Dr. Patricia Gunter, ADC Menopause specialist answers some common questions about hormone therapy.

The following is the full transcript of the video.

Why do women choose hormone therapy?

Most women take hormone therapy because of the vasomotor symptoms, hot flashes, night sweats, difficult sleep, mood swings, those sorts of issues that come along with menopause.

Are younger women taking hormones? Why?

There are younger women that should take hormone therapy because if you go through a premature menopause you get premature aging. Whether it’s osteoporosis, early onset heart disease, and so younger women should take it just to maintain until the normal time of menopause.

What is the difference between premature and early menopause?

Premature menopause of a woman is under 40. And those women do have more significant health issues in general.

Early menopause is under the age of 45. In the most recent North American Menopause Society guidelines, it is recommended that women who have menopause under the age of 50 should be encouraged to take hormone therapy.

Are there different types of hormone therapy available?

That’s one of the best things about menopause now, as compared to when 20 years ago is that we have a lot of options.

We have estrogen in pill form, we have estrogen in gel, in patches, in creams, in vaginal products. And, we have progesterone in pills and, to some extent, synthetic progestins are also in patches.

Another thing is that we have bioidentical and we also have synthetic bioidenticals.

Does hormone therapy cause breast cancer?

This giant study that was done called The Women’s Health Initiative Study was published in 2002. There was a slight increased risk of breast cancer in women on the combination pill that was used in that study. The problem that people don’t realize is that there was actually a decreased risk of breast cancer in women who took the estrogen alone product. And so, we believe that the problem was the synthetic progesterone that was used.

The increased risk of breast cancer did not show up in the first 3-4 years, but did continue to go up every year and it amounts to an additional 8 cases per 10,000.

How long should you take hormones?

It’s only recommended to take hormones until either the natural aqe of menopause, which in the US right now is 52, or until the symptoms are manageable.

And, all women are different. Most women, the symptoms are worse in the first 3-5 years, but there are women who have symptoms for 10 or more years. In fact, 10% of women will have symptoms the rest of their lives.

What are the risks of hormone therapy?

Besides the risk of breast cancer, which we talked about already, there is an increased risk of blood clots if estrogen is taken in pill form. That was one of the problems clearly seen in the WHI study that was published. And this is increased also in women as they aged, and also increased with obesity and various health problems like high blood pressure, diabetes, high cholesterol.

So, we do recommend that older women who still have to take hormones are probably best off with transdermal. Now, that is the biggest concern besides the breast cancer. There are also smaller risks if you start hormones in pill form after the age of 65 – there’s an increased risk of Alzheimer’s disease. We suspect if that started younger that it doesn’t show up.

What are the benefits of hormone therapy?

There are other benefits, primarily prevention of osteoporosis. The younger a woman is when she starts hormone therapy, the more benefits we see. Particularly on the heart – cardiovascular system in general. But it’s primarily symptom relief.

What are bioidentical hormones?

This is a complicated topic. And it’s been associated with something called custom compounding hormones. Technically bioidentical means “exactly like what the body used to make”. So it means estradiol instead of ethinyl estradiol; or instead of conjugated equine estrogen. Because that’s what the ovary used to make is estradiol.

There’s only one commercially available FDA approved bioidentical progesterone. And, it has to be coated in peanut oil so that it will pass through the body and be properly absorbed. It’s very difficult to get the bioidentical progesterones absorbed.

So, this got confused with the custom compounding industry which started really in the mid 1990s as far as hormones go. And, it is true, that the custom compounded hormones are all bioidentical, but there are also FDA approved bioidentical hormones. So, just because something is bioidentical does not mean that it is custom compounded.

Does hormone therapy cause weight gain?

Unfortunately, hormones are associated in some manner. There is a natural weight gain that happens to all women between the ages of 45 and 60. And if you keep doing exactly the same thing you’ve always done you’re going to gain weight whether you take hormones or not. Now, if you take 100 women, the vast majority of women are just going to go along that normal trajectory, whether they take hormones or not. There may be a small number of women who have an increase in appetite from some of the synthetic progesterones in particular. But, in general, I see women who sleep better and feel better are more likely to stick to their diet and exercise. So, net, if you take 100 women it’s not going to be any different whether women choosed to take hormones or not.

Will women on hormone therapy have periods?

When estrogen was first discovered, and first given to women, it was given all by itself and there was an increased risk of uterine cancer. So doctors purposefully gave women progesterone for 10 days every month which prevented the uterine cancer but gave them periods. Which they didn’t like. So, a long time ago, when I was first in training 30 something years ago, they started giving a small dose of both every single day. And, eventually, women do stop bleeding. Although, there can be some irregular, light bleeding right at first. Now, if we start hormones before a women has not gone a year without a period, we do see more irregular bleeding. And, in general, it improves with time. But for women who just don’t like irregular bleeding I give them the progesterone for 10-12 days each month and make that a scheduled period.

Hormone therapy can be highly individualized

We can individualize therapy. 30 years ago when I was in training, we only had one choice and that was premarin and prempro and women either took it or they didn’t. And, now we have a lot of choices available so that we can tailor it to both for the risk/benefit ratio and also for the patient’s basic symptom relief. And, for cost-factors because some of these things are covered better by insurance than others are. So, women who are young should take it; women who are in their 50s, newly menopausal, having symptoms – don’t be worried about the risks because for younger women the risks are very small. But, it probably isn’t a good idea for women who don’t have any symptoms to take hormones just to look younger, or feel younger, because it will catch up with you eventually.

For more information about Dr. Patricia Gunter or to make an appointment call 512-901-4022.

August is National Immunization Awareness Month

Getting the kids ready for back to school means making time to get new clothes, supplies, back packs and more, but parents are reminded to make time to update your child’s immunizations.  ADC Circle C family practitioner Adrian Dennington, DO discusses immunizations for various age groups including college bound students and adults.

There’s a lot to do this time of the year. While August is the time to transition to back to school it’s also National Immunization Awareness Month. So if you plan to vaccinate your kids after vacation. Dr. Adrian Dennington with The Austin Diagnostic Clinic joins us to talk about why now is a good time to get it done.

Why is this the best time of year to immunize?

It’s just a good time of year, summer is over, you’re getting the kids ready for school. It’s a nice reminder to make sure to get in and get a doctor’s appointment so it’s something that is not forgotten over the years.

Kids of all ages need immunizations.

You may have children of different ages and they all require different things.
for toddler, there are a number of immunizations that come in series. When a child is two there is a series and again when they turn four years old.  Those are the main immunizations for elementary school kids.

How do you prepare kids for a shot?

Dr. Dennington says that nurses and parents help a lot. Parents can talk to the kids about the shot before preparing them for what’s coming. It may not be a fun visit but at least they know what to expect.  The Academy of Pediatrics published this article to help parents manage a child’s pain and anxiety during a shot.

For older children:

Your a kid until your 18, so they are shots until you are 18. 12 to 13 year old and older you look towards the HPV or gardasil vaccine to help prevent certain cancers in boys and girls when they are older. And for students going off to college
meningitis shots are very important.

Do adults get vaccinations too?

There are some routine vaccinations that most adults should get. The shingles vaccination is one that adults may get starting at 60. When you turn 65 a pneumonia vaccine is also recommended.

And the annual flu shot is recommended for everyone 6 months and older. Winter is coming, and it is a good way to remember in the fall to get your flu shot.

Shot schedules

The CDC does have a schedule for the recommended timing of shots for children and adults.  For those parents who may not want to stick to the schedule, Dr. Dennington recommends that individuals have that conversation with their doctor or pediatrician. He says some doctors can be very regimented with what the CDC recommends because those schedules are determined based on very good evidence. There is some variation; it just depends on the doctor.

What about parents who don’t want to vaccinate at all? Again, Dr. Dennington recommends having those conversations with your doctor so everyone is on the same page.

Gigi asks if there are some schools that require specific vaccinations and Dr. Dennington says yes.  It’s best to check with your child’s school for those specifications.


CDC Immunization Schedules – the links below will take you to the CDC site.

Dr. Adrian Dennington sees patients at ADC Circle C.  To schedule your visit contact our Call Center at 512-901-1111.

Strawberry Pineapple Paradise Shake takes your taste buds to the tropics!

This delicious Strawberry Pineapple Paradise weight loss shake makes you feel like you’re relaxing in a tropical paradise.


  • ½ cup pineapple chunks – canned with 100% juice
  • 1 cup frozen strawberries (unsweetened)
  • 1 HMR Vanilla 70+ shake
  • Cold water or ice as needed


  • Blend fruit together with juice, ice and/or water
  • Add the HMR Vanilla 70+ shake. Blend until combined.
  • Pro tip: For a thicker shake, add more ice and for a thinner shake, add more water.


For more information about the ADC Health Risk Management program for weight loss call 512-901-4540 or join us for a free weekly orientation.

Berry Cloud Mousse is Divinely Delicious!

The ADC Health Risk Management team once again brings you a delicious, healthy and divine Berry Cloud Mousse to enjoy anytime!


  • 1 cup frozen berries (unsweetened)
  • 2 tsp sugar-free pistachio pudding
  • 1 HMR Chocolate 70+ shake
  • ¼-1/2 cup cold water


  1. Use a food processor to blend fruit.
  2. Add water.
  3. Add HMR 70+ shake and pistachio pudding.
  4. Blend to a fine consistency.

For more information about the ADC Health Risk Management program for weight loss call 512-901-4540 or join us for a free weekly orientation.

Looking to add a healthy twist to your Taco Tuesday? ADC Dietitian and Diabetes Educator Haley Kormos, RD pulls together a nutrient rich, flavorful, easy to make taco recipe that you and your family will love!


  • 8 corn tortillas
  • Vegetables
    • 1 tablespoon canola oil
    • 1 sweet potato, diced
    • 1 zucchini, diced
    • 1 yellow squash, diced
    • 1 red onion, diced
  • Spices
    • 2 teaspoons chili powder
    • 1 teaspoon cumin
    • 1 teaspoon garlic powder
    • 1 teaspoon oregano
    • 1 teaspoon onion powder
    • 1/4 teaspoon sea salt
    • 1/4 teaspoon fresh cracked black pepper
  • Avocado-Chipotle Crema
    • 1/2 cup water
    • 1/2 avocado
    • 1 chipotle pepper from canned chipotle adobo
    • 2 teaspoons adobo sauce from canned chipotle adobo
    • Juice of 1 lime
  • Black Beans
    • 15-ounce can of fat-free refried black beans
    • Juice of 1 lime
  • Optional Toppings
    • Sliced radishes
    • Lime wedges
    • Queso Fresco


Pre-heat oven to 425 degrees. Toss diced vegetables with canola oil and spices until well-coated. Spread vegetables onto parchment lined shallow baking pan. Roast for 40 minutes, stirring once half-way through the cooking time. Remove from oven, set aside.

While the vegetables are cooking, combine all of the ingredients for the avocado-chipotle crema and blend either in a blender or in a small container using an immersion blender.

Heat the beans on the stove top until warm. Stir in lime juice, taste, and adjust seasonings as desired.

Divide the beans and roasted vegetable mix evenly between the corn tortillas. Top the tortillas with a scoop of the beans, a scoop of the roasted vegetable mix, and then a drizzle of the avocado-chipotle crema. Add additional toppings, as desired. Enjoy!

Nutrition info:

Per taco: 182 calories, 28g carbohydrate, 7g fiber, 6g fat, 5g protein

How to clean your hearing instrument

ADC Audiologist Janet Davila, Aud, CCC-A takes viewers on a step by step tutorial on how to clean the most common hearing instruments.   She demonstrates how to clean three types:

  • Receiver in the Ear
  • In-the-Ear
  • Behind the Ear

Receiver-in-the-ear hearing aid

  1. First, you pull the dome off of the hearing aid speaker. You put it in a tissue and you roll the dome or squeeze the dome in the tissue to remove the wax that’s in the dome.
  2. Next, you’re going to pull out the wax guard that’s in the speaker and it’s that little white light saber-looking object. You take a black tab off of the wax guard wheel and then, you pick up your speaker. You’re going to take the empty post or the pulling post, push it into the dirty wax guard until it snaps. Then, you pull it out. Now, you’re going to put the new wax guard into the speaker. Just push it in, press it kind of firmly and it will stay in. Lastly, you put your dome back on your speaker and your hearing aid is clean and ready to go.
  3. This is an older version of receiver-in-the-ear instrument. They can have wax guards with blue tabs or gray tabs, depending on the model. When you buy new wax guards, bring your packaging so you know what you need for your instrument.

In-the-ear hearing aid

  1. If you have an in-the-ear model hearing aid, it works the same way. Pull it out with a pulling post and put a fresh, clean wax guard in after you’ve pulled out the dirty one.

Behind-the-ear hearing aid, with custom ear mold

Notice the ear mold is a custom ear piece. The hearing instrument ear piece needs to be cleaned where that tube comes out or comes through the ear piece. That’s where your sound is coming through. You can pick up from us a small brush with a wire-loop at the end. That wire-loop can be used to clean wax and other debris out of that top hole. It also has a bottom hole called the vent, that lets air in and out of your ear. So keep that one clean in exactly the same way.

Additional information:

Different hearing aids require specific types of wax guards (filters) and domes. Below is a general list. Try to keep your packaging and bring it with you when you need to purchase new supplies, in order to ensure that we provide you with the appropriate type.

  • Oticon hearing aids
    • Wax guard: ProWax, NoWax, or ProWax miniFit, depending on hearing aid
    • Dome (hat): RITE or miniFit, depending on hearing aid (various sizes/styles)
  • Phonak
    • Wax guard: Cerustop
    • Dome (hat): Smokey dome (various sizes/styles)
  • Widex
    • Wax guard: Nanocare
    • Dome (hat): Instant or RIC domes, depending on hearing aid (various sizes/styles)

For more information about the ADC Audiology department and the services we provide patients of all ages,  visit our page or call our office at 512-901-4808.

Seeking work life balance every day

Dr. Yetunde Sokunbi, family practitioner at ADC Circle C is like the rest of us and struggles to find that perfect balance of job satisfaction and enjoying life.  In this video Dr. Sokunbi shares some of what she does and the advice she gives her patients to help achieve their own work life balance.

Why is it important to have a work life balance?

I think work life balance is really important for everybody so I really encourage all my patients to make sure they take time for themselves each and every day after they come home from work. Whatever you do to center yourself every day –  to kind of just take what I call ‘me-time’ if you want to say. Because it helps you just kind of relax after a long, long, stressful day.  I think having hobbies is really important. I think friends and having good social support is really important for everybody. Just because of where our society is now. We’re always on the go, so I think taking time out for yourself and making sure you’re spending time with your loved ones is really important for you.

What do you like to do?

I’ve been doing voice-lessons because I really like music a lot so voice-lessons weekly is kind of my thing after work. I think exercise is really important so I encourage all my patients to find something that they like to do, whether that’s..I have some people that like to do Zumba, people that like to do running, I have people that have roped me into doing Camp Gladiator early morning, so I’m going to start doing that in a couple of weeks so that’s really cool. I think running’s really fun. I used to run a lot, so I’m trying to get back into that so I’m training for a half-marathon.

I also love soccer so I’m a huge Arsenal fan so I think it’s important if you love sports or love watching sports, kind of you know, watch with a group of your friends, just hanging out and having a good time. It’s important to keep yourself mentally active, so if you like doing puzzles or reading, just getting involved in your community, however you can. Either through volunteering, that’s really important. Having a spiritual practice is really important too. I go to church and that is really enriching for my life.

Advice for patients

So, I tell my patients these things. You don’t have to do a ton of things. You can just find one thing and kind of be consistent with it. So, I encourage you all to find whatever you love and pursue it with all your passion.


For more information about Dr. Sokunbi visit her biography page or to make an appointment call 512-901-1111.


How does gestational diabetes affect you and your baby?

Dr. Kiran Mechineni, an Ob/Gyn specialist with The Austin Diagnostic Clinic in North Austin discusses risk factors, its affect on mom and baby and what you can do if you are diagnosed with gestational diabetes.

What is it?

It’s diabetes that occurs in pregnancy. This causes high blood-glucose levels, which can negatively affect the pregnancy and the well-being of the baby.

Risk Factors 

If women eat a lot of carbs, about 50-60% of their diet is carbohydrates, they are at an increased risk. If they are obese and also they have a sedentary life. Those are the risk factors that increase gestational diabetes.

According to the American College of Gynecology, gestational diabetes is more likely in women who

  • are older than 25 years
  • are overweight
  • have had gestational diabetes before
  • have had a very large baby
  • have a close relative with diabetes
  • have had a stillbirth in a previous pregnancy
  • are African American, American Indian, Asian American, Hispanic, Latina, or Pacific Islander

How can it affect my baby and me?

Gestational diabetes can increase the risk of gestational hypertension, preeclampsia and also the babies are big so increased risk of cesarean deliveries or operative deliveries in the women. And, in the baby, they can cause, because there is high sugar levels, the babies grow bigger and they are called macrosomic babies. Also, the fluid around the baby increases, called polyhydramnios, and at the time of delivery, there is increased risk of operative delivery like vacuum, forceps or cesarean deliveries. Also, there is increased risk of unexplained fetal deaths. And after delivery, there is increased risk of the babies having hypoglycemia, jaundice and later on, they may become obese and diabetic too.

What can I do?

Women with gestational diabetes have to change how they eat and they mainly should eat less carbs. Carbohydrates should be around 30-40% of their diet and 20% of protein and 40% of fat. And in the carbs too, they have to eat low glycemic index foods and switch from simple carbs to complex carbs like from white rice to brown rice, quinoa, all those things, oats. From white bread to brown bread, things like that and also increase their fiber intake so that way, the diet is controlled. And also, do moderate exercise.


American College of Gynecology (ACOG) Gestational Diabetes Overview

 ADC Urgent Care practice manager Katy Bolton, RN shares some tips to celebrate safely during Fourth of July and when you should visit an urgent care.  She stopped by the KXAN studios to speak with Gigi Barnett about what to keep in mind when planning activities this holiday.

Safety first for a fun holiday!

 Stay hydrated

  • Water is the best choice.
  • Fruits like watermelon, cantaloupe and grapes can also help keep you hydrated.
  • Avoid sugary drinks and caffeine and limit alcohol intake.


  • Choose the right sunscreen SPF 30 or higher.
  • Make sure to reapply often usually every 2-3 hours especially after swimming or excessive sweating.

Bug spray

  • Choose a bug repellent with 20% Picardin – it’s shown to be more effective against Zika carrying mosquitoes.
  • If you use a more natural repellent – make sure to reapply often, at least every 2 hours.
  • If you have known stinging insect allergies, make sure to carry your Epi-pen with you always.

Keep food cool and out of the sun

  • Clean your utensils and cutting surfaces.
  • Separate your meats and veggies- use different cutting surfaces and containers for storage.
  • Cook meats to safe temperatures.
  • Chill immediately.  Keep food out of the sun and store and chill quickly to avoid harmful bacteria from forming.

 Be fireworks smart

  • Even sparklers burn at 1200 degrees and may cause 3rd degree burns.  Consider giving young children glow sticks or bubbles instead.
  • Always supervise children & young teens around fireworks.
  • Make sure to have water close by.
  • Be aware of any burn bans and or other regulations governing your neighborhood/county.

When should you seek help at an urgent care?

We hope you stay healthy and safe, but when should you seek care?

  • Minor burns or cuts, sprains or strains
  • Upset stomach or nausea
  • Sunburns that continue to feel hot, cause nausea or headaches even after treatment with cool compresses
  • Bites that cause an allergic reaction
  • Signs of Dehydration – this is where IV hydration can help at the urgent care.
    • Thirst
    • Dry or sticky mouth
    • Not urinating very much
    • Dark yellow urine
    • Dry, cool skin
    • Headache
    • Muscle cramps


For more information about ADC Urgent Care locations and services call us at 512-901-1111 or visit our webpage.   Our Urgent Care offices are located north at ADC Cedar Bend and south at ADC Circle C.  We welcome ADC patients and the general public, adults and children, most insurances, and there is never an ER deductible.

Healthier Eating is a Family Priority

We recently sat down with ADC Cedar Park pediatrician Kimberly Albert, MD to talk about ways to get your child to engage in making healthy food choices.  As parents, the first thing is establishing that healthy eating is a priority for you and your family.

1. Start them young

The younger you start, they don’t know any different. This is all they know is eating lots of fruits and veggies, lots of good protein sources such as, beans, lentils, lean meats, fish, eggs and such. And they don’t know that there are such things as white bread or sugary cereals and that along the way there.

2. No good or bad foods

Never ever should you use food as being good or bad foods. Only being as a reward. You should never use it as foods being related to weight. The term ‘fat’ should never be used. Food should be, again used in terms of nutrition.

3. Mealtime is family time

You should try to eat together as a family even when they are very young. At least one meal a day and set a reasonable expectation. Maybe 15-20 minutes and then gradually extend that up to half hour.

4. Be the provider

As the parent, you provide the food that the children choose from. But you can’t control them eating. They’re the ones who control the eating. So you put out the healthy stuff, don’t engage in battle as to whether they are going to eat it or not eat it. And don’t worry if they don’t. If they get up and they haven’t eaten, tell them if you’re hungry later, I’ll leave this for you and you can come back to have it. You are not starving them by any means but you just don’t replace it with something else.

5. Be creative

Make it fun – have it in an encouraging plate or something like that that kind of helps them get through there. Let them be able to be participating in feeding themselves. Something like their food can stay in one place and food doesn’t touch one another. That’s something kids can’t stand is that if one food touches another. You know, having them have utensils that are appropriate for them and that they can start becoming more independent on their eating and such on that.

6. Offer small meals

Now, if you have a child that tends to eat very small amounts and you are always worried that they’re not eating enough, well break the meals into instead of 3 big meals, into 5 or 6 small meals. So take the fruit out of your dinner and let that be the afternoon snack or let that be the after dinner snack.

7. Disguise the taste of healthier foods

Veggies are always a hard thing to do. Well, it is okay to hide it into things. Maybe you mix into a spaghetti sauce, maybe you bake sweet potatoes into pancake or waffle.

8. Have fun in the kitchen

Have them participate in the preparation of foods and that is the hard thing, I think. A lot of the times with our busy lives is kind preparing ahead of time as to what are the best foods.

9. Stay involved

You know, help the kids with their choices. Help them make their lunches. Cut up vegetables and fruits on the weekend and get them ready so it’s easy to go during the week. If they’re going to buy lunch at school, help them look at the meal plan before and help them choose what things they want to eat.


*Disclaimer: The products shown in this video are not endorsed by The Austin Diagnostic Clinic. They are used for demonstration purposes only.

Prevention is the best defense against Zika

Crystal Cherico, RN, Travel Clinic Director discusses how to prevent Zika while traveling. The Zika virus is a virus that is transmitted by a day-time biting mosquito. It’s in a family of viruses that can cause an array of symptoms. Most of the times Zika causes high fever, some joint paint, flu-like symptom. The reason it’s garnered such national attention is because of the link to a birth-defect if pregnant women are infected. Children generally display the same symptoms but can become more severe if they become dehydrated due to fever.

How is Zika transmitted?

It’s primary transmission route is through a mosquito bite. So if you’re bit by an infected mosquito it will take a few days for the symptoms to appear, that virus will stay in your blood for about 5-7 days. It is also able to be transmitted through sex and blood transfusions but those are rare. For women, it’s only in the blood stream for 5-7 days. For men, it can last longer in the genitourinary tract; Some studies have shown the virus persists for 3 months and there are continuing studies to confirm how long the virus is present.

Are there special precautions for pregnant travelers?

If you are a pregnant traveler, we always advise to delay to cancel travel to Zika-infected areas. For standard travelers, practice insect precautions. That means, covering up as much of your body as possible with clothing. They sell insect-repellent clothing which is a good idea. We also want you to cover any exposed body areas with an insect repellent that is proven to help ward off the mosquitoes that carry these diseases. All insect-repellents can be applied beginning at 6 months and older and it’s safe to use in pregnancy. Before 6 months, we recommend people practice strict insect precautions for infants.

Is there a vaccine for Zika?*

There is not a vaccine for Zika. It’s symptomatic support. Most people get mild flu-like symptoms that can be treated at home with over the counter medications. People who have more severe symptoms and get dehydrated may need to seek medical treatment.

What can I use to prevent mosquito bites?

According to a recent Consumer Report study, the product that was the number one rated insect-repellent was Sawyer’s branded ‘Fisherman’s Formula’ with 20% Picaridin. It is a Picaridin based insect repellent versus Deet or lemongrass repellant. Picaridin is proven to help ward off mosquitoes for 8 hours at a 20% concentration. The Sawyers has a pleasant smell and is gentle on the skin. We always tell our travelers 6-8 hours but if you shower or swim or sweat profusely, you do need to re-apply. Just make sure you’re wearing your insect-repellent. Practice good insect precautions.

Sawyer Fisherman's Formula, Zika prevention, The Austin Diagnostic Clinic





Know how to prevent heat-illness

Austin is no stranger when it comes to extreme heat. With summer heat taking its hold over Central Texas, making work and play during the day much more uncomfortable.. and possibly more dangerous.  Heat illness is a condition doctors and providers at The Austin Diagnostic Clinic see a lot more of during the hottest months of the year.

What is heat illness?

Heat cramps

Heat cramps are painful muscle spasms, and they usually happen while exercising in the heat. They are usually caused by not drinking enough fluids.


  • Rest and cool down
  • Drink fluids, especially those with electrolytes
  • Gently stretch and massage the muscles affected

Heat exhaustion

Heat exhaustion is more serious than heat cramps. It is often associated with

  • Weakness
  • Cold or clammy skin
  • Heavy sweating
  • Nausea
  • Weak pulse
Drying off with towel

It’s important to find ways to stay cool in the heat.

Heat exhaustion can lead to heat stroke if it is not treated. If you or someone with you shows signs of heat exhaustion:

  • Go to a cool place and rest
    The best place to go is a building with air conditioning. But you can also get out of the direct sun and find shade.
  • Drink fluids
    Water with electrolytes is best, but be aware that sports drinks may have a lot of sugar. Avoid soda and alcohol, which can actually cause dehydration.
  • Take a cool shower
    Applying cool water to your skin can help cool you down.
  • Loosen your clothing
    Remove any unnecessary layers so that air can reach your skin to cool you down.

Heat stroke

Is the most severe form of heat illness. It happens when you body is no longer able to regulate its own temperature.


  • Body temperature over 103 degrees
  • Hot, red skin
  • Rapid heart rate
  • Loss of consciousness

In the case of a heat stroke, call 911. The person should be moved to a cool place immediately.

How to prevent heat illness

Fortunately, there are steps you and your family can take to manage the heat and avoid harming your health. Howard Baade, a nurse practitioner with The Austin Diagnostic Clinic, says it starts with planning your time outside. “Exercise common sense,” Baade said. “Don’t go out and try to be a hero when it’s 105 degrees at 2 o’clock in the afternoon. Give yourself 15 minutes on and 5 minutes off.” Baade recommends checking the weather forecast before heading out for the day. “Sometimes, if the humidity is too high or the heat and humidity combined are high, it could affect what you are going to do the rest of the day,” he said. Sometimes just knowing what to expect can help you avoid heat illness.

What are some other things you can dobefore you go out in the heat?

  • Drink water
    Hydrating before and during strenuous activity outdoors is crucial. Avoid waiting until you are thirsty to drink water.
  • Eat smaller meals, including a little salt
    Foods can also replenish some of the necessary electrolytes. Just a small amount of salty foods, like crackers, can replenish as well as fluids.
  • Wear loose-fitting clothing
    A wide-brimmed hat and sunscreen are also a good idea.
  • Avoid alcohol
    It may be tempting to enjoy some cold adult beverages while enjoying the lake, but it’s important to avoid alcohol in the heat. Alcohol can affect the way the body cools itself and cause dehydration.

Are there lasting effects to suffering heat illness?

Heat illness does not have long-term effects on the body unless the heat it is severe.

Severe heat illness can cause seizures, unconsciousness, organ failure and death.

But in general, as long as mild heat illness is treated quickly, there are no lasting effects.

One might feel a little fuzzy and weak for a day or two, but usually those symptoms will resolve.


Adjusting your hearing aids for daily use and volume

In this video, ADC Audiologist Janet Davila, AuD, CCC-A explains how to put on your hearing aids and adjust volume.

How to put on your hearing aid

  1. Set the hearing aid or instrument on top of the ear
  2. Insert the dome in your ear
  3. Using your index finger, push (gently) the dome into your ear canal
  4. Flip the anchor or spring upwards to stay flush with your outer ear

When you  look in the mirror the wire should be flush with your skin.

Adjusting Volume Control

Dr. Davila offers this helpful tip to adjust the volume on your hearing aids.  She says to remember that your right instrument raises the volume and your left instrument lowers the volume:

  • Right=Raises volume
  • Left=Lowers volume
  1. Find your volume control button on the back of your hearing aid.  With your index finger give the button a quick tap or push.

Switching to a Saved Program

To switch your hearing instruments to a set program, for example a crowded room setting, follow these directions.

  1. To change from one program to another, hold your volume button down for 1.5 to 2 seconds.
  2. You will hear a beep in each ear when the program has changed.
  3. To return to your previous program, hold the volume button down again for 1.5 to 2 seconds.  You will once again hear the two beeps to indicate the program has been changed.

Does it matter which hearing aid you use to switch to adjust volume or switch to another program?

According to Dr. Davila, it depends on how the buttons on the back are programmed and how big the hearing aids are.  The smaller, mini receiver in the ear aids are ear specific. That is, the button on the right aid turns the volume up for both aids. The left aid button turns the volume down for both aids.

If you have a larger standard sized receiver in the ear, there is a “rocker” switch on the back. Tap the top of the switch and both aids go up, no matter which aid you use. Tap the bottom of the switch and both get softer no matter which aid you use.  Press and hold the top (or bottom) of the switch for two seconds and release it, and the program will change.  It is best to change the program with the right aid though, because it cycles through the programs  as follows; 1 -2 -3 -4, while the left will cycle 4 – 3 – 2 – 1.  Using the right to change programs is more intuitive.

For more information about hearing aids and instruments contact the ADC Audiology department at 512-901-4808.

Did you know ADC’s Audiology department offers free hearing aid cleaning?

If you’re not comfortable cleaning your hearing aids, come by the ADC Audiology department at 12221 MoPac Expwy, 2nd Floor, North Entrance, and we can help you out.  It’s easy, just follow the steps below:

  1. Drop off your hearing aids at the front desk.
  2. Our staff will ask you to complete a form.  Remember to check the box marked, “Please clean my hearing aids.”
  3. Receive a call from our team when your hearing aids are clean or, you may call our office to check.

Please allow 1-2 business days for the cleaning to be completed. For more information about ADC Audiology or any of the services we provide call us at  512-901-4808.

How can you protect your hearing at concerts and events?

We go to outdoor and indoor concerts, attend motor events and sometimes take our kids. And with MP3 players and phones as the most popular option for listening to music, how do you protect hearing for adults and children? ADC Audiologists Janet Davila, AuD, CCC-A and Natalie Rooker, AuD, CCC-A have some great options for you and your child.


Ear plugs: these simple, yet very effective, foam ear plugs are readily available at grocery stores and pharmacies.
The second type of ear plug has a small stick on the outside for easy insertion and removal. They are typically available at stores, pharmacies and online.

Custom ear plugs: for serious music fans or musicians, ADC audiology can customize filtered ear plugs. You would have molds made for a customized fit, which are then sent to the manufacturer and returned to ADC. These are available in custom colors as well.


Headphones: There are a variety of headphones available online for children.

  • Volume limiting headphones allow parents to set the limit so no matter how high your child turns the volume setting, it won’t go past the set parameter. For older children, volume limiting earbuds are available in a variety of colors as well.
  • Noise-cancelling headphones are a great choice for the parent who wants to bring their child to a concert or event where they may be exposed to loud noises over an extended period of time. The noise-cancelling headphones block out sound and are available in many sizes from infant to child to adult.

How do you know when loud is too loud?

Dr. Davila recommends that parents educate themselves and their children about how loud is too loud. The website, DangerousDecibles.org,  is a virutal exhibit that teaches children of all ages (and adults) the levels of loudness that are most dangerous and how to avoid them.

The ADC Audiology department sees patients of all ages and provides services from infant and child hearing screenings to adult ear cleanings, testing and fitting for hearing devices. If your concerned about your or your child’s hearing, please contact the ADC Audiology department at 512-901-1111 or complete the appointment request below.

Request Appointment

Use this form to request an appointment with one of our doctors or providers.
  • Please note effective Dec 31, 2017, ADC will terminate plan participation with Ambetter. At this time we are no longer scheduling new patients with these plans.
  • This field is for validation purposes and should be left unchanged.

There is an osteoporosis crisis in the US with up to 50 million people at risk for fractures. ADC osteoporosis specialist Michele McDermott, MD visited the KXAN studios to speak to Gigi Barnett about this disease.  As Gigi states, “we talk about heart disease and cancer, but no one talks about what happens when your bones cannot keep you upright”.   Dr. McDermott agrees by saying many people are unaware of fractures or fracture risk until they begin to lose height.

Know your risk factors

Dr. McDermott lists the following as risk factors for osteoporois:

  • Being a woman
  • Age
  • Smoker
  • Not getting enough calcium and vitamin D in your diet
  • Family history of hip or vertebral fracture

Bone density is key to bone strength.   When the bone density is weakened, bone strength and structure is lost. For women, since estrogen regulates the remodeling of bones, it makes sense that after menopause, the body loses that ability to remodel bone.


There are two types of treatments for osteoporosis:

  • Antiresorptive drugs
  • Bone building drugs

Dr. McDermott says she comes across many patients who are fearful of taking these drugs due to side effects.  She states the side effects are rare, but fractures are not.   She encourages patients to speak to their doctors and get the facts about these medications and treatments.

Recommendations for good bone health

  • Exercise – weight bearing exercises are great for building & maintaining bone strength
  • Get your daily dose of Calcium (1200mg) and Vitamin D (800-1000 IUs)
  • Limit alcohol intake
  • No smoking
  • If you have a family history visit your doctor to get a bone density screening


Summer Travel advice before you take to the skies or seas

KXAN’s Kylie McGivern spoke to ADC Travel Clinic director, Crystal Cherico, RN about how to protect yourself and your family while traveling this summer.  First and foremost, if you are traveling to a foreign country make sure you visit a Travel Clinic as part of your planning process.  Crystal says ideally, you want to schedule visits 4-6 weeks prior to departure, however, she said it’s not unusual for the office to get calls from patients on the way to the airport to provide medications or immunizations.

Do children need more protection than adults for travel?

Because of school admission requirements, Ms. Cherico says that most children are well vaccinated and often need fewer vaccines than most adults.  She does caution that children will often touch items, put their hands in their mouths or have open mouths in showers so they may have some issues with diarrhea.  However, there are medications that she and her team can provide families, especially those traveling to locations where malaria and travelers diarrhea are a concern.

Is Zika still something to worry about?

For most normal, healthy adults and children an exposure to the Zika virus may result in an experience of mild, flu-like symptoms.  However, for women who are pregnant, there are a whole set of guidelines for travel to help avoid birth defects from Zika.  Avoiding Zika prones areas for expectant mothers is recommended, as insect repellents are not 100% effective.

Questions about where you will be traveling?

Crystal recommends the Centers for Disease Control (CDC) website for travelers.  https://wwwnc.cdc.gov/travel/   Travelers can find advice on outbreaks, medications, tropical diseases and a broad overview of travel advice.  It will not be as personalized as the advice you will get at the ADC Travel Clinic, but it is a good starting place when planning.

Tips for international travel

  • Visit a Travel Clinic
  • Make sure to take your sunscreen and insect repellent – Don’t count on your destination having a reliable supply.
  • Check embassy websites for any precautions or outbreaks
  • Take more of your prescription medication(s) than just for your days of travel.  Keep them in the prescription bottles with your name on it.  Just in case your travel lasts longer than expected, you’ll have a supply of the medications you need.


It begins in the early stages of our lives – developing a healthy relationship with food.

Dr. Kimberly Albert, pediatrician at ADC Cedar Park, discusses some simple ways to create healthy food routines for your family.

Eating together as a family serves a lot of different purposes.

  • It allows parents to be a role model by establishing and showing their children that they are eating the same foods.
  • It’s good to be social by eating together and talking about your day.
  • With older children, it allows them to be part of the food preparation process and building a healthy relationship with food.

How do parents avoid being short-order cooks:

  • Focus on foods as being part of what nourishes the body, helping children to grow and regenerate.
  • Don’t focus on good food vs bad food
  • Approach food as a matter of fact: this is what we have and what we are eating at this meal.

How to eat well daily:

  • In your household, buy and have mostly fruits and veggies and good protein sources.
  • Limit the processed foods – especially when children are younger they have no idea that there is anything else but healthy choices at home.
  • Don’t try to control or battle over what your kids eat – If you offer healthy choices and they choose to eat it great.  If not, let it sit there and they will come back to it.

Resources from the American Academy of Pediatrics – HealthyChildren.org

Vanessa Chiapetta

Dr. Vanessa Chiapetta

National Poison Prevention Week is March 19-25.

Dr. Vanessa Chiapetta, a pediatrician with The Austin Diagnostic Clinic, recorded this message for Poison Prevention Month on where and how you can guard against accidental poisonings.

Valentines Day is often associated with the heart, this year ADC doctors remind you to love your kidneys as well.

Dr. Vincent Tjia, ADC nephrologist, stopped by the KXAN studios to discuss the prevalence of kidney disease, how you can use the “kidney two-step” to diagnosis kidney disease early, and what Love Kidney Day at the Capitol is all about.

How do you know if you have kidney disease?

Unfortunately, an individual with kidney disease may be asymptomatic for years. Dr. Tjia says in most cases patients may not know they have kidney disease until symptoms become severe. In severe cases someone may experience fluid retention, elevated blood pressure and changes in urine. He recommends that if you have a diabetes, hypertension, high blood pressure to get screened for kidney disease.  Likewise, if you have a family history, or are Hispanic or African American you should also be screened.  According to LoveKidneys.com, 4 out of 10 dialysis patients are Hispanic and African Americans are 3.8 times more likely to develop kidney disease than whites.

lovekidney.org Kidney two step inforgraphicLove your kidneys with the Kidney Two-Step

The Kidney Two-Step are two screenings that help doctors diagnose kidney disease. A patient who may be concerned about kidney disease may ask their primary care doctor to perform the blood and urine test that comprise this screening. The blood test looks at your blood creatnine levels and the urine test looks at specific proteins. The lovekidneys.com site has detailed information about how doctors diagnose kidney disease.

Love Kidney Day at the Capitol

30 million Americans are diagnosed with Kidney disease.  Texas leads the nation in the number of patients on dialysis and the number is growing each year. That’s why advocates are hosting the Love Kidney Day at the Capitol on Valentine’s Day, Tuesday, February 14, 2017.   Patients, advocates, healthcare providers and doctors are traveling from all over the state to promote early screening and to educate legislators about kidney disease. Organizers hope to increase funding and programs to aid individuals with kidney disease and promote awareness and prevention.  They expect over 400 people to attend Love Kidney Day. For more information visit: http://www.texasrenalcoalition.org/kidneyday2017.html 

Parting Advice

  1. Ask your primary care doctor about the Kidney Two-Step screening (blood and urine test) especially if you are a diabetic, have high blood pressure or family history
  2. Control your risk factors when possible – making healthy lifestyle choices, keep on top of your medications and doctor visits.


  1. http://www.lovekidneys.com/what-is-kidney-disease.php*
  2. http://www.texasrenalcoalition.org/index.html
  3. https://www.kidney.org/

Palak Paneer ( Spinach with Indian Cottage Cheese)

Palak paneer is a popular North Indian curry made of creamy spinach and soft Indian cottage cheese.  A great choice for vegetarians, it is rich in iron and offers a good dose of protein as well.

Ingredients for 4 Servings

  • Spinach leaves- 2 bunches
  • Indian Cottage Cheese-1 block (available at Indian grocery stores)
  • Garlic -3 cloves (chopped finely)
  • Tomato-2 medium sized (chopped)
  • Onion- 1 medium sized (chopped)
  • Cumin seeds-1 tsp
  • Red chilli powder -1 tsp
  • Coriander powder-1 tsp
  • Cardamom-1 pod
  • Salt to taste
  • Sugar- A pinch
  • Oil- 1 tbsp
  • Cream (optional)


  • Trim the spinach leaves. Cut off the stems at the back
  • Take the spinach leaves and wash them thoroughly under running water. Be sure to remove the soil and impurities.
  • Boil water. Add a pinch of salt and sugar. Blanch spinach for 1 minute until wilted.
  • Grind the spinach leaves in a blender to a fine consistency.
  • Heat oil in a pan. Add cumin seeds until they sizzle. Now add 1 pod of cardamom. Add chopped onion. Sauté until they turn to a nice golden color. Add garlic and sauté for another minute. Add chopped tomatoes, red chilli powder, coriander powder, salt and keep stirring till the tomatoes are reduced to a pulp consistency. If the mixture is too dry, add some cold water. Sauté for couple of minutes. To lower the fat content of the dish, one can make homemade cottage cheese made from 1% milk. Add spinach puree, stir lightly and cover for 2 minutes. Now add cubed paneer (Indian cottage cheese) and let it cook for 5-10 minutes.
  • If you desire a restaurant style taste; add cream on top.
  • Palak paneer can be served with chappati, rice or nan.

Nutritional Information

  • Serving Size: ½ cup will provide 160 kcals, 12 grams of fat and 9 grams of carb and 6 grams of protein.
  • Spinach is high in Vitamin A, Vitamin K, folic acid, magnesium, potassium, fiber and is a good source of iron for people on a vegetarian diet.

It’s important to establish with a primary care doctor for preventive care

ADC Family Practitioner Dr. Grace Honles from Circle C visited the KXAN studios to discuss the importance of establishing with a primary care doctor for good preventive care by utilizing annual exams and screenings.

When most people think of annual exams they think of the typical sports or school physical for children and teens.   But did you know adults need annual exams too?

Depending on your family history, risk factors and lifestyle, there may be immunizations and screenings need to prevent and diagnose disease.   Dr. Honles states that young adults, adults and seniors should establish with a primary care doctor to work together to decide which screenings and immunizations are right for you.  She emphasized the importance of the relationship you have with your doctor throughout your lifetime is crucial for good health at all stages of your life.

ADC has pulled together some recommended screenings for different ages.  Again, every person is different and only you and your doctor can decide which is best for you.  You may also download a copy of Adult Screenings by Age.


KXAN’s Amanda Brandeis spoke with a patient with MS about how she has managed with MS (multiple sclerosis) and how this drug may be a benefit to others.   Dr. Greg Thaera, ADC neurologist with a special interest in MS, discusses how patients with Primary Progressive Multiple Sclerosis (PPMS) may benefit from this new drug.

The following is a transcript from KXAN:

AUSTIN (KXAN) — Mary Thompson says when she first learned she had Multiple Sclerosis (MS) in 1987, there were no treatments available. It all began when she woke up one morning and everything was blurry in her left eye.

“It is pretty terrifying when you don’t know whether it’s going to affect your walking, your eye sight, your brain,” said Thompson. “I have had it affect just about all my body parts. Now it is also affecting my brain, which is extremely difficult for me.”

Thompson and her husband have been in the beer business for years, starting the first microbrewery in southwest Texas. Her husband is now the Brewmaster at North by North West Restaurant and Brewery.

Because of MS, Thompson is no longer able to work in the brewery. She started a support group in Austin, connecting with others who live with the unpredictable disease of the central nervous system (CNS).

“Nobody understands MS like somebody that has MS. So it is very important to me to have people to talk to about it, moan about it, get angry about it, whatever,” said Thompson.

Many in the group have been looking forward to FDA-approval of a new treatment option, Ocrevus. The drug works by suppressing the immune system and would be the first treatment approved for patients with primary progressive Multiple Sclerosis (PPMS), which is usually more severe.

Dr. Greg Thaera is a neurologist at the Austin Diagnostic Clinic, who has patients eager to try the new treatment.

“The trials did prove positive, meaning that there was some benefit in prevention of long-term disability, which is actually a first for a Multiple Sclerosis drug, so it’s actually quite promising,” said Dr. Thaera.

But patients will now have to wait a bit longer for the drug. Ocrevus was expected to get FDA-approval by the end of the year, but it’s been pushed back another three months.

According to pharmaceutical company that created the drug, the extension is due to the manufacturing process, not the efficacy or safety of the drug.

“It’s the progressive forms of Multiple Sclerosis that at least at this time in 2016, we lack effective treatments for to halt the progression,” said Dr. Thaera.

“Some of them are desperate. We’ve had members of our group that have gone overseas to try and get some of the stem cell treatments,” said Thompson.

She herself has secondary progressive MS, and has tried several treatments over the years. She says many caused terrible side effects.

“The longer you’ve had MS and the more drugs you tried and the more drugs you hear about, you have a tendency to sit back and say, ‘Yeah, we’ll wait and see’,” said Thompson. “I’m hopeful, but hesitant.”

Dr. Thaera says the drug hasn’t yet proven to treat the type of Multiple Sclerosis Thompson has. But Thompson wants people to know that if you have MS it doesn’t mean your life is over.

“I think a lot of people fear MS is a death sentence, and it’s not. I’ve led an extremely happy life and I’ve been married 40 plus years, I have three wonderful children, two grandchildren.”

For Thompson’s friends and Dr. Thaera’s patients, they hope the wait is worth it.

ADC Allergist Scott Oberhoff, MD, discusses winter allergies and how you can tell the difference between allergies and a cold.

Between January and March, many Central Texans will experience winter allergies brought on by cedar pollen and weather changes.  These changes may, cause nasal symptoms, coughing, sneezing and other respiratory illnesses to be at their worst.  ADC allergists, Dr. Scott Oberhoff, Dr. John Villacis and Nurse Practitioner Kris Flury help people prepare in the fall or the beginning of winter season to prepare for those allergens that may cause it to be a bad winter.

What are the top winter allergens?

In the Austin and Central Texas area, cedar pollen is the dominant allergen typically starting in late December, through January into early February.  Mold particles can also be in the high counts, especially when the winter season is rainy and wet.  Molds are usually a “year-round” allergen with different molds being more prevalent at different times of the year.  Additionally, grass pollens may also have higher counts towards the end of winter and early spring in mid-February through March and April.

How can you tell if you have allergies or a cold?

The differences between diagnosing winter allergies or a cold can be difficult to tease out.  Dr. Oberhoff says both will give you a runny nose, congestion and sneezing so he uses a few key symptoms to make the conclusive diagnosis.

Signs of allergies in an individual include itchy eyes,  itchy nose and sneezing attacks.  These are usually the hallmarks of allergy symptoms.  Also, patients who take an antihistamine and have a positive response find this is also key to diagnosing allergies versus a cold.  According to Dr. Oberhoff, colds also tend to start quickly, progress after about three to four days, hit their peak and then typically  resolve over the next week or so.  Allergies however will continue to be problematic as long as there is exposure, or as long as the cedar pollen, mold or grass counts are high.  Although medications may help initially, ultimately, allergy testing may be necessary to pinpoint the allergen and focus your treatment options.

What precautions should you take?

Individuals start their medications at the earliest signs and symptoms of  itchy eyes, sneezing that may occur with increased cedar or pollens in the air.   If the allergy symptoms do occur start taking your antihistamines and using your nasal sprays and other allergy medications before the season begins is generally much more effective at offsetting symptoms.  However, if a patient’s symptoms have already begun, it is important to get on those medications as soon as possible and to continue taking them throughout the rest of the season.  This will help reduce inflammation and help manage symptoms better.

How do you treat allergies?

ADC’s allergy department offers three basic options for allergy treatment:

  • One – patients are advised to avoid the allergen
  • Two – use medications to treat allergy symptoms
  • Three – use immunotherapy such as allergy shots or allergy drops

For more information about how The Austin Diagnostic Clinic Allergy and Immunology department can help you get relief this allergy season call 512-901-4052 or request an appointment below.

Request Appointment

Use this form to request an appointment with one of our doctors or providers.
  • Please note effective Dec 31, 2017, ADC will terminate plan participation with Ambetter. At this time we are no longer scheduling new patients with these plans.
  • This field is for validation purposes and should be left unchanged.

Concerned about your kids and flu?

Dr. Christopher Saenz, pediatrician at ADC Steiner Ranch, hosts a Q &A about your child and the flu.

When should you take your child to the pediatrician?

If you’re concerned about your child being ill, bring them in. Even if it’s not the flu, we can make them feel better and shorten the duration of the illness.

What is the best way to prevent flu?

The best way to prevent your child from getting the flu is the annual flu vaccine.

How long does the flu last?

The flu typically lasts a week, although Dr. Saenz explains that using Tamiflu can sometimes shorten the illness by a day and sometimes offset the chance of getting pneumonia that may prolong illness.

How can parents help their child recover?

Dr. Saenz encourages parents to take their child to the doctor if you feel your child may have the flu. In addition to Tamiflu, some over the counter medication like Tylenol or Motrin, that are age appropriate, lots of fluids, and rest can help your child overcome the flu.

Dr. Christopher Saenz is a pediatrician at ADC’s Steiner Ranch office (5145 FM 620 N, 78732) for more information, or to make an appointment call 512-901-4066.


‘Tis the weeks before Christmas and all through Central Texas parents are desperately seeking the right toy for their girl or boy!   Dr. Christopher Saenz, ADC Steiner Ranch pediatrician shared helpful advice about selecting safe toys for your child with KXANs Gigi Barnet.

Toy Safety

Parents should consider the following when purchasing toys for their child

  • Age
  • Ability
  • Interest

Dr. Saenz recommends reading the labels on each toy and purchasing the age appropriate toy for your child.   Often younger children explore new things by putting them in their mouths, he says legos or game pieces for a 10 year old may wind up in the throat, nose or gut of an 18 month old.

When should electronic devices and toys be introduced?

 Dr. Saenz, and the American Academy of Pediatrics  recommend that parents introduce electronic devices for children no earlier than 18 months of age.  And, from 18 months to 5 years old, they should limit the time to one hour of screen time.  Dr. Saenz further recommends that the parent spend that hour with child on a quality, educational website or game.

What are common toy/play injuries you see as a pediatrician over the holidays?

As a former pediatric ER physician Dr. Saenz saw many injuries.  Last year, he said the most common injuries were attributed to hoverboards, but most he sees are from children putting small toys in their mouths, ears and nose.  He said parents should remind older children to pick up their small toys to avoid accidents with their younger siblings.

Where can a parent go for more information or to view recall information?

Start your mornings of right with a warm, hearty and quick breakfast brought to you by the Health Risk Management education staff.  Apple cider mix adds a little extra flavor to this weight management favorite.


  • 2 HMR Cereal packets
  • 1 small packet of sugar-free apple cider mix
  • 8 ounces of water
  • A pinch of cinnamon


1. Pour cereal packets in a large, microwave-proof bowl
2. Add water and cider mix into the bowl. Mix until combined.
3. Microwave for 3-4 minutes. Stir every minute until cooked.
4. Sprinkle cinnamon for flavoring and enjoy!

For more information about the Health Risk Management weight loss program call us at 512-901-4540.   We offer free weekly orientations so you can learn more about the program and how we’ve helped thousands of Central Texans meet and retain their weight loss goals.