Greater Alabama Health Network

First Steps for a Healthy Pregnancy

February 2012 VOL. 1 ISSUE 2 Myth: You get gestational diabetes from gaining too much weight during your pregnancy.
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Fact: Medical experts dont know exactly what causes gestational diabetes, but they have some clues. The same hormones from the placenta that help the baby develop also block the action of the mothers insulin in her body. This is called insulin resistance, and it makes it hard for the mother's body to use insulin. She may need up to three times as much insulin, but her body may not be able to make and use that much, which is when gestational diabetes begins.

Myth: Gestational diabetes can cause birth defects. Fact: Gestational diabetes affects the mother in late pregnancy, when the babys body has already been formed. Because of this, it doesnt cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.

If your doctor has just told you that you have gestational diabetes, you may not know how concerned you should be. On one hand, you know that diabetes is a serious condition, and that may worry you. On the other, youve been told that this type of diabetes goes away after you deliver your baby, so you may think that you dont have to do anything about it.

Myth: You can ignore gestational diabetes, since it will go away after delivery anyway. Fact: Untreated or poorly controlled gestational diabetes can hurt your baby. When you have this condition, you cant produce enough insulin to lower your blood glucose levels. That extra blood glucose goes through the placenta, giving the baby high blood glucose levels, which prompts the baby's pancreas to make extra insulin. Since the baby is getting more energy than it needs to grow and

Whats a myth and whats a fact?

develop, the extra energy is stored as fat. Continued next page

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This can lead to a fat baby, or macrosomia. Having a big baby can make a vaginal delivery difficult, and can damage the babys shoulders during birth. Newborns of mothers with gestational diabetes may have very low blood glucose levels at birth and are also at higher risk for breathing problems. And babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes. Myth: After you deliver your baby, gestational diabetes is gone and you dont have to worry about it again. Fact: Once you've had gestational diabetes, your chances are 2 in 3 that it will return in future pregnancies. And many women who have gestational diabetes go on to develop type 2 diabetes years later. If you have gestational diabetes, work with your health care team to lower your high blood glucose levels. With their help, you can stop worrying and start enjoying a healthy pregnancy for you and your baby. No Myth - Exercise Helps Prevent Gestational Diabetes

Patient Engagement is the Holy Grail of Healthcare

by Steve Wilkins, MPH

For health care professionals, patient engagement is the holy grail of healthcare. It is the key to patient adherence a prerequisite to achieving better outcomes, fewer ER visits and hospitalizations and more satisfied patients. It is easy to recognize an engaged patient they do what their health care providers recommends what their healthcare team knows what is right for them. But doesnt engagement depend upon your perspective? In a earlier life I spent a lot of time looking at health behavior. Among the many things I learned were the following: We all define health within the context of our own lives and in our own way. We all are satisfied with different levels of health. Admittedly there are patterns of health behavior or archetypes which can be used to segment health populations. One such archetype is characterized as, 1) placing a high priority on achieving a high level

Article Courtesy of TypeFreeDiabetes.com

of personal health, 2) being very proactive in terms of achieving and maintaining their above average health, and 3) having a mod-

March of Dimes Walk for Babies

Join us April 28, 2012
Every day, thousands of babies are born too soon, too small and often very sick. Team GAHN is walking in March for Babies because we want to do something about this. I know you care, too, so if you want to join us or for more info, visit our team web page at www.marchforbabies.org/team/t1526918, click the join this team button. If you can't walk with us, please help by donating to our team. You can do so right on the web page. Thank you for helping us give all babies a healthy start! The mission of March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality.
Courtesy of March of Dimes

erate to high distrust of the medical professionals. Not surprisingly, people who shared this pattern of health-related thinking demonstrated lower levels of physician visits, fewer hospital and ER visits, lower health care costs. They were also the healthiest when compared to all other patterns of health thinking and behavior. Because of their trust issues with their providers, these patients were mavericks doing their own thing when it came to staying healthy. In other words they were not very compliant and would be considered unengaged from the perspective of health care professionals as defined above. People can be engaged in their own health and never see a doctor, visit a hospital, or take a prescription medication.
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If you were to tell these independently healthy folks that they were not engaged in their own health they would likely scoff and say what do you expect the health care industry doesnt take the time to understand the patients perspective. In truth, arent people like this doing a better job than the health industry when it comes to engagement and staying healthy? The point is that we as health care professionals need to start looking at things like the definition of health, health goals, compliance, and outcomes from the patients perspective. We need to incorporate the patients perspective into outcome and satisfaction measures. Only then do we have the right to judge whether a person (aka patient) is engaged, activated, or empowered. Once the health industry gets past this paternalistic, we know better than you do attitude then we can expect to see real change in health behavior and outcomes. Article Courtesy of www.kevinmd.com

Dean of Admissions at the University of Alabama School of Medicine told me not to waste my money applying to medical school because I would never get in any medical school including UASOM. That was the day I decided to be a doctor, no matter what it took. During medical school, I worked at the medical examiners office in Birmingham. One of my classmates convinced me to do my third and fourth year at the Tuscaloosa Campus and I had a great experience here. After residency training in pathology, I completed an OB/GYN residency in Birmingham, where I practiced for a few years. After fellowship training, I agreed to

Dr. Daniel Avery

University Medical Center
Photo Courtesy Of UMC

help Dr. Will Lenahan in Winfield, Alabama. Winfield was a small

I was born at Druid City Hospital and grew up in Tuscaloosa, Alabama. I am married to Kathy Tywann Avery from Jasper, Alabama, who is the clinical supervisor for the UA Student Health Center. We have three children and four grand children. My son is an orthopedic surgery resident in Bethlehem, PA. My son in law is a general surgery resident at Bethesda Naval Hospital in Washington, DC. I serve as the Chair of Obstetrics & Gynecology and the Medical Laboratory Director at the University Medical Center. I also serve as the President of the Joint Medical Staff of DCH Regional Medical Center. There were no doctors in our family; most everyone in our family had been in the railroad business for several generations. I have wanted to be a doctor as long as I can remember. I was heavily influenced by our family physician growing up. I worked as an Emergency Medical Technician for an ambulance service during college. When I applied for medical school the

rural town in West Ala-

bama with a new hospital, great facilities and an outstanding medical staff. I believe that my greatest contribution to medicine has been practicing OB/GYN in rural Alabama. One Sunday night while laboring two women, the pediatrician on call and I saw on the Sunday night news that our malpractice carrier had gone bankrupt. We had no malpractice coverage. Some time after that the hospital decided to stop delivering babies. I joined Dr. Dwight E. Hooper at the University Medical Center in 2003. Teaching medical students, residents and fellows has been the most exciting thing I have ever done in medicine. I am excited about going to work every day. I am reminded of a statement by Dr Bruce Harris the founding chair of OB/GYN here at the University Medical Center who told me: Treat every woman as if she was you wife, your mother or your daughter you will never go wrong. He was right!

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QUALITY ASSURANCE BOARD

Board Members: Dr. Daniel Avery, Dr. Sid Smith, Dr. Steve Madden, Mrs. Becky Henderson, Mrs. Dawn Jackson, Mrs. April Hansford, Mrs. Kristy Kelly and Mrs. Earnestine Tucker.

GAHN Quality Assurance Department has the role of assuring that our agency GAHN, Inc. is in compliance with guidelines established by the Alabama Medicaid Maternity Program. Those guidelines are specific with certain expectations that are used to evaluate program effectiveness with defined benchmarks. Internal audits/ reviews are done on ongoing basis in house with the intent of identifying and correcting deficiencies before the report is submitted to Medicaid.

VOL. 1 ISSUE 2

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Contact Us

Becky Henderson, Program Director

beckyh@greaterahn.com

205.345.1905

Tina West, Editor

twest@greaterahn.com

Tiffaney Sturdivant, Asst. Editor

tiffanys@greaterahn.com