Wednesday, 30 July 2014
What Does Good Care Look Like Part 2

While we specialize in eliminating eye problems, the eyes are really a reflection of your overall health status. Therefore, it is helpful to review what good care looks like. In this second part of our summary, we want to focus on diabetes.

Become more educated about diabetes 
Few family doctors have the time needed to answer a patient's many questions about their diabetes. But a doctor can refer you to diabetes educators who can provide added help and education. For example, a registered dietician may develop a meal plan that will help you manage diabetes and lose weight if necessary. If a doctor says "just avoid eating sweets" in response to dietary questions, this approach is too simple. Seek more detailed care elsewhere.

Doctors frequently work with certified educational programs so patients can learn skills such as blood sugar monitoring and how to incorporate exercise into diabetes care. If test results indicate early signs of kidney disease, eye disease, or out-of-control diabetes, referral to a specialist, like your eye doctor at Cool Springs or Donelson EyeCare, is customary.

Referrals, insurance and physicians
In addition to a family doctor, people with diabetes need to see diabetes specialists and other types of specialists. People treated with insulin and those with complications see specialists more often. 

The latest on preventing complications
People with diabetes are more likely to develop heart and blood vessel disease than non-diabetics. You can reduce the risk of developing these problems, but it involves more than just treating the sugar levels. Blood pressure and cholesterol (lipid) target levels for people with diabetes are lower than for those who don't have diabetes because of the risk of cardiovascular complications. Unless there is a reason that it would be unsafe, doctors recommend taking blood pressure-lowering medications and an aspirin a day to keep blood vessels healthy and prevent cardiac disease. Feet should be examined at every office visit for signs of circulation, nerve problems or unhealed sores. Patients with diabetes need yearly eye exams as well. These are just some of the vital basics of diabetes care - make sure you are getting them! Dr. Keg
Adapted from the article What Does Good Diabetes Care Look Like?  Richard S. Beaser, M.D., Director, Professional Education, Joslin Diabetes Center

Posted on 07/30/2014 1:13 PM by Dr. Jeff Kegarise
Friday, 11 July 2014
Heads Up!

All of the United States and the world have been caught up with the excitement and fervor over soccer's world cup in Brazil. From a sports vision perspective, it's a great opportunity for us to highlight a few important principles regarding soccer and sports vision.

First, head injuries from collisions and/or chronic "heading" off the ball results in traumatic brain injury. We unfortunately see many of the players knocked down only to return a few minutes later.  FIFA, the world oversight body of international soccer, is going to have to address this issue in a more up-to-date and player-sensitive manner. When I was growing up, we were told to "shake it off" whenever an injury or a "ding" occurred. We now know that those dings are actually traumatic brain injuries and the danger exists not only with the first injury, but especially the subsequent second injury when the brain is still vulnerable from the first concussion. Here's a list, in order, of the most common sports that can result in traumatic brain injury:

1.    College Football
2.    College Ice Hockey
3.    Girls College Soccer
4.    High School Football
5.    Boys College Soccer
6.    Girls High School Soccer
7.    Girls College Hoops
8.    Girls High School Hoops
9.    Boys High School Soccer
10.    Boys College Basketball

It's important to have student athletes tested pre-season with pre-concussion baselines and to have coaches and athletic departments aware of the current recommendations for managing concussions on the field. Protocols should be in place for appropriate follow-up with medical personnel who specialize in post-concussion treatment.  Rehabilitation (not in the first two weeks when the brain needs rest) is an important adjunct of longer term post-concussion treatment to help the athlete regain pre-concussion abilities. I hope that our local parents, athletic directors, and coaches are reading or listening to this blog. I wish that FIFA could also.

Posted on 07/11/2014 12:16 PM by Dr. Jeff Kegarise
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