Ask the Doctor: Fall 2020

Advice from Area Health & Wellness Professionals




Q. My mother’s health is declining, and her doctor has encouraged us to look into hospice care. What can we expect?

A. You can expect hospice care to provide support to the patient and family. The hospice team will provide emotional and spiritual support to the patient and family, as well as physical and medical support to the patient. The hospice team includes nurses, hospice aides, social workers, chaplains, bereavement counselors, and physicians. The hospice team will help prepare you for the next stages of your loved one’s disease by providing education about the process as well as how to assist in providing the care your loved one needs. We often hear families tell us they wish they had called sooner because they feel such relief with the support provided. I would encourage you to have a hospice representative come out and discuss the services with you.

Marissa Warden, NP headshot and contact info

Q. Our 5-year-old son was diagnosed with an autism spectrum disorder, and we’ve been told Applied Behavior Analysis is a great tool. What can we expect from therapy?

A. Intensive Applied Behavior Analysis (ABA) therapy is recognized as an effective treatment for autism by the American Academy of Pediatrics and National Institute of Mental Health. The goal of ABA is to help children learn skills they need to be successful across home, school, and community settings. Intensive ABA therapy is often carried out by a behavior technician who is supervised by a Board-Certified Behavior Analyst (BCBA). The hours programmed per week or dosage of therapy is determined following an individualized assessment. Treatment goals are individualized to the needs/priorities of a particular child and his or her family. Common goals include promoting behaviors that align with personal safety, self-care skills, personal hygiene, tolerating transitions, social interactions with peers, and communication. An important and necessary part of ABA is collaboration and coaching of caregivers so that those closest to the child are learning ways to best support him or her throughout the day. Treatment often lasts for a minimum of six months with overall duration based on the child’s needs and rate of progress toward goals.

Melissa Gonzalez headshot and contact info

Q. I fear my daughter might be struggling with the beginning stages
of an eating disorder, but I’m not sure. Do you have any advice?

A. First of all, trust your instincts. You know your daughter better than anyone. Pay attention to possible indicators of eating issues such as a drop in weight (where is she on the growth charts?), exclusion of food groups, and negative talk about her body. Other concerns include changes in her personality. Have you noticed her unique qualities diminished?

The earlier you get support the better. Contact her pediatrician and find a good therapist and registered dietitian who specializes in eating disorders. Make sure she knows she has not done anything wrong but emphasize the importance of support and encouragement for her or anyone who struggles with food, eating, and body image issues.

Pamela Kelle headshot and contact info
wedding bands

Q. My fiancé doesn’t want to do premarital counseling, but I’ve always heard it’s a good idea. How can I encourage him to give it a try?

A. “Can you imagine how different our marriage would’ve been if we had learned these things in the beginning?!” “I wish we would’ve known this stuff when we first got married!”

This is the feedback I get from couples that have been married for 20-30+ years. If I could convince every couple getting married to do premarital counseling, I would! Premarital counseling sets couples up for success by equipping them with the tools they need to be able to address difficult topics they’ll face as a team.

As a marriage therapist, I have found that premarital counseling can make all the difference for a couple. Each of us brings our own individual story and issues into the relationship.
A competent premarital therapist will be able to help you identify those – and hopefully work through those – before you say, “I do.”

With the divorce rate as high as it is, I think the more proactive a couple can be in setting themselves up for success in the beginning, the better off they will be long-term.

Be picky about your premarital counselor. Over 70% of therapists will claim to do couples work, but only about 11% have actual training in working with couples.

Karisa Kaye headshot and contact info

Q. I’m so tired of my varicose veins! How can I get rid of them?

A. Varicose veins are a sign of venous insufficiency in your legs. There are both superficial and deep veins in your legs, and treatment varies depending on what veins are affected. Patients can either be symptomatic or asymptomatic from this. Symptoms include swollen, painful, and heavy legs, or visible veins. The first step is to be evaluated by a vascular specialist. They will examine your legs and obtain an ultrasound to determine the best method of treatment. Treatment may include compression therapy, vein ablation, phlebectomy, sclerotherapy, or venogram.

Elizabeth Hartmann, MD headshot and contact info

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