The correct use of seatbelts and infant and child carseats increases the rates of survival in motor vehicle accidents. It is important to buckle yourself, and your children, in appropriate safety restraints whenever you get in the car. This is true even for short trips. Most accidents occur near the home. Statistics from the U.S. Department of Transportation show that (in 2004) Nebraskans wore their seatbelts "79% of the time":http://www.statemaster.com/graph/trn_sea_bel_use-transportation-seat-belt-use which was about the national average but well below the 95% use of states like Arizona and Hawaii. The proper use of child safety seats greatly improves the chances of a child surviving a serious motor vehicle accident. Children should never ride without a safety seat or booster seat appropriate for their age, they should always be restrained properly, and they should never ride in the front seat. "This page":http://www.nhtsa.dot.gov/cps/cpsfitting/FindFitting.cfm lists local child safety seat inspection stations that operate on a regular basis. The "Broken Bow Fire Department":http://brokenbowne.org/id2.html has child safety seat inspections every other month. The "American Academy of Pediatrics":http://www.aap.org publishes a guide for proper child safety seat use "on their website":http://www.aap.org/family/Carseatguide.htm and is a great resource for proper use. If you have further questions you can always contact Central Nebraska Medical Clinic or talk to your doctor. Remember, it only takes a few seconds or minutes to buckle up when you get in the car and it can save a lifetime. 2009-06-05T09:25:36-05:00 19 1 image/jpeg child_safety_seat.jpg 26287 2009-06-05T05:25:36-05:00 true 2009-06-05T09:31:49-05:00 People who experience heartburn at least two to three times a week may have gastroesophageal reflux disease, or GERD. The most common symptom of GERD, heartburn, is estimated to affect 10 million adults in the United States on a daily basis. Heartburn is experienced as a burning sensation in the center of the chest, which sometimes spreads to the throat; there also may be an acid taste in the throat. Less common symptoms include: * Stomach pain (pain in the upper abdomen) * Non-burning chest pain * Difficulty swallowing (called dysphagia), or food getting stuck * Painful swallowing (called odynophagia) * Persistent laryngitis/hoarseness * Persistent sore throat * Chronic cough, new onset asthma, or asthma only at night * Regurgitation of foods/fluids; taste of acid in the throat * Sense of a lump in the throat The following signs and symptoms may indicate a more serious problem, and should be reported to a healthcare provider immediately: * Difficulty or pain with swallowing (feeling that food gets "stuck") * Unexplained weight loss * Chest pain * Choking * Bleeding (vomiting blood or dark-colored stools) *Treatment* Changes to the diet or lifestyle have been recommended for many years, although their effectiveness has not been extensively evaluated in well-designed clinical trials. Thus, these recommendations may be helpful in some, but not all people with mild symptoms of reflux. Weight loss — Losing weight may help people who are overweight to reduce reflux. In addition, weight loss has a number of other health benefits, including a decreased risk of type 2 diabetes and heart disease. Raise the head of the bed six to eight inches — Although most people only have heartburn for the two- to three-hour period after meals, some wake up at night with heartburn. People with nighttime heartburn can elevate the head of their bed, which raises the head and shoulders higher than the stomach, allowing gravity to prevent acid from refluxing. Raising the head of the bed can be done with blocks of wood under the legs of the bed or a foam wedge under the mattress. Several manufacturers have developed "commercial products":http://www.bedge.com for this purpose. However, it is not helpful to use additional pillows; this can cause an unnatural bend in the body that increases pressure on the stomach, worsening reflux. Avoid reflux inducing foods — Some foods also cause relaxation of the lower esophageal sphincter, promoting reflux. Excessive caffeine, chocolate, alcohol, peppermint, and fatty foods may cause bothersome reflux in some people. Quit smoking — Saliva helps to neutralize refluxed acid, and smoking reduces the amount of saliva in the mouth and throat. Smoking also lowers the pressure in the lower esophageal sphincter and provokes coughing, causing frequent episodes of acid reflux in the esophagus. Quitting smoking can reduce or eliminate symptoms of mild reflux. Avoid large and late meals — Lying down with a full stomach may increase the risk of reflux. By eating three or more hours before bedtime, reflux may be reduced. In addition, eating smaller meals may prevent the stomach from becoming overdistended, which can cause reflux. Chew gum or use oral lozenges — Chewing gum or using lozenges can increase saliva production, which may help to clear stomach acid that has entered the esophagus. Medication -- Over the counter medications such as Prilosec, Zantac, or Pepcid can also improve symptoms that are not controlled by the conservative measures listed above. For more than mild symptoms of reflux you should consult your healthcare provider. 2009-06-01T11:03:34-05:00 18 1 image/gif image001.gif 44434 2009-06-01T07:03:33-05:00 true 2009-06-01T11:03:34-05:00 In the coming days and weeks we will be highlighting each new feature of http://www.cnmcpc.com separately. Today we’ll be talking about the new schedule section. Clicking on the schedule section of the navigation bar will take you to the schedule page. At the top there are listings of the Central Nebraska Clinics and their hours of operation. Note that the CNMC clinic in Broken Bow is open every other Saturday. Located directly below this information is the schedule application. You can select a provider from the dropdown list and then click on a day and see the provider's schedule for that day. Because the four physicians in the practice must round in the hospital once every four weeks there will be gaps in their schedules. This can help you find out when your doctor will be in clinic and schedule appropriately. In the next version of the site there will be an appointment scheduler which can help you make an appointment to be seen right from the site. 2009-05-08T15:10:46-05:00 17 1 image/png schedule-grab.png 120015 2009-05-08T11:10:45-05:00 true 2009-05-08T15:10:46-05:00 In the coming days and weeks we will be highlighting each new feature of http://www.cnmcpc.com separately. Today we’ll be talking about the new links section. At the bottom of each page you'll find a section of links that will provide more information on topics of interest. The first visible section is populated with links that we think will be of help to current or prospective patients. Clicking on these links will navigate you away from http://www.cnmcpc.com but you can return quickly by using your browser's back button. The next section of links are calculators used by our providers to improve quality of patient care. These calculators are freely available and patient's may use them but they will probably be of limited interest to patients without the guidance of a health care provider. Ask your provider if they will go through the calculations with you if you are interested. The third section contains contact information for local hospitals and specialists to assist you in contacting their offices. Finally, the clinical reference links section provides a quick reference for your health care providers to information they need to deliver the best care possible. The same caveats apply to this section as to the calculators section. We plan to add many new and helpful links in the future so check back often for updated information to help you make informed health care choices. If you would like to suggest a link email us using the link in the contact bar or "create an account":http://www.cnmcpc.com/patients/new and then "log in":http://www.cnmcpc.com/login and send us a message. 2009-04-17T12:34:24-05:00 16 1 image/png cnmcpc_links_screen.png 90478 2009-04-17T08:34:22-05:00 true 2009-04-17T12:35:41-05:00 In the coming days and weeks we will be highlighting each new feature of http://www.cnmcpc.com separately. Today we'll be talking about the new maps page. The clinic addresses that were previously located at "http://www.cnmcpc.com/schedule":http://www.cnmcpc.com/schedule have been moved out into their own page at "http://www.cnmcpc.com/map":http://www.cnmcpc.com/map in order to add some clarity and extra functionality. Clicking on the "map" link next to each clinic address will show that clinic on the map directly below the addresses. You no longer have to leave the site to view the map. You can zoom using the controllers on the left of the map and pan by dragging the map around with the mouse pointer just like any other Google Map. Try it out and let us know how you like the new feature! You may send us a message by creating an account "here":http://www.cnmcpc.com/patients/new and then using the form at the bottom of each page to send a message. 2009-04-16T06:45:34-05:00 15 1 image/png cnmcpc_map_screen.png 143031 2009-04-16T02:45:33-05:00 true 2009-04-16T06:46:15-05:00 Jennie Melham Medical Center will be hosting childbirth classes on April 7th, 14th, and 21st 2009. The classes will be held in the Multipurpose room at the Melham Medical Center. To register for the classes please contact *Wanda Anderson* at *(308) 872-4100 ext. 4386*. The childbirth classes will use internet based and interactive materials, and are a great idea for any moms or dads to be. 2009-04-03T05:38:49-05:00 14 1 image/jpeg pregnancy_1.jpg 16672 2009-04-03T01:43:18-05:00 false 2009-04-03T05:43:19-05:00 Sleep apnea is a serious condition that can affect a person's ability to safely perform normal daily activities and can affect long term health. Approximately 25 percent of adults are at risk for sleep apnea of some degree. Sleep apnea's chief cause is a small upper airway. As the bones of the face and skull develop, some people develop a small lower face, a small mouth, and a tongue that seems too large for the mouth. These features are genetically determined, which explains why sleep apnea tends to cluster in families. Obesity is another major factor. Tonsil enlargement can be an important cause, especially in children. Loud snoring, fatigue, and daytime sleepiness are all symptoms of sleep apnea. However, some people have no symptoms. For example, if the person does not have a bed partner, he or she may not be aware of the snoring. Fatigue and sleepiness have many causes and are often attributed to overwork and increasing age. The following symptoms can be caused by sleep apnea: * Restless sleep * Awakening with choking, gasping, or smothering * Morning headaches, dry mouth, or sore throat * Waking frequently to urinate * Awakening unrested, groggy * Memory impairment, difficulty concentrating, low energy The goal of sleep apnea treatment is to maintain an open airway during sleep. Effective treatment will eliminate the symptoms of sleep disturbance; long-term health consequences are also reduced. Most treatments require nightly use. The challenge for the physician and the patient is to select an effective therapy that is appropriate for the patient's problem and that is acceptable for long term use. Contact your physician if you think you may have sleep apnea. More information can be found by visiting the following links: # "American Academy of Sleep Medicine":http://www.sleepeducation.com # "CDC Sleep Disorders":http://www.cdc.gov/sleep/disorders.htm # "Up To Date - Sleep Apnea":http://www.uptodate.com/patients/content/topic.do?topicKey=~OL0MfuAtZAAqj0&selectedTitle=1~149&source=search_result 2009-04-01T13:25:51-05:00 13 1 image/jpeg sleep-apnea-heart.jpg 22616 2009-04-01T09:25:50-05:00 true 2009-04-01T13:26:36-05:00 *Mark your calendars!* This year Central Nebraska Medical Clinic will be performing school physicals at the Broken Bow office +May 12+ from +4:00 PM+ to +7:00 PM+. In addition, physicals will be performed at the following locations on the following dates: # Sandhills School in Dunning +May 6+ from +9:00 AM+ to +12:00 NOON+ # Sargent office +May 21+ from +2:00 PM+ to +4:00 PM+ # Ansley office +May 27+ from +9:00 AM+ to +12:00 NOON+ Both boys and girls who will be in grades 8-12 during the 2009-2010 school year may have their school physicals done at those times and all dates will be open to students from any school in the surrounding area that wishes to participate. *No immunizations* will be given during these times. Therefore, it is recommended that 7th graders call the clinic and schedule an appointment for their physical and immunization updates. More information will be forthcoming in the school's newsletter, and in further announcements at "cnmcpc.com":http://www.cnmcpc.com in the upcoming weeks. Pre-participation physical forms can be downloaded from the "Nebraska School Activities Association website":http://nsaahome.org/textfile/spmeds/PPE.pdf. The forms should be completed and taken to the physical. You can subscribe to the announcements feed "here":http://www.cnmcpc.com/announcements.atom so you don't miss any further important announcements about the school physicals or any events at Central Nebraska Medical Clinic. 2009-03-03T06:51:12-06:00 12 1 image/jpeg school-kids-studying.jpg 110905 2009-03-03T01:51:12-06:00 true 2009-03-19T06:33:18-05:00 The following studies are currently available for enrollment at Central Nebraska Medical Clinic: h3. Diabetes # *GLP153* - A randomized, double blind, placebo controlled study to evaluate a new once-weekly injectable diabetes medicine. Open to Type 2 diabetics who are _not controlled on Glucophage alone._ # *GLP154* - A long term safety study for the injectable diabetes medicine mentioned above. Open to Type 2 diabetics who are _not controlled on Glucophage or Glucophage and another medicine._ # *GLP155* - A randomized, double blind, parallel-group study to evaluate safety of twice-weekly injections of the new diabetes medicine mentioned above, plus oral medicine. Open to Type 2 diabetics who _not controlled on one or two medicines._ # *GLP156* - A randomized, double blind, placebo controlled, parallel-group study to compare the safety of twice-weekly injection of the new diabetes medicine mentioned above as compared to placebo. Open to Type 2 diabetics who are _not controlled on diet and exercise alone._ # *GLP157* - A randomized, double blind, placebo controlled, parallel-group study to evaluate safety of once weekly injection of the new diabetes medicine mentioned above in combination with 3 other oral medicines. Open to Type 2 diabetics who are _not controlled on two medicines alone._ h3. Osteoarthritis # A randomized, open label study of Celebrex compared with ibuprofen to evaluate the potential of ulcer production. Open to patients with _osteoarthritis._ h3. Soft Tissue Injury # A randomized, double blind, placebo controlled study to assess effectiveness of topical Ketoprofen cream for tendonitis, acute sprains, and bursitis. Open to patients with the aforementioned injuries. h3. Constipation # An observational, longitudinal, multi-centre study to compile data on treatment of patients with chronic constipation. Open to any patient with _chronic constipation._ You can talk with your doctor or "Terri Leibert":http://cnmcpc.com/staff#terri about enrolling in these studies. Call the clinic or send us a message if you are interested. 2009-02-18T10:07:06-06:00 11 1 image/png generic_scientist_blue.png 697509 2009-02-18T05:07:03-06:00 true 2009-02-18T10:07:06-06:00 On *April 1st, 2009* a diabetes educator Faye Anderson will be at Central Nebraska Medical Clinic to see patients and teach them about diabetes. Faye Anderson is a certified diabetic educator and will educate patients in a one-on-one environment with up to one hour long appointments. The education will be tailored to each patient's needs. To schedule an appointment please call the clinic or click the link above to email us. Appointments will be on a first come, first served basis. Further reading about diabetes: "Up To Date reference for patients":http://www.uptodate.com/patients/about/toc.do?full_url_key=true&tocKey=table_of_contents/patient_information/diabetes "Centers for Disease Control":http://cdc.gov/diabetes/ "American Diabetes Association":http://www.diabetes.org 2009-02-17T13:35:40-06:00 10 1 image/jpeg diabetes_0.jpg 12434 2009-02-17T08:35:40-06:00 true 2009-02-17T13:36:33-06:00