United States, but throughout the world, and according to the American Heart Association (AHA), they are responsible for one in three women’s deaths per year.
Here are practical steps you can take to protect your heart health:
• Stop smoking. According to the Centers for Disease Control and Prevention, a quarter of CVD deaths result from smoking. Consult with your doctor for tips on stopping or for guidance on support groups or programs that might help you quit.
• Lower your alcohol intake. A March 2022 JAMA study reported that any amount of alcohol was bad for your heart health, which includes red wine. Smaller amounts, of course, pose a lower risk, so reducing your alcohol consumption will improve your health.
• Increase your exercise level. You do not have to live at the gym to be healthy, but you should get a minimum of 150 minutes of moderate exercise each week (such as dancing or walking at a quick pace). A couple of days of strength exercises will also help you keep your heart healthy.
• Join a class focused on your health issues. The Eskenazi Health Center Hypertension Education Program, for example, is a three-to-five-week class in which you have the guidance of a nurse, pharmacist, lifestyle coach and dietitian in creating a plan to lower your blood pressure. Consider joining the Eskenazi Health Center Diabetes Education Program as well if you have that disease; diabetes is a risk factor for CVDs. To register for either free course, call 317-880-3132.
• Improve your diet. Eat more fruits, vegetables, legumes, nuts, seeds and whole-grain foods and limit your meat and dairy consumption. Changing your diet is never easy, so don’t feel you need to alter everything at once. Even if you’re not in Eskenazi Health’s hypertension or diabetes education program, you can get general wellness guidance through the Eskenazi Health Healthy Me program (eskenazihealth.edu/programs/healthy-me).
• Monitor your blood pressure. Waiting for your annual doctor’s appointment to get your blood pressure checked is not enough, especially if you’re getting older, are pregnant or are in menopause — all of which can put you at greater risk of CVDs. You can purchase a monitor for home use or take advantage of free self-monitoring stations, which you can find at numerous pharmacies and some stores.
In addition to practicing these tips for improving your own heart health, keep a watch on your peers’ heart health as well: during a stroke or heart attack, we all benefit from one another’s aid. While the AHA cites pain in the center of the chest as the most common heart attack symptom for men and women, women are also likely to experience other/additional symptoms, such as shortness of breath, upper body pain (such as in the back, jaw, arm/s or neck) and stomach upset. Additional symptoms, according to the AHA, include lightheadedness, nausea, rapid/irregular heartbeat, exhaustion and cold sweat.
The acronym B.E. F.A.S.T. tells you what to look for if you suspect someone has had a stroke:
• Balance (difficulties keeping one’s balance)
• Eyes (vision worsens or is blurred or doubled)
• Face (drooping or numb on one side)
• Arm (one arm weak or numb or drifts down if both are raised)
• Speech (slurred or challenging for the victim)
• Time (call 911 if you notice these signs). Stroke can lead to brain damage in minutes.
For lifestyle change tips or guidance on CVDs, rely on your primary care provider. If you are due for an appointment or are looking for a new provider, contact Eskenazi Health Connections at 317-880-7666.

Nydia Nunez-Estrada, M.D., family medicine specialist with Eskenazi Health Center Grande

Protect Yourself from Cervical Cancer

Dr. Nydia Nunez-Estrada — Thu, 16 Jan 2025 06:09:42 +0000

None of us want to think about cancer, but with preventative steps, we can avoid one form of it that can be deadly for women. Cervical cancer develops in the cervix, located at the lower end of the uterus. The virus that causes it is so widespread that the Centers for Disease Control and Prevention (CDC) claim nearly all of us will get it at some stage if we are unvaccinated.
All women should do what they can to avoid the virus that causes cervical cancer. January is Cervical Cancer Awareness month, so there’s no better time to think about ways to protect yourself and your loved ones from the disease that about 11,500 women are diagnosed with and 4,000 die from each year according to the CDC.
The human papillomavirus (HPV), the virus which causes cervical cancer, is the most common sexually transmitted infection (STI) in the United States. Many forms of HPV are harmless. If an infection develops from a non-risky form of HPV, it might go away on its own or lead to nondangerous symptoms, such as genital warts. It’s difficult, however, to even know whether we or our sexual partners have HPV since both risky and non-risky versions of it often produce no symptoms.
Vaccination for HPV starts early. Girls as young as nine can get it, and it’s recommended starting at age 11 or 12. Young women up to the age of 26 are advised to be vaccinated if they weren’t when they were younger. Vaccinations for women in the 27 to 45 age group are not typically recommended; they have likely already been exposed if unvaccinated but can consult with their doctor if they would like the vaccine.
Pap smears, which screen for cervical cancer, are now recommended every three years for women between 21 and 29 years of age. Another test, the HPV test, is recommended for women between the ages of 30 and 65. For women in the 30 to 65 age group, options are to get a pap smear every three years, the HPV test every five or both tests every five years.
Once women are older than 65, they can often stop screenings but should continue them if doctors advise they do based on their health or test results. For example, women who are HIV positive may be advised to continue screenings.
Be sure to ask your primary care provider if you haven’t done regular health care visits and fear it’s been a long time since your last screening. To schedule an appointment, Eskenazi Health patients can use their Eskenazi Health MyChart (mychart.eskenazihealth.edu/MyChart) or call Eskenazi Health Connections at 317-880-7666. Those who are not patients with Eskenazi Health can also call that number to find a new primary care provider.
While men are not at risk for cervical cancer, HPV causes other forms of cancer that men can develop, including cancer of the penis, anus, mouth and throat. Men also can spread the cervical-cancer-producing form of HPV to female partners through oral, vaginal and anal sex. Therefore, the HPV vaccine is recommended for boys starting at age eleven or twelve as well as for girls.
You can go to a pharmacy for an HPV vaccine without an appointment. Find the closest Eskenazi Health pharmacy by going to eskenazihealth.edu/health-services/pharmacy.
Please note that the Vaccines for Children program, which offers free vaccines for kids of the parents and guardians who qualify, does not cover vaccines from pharmacies. Children in that program need to get their vaccinations at their primary care provider’s office. If you want to learn more about the program, you can find details at cdc.gov/vaccines-for-children.
Stay safe this January by protecting yourself from a cancer that can often be avoided with a little bit of preparation.

Nydia Nunez-Estrada, M.D., family medicine specialist with Eskenazi Health Center Grande

It’s Not Too Late to Get Help Choosing Your Marketplace Plan

Dr. Nydia Nunez-Estrada — Thu, 12 Dec 2024 06:09:10 +0000

You still have time to choose your plan in the Health Insurance Marketplace at healthcare.gov. In order to have coverage by January 1, you will need to enroll by Dec. 15. You can still get coverage starting on Feb. 1 as long as you enroll by Jan. 15. After that you will need a special event (marriage, childbirth, move, etc.) to enroll in a Marketplace plan.
Ensure you will remain eligible for Medicaid if you are currently enrolled. Also make sure your contact information is current. You can go to fssabenefits.in.gov to check. If you are no longer eligible for Medicaid, you will want to know that before the Marketplace deadlines pass.
For anyone confused by all the options in the Marketplace, remember that there is a great deal of overlap between plans, including coverage of emergency services, hospitalization, certain types of preventative care, services for both mental health and substance use disorder, pregnancy care, pre-existing condition coverage, etc. For more details, visit this site: healthcare.gov/coverage/what-marketplace-plans-cover.
That said, determining the best insurance selection for yourself and your family will depend on the types of services you regularly need, your budget and your likely future needs. One helpful practice is to look over the health care costs you paid last year since they weren’t covered by insurance (including deductibles). What was the total amount? Do you and your family go to the doctor frequently or rarely? Do you foresee any health care procedures needed this year? Those types of questions will help you narrow your choices.
It also helps to talk to those more familiar with the insurance options rather than relying on the online descriptions. Marketplace representatives can answer your questions. Just call 1-800-318-2596. You can also check out the Marketplace tips on what to consider before making selections at www.healthcare.gov/choose-a-plan/comparing-plans.
As you look through healthcare.gov, you may be confused by the sheer number of unfamiliar terms used in health care. You can go to this page for helpful definitions or even have the page pulled up during your call with a Marketplace representative: healthcare.gov/glossary.
If you are a DACA (Deferred Action for Childhood Arrivals) recipient, this might be your first year of eligibility for the Marketplace. Starting this year, those DACA recipients who meet requirements for Marketplace enrollment have access to a Qualified Health Plan (QHP) and Basic Health Program (BHP).
Eskenazi Health Financial Counseling can also offer you in-person guidance on Marketplace choices as well as on Medicaid and other government programs. They also can discuss whether you might qualify for cost reductions for your insurance. The three biggest Eskenazi Health Center locations are particularly helpful with Marketplace assistance: Eskenazi Health Center West 38th St., Eskenazi Health Thomas & Arlene Grande Campus and the downtown campus at 720 Eskenazi Ave. Your financial counselor can customize the talk based on your individual needs as well as the needs of your family members.
To schedule an appointment with a financial counselor at one of these Eskenazi Health Center locations, please pick a time where you see an opening Monday – Friday, 9 a.m. – 5 p.m. on Eskenazi Health MyChart or call 1-855-202-1053.
Financial Counseling has been offering expanded hours on Saturdays during the enrollment period. The final Saturday for Marketplace help is Dec. 14 on the downtown campus (720 Eskenazi Ave.) between 10 a.m. and 2 p.m.
Keep in mind that the counselors will try to fit in walk-ins during regular and expanded hours, but having an appointment is always preferable to ensure you get in.
While it is certainly a hassle to take the time in this busy season to wade through health insurance options, you will be glad you did once you find a plan that makes sense for your budget and health care needs. Just don’t feel like you ever must make those decisions alone.

Nydia Nunez-Estrada, M.D., family medicine specialist with Eskenazi Health Center Grande

Resources Available for Caregivers Helping Patients with Dementia

Dr. Nydia Nunez-Estrada — Thu, 07 Nov 2024 06:09:25 +0000

The World Health Organization reports that almost 10 million new cases of dementia arise each year, with 60 to 70% of overall cases attributed to Alzheimer’s disease. Individuals suffering from the brain injuries and diseases that cause dementia may struggle to function on their own, leading to heavy responsibilities on loved ones and other caregivers. Someone with dementia may suddenly struggle with tasks and decisions they managed with ease in the past, be unable to communicate clearly with others, experience significant changes in personality and/or behavior, have issues with balance and/or be forgetful about names and events.
While some forms of dementia progress slowly, giving caregivers time to gradually ramp up the amount of their care, other forms of dementia can accelerate quickly. Regardless of the speed of the onset, those who care for individuals with dementia are likely to need resources to manage the steep learning curve of and the emotional, mental, financial and lifestyle adjustments required of providing ongoing care for someone with dementia.
The state of Indiana’s website offers resources for caregivers through the INconnect Alliance at in.gov/fssa/inconnectalliance/support-for-caregivers/. These resources include an educational video series, counseling options, networks for spouses caring for a partner with dementia, financial and legal aid and a 24/7 helpline.
An array of resources is provided by the Sandra Eskenazi Center for Brain Care Innovation and its partners at hii.iu.edu/resources/abc-caregiver-handouts.pdf. This center also gives numerous recommendations, including brain exercises for patients to try. A few of these suggestions include the following:
• Read from right to left, starting at the bottom of the page and working up (may just be a few sentences at first). Do not worry about the logic.
• Perform routine tasks with the hand you don’t typically favor.
• Learn a new hobby.
• Use a new word in a sentence per day or use a new word in a different language each day.
• Try reversing lists (months of the year in reverse-alphabetical order, etc.).
• Play identification games, such as seeking out five red items in the room that will fit into your pocket and five blue items that will not in a two-minute time span.
• List all the items in a category you can come up with in one minute, working to expand that list each week, such as cities, mammals or insects.
• Play with puzzles that challenge the mind, such as crosswords or Sudoku.
According to a report from the Alzheimer’s Association this March, the biggest stressors for those providing care for patients with dementia in 2023 were dealing with costs, coordinating with various doctors, identifying the best doctor for their patient’s needs, getting appointments and managing breaks for themselves. One way to ease several of these worries for caregivers is to find the right health care team.
The Eskenazi Health Aging Brain Care program has been building on its resources and expertise for more than 15 years. Since the program is actively engaged in research, the newest techniques in dementia care can be directly applied. The team is composed of physicians, nurses, psychologists, care coordinator assistants and social workers. This diversity of backgrounds aids the team with problem solving to meet individual patient needs. By combining resources, the program also eases the burden on the caregivers who may otherwise be scheduling care with multiple doctors and organizations.
This team at Eskenazi Health paired up with other doctors and experts to develop the Centers for Medicare and Medicaid Services (CMS) Innovation Center’s new dementia care and payment model. As of this July, Eskenazi Health patients can take advantage of this model, which includes approaches for keeping patients home and lowering the burden on unpaid caregivers.
For caregivers looking for a health care team, Eskenazi Health aging brain care providers can be reached by visiting eskenazihealth.edu/health-services/brain-center/aging-brain-care-program or calling 317-880-2224.

Nydia Nunez-Estrada, M.D., family medicine specialist with Eskenazi Health Center Grande

Assistance for Those Suffering from Domestic Violence

Dr. Nydia Nunez-Estrada — Thu, 10 Oct 2024 05:09:16 +0000

October is Domestic Violence Awareness Month (DVAM), which was formed to raise awareness about the repercussions of domestic violence and bring together those fighting to end it. The United States Department of Justice defines domestic violence as “a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner.” Included within that definition are physical, sexual, emotional, economic, psychological and technological abuse. More than a third of women and a quarter of men in this country have been raped, physically attacked and/or stalked by an intimate partner and nearly half of men and women have experienced psychological aggression from an intimate partner in their lifetimes according to the National Domestic Violence Hotline.
Victims may not know all the signs of or be reluctant to reveal domestic abuse. The Domestic Abuse Intervention Programs provide an informative image, the Power and Control Wheel, which helps victims and those concerned about possible victims identify signs of domestic abuse, both subtle and blatant. The wheel breaks down these approaches into the following categories: physical and sexual violence, coercion and threats, intimidation, economic abuse, male privilege, use of children, isolation, emotional abuse and minimizing, denying and blaming.
For example, a male abuser may tell a female partner that he will take the kids. He may block her from getting a job to control her finances, gaslight her, blame her for his violence and distance her from those who could protect her from it. You can view a copy of this wheel at the National Domestic Violence Hotline or download your own at theduluthmodel.org/wheel-gallery/. Male privilege (such as asserting a wife is the husband’s servant) is a common method of domestic abuse, but men and those who don’t conform to gender identities can be victims of domestic abuse as well.
Financial abuse is a widespread form of partner control. According to the National Domestic Violence Hotline, the majority of those experiencing domestic abuse remain longer than they would have with an abuser because they simply don’t have the financial means to leave. The National Domestic Violence Hotline says one in three of the survivors who called them in 2022 cited financial abuse. Helping survivors take steps toward financial independence is one of many ways that nonprofit organizations and corporate partners can assist.
A victim resource program through the National Center for Victims of Crime describes several steps for leaving and surviving domestic abusers, including calling 9-1-1 when under immediate threat, getting a protective order, seeking help at a hotline, going to counseling, creating a safety plan, working with an advocate and self-care. The best approach may vary depending on circumstances, so consulting with an advocate or other resource may help.
Luckily, there are many resources out there. If you are a victim, a family member or friend of one or a perpetrator of domestic violence seeking to change, there is a service for you, the National Domestic Violence Hotline. This free, confidential service is available 24-7 and can address questions in 140 languages with the aid of their interpreter. Call 1-800-799-SAFE (7233), text “start” to 88788 or chat at thehotline.org. This website has a quick exit button if you fear being seen viewing it. The hotline can link you to resources, including for financial assistance.
Eskenazi Health Center of Hope works closely with victims’ assistance agencies as well as with prosecutors and local law enforcement to provide care for victims of sexual assault and family violence in the Indianapolis area. Call 317-880-8006 for their assistance or read about the resources they offer on their website.
To find other local resources, volunteer opportunities and ways to donate to the cause of ending this abuse, go to the Domestic Violence Network or Indiana Coalition Against Domestic Violence.

Nydia Nunez-Estrada, M.D., family medicine specialist with Eskenazi Health Center Grande

Strengthen Your Back Now to Avoid Future Pain

Dr. Nydia Nunez-Estrada — Thu, 05 Sep 2024 05:09:23 +0000

Lower back pain (LBP) is quite common, but it can also lead to serious issues. According to the World Health Organization (WHO), it is the leading cause of disability. It is also, WHO warns, an ailment that leads to reduced quality of life and issues with work loss. Next month is National Spine Health Awareness Month. Use it as a reminder to improve your back health now, which could have far-reaching repercussions for your happiness and mobility as you age.
Even if you currently have no back pain, there are many steps you can take to avoid it or lessen its intensity. Those who regularly lift weights often joke about gym members who skip days working on their back or leg muscles to focus on arm or chest strength. This kind of strength imbalance, unfortunately, can lead to injury. According to the Physical Activity Guidelines for Americans developed by the United States Department of Health and Human Services, adults should perform muscle-strengthening exercises of moderate or greater intensity at least twice a week for all major muscles groups.
If you’re looking for back-strengthening exercises, you can find seven options on the Mayo Clinic’s Web site that only take 15 minutes. Some of these options include the bridge and cat stretch exercises, which you can incorporate into your daily routine. Abdominal and other core-strengthening exercises are also recommended for increasing your back health. (Whenever you are unsure whether a certain exercise will injure your back, check with your primary care provider (PCP) before beginning the activity.)
In addition to these types of movements, make sure you are getting aerobic activity. A sedentary lifestyle weakens muscles, making them less limber and more prone to pain. The Physical Activity Guidelines for Americans recommend at least 150 to 300 minutes of moderate or 75 to 150 minutes of intense aerobic physical activity per week. Some mixture of moderate and vigorous activity is also an option.
While determining which exercises to do, consider those that help with stress reduction, core strength, balance and flexibility. Many of these types of exercise are included in a list of clinical guidelines for dealing with nonradical lower back pain published in 2017 by the American College of Physicians (ACP), including tai chi, yoga, acupuncture and stress-reducing mindfulness practices. The National Institute on Aging advises the following four types of exercise for good health: strength, balance, flexibility and endurance exercises.
Consider quitting smoking to lower your risk of experiencing back pain as well. Smoking reduces the flow of blood to your muscles and increases your chances of getting osteoporosis. Other recommendations for back health include maintaining good posture, watching your weight, lifting objects carefully, paying attention to your position when you sleep and utilizing massages when needed.
While pharmaceuticals are frequently prescribed to manage some forms of back pain, other options are typically recommended first, such as physical therapy and chiropractic services. In a Chiropractic & Manual Therapies 2002 study led by James Whedon, D.C., for example, the adjusted risk for filling an opioid prescription within a year was more than 50% lower for older Medicare beneficiaries who had visited a chiropractor than for those who had not.
If you are ready to seek chiropractic care, you can now find it at Eskenazi Health Center Grande, which offers appointments four days a week for children, teens and adults, including pregnant women. You’ll need a referral from your PCP, so call Eskenazi Health Connections to schedule that appointment first at 317-880-7666.
Another option for back pain care is to work with your primary care physician for a referral to an orthopaedic or neurology physician. Eskenazi Health Spine Care is one example and can be reached at 1-866-73SPINE.
To determine whether your insurance covers these services, schedule a meeting with Eskenazi Health financial counselors through Eskenazi Health MyChart or 1-855-202-1053.

Nydia Nunez-Estrada, M.D., family medicine specialist with Eskenazi Health Center Grande

Watch for Stroke Symptoms in Others

Dr. Nydia Nunez-Estrada — Thu, 01 Aug 2024 05:09:15 +0000

We often think of strokes as dangers faced by the elderly. It is true that the risk of stroke increases after the age of 65. However, stroke rates have been rising for those in the 18-64 age range according to a study published by the CDC this May, so it is best to watch for signs of a stroke in individuals of any age.
Once a stroke occurs, minutes count. Helping a victim right away can sometimes prevent severe disability and even death. Luckily, the signs of a stroke are easy to remember. Just keep in mind to BE FAST, which stands for the following:
• Balance. Look for an abrupt loss of balance.
• Eyes. Watch for and ask the possible stroke victim about vision loss.
• Face. Notice whether one side of the potential victim’s face is numb or starts to droop.
• Arm. Ask the potential victim to raise their arms. If a stroke has occurred, one of the arms will likely fall or be numb or weak.
• Speech. Have the individual repeat a simple phrase. Do you notice slurring or mistakes when they repeat it? Is it hard to understand what they are saying?
• Time to call 9-1-1. Even if these symptoms don’t last long, be sure to call for help.
Other common symptoms of a stroke are a bad headache that can’t be explained, confusion, vomiting and dizziness.
There are two types of strokes. The rarer kind, the hemorrhagic stroke, is more dangerous; it means blood vessels in the brain have broken and are bleeding. The ischemic stroke, the more common type of stroke, is typically caused by a clot in a vessel that transmits blood to or is already in the brain. Moments count after someone has experienced either type of stroke because according to the American Stroke Association, almost two million brain cells could be dying for every minute of delay in treatment. A stroke can cause numerous health problems even if it is not fatal, including blood clots, bladder and bowel control issues, difficulty with movement, seizures, problems swallowing and communication and memory losses.
Luckily, lifestyle choices can have a significant impact on the likelihood of a stroke. An August 2016 study in the journal Lancet analyzed participants in 32 countries. This study, led by Martin O’Donnell, Ph.D., concluded that 10 of the risk factors for stroke can possibly be reduced with behavioral changes. Some of the risks studied include alcohol use, current smoking, hypertension, exercise and diet. Other factors were heart health and psychosocial factors, which could include, among other issues, a person’s stress level.
No wonder the American Stroke Association claims that as many as 80 percent of strokes could be avoided with lifestyle changes. If you are making substantial changes to your daily behavior, of course, you may need to make them gradually so that you can stick to your new routines. If you are planning diet or exercise changes, you can find wellness offerings through the Eskenazi Health Healthy Me program at www.eskenazihealth.edu/programs/healthy-me. If you are worried about the ways workplace stress or other mental health factors may be increasing your chances of having a stroke, call the Sandra Eskenazi Mental Health Center at 317-880-8491. You can always consult with your primary care provider if you are unsure which steps to take.
While your first response to a stroke should be calling 9-1-1, resources are also available after or even before a stroke. The Eskenazi Health Stroke Center provides comprehensive care, including prevention, diagnosis and acute treatment for stroke. Request an appointment at eskenazihealth.edu/health-services/stroke-center or reach them through the main switchboard at 317-880-0000.

Nydia Nunez-Estrada, M.D., family medicine specialist with Eskenazi Health Center Grande

Choose Your Words Carefully When Talking about Substance Use Disorder

Dr. Nydia Nunez-Estrada — Wed, 03 Jul 2024 05:09:55 +0000

It can be overwhelming to try to help a friend or loved one with substance use disorder (SUD). So much is out of your control. There is, however, one easy step you can take that can help anyone suffering from an SUD. The fear of judgment can prevent people, especially adolescents, from acknowledging their illness and trying to get treatment. The words you use when describing SUDs can either contribute to this fear — or help reduce it.
You are likely familiar with many offensive words used to describe addiction, but you might not realize that some other words are judgmental as well. The word “alcoholic,” for example, suggests that overuse of alcohol is caused by one’s personality, not an illness. Even the Cambridge Dictionary definition is troubling, with the word “habit” used even though we know alcoholism is an illness, not a conscious choice. When it comes to drug misuse, a similar problematic term is “addict.” If you think of the images that come to mind when you use that word, you’ll know not to say it again.
Instead, think of the person first. To say “a person with a disorder” is much kinder than putting the disorder front and center, as if that is all that person is. Keep in mind too that “with a disorder” gets at the range of possibilities and levels when it comes to addiction instead of characterizing anyone who struggles with any drug or alcohol misuse as the same. A person eager to avoid being seen as an “addict” might feel more comfortable seeking treatment if described as having a “disorder.”
In addition, consider how frequently we use the term “staying clean” to reference someone who is on the path to healing instead of better words, like “in recovery” or “in remission.” Even the term “drug abuse,” which is still frequently used, suggests that someone is making deliberate attempts to misuse substances. “Use” is a far better choice. There are numerous lists on health sites of terms that stigmatize those with SUDs and even pledges to be more thoughtful in how we talk about such disorders, such as this one on Johns Hopkins Medicine: www.hopkinsmedicine.org/stigma-of-addiction/pledge.
It can be difficult to stop using words we have used for a long time, and it can seem like every few years or so, we’re asked to use new ones. Just keep in mind what’s at stake. According to a government survey published last fall, only 24% of those 12 years old and older in 2022 who were categorized as needing treatment for SUDs received it. The National Survey on Drug Use and Health (NSDUH) also noted that in that year not even 1% of adolescents with an SUD sought treatment. If the right words can start increasing the numbers of those in treatment, why not use them?
If you or a loved one needs assistance with an SUD, contact the information and referral helpline, 1-800-662-HELP (4357), which is offered 24-7 by the Substance Abuse and Mental Health Services Administration (SAMHSA) for not only those with mental and/or substance use disorders, but also for their families. These services are offered in both Spanish and English. If in crisis and in need of immediate assistance, call, chat or text the Suicide and Crisis Lifeline at 9-8-8 in English or Spanish.
Local help is also available. Sandra Eskenazi Mental Health Center provides comprehensive mental health services, including treatment for substance use disorders. Sandra Eskenazi Mental Health Center Adult Addiction offers outpatient care and treatment for clients with addictions to drugs, alcohol or gambling. You can find the Sandra Eskenazi Mental Health Center Caring Recovery Opioid Treatment Program, which provides support for those with opioid addiction, at its new location, 3419 English Ave. Please call 317-880-8491 for information on any of these services.

Nydia Nunez-Estrada, M.D., family medicine specialist with Eskenazi Health Center Grande