Doc, Should I Go to the ER?

By Dr. Kenneth Rudd, MD, MPH, MHCDS from Grace Cottage Family Health & Hospital

How do you know when it’s time to go to the hospital Emergency Room versus seeking care elsewhere?

Because I work as both an Emergency Room doctor for Grace Cottage Family Health & Hospital in Townshend, VT, and as a primary care doctor for Dartmouth-Hitchcock in Lebanon, NH, and have also worked for an Urgent Care Center, I enjoy helping patients navigate the best place to go for healthcare.

The Primary Care Advantage:

My main advice, which I have seen hold true all over the world, from living in China for seven years, to studying Public Health, to working at Dartmouth College and the World Health Organization on international healthcare collaborations, to global primary care research on shared decision making, is, whenever possible, see your primary care provider (PCP).  

What doctor knows you best?  Where do you have relationship and trust? If it isn’t with your PCP, then find a provider that is a good fit for you and build this. 


Lymphedema Therapy: Not Just for Breast Cancer Survivors

Lymphedema Therapy

Abigail Abbott and Cindy Kenyon, Grace Cottage Physical Therapists

If you have had breast cancer, it’s quite likely that you’ve heard of Lymphedema. As many as 50% of breast cancer survivors must deal with this condition.

But breast cancer isn’t the only cause of Lymphedema. It can be congenital, meaning you can be born with the tendency. Or it can be caused by dysfunction of valves in the vein of an arm or leg (in medical terms, this is called chronic venous insufficiency). If you have unexplained swelling in an arm or leg, it could be due to Lymphedema.

The good news is that help is available to relieve this swelling. Specially trained therapists can offer treatment to start you in the right direction, and they can teach you to carry on with this treatment for yourself.

Further good news: Lymphedema therapists are few and far between, but Grace Cottage now has two physical therapists certified to provide this therapy, Cindy Kenyon and Abby Abbott.

In order for us to explain what is involved with Lymphedema therapy, we first need to explain what causes Lymphedema.


Graston Technique Promotes Faster Soft Tissue Healing

By Margaret van den Bergh, PT

Graston Technique. It’s a strange-sounding name for a new physical therapy method that can help patients heal faster from soft tissue injuries like sprains, fibromyalgia, tennis elbow, golfer’s elbow, back pain, carpal tunnel syndrome, tendonitis, shin splints, trigger finger, and plantar fasciitis, to name a few.

Backed by over 20 years of research, clinical studies, and successful clinical application. GT therapy is part of the curriculum for 43 advanced degree programs in physical therapy, chiropractics, and athletic training. It is used regularly by over 250 professional and amateur sports teams and by U.S. Olympic training centers. There are over 16,000 certified physical therapists, chiropractors, and athlete trainers worldwide.

Now three Grace Cottage Family Health & Hospital’s physical therapy staff members are also certified to offer this treatment: Rebecca Griswold, PTA; Melissa Walker, DPT; and me.


Be a Life Saver!

By Dr. Timothy Shafer, Grace Cottage Family Health

Did you know that you have the potential to save eight lives, by donating your organs after you die? All across the nation, thousands of people are waiting for a heart, lung, liver, pancreas, kidney, or intestines. Others could benefit from a tissue donation. You could make the difference.

It’s understandable that talking about organ donation is difficult. Until the issue touches you directly, affecting you or someone you know, it’s easier to avoid the topic.

Consider, though, that this is one way you can save someone’s life without risk to your own.

Consider also the following illustrative story: A baby boy was born a few years ago. It should have been a happy occasion, but instead, there was much anxiety because the baby had two malfunctioning kidneys. If only one kidney was faulty, he could have survived that way.

It is actually fairly common to live with one kidney. Some people are born this way. Amazingly, others give away one of their kidneys to help someone who needs it. As long as they protect the remaining kidney, they can live normal lives.


Time for a Colon Cancer Screening Test? You Have Options

By Dr. Ewa Arnold, Grace Cottage Family Health

Is it time for your colonoscopy? I bet you’re not looking forward to that! Colon cancer screening tests are highly unpopular, but they are certainly worth the discomfort.

Did you know that colon cancer is the second leading cause of cancer deaths in the U.S.? The disease affects both men and women, mainly but not exclusively those over age 50. Despite this dire morbidity statistic, it’s important to remember that colon cancer is highly treatable—if discovered early. That’s why it’s so important to have your colon screening tests on schedule.

March is National Colorectal Cancer Awareness Month, so this is a good time to revisit the topic.

The Centers for Disease Control (CDC) recommends that, beginning at age 50, adults have regular screenings until at least age 75. Colon cancers generally develop slowly. After age 75, you should discuss the alternatives with your provider.

Despite the notoriously uncomfortable preparation required,


What Do Your Kidneys Do?

By Dr. Maurice Geurts, Grace Cottage Family Health

What is the function of your kidneys, and why do you have two of them? Good questions to ask, especially during March. It’s National Kidney Awareness Month.

First question first: your kidneys are two bean-shaped organs, each about the size of your fist, located just below your rib cage and toward your back, near the spine. They are part of an important blood filtering system that extracts wastes and extra water, sending this out of your body through the bladder.

The kidneys are busy organs. They filter about 150-200 quarts of liquid each day. One or two of these are excreted as urine, and the rest of the liquid returns to the bloodstream.


Take the 2 + 3 Challenge

By Cheryl Shaw, Grace Cottage Family Health & Hospital Health Coach

Winter. Fresh fruits and vegetables. When gardens and farmland are buried under snow, it’s easy to think these two don’t go together, but actually, winter offers us a wide array of super healthy, budget-friendly fruits and vegetables to enjoy.

Why is it so important to get plenty of fruits and vegetables year-round? These two categories of foods are powerhouses for the essentials vitamins and minerals that perform hundreds of roles in the body. They are important for growth, healing, repair and maintenance of all of the body’s systems. Deficiencies in vitamins and minerals can lead to fatigue, illness and disease. Experts suggest we eat 5-9 servings of fruits and vegetables each day in order to stay healthy.

It’s best to eat the whole plant foods themselves. They provide natural, not synthetic, vitamins and minerals, plus fiber, and disease-preventing phytochemicals not generally available through multi-vitamin pills.


Time is of Essence During a Heart Attack

By Lisa May, RN, Clinical Nurse Educator, Grace Cottage Hospital

What is the difference between a heart attack and sudden cardiac arrest? One of the biggest differences is time. A person having a heart attack may have time to get help.  

One out of four deaths in the U.S. is caused by heart disease. It is the leading cause of death for both men and women. The term “heart disease” actually refers to a variety of conditions. The most common one is coronary heart disease, when plaque builds up in the arteries, narrows them, and restricts the flow of blood. A heart attack occurs when an artery becomes blocked, restricting blood flow and oxygen to an area of the heart. Without blood and oxygen, that area of the heart becomes ischemic and dies. 

Time is of the essence during a heart attack, but depending on how severely the blood flow is compromised, the person having a heart attack may have enough time to get help, as long as early warning signs are heeded.


SAD: Don’t Suffer, Get Help

By Benjamin Wright, Psychiatric Nurse Practitioner, Grace Cottage Family Health

Do you have the winter blues? Winters can be long and difficult here in Vermont. The most recent weeks of temperatures well below zero certainly gave our community a spell of hard New England weather. Cold weather and heavy snow falls can limit outdoor activities. With less time spent in outdoor activities, less exercise, long nights and less time in the sun during the winter months, some people experience sad moods.

When the symptoms of the winter blues become severe, they could mean the person is experiencing Seasonal Affective Disorder, also known as SAD. Seasonal Affective Disorder is a serious medical condition and is best treated by a medical provider. The symptoms of SAD include depressed mood, low energy, too much or too little sleep, change in appetite and weight, diminished interest in things that were once enjoyed, poor concentration and, in some cases, thoughts of suicide.


What Does Your Thyroid Do?

Lucian Devan

By Devan Lucier, Grace Cottage Family Health AGNP

One of the first health promotions for 2018 is National Thyroid Awareness Month. That’s appropriate, considering how vital your thyroid is for all of your body’s functions.

The thyroid is a butterfly-shaped gland in your neck (just below the Adam’s apple). I have heard this gland compared to a car engine because, just as the engine controls when and how fast the car runs, likewise, the thyroid gland produces hormones that control everything that happens in your body. These hormones determine your adrenaline and dopamine levels, and therefore, your responses to fear, excitement, and pleasure. They also control metabolism–how fast your heart beats, how calories are burned, how your body uses food, and a number of other important actions. If your thyroid is not working right, all kinds of things will go wrong.