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4 Steps to Decrease Your Risk For Cancer

March 4, 2013 in Cancer Care, Lifestyle Tips, Outdoors, Tips with 0 Comments

(via American Cancer Society)

More than half of all cancer deaths could be prevented by making healthy choices like not smoking, staying at a healthy weight, eating right and keeping active. February is National Cancer Prevention Month. St. David’s Round Rock Medical Center partners with the American Cancer Society (ACS) to provide quality care for our cancer patients and families as well as educating the community on how to decrease the risk for cancer.

1. Stay Away from Tobacco

  • Lung cancer is the leading cause of cancer death in the U.S. for both men and women. (Source: ACS Cancer Facts and Figures 2013)
  • Lung cancer is the most preventable form of cancer death in our society. (Source: Cancer Facts and Figures 2013)
  • It is estimated that there will be 228,190 new cases of lung cancer and 159,480 deaths from lung cancer in 2013. (Source: Cancer Facts and Figures 2013)
  • Besides lung cancer, tobacco use also increases the risk for cancers of the mouth, lips, nasal cavity (nose) and sinuses, larynx (voice box), pharynx (throat), esophagus (swallowing tube), stomach, pancreas, kidney, bladder, uterus, cervix, colon/rectum, and ovary (mucinous), as well as acute myeloid leukemia. (Source: ACS Cancer Facts & Figures 2013)
  • Each year, about 3,400 non-smoking adults die of lung cancer as a result of breathing secondhand smoke. Each year, secondhand smoke also causes about 46,000 deaths from heart disease in people who are not current smokers. (Source: Cancer Facts & Figures 2013)

2. Eat Healthy and Get Active

ACS “Guidelines on Nutrition and Physical Activity for Cancer Prevention” include:

  • Achieve and maintain a healthy weight throughout life by getting regular physical activity and limiting the intake of high-calorie food and drinks.
  • In the U.S., excess body weight is thought to contribute to as many as 1 out of 5 of all cancer-related deaths.
  • Being overweight is clearly linked with increased risk for cancer of the breast, colon/rectum, endometrium (lining of uterus), esophagus, kidney and pancreas.

3. Be Safe in the Sun

  • You don’t have to avoid sunlight completely, but too much sunlight can be harmful.
  • Sun exposure adds up day after day and happens every time you are in the sun.
  • American Cancer Society recommends simply staying in the shade to limit UV exposure, but if you are going to be in the sun, remember to “Slip!”, “Slop!”, “Slap!” and “Wrap!” to protect yourself from UV rays:
    • Slip on a shirt
    • Slop on sunscreen
    • Slap on a hat
    • Wrap on sunglasses to protect the eyes and sensitive skin around them

4. Find Cancer Early

  • Screening increases the chances of detecting certain cancers early, when they are most likely to be curable.
  • Learn what screening tests the American Cancer Society recommends and when you should have them. (www.cancer.org/healthy/findcancerearly/index)

Bonus: Other Ways to Prevent Cancer

  • Visit www.cancer.org to learn about potential carcinogens in your home and environment.
  • Talk to your physician to determine if certain genetic testing is recommended for you.

Checking Your Heart Rate With an iPhone

February 15, 2013 in Exercise, Heart, Lifestyle Tips, Outdoors with 1 Comment

(by David S Abrams, MD)

FB-Teasers-FEB-HeartRateThe heart rate is a very important piece of medical information. An abnormally elevated resting heart rate may indicate the presence of an underlying medical condition. Heart rate response to exercise is an excellent indicator of physical conditioning. Knowing one’s heart rate during exercise is important when it comes to maximizing aerobic benefit or maximizing fat burning. For those interested in an iPhone app that can check heart rate, here are two that I have tried out.

Instant Heart Rate, by Azumio
This free app uses the camera lens on the iPhone 3GS or later to detect pulses from the fingertip similar to what a pulse oximeter does. It detects color changes in the skin which correlate with each heart beat. It is very easy to use. You simply place your fingertip lightly over the camera lens and watch as the app detects your pulse and then displays your heart rate. I did it several times under different circumstances (sitting, after walking, after climbing a flight of stairs) to see how it would perform. I counted my pulse manually and got identical values to what the app displayed. It takes 10 seconds for the app to do this. After it displays the heart rate, it presents you with the option to store the value and to add a note. The five most recent stored values are kept in a timeline feature. You can upgrade to a Pro version ($0.99) which provides unlimited storage as well as charts to show heart rate recovery after exercise. The app’s Help feature is well organized. There is a section on Heart Rate Zones indicating what the heart rate should be for warm up, fat burn, cardio, extreme, and maximum. Settings allow entry of age and gender data to calculate ideal resting and maximal heart rates. This app receives 4.5/5 stars in iTunes. The app is not available for iPad.

Free Heart Rate Calculator, by Carre
This is a free app which requires one to check the pulse manually (e.g. at the wrist) and to tap a heart icon on the phone’s display every time a heart beat is felt. The app will then calculate the heart rate. I found this to be quite cumbersome and not very accurate. The display shows a graph along the top which alternates between Resting Heart Rate and Training Heart Rate. I could not figure out how to switch between the two, and there is no Help feature. When I tried to get to Carre support through iTunes, it took me to a site that wanted me to sign up for Hexoskin Wearable Body Metrics! The app receives 2.5/5 stars on iTunes and is available for both iPhone and iPad.

I clearly prefer Instant Heart Rate by Azumio. It is easy and fun to use, very accurate, and filled with useful information. It can be used at rest or during or after exercise. Those wanting to store data over a longer period of time will need to upgrade for $0.99. Either way, this app is valuable for those wanting to know exactly what their heart rate is at any time.

Boost Your Workout: Wear a Heart Rate Monitor

January 28, 2013 in Exercise, Heart, Lifestyle Tips, Outdoors, Sports with 0 Comments

FB-Teasers-JAN28Regular aerobic exercise may decrease your risk of death by 15% and add 3 years to your life.   Effectiveness of exercise depends on what you do—1 hour of walking versus P90X requires very different amounts of energy expenditure.  Heart rate monitors help gauge how much you are exerting yourself and potentially how much benefit you are going to get.   They can be purchased as watches that often have a strap that goes around the chest, although some newer ones may not need a strap.  Often they can be added as accessories to modern smartphones.   Most of these are now wireless, making them much less cumbersome.  Costs vary from under $100 to up to $500 depending on the features.  Higher end treadmills and ellipticals often have heart rate monitors imbedded into the handles.

These monitors can be helpful with any type of aerobic exercise such as jogging, biking, elliptical training and even swimming (find one that is waterproof not water resistant).   To use your heart monitor effectively you first need to know your maximum predicted heart rate.   This is estimated by subtracting your age from 220 for men and 226 for women.  You then know your theoretical maximum heart rate in beats per minute.  Now pick your sport and set up training zones.  These can help you achieve your goals and prevent both under and overtraining.

I’ll share how I use this.  I like running.  At 42 years of age, my maximum heart rate calculates to 178 bpm (beats per minute).  My training goal is to prepare for half/full marathons.  This requires endurance training (ability to go long distances with moderate energy expenditures).  So for most of my training I will want to be in the ‘aerobic zone’.  In this zone, the body’s primary energy stores are in the form of glycogen.  When you do aerobic exercise the body does not have to go into ‘back up stores’ to create energy.  Higher intensity training for long periods of time forces your body into the ‘anaerobic zone’ where the body then has to look for alternative sources of fuel which could result in muscle break down.

So if I go out on a training run I will want a target heart rate between 125 to 142 bpm.  Typically I will find a pace at which my heart rate remains around 135 bpm, and I feel comfortable.  Once I find that pace, it is amazing how constant the heart rate remains.  Because my main goal is endurance training, this is where the bulk of my exercise focuses, but say I want to work on speed.  This can help me finish a race or help on hills when the ‘extra push is needed’.  I will mix it up by running ¾ of a mile at a lower heart rate goal of say 120 bpm (67% or 2/3 of maximum) and then finishing the remaining ¼ mile at 160 bpm (90% of maximum), then repeating this for several miles.  This gets my heart rate into the anaerobic zone and allows me to work on speed but not long enough that I start to tear down my own muscle.

If just starting an exercise program, you will want to start with a lower target heart rate like 50-60% of maximum and then build upwards as your body gets in better shape.  For weight loss, you can target 60-70% of maximum heart rate with exercise 4-5 days, per week 45 minutes at a time.  Then as you get hooked on fitness, you will want to increase to the aerobic zone at 70-80% of maximum to gain endurance and strength.  As I previously explained, pushing into the anaerobic zone at 80-90% can be helpful in building speed/finishing power.  But if you see yourself constantly in that zone, you will want to pull back a little to avoid overtraining, injury, or breakdown of muscle.

As you get in shape, you should also notice your resting heart rate decrease as your heart is now more efficient.  It may also take more effort to get in the right training zone which is a sign that your body is ready for more vigorous physical exercise.

All of this heart rate monitoring can lead to some compulsiveness.  I recommend 1-2 times per week that you just go out and exercise with the monitor off.  Exercise at a level where you feel good, and forget about the heart rate.  Enjoy staying healthy!

Jeffrey N. Whitehill, M.D.

 

The Game Plan: Preventing Youth Sports Injuries

November 20, 2012 in Children, Exercise, Outdoors, Sports, Tips, Urgent Care with 0 Comments

By Lewis Leibovich, M.D.

According to the National Alliance of Youth Sports, more than 30 million children participate in team and individual sports each year. The school year is peppered with sporting activities—from cheerleading and track to football and soccer. They are all fun ways to improve physical fitness and hand-eye coordination, while teaching children determination and teamwork. Unfortunately, these activities are also some of the most frequent causes of youth injuries.

Annually, more than 3.5 million sports-related injuries in kids require medical attention, according to the National SAFE KIDS Campaign. However, many of these injuries are preventable.

Since younger athletes are still growing, their bones, muscles, tendons and ligaments are more likely to be affected by minor accidents. As children get older, the rate and severity of sports-related injuries increases. The most common types of sport-related injuries in children are ankle sprains, shoulder strains, concussions, dehydration and patellofemoral pain syndrome, which is related to knee strain and injury. With proper precautions, young athletes can play sports knowing their bodies are in the best physical condition.

Below are some measures young athletes, their parents and coaches can take to prevent some sports-related injuries:

  • Ensure children get physicals before they begin practicing or playing sports. It’s important to know if there are any underlying health conditions that may interfere with the level of activity a child can achieve.
  • As with any physical activity, participants should drink at least 12 ounces of water 30 minutes before the activity begins. Continue to hydrate throughout, as well as 20 minutes following the activity.
  • Require at least a 10-minute warm up before any strenuous physical activity to raise the heart rate gradually—not suddenly—and increase blood flow to the muscles.
  • Athletes should stretch both before and after the activity. They should hold each stretch for 10 to 15 seconds for maximum effectiveness. Make sure they stretch their entire bodies—stretching the legs will only help warm up the lower body.
  • If athletes complain of exhaustion or pain, listen to them and do not force them to play through the pain. Adults are taught to listen to their bodies and know their limits—there is no exception for children.
  • Be sure someone on the coaching or training staff is certified in CPR and first aid.
  • Kids of the same age can differ in size, maturity and strength. Take extra caution when children are competing with kids who are more physically advanced, and avoid that situation if possible.
  • For younger athletes, make sure practices are suited to the sport they play. It’s critical to ensure they are receiving the proper conditioning that will allow their bodies to adapt so they can continue playing for years to come.
  • Ensure athletes are wearing and using the appropriate safety equipment, even during practice. Be sure to adjust the equipment to fit the child. If something does not fit properly, it will be less likely to prevent injury.

Keep in mind that contact sports have higher rates of injury, but individual sports injuries tend to be more severe. As soon as an accident occurs, appropriate action should be taken. For treatment of simple injuries, apply the R.I.C.E. technique—rest, ice, compression and elevation—but never hesitate to take an injured athlete to a hospital.

Even if an injury seems minor, listen to the child. If the child complains of persistent pain following an accident, or if their “minor” injury prevents them from performing at their normal level, it is time to see a doctor. The faster an injury is treated, the faster the body can begin to heal and recover.

Lewis Leibovich, M.D., is a physician with St. David’s Urgent Care Pflugerville.

3 Things You Can Do to Help Avoid West Nile Virus

September 9, 2012 in Children, Community, Exercise, Outdoors, Rehabilitation, Sports, Tips with 0 Comments

via flickr

West Nile virus illnesses in Texas continue to rise dramatically, with the number of cases this summer rising to 1,013 — with 40 deaths. That is a 58 percent increase in cases and 74 percent increase in deaths. State officials warned that the infections may continue until the first hard freeze of the year. To protect yourself and your family from exposure to mosquitoes infected with West Nile virus:

  1. Be sure to wear long pants and long sleeves during dusk and dawn.
  2. Apply a repellant with DEET.
  3. Remove all standing water from the yard.

West Nile virus is asymptomatic in 80% of those infected. 20% of patients present with clinical disease. West Nile virus can cause a neuro-invasive disease or West Nile fever. In addition, a recent research study completed by Dr. Art Leis indicated that 40% of West Nile fever patients also had markers for the more serious West Nile illness indicating the effects of West Nile fever may be more extensive than previously thought.
In the more severe cases, patients can develop a variety of neurological deficits including meningitis, encephalitis and polio-like limb weakness. Rehabilitation at an intensive rehabilitation hospital and the expertise of neurology may be required. Patients may require physical therapy for strengthening and training to learn to walk again, occupational therapy to relearn activities of daily living such as bathing, dressing and toileting and speech therapy to address any deficits in cognitive function, memory, swallow or communication.

There is no cure or treatment for West Nile virus. Until our first hard freeze, remember to protect yourself and your family from exposure to mosquitoes.

Diane Owens, PT, FACHE
Assistant Administrator
St. David’s Rehabilitation Hospital

What You Should Know About West Nile Virus

August 29, 2012 in Community, Lifestyle Tips, Outdoors with 0 Comments

According to the Centers for Disease Control and Prevention, this year has been the worst year for West Nile virus in the United States in 10 years, and Texas has the nation’s highest number of West Nile virus cases to date. There have been multiple cases of West Nile illnesses reported in Central Texas, aerial sprays in Dallas to combat mosquitoes, and numerous questions about prevention and treatment from the public.

Although this elevated number of cases can be alarming, it should be noted that about 80 percent of people who contract West Nile virus will not develop any symptoms. This is because the body’s immune system is able to detect and control the virus before it is able to cause significant damage, as is the case with many other infections. The remaining 20 percent tend to develop non-life threatening febrile illness, which is characterized by a sudden onset of fever. Less than 1 percent of those infected develop a more severe illness that invades the neurological system, which can cause meningitis or encephalitis and can be fatal.

As with most illnesses, prevention is the best defense against West Nile virus. Since the primary means of transmission is through bites from infected mosquitoes, you should minimize your exposure to them. While anyone can be infected with West Nile, the elderly and people with weakened immune systems are at a greater risk of developing severe illness.

  • Avoid being outside at dusk and dawn when mosquitoes are more active
  • Minimize your time outdoors
  • Keep your windows and doors closed when you are inside
  • Use insect repellent, especially those with DEET
  • Drain any standing water around your home or business, as it can be an ideal breeding ground for mosquitoes
  • Wear long-sleeved shirts and pants when you are going to be outside—there are breathable long-sleeve shirts that can still be worn comfortably in the heat

West Nile symptoms usually appear within 3 to 14 days of the bite. People who are infected, but exhibit mild symptoms, may find that those symptoms subside on their own. Of course, if you ever question whether or not you should seek medical attention, err on the side of caution. These symptoms, which are similar to those of many other infections, include:

  • Fever (moderate to high)
  • Joint and muscle aches
  • Headache
  • Rash

More serious cases may include neurological signs, such as:

  • Stiff neck
  • Disorientation
  • Difficulty walking
  • Weakness or even paralysis in the extremities
  • Convulsions

Individuals exhibiting any of these symptoms should seek medical attention immediately.

Even though most West Nile viruses are spread by the bite of an infected mosquito, not all mosquitoes carry the virus. If you think you have been infected with West Nile virus and you are exhibiting any of the more severe symptoms or running a high-grade fever, it is important to seek medical attention immediately.

Dan Mackay, M.D., is a physician at the St. David’s Urgent Care Round Rock.

The Buzz on Bee Stings – 4 Things to Ease the Pain

August 22, 2012 in ER/Urgent Care, Outdoors, Tips with 0 Comments

photo via flickr

If you’ve spent any time outdoors this summer, you’ve likely encountered bees. In fact, in April, a swarm of honeybees surrounding a tree branch temporarily shut down a portion of the playground at Buda Elementary School. While honeybees are generally harmless if left alone, Africanized bees can be dangerous.

Recently, there have been numerous reports of bee attacks in surrounding counties. According to experts, the recent rains that helped ease the drought conditions have also provided more food for bees, including the aggressive Africanized bees.

While most bee stings can easily be treated at home, immediate emergency medical treatment may be required if a person incurs multiple stings or has an allergic reaction to a sting.

When a bee stings, it digs its barbed stinger—and the attached sac of venom—into a person’s skin. However, prompt and effective treatment can lessen the severity of the sting.

  • Remove the stinger. Removing the stinger the right way may keep additional venom from being released. (It only takes a few seconds for the venom to enter the body.) The best way to do this is to use the edge of a credit card or a pair of tweezers. Be careful not to squeeze the attached venom sac, as it may release more venom.
  • Wash the site of the sting. Thoroughly wash the sting area with soap and water.
  • Apply a cold compress. Applying a cold compress can help relieve any pain or swelling that might occur as a result of the sting.
  • Ease symptoms. You may need to apply hydrocortisone cream or calamine lotion to ease itching or swelling. If these symptoms persist, it may be necessary to take an oral antihistamine, such as Benadryl. Avoid scratching the site of the sting, as it can worsen symptoms and increase the risk of infection.

Bee stings are much more dangerous for those who are severely allergic to them (although many people are not even aware they are allergic), as well as those who suffer multiple bee stings.

During an anaphylactic attack, people can develop difficulty breathing and experience a drop in blood pressure, which can lead to shock. These cases require immediate emergency care. Call 911 or have someone drive you to the nearest emergency room (ER). Do not try to drive yourself to the ER. By doing so, you may not only endanger your life, but also the lives of others who may be driving or walking near you should you go into shock and become unable to operate your vehicle.

When a severe reaction occurs, medical experts may use epinephrine (adrenaline) to treat the body’s allergic response, as well as oxygen to compensate for compromised breathing. Albuterol may be used to relieve breathing symptoms. Some conditions may also require intravenous antihistamines and/or steroids to reduce allergic reaction symptoms.

If you already know you’re allergic to bee stings, you may have probably been prescribed an emergency epinephrine auto-injector, such as an EpiPen—a self-administered syringe that injects a single dose of medicine, when needed. Always carry it with you and be mindful of its expiration date. Also, make sure the people around you know how to administer the drug, should you be unable to do so yourself. It could save your life.

Perhaps the easiest way to avoid a dangerous reaction is to avoid an encounter with bees altogether. Remember that flowery colognes, perfumes and soaps may attract bees, as can bright colors and certain foods and beverages. Also, keep your car windows up, your garbage and recycling cans closed, and stay away from bee hives or nests. If you spot a nest outside your home, call a professional exterminator to deal with the problem.

– Megan Hood, M.D., is the medical director of St. David’s Urgent Care Kyle

Safe in the Summer – Tips to Protect Yourself and Family

July 3, 2012 in Community, ER/Urgent Care, Exercise, Heart, Heat Safety, Lifestyle Tips, Outdoors with 1 Comment

The Dog Days of Summer are here and while you are most likely prepared for all the fun things this presents, are you ready for problems that come with the summer months as well? Sheila Dolbrow, RN, CFN, CA – CP SANE, and the Trauma Coordinator at St. David’s Round Rock Medical Center shares with us some of the top summer related safety concerns below. Join Sheila on July 12th for the Summer Safety Seminar at the St. David’s Round Rock Health and Wellness Center at the Chasco YMCA as she goes into detail on how to keep your family safe during the summer months.

  1. Do you know what to do in a disaster? Do you have a family plan?  -  I have found that a lot of people have never considered this and with recent storms, wildfires, and the threat of tornados and such many families have no plan for shelter, evacuation or anything else. At the seminar, I will have educational booklets that are full of family activities and materials for emergency preparedness.
  2. Water safety - We have already had multiple drownings in the area associated with the lakes and there have been several near drowning situations involving children associated with swimming pools.  I will cover some high points of boating safety, pool safety and appropriate floatation devices for kids.
  3. Bicycle/ATV safety – We had several fatalities over the last year here at St. David’s Round Rock Medical Center related to bicycle and ATV accidents. I will cover general safety related to helmet use, choosing the right helmet, etc.
  4. Heat-related safety - With temperatures well over 100 degrees everyone needs to be aware of risks involved with outdoor activities during extreme heat and the use of sunscreen.
  5. Distracted Driving – This is one of the biggest safety concerns of our time. I will go over all the ways you can be distracted.

The seminar will be from 6:00 -7:30 p.m. and registration is required so call 512-478-3627 and sign up today. We hope to see you there!

Holly Krivokapich
Health and Wellness Coordinator

Blow the Whistle on Skin Cancer

June 29, 2012 in Heat Safety, Holiday, Lifestyle Tips, Outdoors with 1 Comment

Do you love the warm feeling of the sun on your skin – that warmth you feel all the way to your bones? Do you love being outside walking, gardening, or even just reading a book on a park bench? OF COURSE YOU DO! Everyone wants to be outside living an active life and feeling healthy and vibrant. But what about the harmful effects of the sun? Did you know that up to 90% of skin changes that people think are related to aging are actually from the sun?

By now we all know that too much sun can cause skin damage. But what is “too much”? Too much sun = a lot of sun over your lifetime or more than one bad sunburn.

Skin damage, called photo-aging, not only contributes to wrinkles, but it can also cause loose or sagging skin or a loss of elasticity and firmness. It may also give your skin a leathery texture or cause spots and unevenness in color.

The good news is that your dermatologist has treatments to help you actually repair skin damage! Some options are: laser treatments, dermabrasion, chemical peels, and wrinkle fillers. A dermatologist can also prescribe topical creams or serums that help to reverse or repair sun damage, some options are: DNA repair serums, antioxidants, ceramides, skin-lightening products, and retinols.

The appearance of your skin may be your primary focus, but you cannot forget that excessive skin damage can lead to skin cancers. Skin cancer is the most common form of cancer in the United States. There are three types of cancer that are most commonly discussed:

  • Basal cell carcinoma is the most common skin cancer with about 1 million cases per year. While rarely fatal, it can be very disfiguring.
  • Squamous cell carcinoma is another common form of skin cancer, with about 250,000 cases and 2,500 deaths per year.
  • Melanoma is the most serious skin cancer, and is less common than basal or squamous cell cancers. Melanoma occurrences are growing faster than any other kind of cancer. Melanoma is often found in white men, but it also affects younger women with fair skin or with many moles. If detected early, the survival rate is nearly 99%.

What can you do to protect your skin while enjoying outside activities?

  • Self Examination – Check your skin for any changes or new moles. And don’t just check the easy places – check your scalp, the back of your legs, under your breasts, and your back – use a mirror if necessary.
  • Request Mole Mapping – Your dermatologist can “map” your moles by taking photographs of your skin and comparing older photos to new photos for changes.
  • Avoid Too Much Sun – Use sun screen with an SPF of 15 or more (and don’t forget to re-apply!), wear a hat, or long sleeves, or a cover-up.
  • See a Dermatologist Annually – Get yourself checked by a professional and ask questions about your risk, your skin type, and any treatments that may be right for you.

Sources: American Cancer Society at www.cancer.org and The Office on Women’s Health at www.4woman.gov

To find a dermatologist near you,
please call 512-478-3627 or 1-888-868-2104

5 Surprising Foods That Hydrate

June 20, 2012 in Heat Safety, Lifestyle Tips, Outdoors with 0 Comments

It is summer in Texas!!! We all know how important it is to our health to stay hydrated. Water would be the best option, however most liquids (with the exception of alcohol) will count toward your fluid intake. While it can sometimes be hard to drink the recommended amount of water a day, did you know that there are also some foods that have a high water content and can help meet your fluid needs as well? As an added bonus, these foods also provide vitamins/minerals and carbohydrates to help the fluid be better absorbed. Here are five foods that serve a double purpose in hydrating and fueling your body.

  1. Tomato Sauce
  2. Broth Based Soups
  3. Natural Applesauce
  4. Yogurt
  5. Sugar-Free Jello

I hope to see you for class on Thursday, June 28th at the St. David’s Round Rock Health and Wellness Center where we will cover the topic Fueling the Athlete Within (click here for class information.) We will be discussing nutrition and exercise and specifically cover: protein, carbohydrates, fluids, sodium, pre & post work out meals and snacks and lastly discuss ‘myth vs. fact’ on powders, pills, shakes and bars! Registration is required and space is limited so sign up today by calling 512.478.3627.

Tarie Beldin, RD, LD
St. David’s Round Rock Medical Center

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