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>>Lori Casey: Coming up on this edition of Being Well, our
guest is Dr. Scott Meyer, obstetrician/gynecologist from Sarah Bush Lincoln Health System.
Our topic this week is focused on having a healthy pregnancy.
Dr. Meyer will talk about the things that women should do before getting pregnant to
aid in a healthy pregnancy, as well as those things you can do during those 40 weeks so
that you and your baby are happy and healthy. We've got a lot of great information to share
with you this week, so stay tuned for Being Well.
[Music Plays] Production of Being Well is made possible
in part by: Sarah Bush Lincoln Health System, supporting
healthy lifestyles. Eating a heart healthy diet, staying active
managing stress, and regular check-ups are ways of reducing your health risks.
Proper health is important to all at Sarah Bush Lincoln Health System.
Information available at sarahbush.org. Additional funding by Jazzercise of Charleston.
Hello, and thanks for joining us for this edition of Being Well.
I'm your host, Lori Casey. And today, we're talking about having a healthy
pregnancy, and my guest is Dr. Scott Meyer, obstetrician/gynecologist with women's healthcare
of Sarah Bush Lincoln. I got all that out.
>>Dr. Meyer: That's good.
>>Lori Casey: Thank you for coming over today.
We appreciate it. Tell me first what prompted you to get into
this area of medicine? >>Dr. Meyer:
It was a good mix of everything I enjoyed about medicine.
When you go through medical school, you go through many different clinical rotations,
and you kind of find the ones that suit you the best and go toward that direction.
For me, my first rotation was obstetrics and gynecology, and from the first time I was
involved in delivering a baby, it was by far the best thing I ever saw in medicine.
I also enjoyed surgery, and I enjoyed getting to know my patients.
And obstetrics and gynecology gave me a mix of all those things, so it was the perfect
fit for me. >>Lori Casey:
So, tell me, just as an obstetrician/gynecologist, what are the areas of women's healthcare that
you cover? Because, you do a lot more than deliver babies,
which he did this morning, by the way. [Laughs]
>>Dr. Meyer: Yes.
Basically, it's being involved with a women in the entire spectrum of her adult life.
So, from the time she comes in for the first time, not wanting to be pregnant, talking
about ways to accomplish that, until going through every pregnancy that she wants to
have, and then helping her get through the aging process, going through menopause and
the changes that she's going to experience throughout her life.
>>Lori Casey: So, you do surgeries, too.
What kind of surgeries do you perform? >>Dr. Meyer:
A lot of minor procedures, so things like sterilization procedures.
If a woman has a miscarriage or an ectopic pregnancy that needs to be addressed in an
urgent manner, we do that. And then, finally, if a woman has a condition
where she requires a hysterectomy, we do that, as well.
>>Lori Casey: Okay, so the whole scope.
Well, today our focus is on having healthy pregnancies.
So, let's start by what's the ideal range for a women to have a healthy and fairly low
risk pregnancy? >>Dr. Meyer:
It's somewhat difficult to define. Most people consider the ideal age range to
be between the ages of 20 and 35. We know that women who are very young when
they become pregnant have more complications; they're more likely to have preterm delivery,
low birth weight infants, their babies are more likely to die after delivery.
From a socioeconomic standpoint, they're more likely to live in poverty, they're more likely
to be victims of domestic violence, they're more likely to suffer depression.
Older women, on the other hand, it's more of a physiological problem.
Older women over the age of 35 have diminished fertility, they're more likely to have miscarriages
or ectopic pregnancies, they're more likely to have medical complications in pregnancy
like hypertension, diabetes, heart disease, and maternal deaths are much more common at
older ages. So, ideally we want to stay in the center
of the age range. That being said, there's certainly healthy
women over the age of 35 can conceive, carry healthy pregnancies.
But medical complications definitely increase at an older age.
>>Lori Casey: So, if you have a patient that comes in and
says, I'm ready to have a baby, Dr. Meyer, not pregnant yet, but my husband and I want
to start, what would you tell her? >>Dr. Meyer:
The first thing would be to get rid of the bad habits.
Almost 50% of the pregnant women I see smoke at the time they become pregnant.
And the first thing is to stop smoking; it's the most important thing a woman could possibly
do to help her have a healthy pregnancy. Beyond that, it's just being as healthy as
possible. So, if a woman is overweight before she wants
to become pregnant, trying to get closer to an ideal bodyweight or trying to become more
physically fit before she becomes pregnant is beneficial.
>>Lori Casey: Mmhmm.
>>Dr. Meyer: Pregnancy is a physically demanding state,
and the healthier a woman is before she becomes pregnant is definitely better.
Also, women should start taking prenatal vitamins before they conceive.
>>Lori Casey: Okay.
What does that do? >>Dr. Meyer:
The most important component in a prenatal vitamin is folic acid.
Folic acid helps decrease the risk of neural tube defects like spina bifida.
The problem is that the neural tube closes before a lot of women even know they're pregnant.
So, starting prenatal vitamins after a women has the first positive pregnancy test a lot
of times is not terribly beneficial. So, if they can start them before they attempt
conception, that's when the biggest benefit is attained.
>>Lori Casey: Okay.
So, what about for women who have been on birth control for several years?
Will it take them longer to conceive if they've been on a birth control for, you know, more
than a few years? >>Dr. Meyer:
In general, no. It's not a matter, it's not a fact of how
long they've been on birth control which makes the difference, it's more a matter of how
old they are. So, a woman who's 35 who's been on birth control
for 10 years has lower fertility than a woman who's 25 and has been on birth control for
10 years. The vast majority of contraception available
to women is completely reversible within a few days.
Birth control pills are out of their system within about 48 hours.
>>Lori Casey: Okay.
>>Dr. Meyer: So, it's not a matter of how long they've
been on the birth control, it's more a matter of what their age is, and what their underlying
fertility is in the first place, as opposed to how long they've been on birth control.
The one exception to that is the Depo-Provera injection.
It's a shot that a woman gets every three months to prevent pregnancy.
It's designed to prevent conception for three months; however, in some women it can last
one to two years beyond the last dose. So, for women who are on Depo-Provera who
are wanting to conceive, I encourage them to get to a different form of contraception
sooner rather than later, because it may take a year or longer to get it out of their system
before their fertility returns to normal. >>Lori Casey:
What if a woman has an IUD? Does that have any effect on how long it takes
to get pregnant? >>Dr. Meyer:
Not really. Again, there are three different IUD's on
the market right now. Two of them work via hormonal manipulation
of the uterus, and those hormones are gone within a few days.
The second one is actually a piece of copper which is spermicidal.
Once the copper's gone, it's not effective anymore.
So, really, they're completely reversible within just a few days.
>>Lori Casey: So, what do you tell women, what's kind of
the average number of months it takes to get pregnant before they should start thinking
about going to the next step of fertility treatments?
>>Dr. Meyer: I encourage women to try at least six months
to a year. You know, the odds, after six months of trying,
the odds of conceiving spontaneously definitely decrease.
The reality is that most insurance companies won't pay for any form of infertility treatments
or counseling until a woman has been trying for a year spontaneously and has not conceived.
It is certainly normal for it to take six months to a year, even for women who are completely
healthy, have normal fertility, their partner has normal fertility.
So, especially younger women, I encourage to wait at least a year.
A woman who's a little bit older in the first place and maybe less fertile up front, I may
only wait six month. >>Lori Casey:
Because what really is the fertility time frame in a woman's cycle?
It's not a couple of weeks; is it more like a couple of days?
>>Dr. Meyer: As far as when they're actually fertile?
Well, the ideal menstrual cycle is 28 days, which means a woman ovulates on day 14, and
they're most fertile right around that time. They're certainly women who conceive, can
conceive at almost any time because certainly *** are viable in the genital tract for
a week or more sometimes. But we try to target around the date of ovulation
as best as possible. >>Lori Casey:
Are there things, we've talked about some of the physical things that women should do
before they get pregnant, are there some mental things that they should start to kind of wrap
their head around before conceiving? >>Dr. Meyer:
Definitely women with underlying health issues should have those under control before they
get pregnant. Pregnancy is an incredibly stressful state,
and if a woman has some mental health issues beforehand, they don't get better with pregnancy;
if anything, they get worse. >>Lori Casey:
Such as, like, are you talking about anxiety? >>Dr. Meyer:
Depression, anxiety, bipolar disorder; all those kind of conditions can get worse with
pregnancy, rather than better. So, they need to make sure that they are stable
before they become pregnant, preferably stable on either medications or counseling that are
safe during pregnancy. Beyond that, even for women without underlying
health issues, pregnancy is an incredibly stressful time.
There is a lot of anxiety throughout the pregnancy, not only about, you know, what's going on
with the pregnancy, I haven't felt my baby move in an hour, is that normal, but also
what's going to happen in delivery, how good a mom am I going to be.
And it just is an incredibly stressful time. So, they have to be prepared for that.
It's not a state, for nine months you feel the baby move, and then out pops a happy baby,
and you’re a mother naturally. So, there's a lot of stress involved.
And the more a woman is prepared for that, the better.
Ideally, having a good social network is beneficial. We definitely know that women with supportive
partners or spouses, supportive family, definitely have better outcomes than women who don't
have a good social support network. >>Lori Casey:
So, let's talk about the care plan for a pregnant woman.
As she probably takes that first pregnancy test that comes back positive, makes an appointment
to see her doctor, what's the care plan for a pregnant woman?
How often do they see their doctor? >>Dr. Meyer:
In general, we start pregnancy care somewhere between 10 and 12 weeks gestation.
So, when a woman finds out she's pregnant, she needs to, number one, pick a provider
she would like to see and call that office so they can find out, try to determine how
far along she really is and get her scheduled for her first appointment.
At that first prenatal visit, it's a very thorough visit.
We do a complete history, both medical and mental health history, a complete physical
exam that includes a breast exam, a pelvic exam, a pap smear if that's indicated.
There is a lot of blood work that's necessary during pregnancy, and most of that is done
at the first prenatal visit to screen for certain conditions that the state mandates
we should screen for, frankly. And then, we also usually do an ultrasound
at the first visit to verify that she actually has a viable fetus, and to verify how far
along she really is. After that, then the first half of pregnancy,
a woman is seen about once a month. So, between the first visit and 28 weeks,
we see the woman every four weeks. There are some genetic tests that are offered
usually in the late first or early second trimester to screen for down syndrome, spina
bifida, cystic fibrosis, and a few other genetic conditions.
Those are optional tests, but a lot of women opt to have those performed.
Usually, an ultrasound is performed between 18 and 20 weeks gestation to look at, basically
to evaluate the fetal anatomy. And then beyond that, most of the visits just
involve making sure the woman is gaining the appropriate amount of weight; the baby is
growing appropriately, and then answering the many questions women have.
Routine vaginal exams usually don't start until 38 weeks gestation, so we give women
a reprieve from their first visit to the 38 week visit, in most cases.
>>Lori Casey: So, I know a lot of women probably are saying
how much weight should I gain? And what are some of the downsides of gaining
too much weight? >>Dr. Meyer:
Gaining too much weight, number one, can make the labor process more difficult.
So, if a woman gains too much weight during pregnancy that also sometimes means a bigger
baby. Also, extra body weight sometimes causes additional
soft tissue swelling that makes it harder for a baby to get through.
The biggest downside of gaining weight during pregnancy is there's a lot more weight to
lose after pregnancy, and that's not an easy task to perform.
The recommended weight gain during pregnancy has a lot to do with what the woman weighed
before she got pregnant. So, women who are underweight we recommend
they gain a little bit more, women who are overweight would gain a little bit less.
We try to keep pretty close tabs on it now. >>Lori Casey:
Yeah, it used to probably, in the old days it was eat whatever you want, gain however
much you want. But back in the 50s, a lot of Americans or
people weren't as overweight as they are now. So, if a woman is at a normal weight, what
is the recommended amount of weight? >>Dr. Meyer:
The recommended weight gain for a normal weight is 25 to 35 pounds during pregnancy.
The majority of that is actually gained in late pregnancy.
So, the usually recommendation is a half a pound per week through the first half of pregnancy,
and then one pound per week through the second half of pregnancy.
>>Lori Casey: Okay.
So, now you're pregnant. What are some nutritional things that you
recommend for women, as far as eating to maintain their healthy pregnancy?
>>Dr. Meyer: Try to eat as healthy and balanced a diet
as possible. The recommended caloric intake for a woman
is essentially whatever her normal diet is, plus about an extra 300 calories a day.
>>Lori Casey: Okay, so it's not that terribly much.
>>Dr. Meyer: Right, so it's not an extra pizza at night
time, it's an extra apple at some point during the day.
But basically, eat a balanced, healthy diet. There are a lot of physiological changes during
pregnancy. Most women suffer constipation, so eating
a lot of fruits and vegetables during pregnancy is beneficial from that standpoint.
There are certain foods that we recommend women avoid, but in general, not very many.
In general, we recommend avoiding long lived sea fish, like sharks, and swordfish, and
things like that. >>Lori Casey:
Okay. Because of the...
>>Dr. Meyer: Because of the long, when they live a long
time, they can have more toxins. So, normal fish is fine, it's just the long
lived fish we try to avoid. There are some references that say women should
avoid lunch meat during pregnancy. In reality, if they like lunch meat and they're
worried, they should just heat it to steaming, then go ahead and eat it.
>>Lori Casey: Mmhmm.
Is that because of the risk of, like, listeria? >>Dr. Meyer:
There's an infection called listeria, which can have extremely adverse effects on the
fetus. In reality, that's an incredibly rare occurrence.
I tell women they're more likely to get hit by a car than get listeria.
But if they're worried about it, they can just steam their meat.
>>Dr. Meyer: What about caffeine, and coffee, and soda,
things like that? >>Dr. Meyer:
It's recommended that caffeine intake be as minimal as possible.
It's generally accepted that one can of soda a day or one cup of coffee a day is probably
okay. Definitely higher amounts of caffeine slightly
increase the risk of miscarriage, so we try to avoid high caffeine amounts if possible.
>>Lori Casey: Are there other foods or things that women
should avoid? Obviously, alcohol and smoking.
>>Dr. Meyer: Yes.
Beyond that, sushi, things like that. Anything that's not fully cooked.
So, one of the other conditions in pregnancy is called toxoplasmosis.
Most women think they get it from changing the cat litter.
In reality, most women get it from eating undercooked meat.
So, make sure chicken and foods like that are fully cooked before you eat them.
But beyond that, there aren't a lot of restrictions. >>Lori Casey:
Well, let's talk about some of the common pregnancy health, well, not health problems,
but side effects: morning sickness, joint pain.
What causes some of that sort of stuff? Anything women can do to prevent some of those
things? >>Dr. Meyer:
In general, no. [Laughter]
Some of it is certainly genetic predisposition. Morning sickness has a lot to do with the
hormones of pregnancy, and the hormones of pregnancy peak toward the end of the first
trimester. So, most women have morning sickness much
worse in the first trimester, then it tends to get better later in pregnancy.
There's also some, most people have somewhat of a psychological component to morning sickness.
So, women who are more anxious or suffer from depression, things like that are more likely
to get morning sickness, but that doesn't necessarily hold true all the time, either.
Things like joint pain; again, there is a physiological basis for them during pregnancy.
High levels of hormones in pregnancy tend to make all the ligaments a little more loose.
And also, there tends to be a smooth muscle relaxation during pregnancy.
From a pregnancy standpoint, that's a good thing because the pelvis can flex more, and
the baby can fit through there easier. But in late pregnancy, it tends to cause a
lot of hip pain, wrist pain, knee pain, elbow pain, and there's not a lot you can do about
it. >>Lori Casey:
And what about swelling? You hear women talk about their feet and their
lower extremities swelling, especially towards the end.
>>Dr. Meyer: Again, that's somewhat of a normal physiologic
response during pregnancy. We counsel women to watch their salt intake
and drink plenty of fluids, but even women that are on a complete low sodium diet and
drink the water they're supposed to drink still swell.
So, there's not a lot of good ways to prevent it.
Usually, it's a harmless condition, other than it causes some discomfort.
>>Lori Casey: So, if you have your first pregnancy, you
go through with a lot of morning sickness, a lot of those side effects, are you probably
going to have that in the second and maybe the third?
Or you probably, do you see both? >>Dr. Meyer:
Every pregnancy's a little bit different. Certainly, it seems with morning sickness,
if a woman has it with her first one; she's highly likely to get it with the second one.
The joint pain and things like that tend to be compounded with pregnancies because, after
the baby's born, nothing completely goes back to the way it was before the pregnancy.
And then, when you get pregnant again, those conditions are still already there, and then
you add the pregnancy on top of it, things appear to get worse.
So, a lot of women will tell you this is a lot worse than my last pregnancy.
The baby's riding lower now, and things like that.
That's, yes, that's normal. >>Lori Casey:
Let's talk about some of the more significant health problems that you see with pregnancy,
like pre-eclampsia and that sort of stuff. What are some of the more severe things that
can happen? >>Dr. Meyer:
Well, pre-eclampsia is one of the worst ones we see during pregnancy.
Most of the time, pre-eclampsia is detected very late in pregnancy, and usually it's cured
with just delivery of the baby. Where pre-eclampsia becomes a bigger concern
is if it happens earlier in pregnancy, and it sometimes necessitates delivery of the
baby, sometimes very early. We know women who are less healthy before
they get pregnant are more likely to get pre-eclampsia. So, women who are morbidly obese before pregnancy,
women who already have underlying hypertension, women who are diabetic before they get pregnant
are much more likely to get pre-eclampsia. Again, women who are very old or very young
are more likely to get pre-eclampsia. It can be a life threatening condition for
both the mother and the baby. So, in general, it does result in delivering
the infant, even if it's early, mainly to save the mother's life.
>>Lori Casey: Okay.
Are there other things like that, or is that kind of the most common one that can occur?
>>Dr. Meyer: Pre-eclampsia seems to be the most common
one. Obviously, with our population getting heavier,
diabetes is much more common in pregnancy. That tends to not be so much of a life threatening
condition for the mother, as it is sometimes potentially a complicating factor for the
baby. Certainly, women with diabetes have much larger
infants in general. Women with poorly controlled diabetes have
much higher risk of stillbirth. Then again, sometimes delivery is necessitated
early because the baby is not safe inside anymore, essentially.
>>Lori Casey: Let's talk about, now we're, you know, to
the end, and we're talking about birth, what determines for you as the doctor to decide
this one's going to have a C-section or not? Because, is it the mother that gets to decide
that? Or is it...?
>>Dr. Meyer: That's kind of a controversial subject.
In general, vaginal delivery is considerably safer for the mother.
There are certainly conditions where it's not safer, but for the most part, vaginal
deliveries safer on the mother and probably not any more dangerous on the infant.
Having a vaginal delivery also makes subsequent pregnancies a little bit safer, as well.
So, if we end up with a C-section with a first pregnancy that complicates subsequent pregnancies.
So, we definitely encourage women to have vaginal deliveries, if at all possible.
If infants are extremely large, sometimes that prevents us from attempting a vaginal
delivery, especially in diabetic women. If the mother has some sort of underlying
condition which would make vaginal delivery contraindicated, we perform cesarean sections.
There's definitely a push now nationwide for cesarean section on demand, which means the
mother can come in and say, I want a cesarean section.
From an ethical standpoint, that is acceptable. As long as a women is counseled about the
risks she wants to do, it's her body, she can do what she wants to do.
From an insurance company standpoint, that becomes an issue, because right now, most
insurance companies aren't paying for elective cesarean sections.
So, if a woman comes in and says, I want a cesarean section, I can counsel her about
the risks and benefits of doing that, and then she has to decide if she wants to pull
a bunch of money out of her pocket to pay for that, in most cases.
So, although it is certainly becoming more popular in certain areas, most of the time
it's not performed because of financial constraints. >>Lori Casey:
And the, you know, the recovery is longer if you have a C-section.
You’re in the hospital a little bit longer. >>Dr. Meyer:
Much longer. In general, a woman who has a vaginal delivery
is in the hospital one to two days after vaginal delivery.
After a cesarean section, it's usually two to four days.
In addition, women with vaginal delivery go home without very much discomfort.
Women with cesarean sections usually need pain medicine for a week or more.
So, they're slower to get up and get around when they get home, they need much more help
taking care of their infant when they get home, or taking care of their children when
they get home, and they have a much slower return to normal functioning because of a
cesarean section. >>Lori Casey:
In these last few minutes, I want to talk about wives' tales or myths; I'm sure you've
had many a mother come in and say, I heard this.
What are some of the most common ones that you hear that are just completely outlandish?
>>Dr. Meyer: I have yet to hear any that are true.
The most common ones have to do with the fetal heart rate determining the sex of the baby,
meaning it's usually if the heart rate is high, it's a girl; if it's low it's a boy.
But nobody can tell me what's high and what's low.
And I really wish it would hold true; that would save us a lot of ultrasounds probably.
The other one is that if you have a lot of heartburn, you're going to have a baby with
a lot of hair. That doesn't hold true.
A lot of women believe that they're more likely to go into labor when there's a full moon
or when there's a thunderstorm. Again, that doesn't hold true.
Beyond that, there's a lot of advice from mothers that I tell people to ignore.
I get a lot of mothers telling their daughters to take castor oil to make them go into labor;
don't do it. >>Lori Casey:
Don't do it. >>Dr. Meyer:
It's not fun. >>Lori Casey:
No, I would think not. And just finally, as we wrap up, just give
our viewers out there just a few last things that they should be thinking about to have
a healthy pregnancy, even before they get pregnant, and during their pregnancy.
What are your last bits of advice? >>Dr. Meyer:
My first piece of advice is don't get pregnant until you're ready to.
About 50% of the pregnancies in this country are not planned, and that certainly complicates
things, both physically and emotionally. But for a woman who is planning a pregnancy,
be as healthy as you can before you get pregnant. So, it's probably beneficial to wait a year
to get in good physical health, as opposed to trying to hurry up before you get to a
certain age, because in general, a healthier woman a year later is going to do better than
a younger woman who's not healthy. So, if they're not regularly exercising, get
into a regular exercise routine. Pregnancy is stressful on the body, and labor
is incredibly stressful on the body, and the better physical shape a woman is in beforehand,
the better she's going to do. Similarly, any medical conditions that she
has should be well controlled before she tries to get pregnant.
You shouldn't try to get pregnant two weeks after being diagnosed with diabetes.
You should have your diabetes well controlled; make sure your doctor who's controlling your
diabetes is comfortable with you getting pregnant before you even attempt it.
>>Lori Casey: Okay.
Sounds like a... We've got a lot of questions we didn't get through, so you know what that
means. You have to come back.
>>Dr. Meyer: That's okay.
>>Lori Casey: Thank you for coming by Being Well today,
Dr. Meyer. >>Dr. Meyer:
You're welcome. [Music]
>>Ke’an Armstrong: Remember this? You’re all excited about a high school dance and
the day of the event you wake up with a giant zit. Acne
happens to everyone at some point or another and it can be a huge source of embarrassment
and stress for many teens. Doctors at Mayo Clinic have tips on how to
best prevent and treat teenage acne. No matter how much you wash your face
or apply anti-acne ointment, breakouts still happen.
Some people argue that acne is not a medical disease but, rather, a
developmental condition because everyone gets acne.
That’s the tough truth of youth. The medical term is acne vulgaris, and Mayo
Clinic Dr. Dawn Davis says there are four main factors that cause it. Over growth of
skin, clogged pores, oil production and bacteria, called propionibacterium, or p-
acnes.
The bacteria grow on our skin all the time, but then once we get one of the
other components of acne, which is oil production, the p. acnes has a food
source and then it can grow and multiply easier.
Your immune system fights back causing redness. Plus you can get whiteheads
and blackheads, which many think are plugs of dirt stuck in pores.
People assume it’s due to chocolate or to pizza or to dirt, and a lot of parents
encourage their teenagers to scrub their face harder or the teenager thinks they
should scrub their face harder to get out the dirt. But actually, what happens is an
oxidization reaction between the oil and the bacteria and their byproducts. The
pore is simply congested with bacteria, oil and bacterial waste. And when this oil
gets exposed to the oxygen in the air, it turns brown. So I always tell my patients
this is not dirt. It is not chocolate. It's not from
pizza. It's simply biology of your skin.
So how do you prevent and get rid of acne? Dr. Davis says start with using
your hands to gently wash your face with a mild soap and water. For milder cases,
try over the counter products that contain salicylic acid or benzyl peroxide. If that
doesn’t work, Dr. Davis recommends seeing your primary care doctor who can
prescribe stronger medication such as antibiotics and acid products. If acne
persists or is severe, dermatologists are there to help.
Dermatologists use isotretinoin for very severe acne.
As you can see here, treatment can work. It does take time; your skin has
many layers and it takes about three months to turn over. But with diligence
and the right products, most teens can end up with clearer skin. For Mayo Clinic
News Network, I’m Vivien Williams. Production of Being Well is made possible
in part by: Sarah Bush Lincoln Health System, supporting
healthy lifestyles. Eating a heart healthy diet, staying active
managing stress, and regular check-ups are ways of reducing your health risks.
Proper health is important to all at Sarah Bush Lincoln Health System.
[music]