Reasons to Consider Becoming a Blood Donor

By Francis Mercado, MD

The need for blood donations is constant as it contributes to lifesaving care for patients across the country. But only a small percentage of age-eligible individuals donate annually, which can lead to an imbalance between supply and demand.

In January 2022, the American Red Cross declared a national blood crisis, calling this the worst shortage the U.S. has faced in over a decade. This has significantly impacted patient care and providers have been forced to make difficult decisions around blood allocation.

We urge everyone to consider becoming a donor to help combat this shortage and have provided a few benefits of giving blood to help you make an informed decision.

You get access to a free health screening

Upon volunteering to give blood, you will undergo a health screening to ensure you’re fit for donating. This screening involves measuring your vitals, like blood pressure and heart rate, to uncover any potential issues that could hinder you from donating blood. The Red Cross is also screening all donations for COVID-19 antibodies.

You might discover new health issues

Insight into your overall bill of health does not stop at just the initial screening. If eligible, your blood sample will then be sent to a lab to undergo further testing. These additional screenings include:

If the lab technician detects anything awry, you will be notified and can then seek the proper care. This is especially beneficial if you are someone that does not have access to routine blood testing with a primary care physician.

It may reduce your risk of unhealthy iron stores

Hemochromatosis is a hereditary condition where your body absorbs a higher volume of iron from food you eat, resulting in an iron overload. Though rare (200,000 cases in the U.S. annually), individuals affected typically are not even aware they have it. Because donating involves the removal of red blood cells, giving regularly can reduce harmful levels of iron and mitigate risk for patients with hemochromatosis.

You’re saving lives

Above all, each pint donated supports critical care for patients in need of blood. You could be helping a patient survive a risky surgery or aiding a patient that has lost a high volume of blood due to a traumatic injury. No matter the end source, your donation is guaranteed to make a difference.

Considering becoming a blood donor is more important than ever before and we encourage you to donate. For more information, visit https://www.redcrossblood.org/.

If you need medical attention upon blood analysis, find a Virginia Mason Franciscan Health provider on our website here.


Dr. Francis Mercado is the associate chief medical officer of primary care for Virginia Mason Franciscan Health.

A Parent’s Guide to Calling and Going to the Doctor

**By Carrie Jenner, MD**

If you’re a parent, you’re likely familiar with the woes of caring for your child when they become ill. For some, this time can be filled with a whirlwind of uncertainty and second guessing, particularly if your little one is very sick, or it’s lasted a long time. Questions start to surface like, should you wait it out or is it time to call your pediatrician?

While every situation is different, I’ve compiled the below guide that details some of the most common symptoms and issues and when it comes to your child getting sick. Here, I detail when it might be time to make an appointment or other medical intervention, so your focus can be helping your child feel better.

This guide is not meant to replace medical advice. For any concerns, please work directly with your provider.

Fever

Figuring out the best course of action when your child has a fever will depend on their age. If your baby is less than two months old and has a temperature of 100.4 F or higher, it’s imperative to head straight to the emergency room as they could have a serious infection. At the hospital, your baby will receive a full workup of tests to discover the root cause.

In older children, temperatures will vary a bit more (typically between 100-103 F), so pay attention to other factors as well, such as how your child is acting and how long their fever has been going on. For instance, if their fever is on the lower end but they’re irritable or not eating, it might be wise to give your pediatrician a ring. As a general rule of thumb, fevers tend to run for three days. If your child’s fever lasts longer than this, your pediatrician will be able to help you get to the bottom of it.

Coughing and Sneezing

Coughing and sneezing can be associated with upper respiratory infections such as colds, which children are highly prone to catching. Fortunately, the best thing to do here is to let the cold run its course – which can be up to 10 days for viral infections. As mentioned earlier, take your child in if a fever lasts more than three days.

If your child’s nasal discharge starts to thicken and turn green or yellow, this isn’t quite cause for concern as the cells in their body are likely in infection-fighting mode. However, if your child is struggling to breathe at any point or is flaring their nostrils or ribs when taking a breath, enlist your pediatrician as soon as possible. Additionally, if your child has developed a bluish color around their lips or nails, they’re not getting enough oxygen and you should call 911 right away.

Vomiting and Diarrhea

Generally speaking, stomach viruses typically last 2-3 days. They start with vomiting for 12-24 hours, then diarrhea develops and can last a few days. If your child is unable to hold down any form of liquid or solid for over 24 hours, call your pediatrician. Giving small amounts of clear liquids like Pedialyte frequently is the best way to keep your child hydrated during the illness.

While vomiting and diarrhea are fairly common symptoms, the main concern associated with these is dehydration. Some signs of dehydration to look out for include dark urine, sunken eyes, excess irritability, lack of tears if your child is crying or less than 3 wet diapers in 24 hours.

Rashes and Other Skin Conditions

These can be particularly puzzling as rashes come in many shapes and sizes and can be caused by a variety of things. If your child has a rash but doesn’t seem to be bothered by it, then it’s probably fine to treat it with over-the-counter skin creams. However, if the rash lingers for more than a few days and is accompanied by a fever, give your pediatrician a call as this could be a sign of a larger infection.

Other rash symptoms to make your pediatrician aware of include blistering or bubbling, oozing or bleeding, a rash in the shape of a “target” and rashes accompanied with difficulty breathing.

COVID-19

Though children of all ages can contract COVID-19, they typically do not get as sick as adults. Symptoms in children tend to be on the milder side and present in more of a cold-like fashion, including fever, sore throat, chills, muscle aches, nasal congestion or extreme fatigue. Lesser-common symptoms in children can include a new loss of taste or smell and gastrointestinal issues like vomiting and diarrhea.

Of course, children with underlying conditions like obesity, asthma or diabetes may experience more severe illness than children without. As we continue to navigate the pandemic, it’s better to play it safe and call your pediatrician if you suspect your child might have COVID-19, so they can be tested promptly.

It can be arduous discerning between simply letting your child’s illness run its natural course or involving your pediatrician. If at any point you’re unsure of what to do, it’s always a good idea to err on the side of caution and give them a call – they’ll be more than happy to help you identify the root cause so your child can get on the mend.


Carrie Jenner, MD, is board-certified in Pediatrics and currently practices at Franciscan Medical Clinic – University Place. Dr. Jenner enjoys working with children and their parents to develop healthy lifestyles that will continue into adulthood.

What to Know About Medical Weight Loss at Virginia Mason Franciscan Health

Losing weight in a safe and sustainable manner provides an abundance of health benefits, including lower blood pressure, lesser risk of heart disease and better sleep, to name a few. At Virginia Mason Franciscan Health, we believe in improving your overall health and wellbeing in any way we can. We’re excited to announce our new comprehensive weight loss program, offering bariatric surgery and non-surgical weight loss solutions.

We know that figuring out how to begin your weight loss journey can seem daunting, and our specialized clinicians are here to help. Our Medical Weight Loss program deploys multiple treatment options that have been proven in clinical trials to greatly improve the chances of success.

In this blog post, we’ve answered a few frequently asked questions surrounding our Medical Weight Loss program to get you on your way to healthier living.

Who is this program for?

If you’re seeking to improve your health and quality of life by means of losing weight, Medical Weight Loss might be for you. But there are also a few other factors to consider, such as Body Mass Index (BMI) and other underlying conditions.

BMI is the measure of fat in a person’s body as it compares to a person’s height and weight. An ideal candidate for this program may have a BMI greater than 30, or one greater than 27 with other weight-related disorders such as diabetes, hypertension, sleep apnea and polycystic ovarian syndrome.

How does this program work?

Medical Weight Loss is a patient-driven and initiated program, meaning you have an active role to play in choosing your overall treatment. We offer many methods through this program, including lifestyle management, nutrition counseling, and FDA-approved medications and other weight loss options based on your unique needs.

Our highly skilled care team, comprised of experienced physicians, nurse practitioners and registered dieticians, will work with you every step of the way to ensure you’re set up for optimal-results and to achieve your overarching goals.

What sets this program apart from other weight loss programs?

A vast majority of weight loss resources speak to a broad audience, usually via classes, books or videos. The fact is that losing weight is a very personal process and there is no one-size-fits-all approach, with various elements coming into play including genetics, age, sex and lifestyle habits.

Medical Weight Loss offers a level of personalized care you won’t receive by attending a nutritional seminar. Instead, you can be involved in key decisions about your treatment that are tailored to your specific situation, allowing you to work with your provider to determine the best course of care.

Plus, with a wide range of participating clinics across Washington state, our providers are likely within, or near, the community you call home.

Learn more about our comprehensive weight loss program:  

For Medical Weight Loss and to find a provider, go to:

For Bariatric Surgery and to find a provider, go to:

When Care Goes Virtual: The Surprising Benefits of Video Visits

One thing Jillian Worth, MD, ABFP, can count on with teenage patients is their hesitancy to talk about serious subjects in the exam room. For teens coping with mood disorders, typical in-person appointments can feel artificial and discourage conversation. When the COVID-19 pandemic suddenly replaced office visits with video sessions, Dr. Worth noticed something remarkable: her young patients were opening up like never before.  

“What I’ve seen is kids on virtual visit in their bedrooms are more likely to talk about what they’re feeling, in the space where they have those feelings,” says Dr. Worth. “They’re willing to jump right into what they’re struggling with, instead of needing lots of warm-up.”

Another big benefit of video for young patients is flexible scheduling. Arranging an in-person appointment can delay care, when a quick video check-in has the power to turn things around for a teen. Adding a 15-minute virtual visit to the end of her day, says Dr. Worth, is much more doable than a regular visit, and takes care of the patient’s problem when it’s happening.

As a family medicine physician, Dr. Worth sees patients of all ages and backgrounds and surprisingly, video visits have proven beneficial across her diverse practice. Instead of having a patient seated in an exam room, video can offer a little window into their world, revealing the important objects, pictures and even people in their lives.    

“With longtime patients, at some point you stop asking social history questions, like who they live with,” says Dr. Worth. “But maybe you’ll see a grandkid running through the room on video and ask about them, and find out that family has moved in.”

Dr. Worth has discovered that asking her patients new questions that come up through video can lead to better patient care. Patients light up, she says, because they want to tell you more about who they are. They can also feel comfortable enough in their homes to admit problems they’ve never considered discussing in the office. If a patient reveals they feel unsafe in their relationship, for example, the care plan can include steps to address the situation.  

For elderly patients, occasional home visits can be a necessity, but before the pandemic they were usually limited to severely ill and homebound patients. Now that Dr. Worth sees most of her older patients on video, she looks out for them in new ways, such as noticing something in their environment that needs attention.

“I can have them pan around the room and see they have a loose area rug, or a dangerous step going down to their living room,” Dr. Worth says. “Maybe they use a walker and there’s a little dog running underfoot. Things I would never have known from an office visit.”

Then there are the patients who struggle more than others to even get to a provider’s office. Chronic conditions that involve regular appointments for care or medication management can be a challenge for those with debilitating illness, or for those who can’t get time off work. Visits using a patient’s smart phone can happen on a work break. People dealing with chronic pain can avoid a car trip and navigating a medical office building.

Another way virtual care boosts more equal access is the prevalence of smart phones across a diverse patient demographic. “It’s difficult for many working families to get themselves or their kids in for care, but most people have some version of a smart phone,” says Dr. Worth. “The flexibility and the capability of video on their device means they can hop on for a visit wherever they are.”

What’s clear is being able to see a patient when a visit might otherwise not have happened can change the course of illness and recovery. One elderly patient became bedridden and was considering hospice care. A family member held up her phone for a virtual visit with Dr. Worth from the patient’s bed.

“To see her in the office would have been impossible, but I was able to observe how it felt for her when she tried to move around,” says Dr. Worth. “I could see her pain and talk with her. Now we’ve got her in physical therapy at home and I see her sitting up in the living room.”  


Jillian Worth, MD, ABFP, is board-certified in Family Practice and currently practices at the Virginia Mason Bainbridge Island Medical Center. Dr. Worth specializes in family medicine, primary care, pediatrics, preventive medicine and transgender health.

10 Goals to Help You Prioritize Your Health

**By Kristopher Dunbrack, MD**

Prioritizing your health is important at any age, and the good news is that any time is a good time to start. If you’re wondering where, or even how, to start, the following tips are for you. While many of us have fallen out of routine during the pandemic, the below can help center us in areas of our lifestyle that we might not be giving the attention it needs.

The reality is that we are facing a mental health crisis in our country and the pandemic has had a substantial impact on the lives of all Americans. While none of us can control the future of our country, we can prioritize our health—and that can have a significant impact on our wellbeing.

Try a few of the below goals this week and see how you feel.

Physical Activity: Find an activity you like and do it daily.

The best medicine for nearly everyone is physical activity. Daily exercise can be a fun chance to unwind, enjoy the outdoors and do something that makes you happy. Tips:

  • Go for variety
  • Buddy up
  • Pace yourself
  • Talk to your doctor
  • Involve your family
  • Increase gradually
  • Take it outside

Portion Sizes: Increase healthy portions and decrease unhealthy ones.

It’s a fact: we eat more when served larger food portions. Portion sizes have dramatically increased in the U.S. over the past decade. Because eating can be an automatic behavior, portion control is the first step toward healthier nutrition choices. Tips:

  • Understand portion size vs. serving size
  • Use visual cues to determine a serving size
  • Focus on food quality
  • Eat mindfully and enjoy your food
  • Try new healthy recipes

Preventive Health Screenings: Verify your immunizations and health screening tests are up to date or make an appointment to do so.

Regular health screenings are an important part of your health care. Results provide a snapshot of your health and reveal opportunities to make healthy changes. Here are a few of the recommended screenings:

Get Adequate Sleep: Make 7-8 hours of sleep per night a priority.

Sleep is vital for good health and well-being. Adequate sleep is important for your personal safety and that of others on the job or while driving. Sleep impacts mood but it also impacts our immune system, our weight and our risk for serious medical illnesses. Tips:

Try Something New: Do something new each month—challenge your mind and body.

New experiences can be both exciting and scary, but overcoming your fear, embracing your strengths and nurturing your curiosity will help you reap the benefits of personal growth and discovery. Tips:

  • Overcome your fear
  • Build on past successes
  • Leverage your strengths
  • Find the fun

Strength and Flexibility: Add strength training and flexibility to your workout twice a week.

Flexibility and strength aid in improving performance, preventing injury and achieving personal fitness goals. We lose about 10 percent of our lean muscle mass per decade starting around age 30. Fortunately, this can be counteracted with regular strength training. Tips:

Laugh: Laughing every day improves overall health and well-being.

Research shows laughter offers us health benefits in four health dimensions.

  • Physical: Boosts the immune system, promotes healing, helps us cope with serious illness and promotes an overall sense of well-being
  • Intellectual: Boosts excitement, self-assurance and cheerfulness; increases intuition, creativity and imagination
  • Emotional: Reduces stress by providing a positive way to view problems
  • Spiritual: Universal language that fosters connection and compassion

Family and Friends: Invest time in the people who matter most to you.

Having close friends and family has far-reaching health benefits. A strong support network can be critical to destress during tough times. It not only wards off lonelinessit increases your sense of self-worth. Tips:

  • Reflect and focus on relationships
  • Be active and spend time outdoors with those you care about
  • Time invested in friendships can pay off for your health
  • Avoid people that drain your energy

Hydrate: As a rule, men should drink 13 cups of water daily and women 9.

Water needs depend on your health, activity level and where you live. Every system in your body needs water. It flushes toxins, carries nutrients and moisturizes ear, nose and throat tissues. Tips:

  • Exercisers need extra water
  • Keep replacing fluids after exercise
  • Hot/humid weather requires more water
  • Drink one glass with each meal and one between
  • You’re generally hydrated if urine is clear or light yellow

Quiet Your Mind: Find a quiet place, take 10 deep breaths daily.

Quieting your mind is about non-reacting. It’s not eliminating problems or emotions, but rather cultivating a healthy response. It requires a sense of exploration and daily practice. Tips:

  • Seek silence by doing nothing for five minutes a few times a day
  • Breathe deeply 10 times without thinking and notice your experience
  • If your mind wanders, just notice and return to your breathing
  • Practice the “just do it” principle and smile


Kristopher Dunbrack, MD, is board-certified in family medicine and currently practices at Franciscan Medical Clinic – Enumclaw. He specializes in both family medicine and pediatrics.

Hit Me With Your Best Shot: 4 Reasons to Consider Getting Your Flu Shot This Year

**By Christopher Baliga, MD**

The flu is a contagious disease caused by influenza viruses that infect the nose, throat and lungs, causing mild to severe illness and, in extreme cases, can lead to death. Fortunately, there is a way to mitigate both your own risk from the flu and the risk of those around you, too – enter the annual flu shot. These influenza viruses tend to mutate year-after-year, meaning that every flu season is different and warrants a new vaccine each year.

The CDC estimates that in the U.S., flu season can begin as early as October and as late as May, and is most rampant between December and February. The ideal time to get your flu shot is in the weeks leading up to the start of flu season but can still be effective if received later than this.

Whether we like it or not, flu season is right around the corner. Read on for four reasons why you should consider getting your flu shot this year.

It can lower your risk of contracting the flu

I’ll start with the obvious – getting your annual flu shot is your best defense against catching the dreaded flu as it allows your body to harbor and build up the necessary antibodies to protect against each new strain. According to the CDC, when the vaccine viruses are similar to the viruses going around, flu shots have proven to reduce the risk of flu-related doctor visits by 40-60%.

 It’s important to note that while the flu shot doesn’t guarantee full protection, it’s still worth getting.

It reduces the severity of flu-related illness

How your body responds to each flu shot varies from person to person. For example, it tends to be more effective for people under the age of 65, as older folks may develop less immunity after receiving it than their younger counterparts.

But, even if the shot doesn’t completely prevent the flu, it can still weaken the severity of illness if you do end up catching it. It can also lower your risk of developing serious complications that could eventually lead to hospitalization. And naturally, reducing the severity of flu-related illness can also lead to fewer hospitalizations on a macro level.

Getting vaccinated helps protect those around you, too

Receiving a flu shot allows you to play a role in protecting those around you who may be more vulnerable to serious flu-related illness, such as young children, older people and those with chronic medical conditions. It helps train your immune system to fight these nasty germs, which in turn diminishes your risk of transmitting them to those around you.

The flu is expected to have a nasty return post-COVID

Thanks to masks, social distancing and heightened hand hygiene across the U.S. amid COVID-19, other germs were kept at bay – including the flu. But, as these preventive measures begin to ease up, cold and flu viruses are expected to make a nasty return, making this year’s vaccine more important than ever before. Getting your flu vaccine at the same time as your COVID-19 vaccine? No problem – it is safe to get both.

Now that summer has come and gone, it’s time to shift attention to protecting ourselves, and those around us, from the flu’s return by receiving a flu shot. If you’re unsure of where to go for this, check out the HealthMap Vaccine Finder or talk to your doctor.


Christopher Baliga, MD is board-certified in Internal Medicine, with a subspecialty in infectious diseases, and currently practices at Virginia Mason Medical Center. He also specializes in travel health and HIV/AIDS care.

Have fun in the sun and keep your skin safe from harmful UV rays with these 3 tips

**By Natalie Moriarty, MD**

Whether it’s summer or not, every day you are outside is a good day to protect your skin. It might be surprising, but you can still get a sunburn when it’s cloudy outside. Ultraviolet radiation (UV rays) comes from the sun and causes sunburns, and worse, skin cancer.

Damage from UV rays is cumulative, which is why it is important to wear sunscreen even on a cloudy day. While skin eventually recovers from a sunburn you might get over the summer, some damage will remain. This can lead to wrinkles, age spots, rough skin texture and eventually, skin cancer.

The good news is that the U.S. Environmental Protection Agency tracks the level of UV rays by city. Each day, a number between 0-15 is assigned reflecting the strength of the UV rays throughout the day. The lower the number, the less risk. As you might expect, UV rays are stronger during spring and summer months, as well as between the hours of 10 a.m. and 4 p.m.

Read on below for some quick tips, so you can enjoy the weather, steer clear of harmful rays and stay safe this summer and beyond!

Know your skin type

Those at higher risk of skin cancer tend to have lighter eyes and pale skin, many moles or a family history of skin cancer. These individuals should be extra careful with sun exposure, avoid sunbathing and stay on top of regular visits with their dermatologist. It’s also a good idea to monitor your own skin monthly for new skin moles, bumps, scaly spots or places where your skin has changed color. Call your doctor if you notice any of these changes.

Skin cancer is much easier to treat when it is caught early, so get to know your skin, actively watch for changes and check in with a dermatologist routinely.

Use sunscreen appropriately

Every sunscreen is assigned a sun protection factor (SPF), which rates how well it blocks UV rays. In general, you should use a product with SPF 30 or higher, with the words “broad-spectrum” on it. Higher numbers indicate more protection, and a broad-spectrum sunscreen will block both UVA and UVB sun rays (both are harmful). When possible, look for a sunscreen containing zinc or titanium, and choose lotions over sprays. 

If you are around water, snow, at elevation or just prone to sunburns, consider a sunscreen with an SPF 50 or higher.

Remember to reapply often! The protection from sunscreen wears off in about 90 minutes, or faster if you are swimming or sweating.

Practice sun-protective behaviors

Even with proper sunscreen use, some UV rays can still get through. Because of this, sunscreen is only one part of sun protection. The other important sun protective behaviors are seeking shade and covering up with sun-protective clothing.  

In fact, when the sun is the strongest between 10 a.m. and 4 p.m., try to avoid direct exposure altogether. During this time, everyone is at risk for skin damage. If you can’t stay in the shade, be sure to wear a lightweight long-sleeve shirt, sunglasses and a wide-brimmed hat to protect your skin. Choose a pair of sunglasses with a UV400 rating or “100% UV protection” on the label, as these sunglasses block more than 99% of UVA and UVB radiation.

So, the next time you are outside, will you think about protecting your skin? We hope so!


Natalie Moriarty, MD is board-certified in dermatology and currently practices at Virginia Mason Medical Center. She specializes in detection and treatment of skin cancer, eczema, psoriasis, infections of the skin, pediatric dermatology and preventative and restorative cosmetic treatments.

How to Ensure You Get the Health Care You Deserve

**By Jane Dunham, MD**

While your health care team does everything in their power to provide appropriate care, the fact is, nobody knows your body better than you. Therefore, it’s important to be a partner in your medical care: speak up about your needs, concerns, and desires, particularly if something feels off or you have lingering questions.

We know that seeking health care (let alone playing an active role in it) can sometimes feel intimidating, especially if you’re not quite sure about the specifics of your condition. Below, we’ve outlined some tips to help empower you to get the health care you deserve, on your terms.

Educate yourself on your condition or diagnosis

Patients equipped with the proper information regarding their diagnosis may have an easier time playing a role in the care they receive. If you’ve received a diagnosis that’s new territory for you, we encourage you to read about it and ask questions as they arise. Ask your doctor if they can point you toward resources that will help you understand your diagnosis and what to expect. The same goes for medications you are prescribed: Know what you are taking and why you are taking it. Keep an updated medication list with you for reference and be sure this includes any over-the-counter medications or supplements that you take. This information can help to avoid harmful interactions with food or other medications that you may be prescribed.

Ask questions about your care plan

It’s well within your rights as a patient to fully understand any care being prescribed to you. Having a clear understanding of the details of your care plan helps you ask informed questions, aids your care team in setting goals that are realistic and achievable, and helps you provide specific feedback to your care team about how things are going. If you’ve asked a question and still don’t understand, don’t be afraid to ask again. Ask for a written copy of your care plan whenever possible so that you can refer to it as needed.

Consider asking a friend or family member to be your advocate

You don’t have to manage your health care alone. Ask a trusted friend or family member to assume the role of your advocate. Having an advocate can provide incredible support, particularly if you are anxious about your diagnosis or are experiencing any sort of issue that might make it difficult to advocate for yourself. Advocates can attend appointments to help ensure that you get all the information you need and make certain that you don’t forget any questions or important areas to address. It’s not uncommon to forget something when you feel nervous or anxious, and an advocate can help ensure you’re receiving the best care possible.

Participate in every decision regarding your health care

Of course, your medical professional is considered the expert, but YOU are the expert on yourself. If your provider suggests a course of treatment you don’t feel comfortable with, let them know and inquire about other potential treatment options. If something doesn’t feel right to you, we encourage you to speak up rather than just going along with things and feeling uneasy or unsure.

Remember, you are the most important person when it comes to your health. The right health care professionals understand this and will help in any way they can to ease your concerns and ensure your experience is positive. Never be afraid to ask questions. Advocate for yourself and always speak up to receive the health care you deserve.


Jane Dunham, MD is board-certified in internal medicine. She practices at Virginia Mason Medical Center and specializes in preventive medicine and primary care.

Warm Weather Stresses Your Heart: Tips to Stay Cool

**By Mariko W. Harper, MD, MS, FACC**

Did you know that warm weather can put stress on your heart? When temperatures rise, the heart must work harder to keep the body cool. This isn’t great news for those living with heart disease because these individuals will have a harder time adapting, leading to a greater risk for heat stroke than their heart-healthy peers.

Additionally, when the body sweats to cool itself down, you tend to lose water and important minerals, like sodium and potassium. These minerals are necessary for muscle contraction and maintenance of fluid levels. Certain common heart medications, like diuretics, beta-blockers and calcium channel blockers, can also affect how the body responds in warm weather.

Don’t worry, though, as this doesn’t mean you or your family cannot enjoy some fun in the sun! Here are a few tips to protect yourself and your heart when the temperature starts to heat up.

Before engaging in vigorous exercise, consult with your physician

Unless you are an avid exerciser, it’s always a good idea to check with your physician before attempting vigorous exercise in the heat. You might be taking up a new sport or hobby, or perhaps it’s just been a while since you’ve had a check-up. Either way, schedule a quick appointment to get your doctor’s approval. You can also consider shaking up your workout by doing it earlier in the morning or in the evenings when it’s not as hot outside.

Drink plenty of water, even when you don’t feel thirsty

Many of us struggle to get enough water throughout the day, so it’s a good idea to find ways to help remind yourself to stay hydrated. This might mean filling up a large water bottle that you can carry around all day or setting reminders on your phone. You can also “eat your water” by enjoying fruits and vegetables like watermelon and cucumber.  

Avoid being in the sun during the hottest time of day

This one might be a no-brainer, but the best way to prevent overheating is to avoid being in the sun when it’s the hottest, typically from 10 a.m. to 2 p.m. If you must be in the sun during these hours, cover your skin with light-colored and lightweight fabrics, such as cotton, and find shade as often as you can.

Avoid alcohol and caffeine

Both alcohol and caffeine can contribute to dehydration. Stick with water and other non-caffeinated beverages.

Heat presents danger for anyone, but particularly those with heart conditions. If you have a serious heart condition such as congestive heart failure, it is best advised to limit your exposure to extremes of temperature.  If you start to feel dizzy, nauseous or disoriented, get out of the heat immediately, apply cool water to your skin and drink water to rehydrate. If you don’t start to feel better, call your doctor, or seek care immediately.

By remembering these tips and taking extra caution when outside in the sun, a summer of heart-healthy fun and fitness awaits you! If you have any concerns about your heart or overall health, there is no time better than now to reach out to your doctor prior to engaging in new activities. 


Mariko Harper, MD is board-certified in internal medicine, cardiovascular disease, nuclear cardiology and echocardiography. She practices at Virginia Mason Heart Institute. Dr. Harper specializes in general cardiology, echocardiography, nuclear cardiology and hypertrophic cardiomyopathy. 

Get the Pelvic ‘Floor-One-One’

**By Kathleen Kobashi, MD, FACS, FPMRS**

While pelvic floor health disorders can seem alienating, it is important to know that you’re not alone and there are a variety of ways to treat bothersome symptoms.

The pelvic floor is a group of muscles in the pelvic region, that can be described as a “hammock” of ligaments that sling between the pubic bone in the front and the tailbone in the back. For women, these muscles and ligaments work to support and control the uterus, vagina, bowel and bladder; whereas for men, they support just the bowel and bladder.

As a multidisciplinary team, the members of the Pelvic Floor Center at Virginia Mason treat virtually every pelvic floor health issue that can be experienced by both men and women. In this article we’ll dive into common health problems associated with the pelvic floor and why maintaining pelvic floor health is so important. Pelvic floor disorders can become huge quality-of-life issues that can interfere with our daily activities. It is vital for us to be aware that there are successful, minimally invasive treatment options available.

Common health issues associated with the pelvic floor

When it comes to pelvic floor health issues, there are several key terms to remember, like incontinence and prolapse. Incontinence is the lack of control of bladder or bowel function resulting in leakage, while prolapse is the displacement or dropping of pelvic organs through a weak pelvic floor, much like a hernia. There are other pelvic floor disorders that may result in the opposite problem of difficulty emptying the bladder or bowel.

Mother and daughter drinking coffeeThe two most common forms of urinary/bladder incontinence are stress and urgency leakage. Stress incontinence is the involuntary release of urine from coughing, sneezing or other similar actions and is commonly (but not exclusively) experienced by women who have had vaginal delivery of babies. Aging, genetics and gravity can also play a role. Conversely, urgency incontinence is exactly as it sounds – when nature calls, you don’t always have a say in when you answer, and it is urgent. This form of incontinence can be caused by the consumption of dietary irritants, such as coffee or wine, that aggravate the bladder, as well as hormonal changes that make the bladder more irritable. In men, urgency can also be related to prostate enlargement.

Fecal/bowel incontinence (aka accidental bowel leakage) is an involuntary loss of bowel control that can result in stool abruptly leaking from the rectum. Disorders associated with bowel function can range from constipation to complete loss of control of the bowel, and everything in between.

Prolapse occurs when pelvic organs – such as the bladder, uterus, bowels, vagina or rectum – drop down into or outside of the anus or vaginal canal. Prolapse can be due to a number of issues, including pregnancy, childbirth, obesity, chronic respiratory issues, constipation and cancer in the pelvic region.

Signs to look out for and when to see your doctor

If you’re concerned you might be dealing with a pelvic floor problem, here are a few signs and symptoms:

  • Urinary/bladder incontinence – symptoms can include leakage of urine with coughing, sneezing or exercise, and can also be associated with a sudden, intense and often uncontrollable urge to urinate. Other lower urinary tract symptoms may include frequent urination, slow or dribbling streams of urine or the inability to completely empty your bladder.
  • Fecal/bowl issues – symptoms can include chronic bloating, constipation, diarrhea or involuntary loss of fecal matter.
  • Pelvic organ prolapse – symptoms can include a feeling of fullness in the pelvic floor or vagina, a feeling that something is “falling” out of the anus or vagina, discomfort with sexual intercourse, urinary or fecal incontinence, a sense of trapping of stool or the inability to completely empty your bowels.

It’s important to note that any combination of the symptoms above can occur.

The importance of pelvic floor health

Given the critical bowel, bladder and sexual functions these muscles support, keeping your pelvic floor healthy and strong is crucial. There are a variety of exercises that can be done to improve overall pelvic floor health and functionality, with some of the more common ones being Kegels. Working your pelvic floor regularly is especially important for women in order to minimize the risk of developing prolapse, incontinence or other pelvic health issues that stem from pregnancy or aging.

If you’re experiencing any one or combination of the symptoms discussed above for an extended period of time, it may be time to call and arrange a visit with your doctor. From there, they can work with you to decide your best course of treatment, whether that’s pelvic floor therapy or proceeding with some tests that can help identify the root cause of your problem and facilitate treatment planning.


Kathleen.KobashiKathleen Kobashi, MD, FACS, FPMRS is board-certified in urology with a subspecialty certification in female pelvic medicine and reconstructive surgery. She is the section head of Urology and director of the  Pelvic Floor Center at Virginia Mason. Dr. Kobashi is a urologist/urogynecologist who specializes in the treatment of pelvic floor disorders, including urinary and bowel incontinence, pelvic organ prolapse, and urinary tract fistulas, with expertise in pelvic floor reconstruction through open and robotic surgery.