Don't "Shoulder" that
Burden - Treat It!

As we age, all of our joints begin to
show signs of wear and tear...

read more

New Facility Set to Open
at Mercy General

The hospital's new Alex G. Spanos
Heart & Vascular Center is...

read more

Important Tax Tips
for Families

It may be only February, but April 15
will be here before we know it...

read more

Stay Active While Pregnant

Whether you are newly pregnant
or nearing the end of your
nine months, exercise may...

read more

A Heart Condition You
need to Know About

While most people are familiar with
heart attacks and the symptoms...

read more

Don't "Shoulder" that Burden - Treat It!

By Dr. Patrick McGahan

As we age, all of our joints begin to show signs of wear and tear. One of the most commonly injured joints is the shoulder. Unfortunately, it can be painful and downright impossible to do many daily activities if your shoulder isn't working properly. Reaching into the cabinets for a glass? Swiping a dust cloth across a table? Picking up your toddler? Playing tennis or golf? Working out at the gym? Forget about all of that if your shoulder is injured!

Shoulder problems are caused by the breakdown of soft tissues. Overuse of the shoulder joint - like any other part of the body - causes injury. Sports that involve excessive, repetitive overhead motion frequently lead to shoulder injuries; these sports can include swimming, tennis, softball and weightlifting. Every day activities like gardening, painting or cleaning can also lead to shoulder problems.

Shoulder pain may be pinpointed to one specific spot or it may encompass the entire region or radiate down the arm. Although shoulder injuries are typically painful with activity, they can also awaken patients at night and make sleeping difficult. Typically, shoulder injuries will fall into one of four categories - instability, impingement, tendonitis, or rotator cuff disease.

Instability: These injuries occur when one of the shoulder joints moves or is forced out of its normal position. This can lead to a dislocation or subluxation (joint slipping in and out of place). Typically, instability injuries will cause pain when the arm is raised and can also feel as if the shoulder is slipping out of place.

Impingement: This type of injury occurs when the shoulder muscle rubs against the shoulder blade. This can occur due to excessive overhead arm motion and can lead to more serious injury.

Tendonitis: Tendonitis is inflammation of one of several tendons in the shoulder. These injuries occur as a result of repetitive activity. The goal of treatment involves breaking the cycle of inflammation and restoring painless function.

Rotator Cuff Disease: Full-thickness or partial-thickness rotator cuff tears can occur as the result of either repetitive injury or a single traumatic episode. Rotator cuff tears cause pain with overhead activity as well as pain that awaken patients at night.

The most common shoulder problems are:

  • Instability
  • Impingement
  • Tendonitis
  • Rotator cuff disease or tear
  • Frozen shoulder
  • Fracture
  • Arthritis

It is helpful to identify and treat any shoulder injury quickly, rather than waiting for the problem to worsen. Good first steps include resting the shoulder for 48 hours; icing the joint for 20 minutes at least four times daily; using compression by wrapping the shoulder in place with a bandage; and elevating the shoulder to keep it above the level of the heart.

If you're debating about whether your shoulder pain needs to be examined by a doctor, ask yourself the following questions:

  • Is your shoulder stiff?
  • Can you rotate your arm in all the normal positions?
  • Does it feel like your shoulder could pop out or slide out of the socket?
  • Does your shoulder lack the strength to perform normal, daily activities?
  • Does your shoulder pain disrupt your sleep?

If you answered "yes" to any of these questions, you should consult with an orthopedic surgeon who can help diagnose the problem and determine appropriate treatment options.

Dr. McGahan grew up in Sacramento and attended Jesuit High School and UC Davis Medical School. He specializes in sports medicine and shoulder reconstruction. For more information about Dr. McGahan and his practice, visit his website.

For more information about Dignity Health's Orthopedic services, visit our website.

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Stay Active While Pregnant

Whether you are newly pregnant or nearing the end of your nine months, exercise may be the last thing on your mind. Between battling morning sickness and battling your ever-increasing belly, heading to the gym probably doesn't sound very enticing. But there are many benefits to staying active while pregnant. Some benefits are physical, but many are emotional - and all can help you achieve a better pregnancy and delivery.

Not too many years ago, women were advised to take it easy during pregnancy - stay on the couch, put your feet up and definitely don't break a sweat. Now we know that not only is that not necessary - it is actually not helpful. Being active during pregnancy has been linked to better pregnancies, shorter labors and quicker recoveries after delivery.

So what do you need to know about exercising while pregnant? Well, first and foremost - always talk to your doctor before adding to or increasing your exercise routine. Your doctor can advise you on what is best for you and your baby, based on your health and your prior fitness level.

Once you get that green light - get moving! Whether you like walking, running, or working on the elliptical at your gym, focus on moving your body. Regular activity is good for your joints and that is especially true during pregnancy when your joints and ligaments are strained by your growing belly and by the hormones your body is producing. Do what feels right - if a steady walk feels good, do it. If you feel great following a job, do it. The important thing is that you are moving your legs and increasing your heart rate.

One activity that often provides both exercise and pain relief for pregnant women is swimming. Whether you swam regularly before pregnancy or not, spending 20 or 30 minutes in a pool may feel like heaven while pregnant. The water makes your belly buoyant, relieving the pressure and pain you may be feeling. Even if you don't swim laps, you can get your heart rate up just holding onto the wall and kicking or "running" through the water. Try it!

Another activity that can be great during pregnancy is light weight lifting or strengthening exercises. Obviously we're not talking about power lifting here, but lifting a weight that is comfortable for you is a great way to keep your muscles toned and ready for the work of delivery. The important thing is to make sure the weight is manageable and that your technique is good. Pregnancy strains and stresses those muscles and ligaments and the last thing you want to do is add more stress with bad technique or heavy weights.

And speaking of strengthening, don't be afraid to work your core during pregnancy! Keeping your core and your pelvic floor muscles strong will help alleviate the aches and pains of pregnancy and also aid in labor and delivery. And the stronger your core is now, the quicker it will bounce back into shape after your baby is born. Just know that you may need to adjust your positioning - pregnant women should not lie flat on their backs after the first trimester, so focus on side work or moves you can do while seated on a balance ball (or a chair).

For information on Dignity Health's Family Birth Centers, visit our website.

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New Facility Set to Open at Mercy General

Mercy General Hospital in East Sacramento is looking very different these days... The hospital's new Alex G. Spanos Heart & Vascular Center is completed and will open to patient care in just a couple months. The 123,000 square foot facility will be the hub for the Dignity Health Heart and Vascular Institute, which each year cares for more than 11,000 heart patients. Mercy General is California's largest cardiac-care provider, performing more heart procedures than any other hospital in the state.

Mercy General Hospital and the Dignity Health Heart and Vascular Institute have long been at the forefront of medical advances, technology and integrated patient care. This new facility builds on that legacy of proven excellence.

The Spanos Center will feature a new main entrance for the hospital as well as:

  • Four state-of-the-art cardiac surgery operating rooms, including an innovative hybrid operating room
  • Highly advanced 20-bed cardiac surgery intensive care unit
  • 71 private, family-friendly patient rooms
  • Expanded 21-bed cardiac ambulatory procedure area
  • Integrated Cardiac and Pulmonary Rehabilitation Pavilion
  • State-of-the-art cardiopulmonary care area
  • New chapel, lobby and main entrance to Mercy General Hospital
  • Healing garden

This facility was made possible by a $15 million gift from local businessman and philanthropist Alex G. Spanos.

This month, hospital staff is in the process of getting the facility ready for patient care. Employees are undergoing training for the new technology that has been placed in the facility and the various units are being stocked with needed supplies.

If the approval process goes as expected, the Alex G. Spanos Heart & Vascular Center is projected to open in April.

To learn more about the Dignity Health Heart and Vascular Institute of Greater Sacramento, visit our website.

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A Heart Condition You Need to Know About

While most people are familiar with heart attacks and the symptoms they bring, very few people understand arrhythmia, a problem in which your heart beats too fast or too slow. Atrial fibrillation - the most common type of arrhythmia - affects more than two and a half million people. The prevalence of atrial fibrillation (AFib) is predicted to grow to approximately 16 million people by the year 2050, based on forecasts by The Advisory Board Company, Cardiovascular Roundtable in Washington DC.

As women age, we tend to experience a myriad of benign yet often annoying changes in our bodies - we gain a few pounds, we have trouble sleeping, our moods swing more wildly... Some of these changes may be related to lifestyle or menopause. But sometimes these seemingly harmless symptoms can be a sign of a problem with your thyroid.

Causes of AFib

The cause of AFib in an individual may be unknown or it may be the result of damage to the heart's electrical system from other underlying conditions, including high blood pressure, heart failure, diabetes, advanced age hyperthyroidism and heart disease. The prevalence of AFib increases with age, with the highest incidence in people in their late 70s.

Symptoms and Treatment of AFib

It is not unusual for people to be living with AFib but not suffering any noticeable symptoms. When symptoms are present they may include irregular or rapid heartbeat; palpitations; lightheadedness; extreme and unusual fatigue; shortness of breath; and chest pain. Typically AFib is diagnosed with electrocardiogram (EKG), which is a painless, non-invasive test that records the heart's electrical activity.

Left untreated, AFib can cause blood vessel blockages and changes in blood flow which can increase a person's risk for stroke, heart failure and other heart rhythm problems. Heart failure can be another side effect of atrial fibrillation because the heart is beating so fast that it never adequately fills with blood, which means enough blood is not pumped out to the body either. AFib can also cause additional heart rhythm problems to develop.

Treatment of AFib is focused on preventing strokes as well as resetting the heart rhythm and controlling the heart rate. While some patients simply need to treat an underlying condition that is causing AFib (such as in the case of AFib caused by hyperthyroidism), most people with AFib will be treated with either medication, surgical procedure, non-surgical procedure or a combination of treatments.

Mercy General Honored with AFib Certification

In early January Mercy General Hospital received Certification in Atrial Fibrillation (AFib) from the Society of Cardiovascular Patient Care (SCPC), an honor which recognizes the hospital's commitment to providing the highest quality care possible to patients living with AFib. Mercy General Hospital is the largest arrhythmia management center in Northern California. Mercy General is already recognized as an Accredited Chest Pain Center by the SCPC (as is Woodland Healthcare).

Atrial fibrillation can be frightening, but is not usually harmful by itself. Preventing symptoms and serious side effects from AFib is possible with appropriate treatment. If you or someone you love is suffering from AFib symptoms, contact the Dignity Health Heart & Vascular Institute about treatment options.

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Important Tax Tips for Families

It may be only February, but April 15 will be here before we know it! Preparing for tax time can be a daunting task. You may not realize it but there are certain tax benefits only available to families. This may be news to you, especially if you are a new parent.

Your children may help you qualify for valuable tax benefits, such as certain credits and deductions. If you are a parent, here are eight benefits you shouldn't miss when filing taxes this year, straight from the IRS.

Dependents. In most cases, you can claim a child as a dependent even if your child was born anytime in 2012. For more information, see IRS Publication 501, Exemptions, Standard Deduction and Filing Information.

Child Tax Credit. You may be able to claim the Child Tax Credit for each of your children that were under age 17 at the end of 2012. If you do not benefit from the full amount of the credit, you may be eligible for the Additional Child Tax Credit. For more information, see the instructions for Schedule 8812, Child Tax Credit, and Publication 972, Child Tax Credit.

Child and Dependent Care Credit. You may be able to claim this credit if you paid someone to care for your child or children under age 13, so that you could work or look for work. See IRS Publication 503, Child and Dependent Care Expenses.

Earned Income Tax Credit. If you worked but earned less than $50,270 last year, you may qualify for EITC. If you have qualifying children, you may get up to $5,891 dollars extra back when you file a return and claim it.

Adoption Credit. You may be able to take a tax credit for certain expenses you incurred to adopt a child. For details about this credit, see the instructions for IRS Form 8839, Qualified Adoption Expenses.

Higher education credits. If you paid higher education costs for yourself or another student who is an immediate family member, you may qualify for either the American Opportunity Credit or the Lifetime Learning Credit. Both credits may reduce the amount of tax you owe. If the American Opportunity Credit is more than the tax you owe, you could be eligible for a refund of up to $1,000. See IRS Publication 970, Tax Benefits for Education.

Student loan interest. You may be able to deduct interest you paid on a qualified student loan, even if you do not itemize your deductions. For more information, see IRS Publication 970, Tax Benefits for Education.

Self-employed health insurance deduction - If you were self-employed and paid for health insurance, you may be able to deduct premiums you paid to cover your child. It applies to children under age 27 at the end of the year, even if not your dependent. See for information on the Affordable Care Act.

Forms and publications on these topics are available at or by calling 800-TAX-FORM (800-829-3676).

For more information on wealth management and estate planning, visit Jack Johal's website.

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