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March 12, 2018

Common pregnancy questions asked

pregnant woman sitting in grass by lake

Welcoming a new life into this world is an exhilarating and special time. Whether you’re a first-time mom, or already have children, you can always learn how to make your pregnancy the healthiest experience possible for both you and baby.

At Family First Health, we have a team of community health workers in our Connections for a Healthy Pregnancy program who are trained to help you navigate through pregnancy and motherhood. We picked some of the top asked pregnancy questions that future moms have.

Q: How do I calculate my baby’s due date?

 A: When you announce your pregnancy, the first question you’ll likely be asked is, “when’s your due date?” However, due dates are typically difficult to calculate because there are a number of factors that can impact how pregnancy stages are identified, which is why only about 5 percent of women deliver their babies on their actual due date.

When doctors calculate your due date, they will count 280 days from the start of your last menstrual cycle or 38 weeks from your conception date. However, if you have irregular cycles, are unsure about when your last cycle was, or you don’t know when you conceived, schedule an appointment as soon as possible to have this verified with a pelvic exam, early ultrasound, or blood test. These are the most accurate ways doctors can identify your due date.

Q: How important is it to take prenatal vitamins?

A: Standard adult multivitamins help to fill in the nutrition gaps one might have, even if he/she is eating a healthy diet. Prenatal vitamins work in the same way; however, they put stress on a few other vitamins that can help your baby develop properly, specifically folic acid and iron.

Folic acid prevents major abnormalities in the brain and spinal cord, and iron supports baby growth and prevents anemia. Other nutrients you want to look for in your prenatal vitamins are omega-3 fatty acids, calcium, and vitamin D. Prenatal vitamins can be taken during all pregnancy stages, and some doctors recommend taking them three months before trying to get pregnant, in order to nurture the growing egg.

But remember, all of these vitamins are a complement to a healthy diet, and not a substitute for one.

Q: How can I prevent or treat stretch marks?

A: Stretch marks are the red badges of motherhood that 90 percent of moms-to-be will experience. Common places to find them developing are across the hips, thighs, breasts, and of course, the belly. Stretch marks are closely tied to genetics; however, there are a few ways you can work to minimize their prominence.

Start by drinking more water to hydrate the skin, apply a rich moisturizing cream to help with the itching and tightness, and finally, focus your efforts on fading the marks with gels and creams containing hyaluronic acid after pregnancy.

Q: What are my restrictions while pregnant?

 A: There are certainly a number of hard and fast rules you can go by for what not to do while pregnant, like using drugs or alcohol, for example. In general, though, your pregnant and pre-pregnant lives shouldn’t be all that different. It is time, however, to put your sushi lunches on a hiatus because raw meat and uncooked seafood should be completely avoided while pregnant. Along with that, step away from fish with high levels of mercury, raw eggs, soft cheeses and unpasteurized dairy because it could contain listeria.

Be mindful about raising your body temperature too much during the first trimester, with hot tubs or saunas for example, because elevated body temperatures could lead to certain birth defects for baby.

Each woman’s pregnancy is different, and it’s important to feel open to ask any and all questions you have; community health workers can help. Visit our website to learn more about how Connections for a Health Pregnancy can help guide you through the steps of pregnancy, and get the resources you need to welcome a healthy baby.

pregnant woman sitting in grass by lake

January 30, 2018

What to Expect at Your First OB Appointment

If you’re feeling nervous as you approach your first OB appointment, you’re not alone. After taking an at-home pregnancy test, it’s normal to have lots of questions.

First, don’t delay your first OB appointment! Schedule a prenatal appointment as soon as you know you are pregnant. That way, you can begin care right away.

What should you expect at your first OB appointment? Here are a few things to keep in mind:

Your first OB appointment will likely be longer.

Your first OB visit is a great opportunity for your health care team to get to know you better.  It’s also a time for you to get more comfortable with the nurses and providers caring for you and your baby.

If you’ve only seen your provider once a year, or you did not meet with certain members of your health care team prior to pregnancy, it’s important to build this relationship. After all, they’ll be caring for your health and the health of your baby!

Be prepared to start from the beginning.

Your OB will want to know any vital dates, including the date of your last menstrual period. They’ll also want to hear a pretty comprehensive medical history.

Consider bringing information or notes to help you remember specifics. This can be helpful both for your history and your family history. Also, bring a list of any medications you are currently taking and be sure to mention any medication allergies.

At your first OB appointment, your provider will confirm your pregnancy through a urine test. They will also perform a physical exam, including a pap smear, cervical cultures and possibly an ultrasound. They will also draw blood for several laboratory tests. These tests help to identify risks for any specific complications in your pregnancy.

Your OB will address any basic questions…

It’s common for you to have questions for your OB on diet, exercise and nutrition. What should you eat? What should you not eat? Often these are the first concerns when you become pregnant.

Your healthcare provider will likely also address safe use of over-the-counter medications or any environmental hazards, travel limitations and miscarriage precautions. They may also give recommendations for prenatal vitamins.

But don’t be afraid to add your own questions!

Every person is different, and every pregnancy is different. It is important to come to your first OB appointment with questions of your own. Also remember that your OB is your partner in this process. It’s important to be completely honest.

Don’t be afraid to ask:

  • Who can I call if I have questions?
  • How much weight should I be gaining?
  • Do I need to change any habits regarding exercise, eating or lifestyle?
  • Is it safe to ____________________ (Dye my hair? Lift heavy items? Etc.)
  • How often do I need to schedule OB appointments moving forward?

Your healthcare provider may also be able to connect you with resources in the community to provide additional support, outside of your OB visits.

One such program, Connections For A Healthy Pregnancy, helps to guide expectant moms in their journey. This may include how to navigate appointments with different doctors or advice on healthy behaviors. The program also shares information on community resources — how do I apply for WIC? Where can I receive assistance with low-cost baby items or clothing? What if I need help getting to and from my OB appointments?

If you’re worried about your first OB appointment or support for your pregnancy, contact Connections For A Healthy Pregnancy today. Call Family First Health at 717-801-4812.

holiday stress

December 18, 2017

Managing Holiday Stress & Wintry Blues

Do you dream of a Christmas Vacation or 8 Crazy Nights?  Holidays can be tough and quite often we feel increased stress between October and March.  During this time, we are bombarded with images, songs and busyness of the holidays, along with changes in seasons, can add stress, anxiety, irritability and depression.  Below are a few ways to better manage holiday stress and wintry weather Blues.

  • Learn what your holiday stressors are. Know your triggers. Is it family get-togethers, parties, gift buying or lack of sleep?  Take time to review your calendar and identify the stressors so you can make plans to reduce the impact of holiday stress.
  • Limit your expectations of reality. This limits disappointments.  Extra work is what we respond to oftentimes with unhealthy habits such as smoking, overeating, alcohol use, feeling distressed, anxiety, poor sleep, mood instability, high blood pressure or upset stomach.  Emotional health impacts the physical health!
  • Keep up with physical activity. Stay active during the winter months.  If you belong to a gym, be sure to take time to visit.   If you don’t, walk through the mall or walk outside when weather permits.  20 minutes 3 times per week is recommended.
  • Accept the feelings. Whether the feelings are positive or negative, accept and feel what you are feeling.  Avoiding is not helpful, but rather causes an increase in anxiety, which can lead to unhealthy coping skills.
  • Be mindful of the here and now. Reflection is good for the soul and making plans is good for the moods.   Take a step back.  Take a breath.  Identify what your needs are.  Rest when your body is tired.  Eat healthily for energy.  Remind yourself that it is okay to say no – set limits and boundaries.
  • Remember self-care doesn’t have to be a day at the spa! Listen or dance to music, read a magazine, knit, crochet, complete a puzzle, take a hot bubble bath, draw, color or doodle.   All of these allow our brains to slow down and rejuvenate us.
  • Laughter is the best medicine.   Relieve holiday stress by watching a comedy, find some jokes online or call up a friend who always makes you laugh.

If feelings of sadness, depression or irritability occur, seek professional help. Sometimes, brief intervention therapy is best to reduce the stressed feelings and help create plans to avoid feelings of being overwhelmed.

______________________________________________________________

Sheila King-Miller, LCSW, CCTP – Behavioral Health Consultant at Family First Health

November 30, 2017

Meet our Connections to a Healthy Pregnancy Staff: Abigail Williams and Arlene Feliciano

Every expectant mother wants to have a healthy pregnancy, but for some women it’s difficult to find the resources needed to help them give their child a healthy start. That’s where Connections for a Healthy Pregnancy can help. Connections for a Healthy Pregnancy is a free community outreach program that helps to guide expectant mothers in need of resources for a healthy pregnancy. Expectant women or caregivers of expectant women, in and around the York City area, are invited to call Family First Health at (717) 801-4812 to learn more.

Abigail Williams is a diehard Philadelphia Eagles fan, but don’t fault her for that, she is also dedicated to helping the women she works with have a healthy pregnancy. She received training in the IMPaCT model from Penn Medicine and excited to be involved in the Connections for a Healthy Pregnancy program.  Abigail is a community health worker who impacts her clients by being supportive, attentive, and showing them that their well-being is important. When asked why this program is important for the community, she stated, “There is high rate of low birth weight and infant mortality in York County. Family First Health is working to help pregnant moms reduce these risks and have a healthy baby.”

Abigail has been working at Family First Health since she graduated and says that working here is like being with family. In her spare time she enjoys reading, watching movies with her family, and go for walks.

Arlene Feliciano has worked for Family First Health since 2012 and is the lead community health worker for the Connections to a Healthy Pregnancy program. She has received training in the IMPaCT model from Penn Medicine, SOAR through SAMHSA, and mental health first aid. Arlene has lived in the York area for over 25 years and truly enjoys working in the community that she serves.

Arlene strives to make a contribution in lowering the high rate of low birth weight babies. She shared, “Having motherhood experience helps me exercise patience, empathy, and pushes me to work harder to help pregnant moms overcome obstacles that they face through their pregnancy.” She loves helping women reach goals they have that they thought were out of their reach by linking them to available resources.

Arlene loves working with people on all levels but particularly enjoys sending time with her family and watching movies in her spare time.

Abigail Williams

November 28, 2017

Meet our Connections to a Healthy Pregnancy Staff: Roseann Stewart and Claudia Salazar

Every expectant mother wants to have a healthy pregnancy, but for some women it’s difficult to find the resources needed to help them give their child a healthy start. That’s where Connections for a Healthy Pregnancy can help. Connections for a Healthy Pregnancy is a free community outreach program that helps to guide expectant mothers in need of resources for a healthy pregnancy. Expectant women or caregivers of expectant women, in and around the York City area, are invited to call Family First Health at (717) 801-4812 to learn more.

Roseann Stewart became a community health worker because she would have the opportunity to help others and to be of service to the community. She says it’s “the perfect opportunity for me to completely be myself.” Roseann describes herself as caring, understanding and nonjudgmental, which is the key formula of what our patients need.  She has a Bachelor’s of Science in Human Development from Penn State University and is trained in the IMPaCT model by Penn Medicine.

When asked why the Connections for a Healthy Pregnancy program is important for our community, Roseann shared, “Not only does a Community Health Worker help the mother, we are helping the unborn baby and the surrounding support system that the mother has. In this way we are positively impacting multiple people’s lives at the same time and also have a small hand in the future. This program is helping mothers make more positive decisions for themselves and their family.” In her spare time, Roseann enjoys reading, writing, watching movies, and spending time with her loved ones.

Claudia Salazar is a certified breastfeeding peer counselor, SOAR certified, and is trained in the IMPaCT model by Penn Medicine. She is compassionate, caring, and enjoys seeing patients be cared for and receive the help they need. She joined the Connections for a Healthy Pregnancy team as a community health worker because she has always loved working with people and families in the community, and is “willing to be that extra hand or support for their needs.”

Claudia feels this program is incredibly important to pregnant mothers in our community to enable them to find resources for a healthy pregnancy like housing, food, child-care, and family services. When asked why she became a community health worker, she shared “I wanted to be a part of a community working together to make a change. I believe that working for Family First Health I am going to have the opportunity to do so, with the amazing team and program we have started.”

David Fetterolf

November 6, 2017

VRI: An Effective Language Barrier Solution for the Healthcare Industry

Good communication between patients and providers is the cornerstone of patient safety and satisfaction in the healthcare industry. However, achieving effective patient-provider communication can be difficult with the growing limited English proficiency (LEP) population in the United States. This population currently exceeds 25 million, up from 14 million in 1990 – a significant increase in less than three decades. In addition, it is estimated that 60 million people speak a language other than English at home, 95 million people have literacy levels below what is required to read and understand basic health instructions, and over 60% of hospitals report treating LEP patients every week.However, video remote interpretation (VRI) can bridge this communication gap. Here’s how:

The Importance of Meaningful Access to Healthcare Information

When Limited English Proficiency individuals seek medical attention, language barriers often hinder effective diagnosis and treatment. Studies have shown that the use of a professional interpreter in a healthcare setting reduces communication errors and can even reduce an LEP patient’s length of stay. These medically qualified interpreters can be accessed on-site, over the phone or via video platforms.

Currently, many institutions rely on either in-person or over-the-phone interpreters. Video remote interpretation (VRI) provides an optimal solution by combining the visual cues of in-person interpretation with the immediacy of phone interpretation. A virtual third party is brought in to facilitate communication between the healthcare provider and the LEP patient instantly and reliably. Essentially, VRI is instant, mobile and personal.

Creating A Comprehensive Language Access Plan

While on-site interpreting has been shown time and again to be the most effective form of interpretation, there are physical limitations to having a live, in-person interpreter when needed. Travel time from the agency to the hospital must be taken into account, as well as the travel time between rooms and departments. The logistics of providing on-site interpretation is challenging, and when an LEP patient needs immediate care, the timeliness of video remote interpretation greatly outweighs the benefits of having an on-site interpreter physically present.

The most effective language access plan incorporates all three modes of interpretation, allowing for more scheduling flexibility, the option to use each mode for situations in which they are most appropriate, and access to a wider range of languages.

The Role of Video Remote Interpretation

VRI is an effective language barrier solution for a number of reasons:

  • It is instant, mobile and cost-effective. Highly skilled American Sign Language (ASL) and language interpreters can be reached over advanced video technology on demand at an affordable cost.
  • Video remote interpreters have extensive training in medical terminology, cultural competency and the interpreter code of ethics.
  • It increases interpreter productivity by eliminating travel time and cost.
  • In an emergency situation, it can be particularly valuable when a medically qualified interpreter in the language needed is not immediately available.
  • It is particularly effective for conversations that rely on nonverbal cues and eliminates the potential for conflicting communications, which increases in significance when the growing population of LEP individuals is taken into consideration. With VRI, medically qualified interpreters can clearly see the patient, taking into account body language and physical cues.

Video remote interpreting has proven to be an extremely powerful language barrier solution for the healthcare industry, as it effectively combines the benefits of both on-site and over-the-phone interpreting (OPI). With VRI, a qualified medical interpreter can be reached in a timely manner without sacrificing the visual cues of an onsite interpreter. And VRI’s advantages do not end with improved communication – it is also an economically sound decision because, on average, hospitals save a significant amount in interpretation costs. With the LEP population projected to rise, it is essential for healthcare providers to have a comprehensive language access plan in place – and VRI just may be the ideal solution.

____________________________________________________________

Author: David Fetterolf

Bio: David leads the overall strategic direction of Stratus Video’s Language Services division. David brings over 26 years of experience working for healthcare information technology and service companies. Prior to joining Stratus Video, he was president and founder of MDeverywhere, revenue cycle management software tailored to the healthcare industry. In 2011 MDeverywhere made the coveted Inc. 500/5000 fastest growing companies list. Prior to MDeverywhere, David was a division president for Datamedic, a leading provider of computer-based patient records and business management software and services for medical practices and clinics. As division president, he was responsible for strategy and financial performance, which included leading the marketing, sales, implementation, support, and manufacturing and development teams. David has a Bachelor’s degree in Electrical Engineering from Cornell University and a Masters of Business Administration from The Wharton School at the University of Pennsylvania.

empowering kids

October 26, 2017

Empowering Medicaid recipients as advocates

Stereotypes and misconceptions about the individuals served by Medicaid are everywhere. In fact, “Medicaid Myths” are so widespread that I devoted an entire article explaining the four key groups that benefit from Medicaid: Children, seniors, individuals with disabilities, and adults.

As I explained in that article, while Medicaid does cover 1 in 2 low-income individuals in Pennsylvania, it also covers working adults who don’t have insurance through their employers, or working individuals who’ve lost their jobs or depleted savings due to an illness.

And yet misconceptions remain: Medicaid recipients are lazy. They’re entitled. They could improve their financial situation if they tried harder. They should be ashamed of accepting assistance.

These beliefs are harmful to the success of Medicaid as a health care safety net, and only add to the confusion around Medicaid and its impact on the communities and populations it serves.

It’s easy to see how these negative perceptions influence Medicaid patients themselves. At Family First Health, a federally qualified health center serving southcentral Pennsylvania, we regularly interact with patients who don’t understand Medicaid or distrust the system, have trouble navigating an ever-changing insurance exchange, or succumb to the stigma surrounding the program and don’t want others to know they’re covered by Medicaid.

A health center’s role

As the national conversation has shifted over the past year, our leadership team has had extended discussions as to our health center’s role in the Medicaid conversation. First and foremost, Medicaid is vital to our role in the continuum of care — to provide accessible, affordable care to underserved areas and populations. More directly, Medicaid impacts our communities by serving those who need it most, leading to better care and better health for our patients.

Our team feels strongly that we play a role in educating audiences on these topics, and debunking the common misconceptions of Medicaid.

Of course, I could shout this from the rooftops until I was hoarse, and perhaps only make a minimal impact. Our approach has to be strategic as we identify audiences who most need to hear our message.

Education in action

This year, National Health Center Week provided a key opportunity to engage our full team and our patient base in sharing Medicaid’s specific impacts. The theme for 2017 celebrating America’s health centers was “The Key to Healthier Communities,” and so our staff took advantage of this message to ask individuals to share why Medicaid matters.

Read through a few responses from our staff and patients (or check them all out on our Facebook page).

·        Without it, there are many services my child could not access to help him succeed.

·        It increases preventative care.

·        Without it, my brother couldn’t get the insulin he needs to survive.

·        It allowed my son to have three life-saving open heart surgeries, and also covered all follow-up care. Today he’s growing, healthy and medically stable.

·        It allows our patients to receive the health care and medications they need.

·        If my dad did not have insurance, he would never have gone to the doctor.

These stories collectively demonstrate the power of sharing your experience.

Imagine if, when legislation threatens to cut funding or eligibility for programs like Medicaid, every individual served by the program used their voice to speak up and advocate for themselves. What if we empowered this group of people to recognize their collective power, to persuade them that they, too, can affect change?

Where to begin

·        Education: Empowering our patients as advocates will always begin with education: Removing the stigma associated with Medicaid and ensuring all patients understand their benefits and how to best navigate the system. When changes arise, we must educate our patients as to their impact.

·        Conversation: We must also be open to hearing their stories — and to take it one step further, to ask for their stories. I was blown away during National Health Center Week by the number of individuals willing to share their personal experiences.

·        Action: Once a patient is fully engaged, they’re likely looking for that next step. How can I ensure I reap the full value of my Medicaid benefits? How can I make an impact for others? How can I share my story? This is where health centers can leverage their own platforms to amplify the patient’s voice: A video testimonial on social media, a story with local or regional media, even a blog post hosted on your website with an interview.

Understanding who benefits from Medicaid is critical. But it is also equally critical to get to know these individuals and empower them to advocate for themselves in our ever-changing health care system.

As we explore additional ways to do so in our own health center, I’d love to hear how you are tackling this challenge in your community.

_______________________________________________________

Jenny Englerth, CEO of Family First Health

October 24, 2017

Mental Illness: Words Matter

Any disease can make a person sad and uncomfortable because it reminds us of our own vulnerability. Mental health disease even more so, because it affects our thoughts, feelings, behaviors and the ability to relate to others or manage daily activities. But unlike talking about medical illness, we don’t talk enough about mental illness due to the attached stigma.

But why is it so important to fight stigma against Mental Illness?  One reason is that it rests on false beliefs. They may include a perception that people living with mental illness are dangerous, incompetent, unreliable, irrational and difficult to interact with or these patients may be responsible for their own poor living conditions or poor attendance to medical and mental health care.

Very often, the behavior of a patient with mental illness is misunderstood.  One misconception is that “People with a mental illness are lazy and weak and if they tried harder they could “snap” out of it.”

According to the US Department of Health and Human Services, Mental illness is very common:  1 in 5 American adults experience a mental health issue, 1 in 10 young people experience a period of major depression.

What can we do?  Most importantly, we can begin to see our patients as a whole person.  Our patients come to us for many reasons and we need to not label them as an illness, be it a medical or mental health illness.  We must begin by being aware of our verbiage.  Instead of referring to a patient as depressed, manic, schizophrenic or BiPolar, begin recognizing the difference in stating the patient (i.e. Jane) is struggling, managing or coping with (fill in the blank).  Our verbiage empowers patients to see themselves, as a patient managing an illness.

_________________________________________________________

Sheila King-Miller, LCSW, CCTP

Family First Health – Behavioral Health Consultant

Man sitting on boardwalk

October 9, 2017

Depression Awareness Month: What are the Warning Signs?

October is Depression Awareness Month and the staff at Family First Health are screening for and treating depression every day. Signs of depression are often characterized by a sad mood, loss of interest in activities, low motivation, and feelings of worthlessness or helplessness. Behavior changes associated with of depression often include problems sleeping, having a poor appetite or over-eating, irritability and an increase in substance use.

There are 5 common warning signs: change in personality, uncharacteristic anger, anxiety or moodiness, social withdrawal, lack of caring for oneself or risky behaviors and a sense of being overwhelmed or hopelessness. Depression is often defined by being a cycle that can be difficult to disrupt and in its most serious form, can lead to thoughts of suicide. The symptoms of depression can also be experienced by people who are dealing with significant life stressors such as the loss of a loved one, loss of job, divorce or other family difficulties. In these cases, such reactions are a normal response to life’s challenging situations and are not a diagnosis of depression.

Depression is different because the symptoms tend to last for longer and are more severe in nature. According to the Depression and Bipolar Support Alliance depression occurs in 20-26% of women and 8-12% of men nationwide. It is one of the most common mental health issues and is responsible for the highest percentage of disability among mental health and behavioral disorders.  Depression is also one of the more common mental health concerns presenting in primary care; 60% of patients in primary care are treated for depression and 79% of anti-depressants are prescribed in the primary care setting.

The good news is that depression can be treated. At Family First Health, we have Integrated Behavioral Health, providing on-site behavioral health consultants to assist patients in dealing with the symptoms of depression by improving or developing coping skills. One of the most effective ways to stop the cycle of depression is to encourage people to re-engage in pleasant activities. Often people forget the things they used to enjoy doing and need extra support and encouragement in getting back involved in their life.

Pleasant activities can include simple things like taking a walk, shopping with a friend, cooking a good meal or working on a puzzle. Exercise or physical activity is essential to both good mental health and physical health and is an effective way to combat depression. It is also important to make sure you have a good support system to help encourage positive activities and reinforce feelings of worthiness. Today we even have apps on our phones that can help with tracking symptoms, meditation, relaxing sounds for sleep and games to distract us from inactivity.

Depression Awareness Month provides an opportunity to be aware of our own mental health and the mental health of our loved ones. If you notice a change in any of the above described behaviors, it might be time to consider discussing this with your primary care provider or a mental health professional.

_________________________________________________________________________

Kathleen McCadam, LCSW

Family First Health – Director of Behavioral Health Integration

 

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