Daylight saving time

Ease the transition to daylight saving time

At 2 a.m. on Sunday, clocks will spring forward one hour, causing many people to lose out on a bit of sleep. Research shows that in the days following the switch to daylight saving time, heart attacks, traffic accidents and workplace accidents all increase as people adjust to the time change.

Although the one-hour time change can have an extended impact on your body clock and overall health, there are a few ways to minimize the impact of the time adjustment. Here’s how:

  • In the few days leading up to Sunday, try to wake up 15 minutes earlier than usual to prepare for a little less sleep.
  • Avoid napping on Saturday to ensure your sleepiness come bedtime.
  • Get some exercise earlier in the day on Saturday to help advance your body clock.
  • Spend some time in the sun on Sunday to help your body clock adjust to the time change.
  • Avoid stimulating substances like alcohol, tobacco and caffeine on Saturday, which will help you get better sleep.
  • If you feel sleepy on Sunday, take a nap, but limit it to a half-hour or less.
  • Make sure your bedroom is always free of distractions, like TVs or other sources of light.
  • If you have infants or toddlers, reduce their nap times by about one-third this weekend to prepare them for a bedtime that might feel too early.

Next steps:

  • How much sleep should you be getting? It might be more than you think.
  • If you or a loved one isn’t getting good sleep, we might be able to help. The UK Sleep Disorder Center works with patients of all ages identify and manage sleep disorders, including daytime sleepiness and disturbed sleep.
How often should you have an eye exam?

How often should you have an eye exam?

Dr. Shaista Vally

Dr. Shaista Vally

Written by Shaista Vally, OD, an optometrist at UK Advanced Eye Care.

There is a widely held belief that if you don’t have any vision problems, you don’t need an eye exam. But this isn’t the case. Getting eye exams, especially for children, is necessary for maintaining healthy vision throughout life. So, how often should you see your eye doctor?

It’s recommended that all children between birth and 6 months old have a vision screening. Depending on the findings of the exam, children may need another exam in six months. If there are no abnormal findings, children can be seen every two years until they’re 6 years old. Then, depending on symptoms and exam results, exams can occur every five to 10 years until the age of 40.

It’s imperative for children under the age of 6 to be screened regularly because that is when the brain is developing strong connections to the eyes. If there is a problem with the eyes turning, blurry prescriptions, or with the eyelids or lens inside the eye obstructing vision, it can lead to a visual impairment known as amblyopia, or lazy eye. The good news is amblyopia can be prevented with adequate and frequent care.

Individuals with no systemic health issues, visual complaints or strong family history of medical conditions don’t have to be examined as frequently. However, anyone with diabetes, hypertension, heart disease, vascular disease or neurological disease and those with visual complaints (blurry vision/headaches) should be seen yearly.

There are some symptoms that are urgent and require immediate attention. Please call your local eye care provider right away if you experience new-onset vision loss, flashing lights, new floaters, painful red eyes, extreme sensitivity to light or any distortions in your vision.

Eye exams are important for maintaining healthy vision, and they can detect changes in your overall health, too. So be sure to schedule regular eye appointments for you and your loved ones.


Next steps:

  • Learn more about UK Advanced Eye Care, which provides comprehensive care for patients of all ages with eye and vision conditions.
  • On March 20, UK Advanced Eye Care is moving to a state-of-the-art location in the new Shriners Building on the UK HealthCare campus. Find out more about our new location.
Dr. Daniel Larrow visits with Maggie Hall, a child he started seeing through telemedicine appointments at the Highlands Center, at the Kentucky Clinic.

UK pediatrician provides specialized support for children with autism spectrum disorders

Amy Hall celebrated her son’s first haircut appointment and the moment her daughter permitted a hug. For parents of children with autism spectrum disorders, even small gestures and slight behavioral changes count as developmental breakthroughs.

Hall’s son, Jacob, who was diagnosed with an autism spectrum disorder at age 2, once spiraled into emotional outbursts when anyone tried to touch his hair. Hall and behavioral therapists at the Highlands Center for Autism in Prestonsburg, Ky., rehearsed Jacob’s first visit to the barbershop. Every day for several weeks, Jacob practiced getting his hair washed in a bathtub at the school. He took a field trip to the barbershop and climbed into the barber’s chair. He even had the chance to inspect the barber’s combs and shears before the big day.

Maggie, Hall’s second child, was diagnosed with an autism disorder at 19 months. She went through a stage avoiding touch, even embraces from her parents. Early intervention and repetitive behavioral training helped Maggie overcome her fear and warm up to cuddling with her parents.

“I think of how difficult some of those months were for us, and how far they’ve come,” Hall said.

Hall credits much of her children’s progress to an intervention spearheaded by UK pediatrician Dr. Daniel Larrow. Through an innovative telemedicine clinic, Larrow and his team at the Kentucky Children’s Hospital give kids like Jacob and Maggie access to the specialized care they need, no matter where they live. Larrow meets with patients and their families via a live telemedicine consultation and offers advice and guidance for overcoming behavioral challenges.

“Having Dr. Larrow there was so convenient,” Hall said. “The kids are comfortable and they are in a familiar setting. He could very clearly see some of the behaviors and concerns that we were experiencing.”

Removing barriers to clinical expertise

After Jacob was diagnosed in 2011, Hall had applied for a scholarship at the Highlands Center, the only developmental learning program east of Louisville in the state based on Applied Behavioral Analysis (ABA). ABA is a scientifically proven method for teaching children basic and complex communication skills, social skills and other skills needed for an independent life.

After Jacob received the scholarship, Hall had relocated with the children to Floyd County, moving in with her in-laws, while her husband remained in Lexington to continue his work. Less than two years later, Maggie received a scholarship to enter the program. In addition to spending the weekdays apart from her husband, Hall had to drive her children three hours both ways to Cincinnati for appointments with a pediatric developmental-behavioral specialist.

It wasn’t until Larrow introduced the telemedicine clinic in partnership with the Highlands Center that things became easier, Hall said.

Larrow, who specializes in developmental-behavioral pediatrics, first observed the Hall children’s behavioral challenges through a computer monitor at the Kentucky Clinic. The telemedicine consultation provided the Hall family a comfortable introduction to Larrow and KCH family support specialist and patient navigator Melanie Tyner-Wilson, a mother of an adult child with an autism spectrum disorder.

The online meetings allow Larrow to gather information about a child’s history and developmental barriers and recommend further testing at the center, if needed, before examining the children in-person. He and Tyner-Wilson travel to Prestonsburg once a month to provide clinical consultations with established families whose children attend the Highlands Center, as well as other children and their families from Eastern Kentucky.

“The treatment for autism and other neurodevelopmental disorders is mostly specialized instruction, the teaching of specific skills that should be present but that aren’t, or to replace bad behavior with more acceptable behavior,” Larrow said. “A lot of times the parents don’t know how to access it or find this specialized therapy, or how to get insurance to pay for it.”

Building a ‘greenhouse’

Larrow came to Kentucky Children’s Hospital in 2013 after working for an organization that operated three developmental schools for autistic children in rural Vermont. A proponent of early behavioral intervention, Larrow urges families he sees in clinic to integrate consistent behavioral learning into their children’s daily lives.Through many years working with children on the autism spectrum, Larrow adopted a practice philosophy emphasizing control and conditioning of the environment to promote positive behavioral development.

Larrow’s approach likens children on the autism spectrum to orchids as opposed to dandelions, or their normally developing counterparts. While most children are developmentally conditioned to adapt to their environment, children with an autism spectrum disorder, like fickle orchids, are not adaptable and need a special environment, or “greenhouse.” The orchid theory holds that children on the autism spectrum can flourish when their environment is best suited to their developmental and learning abilities. As orchids, these children must also be taught to function in the “dandelion world.”

“If you can figure out the right greenhouse for an orchid, they can thrive and potentially excel,” Larrow said. “If they are not in the right environment, they don’t do well.”

Tyner-Wilson said Larrow’s orchid metaphor transforms how parents think about their child’s disorder. Larrow encourages caregivers to immerse their children in nurturing learning environments with consistent practices, adjusting the child’s environment to find a formula that promotes positive development.

“When you hear him call their child an orchid, you can see a change in their faces as it’s a potential positive for them,” Tyner-Wilson said. “Your child has these needs and has challenging behaviors, and, yes, they need special support, but with the right greenhouse, the child can become an opportunity, not a problem.”

‘Happiness out of little things’

Ashley Ratliff, director of the Highlands Clinic, said the telemedicine arrangement with Larrow provides families with a level of clinical expertise that isn’t accessible in rural areas. Their availability eliminates the burden of travel for families already struggling to find resources and opportunities to foster behavioral development.

“They are providing a service in this area that prevents families from having to drive all the way to Lexington or farther away,” Ratliff said. “When you talk about long-distance transportation with a child with autism, it can be very difficult for parents to manage.”

Amy Hall can attest to the advantages of adjusting the environments to accommodate her children’s behavioral challenges. After making significant progress at the Highlands Center, the family returned to Lexington in 2015. Both children see Larrow at the Kentucky Clinic and receive routine behavioral therapy at separate programs in Lexington. Jacob recently completed his first season playing on a Miracle League baseball team and Maggie, who will begin kindergarten this fall, participates in the Chance to Dance program.

“We recognize our life is not typical, not normal, but we feel like in a lot of ways we get to celebrate more,” Hall said. “We get more happiness out of little things we would have taken for granted.”


Next steps:

Nutrition and athletic performance

Fuel your body like an athlete

Dr. Kimberly Kaiser

With spring fast approaching, many people will begin running races, playing tennis, hiking and enjoying other outdoor activities. It can be difficult to navigate the plethora of information on eating to improve athletic performance, but it is possible to make adjustments that work for you.

We sat down with Dr. Kimberly Kaiser, a doctor at UK Orthopaedic Surgery & Sports Medicine and UK Family & Community Medicine, to get the answers to some frequently asked questions about nutrition and athletic performance.

Should I eat before I exercise?

Your body needs energy in the form of calories to maintain exercise. However, too much food or the wrong food can cause gastrointestinal issues especially in endurance athletes.

As a general rule, the closer you are to a workout, the simpler the meal should be. If you eat two to three hours before exercise, food will have time to digest and be absorbed from the GI tract into the blood. A good pre-workout meal contains both complex and simple carbs, such as whole wheat toast with a banana or a smoothie made with Greek yogurt, granola and fruit.

What should I eat to help my body recover after exercise?

Dietary proteins are effective for the maintenance and repair of skeletal muscle proteins. They also serve as a source of energy in conjunction with carbs and fats. Eating whole foods high in protein like beef, poultry, fish, beans, nuts, eggs or dairy are better in general than supplementing. Typically, a well-balanced diet will eliminate the need to ingest extra protein.

Will fat help or hurt my performance?

Fat is a necessary fuel for endurance exercise along with carbohydrates. Your carbohydrate stores are depleted within one to two hours of strenuous exercise, so your body then uses fat as energy. Fats are also necessary to help absorb fat-soluble vitamins A, D, E and K.

Try to limit your how much saturated fat you consume. Eating too much can increase your risk for heart disease.

Do I need to take vitamins to perform better?

Eating whole foods whenever possible is ideal. A food diary can help identify if there are deficiencies in your normal diet that can then be supplemented under the direction of a physician and/or sports dietician. In general, taking a daily multivitamin is a safe way to ensure you are meeting vitamin and mineral needs. It’s important to remember that supplements are not regulated by the FDA; thus, most claims are not backed by scientific studies, and purity is not guaranteed.

We aren’t all destined for the Olympics, but many of us set our own athletic goals that we hope to achieve. By eating well, food can help you achieve those goals and make you feel like you won the gold!


Next steps:

How much sleep do you need?

How much sleep do you need?

When it comes to how much sleep you need, there’s a big difference between what you need to get by and what you need to function optimally.

According to the National Institutes of Health, the average adult sleeps less than seven hours per night. In today’s fast-paced society, six or seven hours of sleep may sound pretty good. In reality, though, it might be less than what your body needs.

Just because you’re able to operate on six or seven hours of sleep doesn’t mean you wouldn’t feel better and get more done if you spent an extra hour or two in bed. And it’s not just your productivity that suffers when you don’t get enough sleep. Insomnia and lack of sleep can have a major impact on your health, too. In fact, long-term sleep deprivation can cause:

  • An increased risk for depression and anxiety.
  • An increased risk for heart disease and cancer.
  • Impaired memory.
  • Reduced immune system function.
  • Weight gain.
  • An increased risk for accidents.
  • An increased risk of Type 2 diabetes.

While sleep requirements vary slightly from person to person, most healthy adults need between seven to nine hours of sleep per night to function at their best. Children and teens need even more. And despite the notion that our sleep needs decrease with age, most older people still need at least seven hours. Since older adults often have trouble sleeping this long at night, daytime naps can help fill in the gap.

So, how much sleep should you and your loved ones be getting? Here’s what the National Sleep Foundation recommends:

  • Newborn to 3 months old: 14-17 hours recommended; 11-19 hours may be appropriate.
  • 4 to 11 months old: 12-15 hours recommended; 10-18 hours may be appropriate.
  • 1 to 2 years old: 11-14 hours recommended; 9-16 hours may be appropriate.
  • 3 to 5 years old: 10-13 hours recommended; 8-14 hours may be appropriate.
  • 6 to 13 years old: 9-11 hours recommended; 7-12 hours may be appropriate.
  • 14 to 17 years old: 8-10 hours recommended; 7-11 hours may be appropriate.
  • Young adults (18 to 25 years old): 7-9 hours recommended; 6-11 hours may be appropriate.
  • Adults (26 to 64 years old): 7-9 hours recommended; 6-10 hours may be appropriate.
  • Older adults (65+): 7-8 hours recommended; 5-9 hours may be appropriate.

Next steps:

Family and friends of those with depression can help reduce that stigma by understanding the illness and supporting loved ones as they seek treatment.

Here’s how you can support a loved one with depression

Theresa Gevedon, MD

Written by Dr. Teresa Gevedon, associate professor of psychiatry in the UK Department of Psychiatry.

Depression is an illness affecting about 16 million people in the United States each year. While effective treatments are available, the stigma of being seen as weak, inadequate or broken prevents many from seeking care. Family and friends of those experiencing depression can help reduce that stigma by understanding the illness and supporting loved ones as they seek treatment.

It’s more than simply being sad

Depression, the illness, differs from the sadness that is a normal part of life. It is biologically based and mediated by neurotransmitters including serotonin, dopamine and stress hormones like cortisol. It is often experienced as a heavy or dark mood, and can be accompanied by feelings of guilt or anxiety. Depression can drain the enjoyment out of life, disturb sleep, appetite, energy, concentration and functioning. It may worsen to the point that life does not seem worth living and suicide is considered.

How to help a loved one

When a loved one is depressed, listen and be respectful of what they are experiencing. It’s important not to be dismissive of the concerns they may have. Avoid using phrases like “get over it” or “what do you have to be depressed about?” Approach depression the same way you would if that person faced diabetes or any other medical illness.

When a loved one is seeking treatment, be supportive of their efforts. You can do this by being encouraging, positive and interested. It’s important to respect privacy, but you can check in with them and express a willingness to help if needed; maybe run errands or provide transportation. Optimizing sleep schedules, good nutrition and regular exercise are important as well. Being respectful of time needed for appointments, supporting healthy eating habits, and joining that loved one at the gym or on a walk are other ways to support their mental health.

Remember, depression is something a person has, not something they are; your loved one is the person they’ve always been; they’re just dealing with some different challenges. Include them and care about them. By reducing the stigma of being diagnosed with depression and seeking treatment you can help your friend or family member lead a healthy, happy life.


Next steps:

MACI knee

UK orthopaedic surgeon performs first knee surgery of its kind in Kentucky

Christian Lattermann, MD

Dr. Christian Lattermann, director of UK’s Center for Cartilage Repair and Restoration in UK Orthopaedic Surgery & Sports Medicine, recently became the first surgeon in Kentucky and in the Midwest to perform a Matrix Associated Chondrocyte Implantation (MACI). The procedure is a less invasive version of cartilage repair surgery that allows patients to recover more quickly. The technology for this new procedure is the first new cartilage technology to be approved by the U.S. Food and Drug Administration (FDA) since 1996.

A different approach to cartilage repair

The MACI technology uses a patient’s own cartilage cells to create the MACI scaffold which, unlike preceding technology, can be glued into the cartilage defect. That means this procedure can be done through smaller incisions, which Lattermann said offers a significant improvement in operating time as well as an easier path to recovery for patients. The MACI technology is new in the U.S. but has an almost 10-year track record in Europe, with excellent results.

On Feb. 15, Victoria Long was the first patient to receive this treatment at UK. An 18-year-old student who had suffered from a cartilage loss in the knee as a consequence of multiple falls onto her knee cap, Long had been experiencing pain for more than a year and had been receiving nonoperative treatment during that time. At her follow-up appointment on Feb. 21, she was recovering from the surgery and was excited to begin the recovery process.

While the procedure is new, Lattermann is familiar with it. Over the past 10 years, he has helped advance the MACI technology through regulatory agencies and receive FDA approval. During that time, he has performed more than 150 Autologous Chondrocyte Implantations, a less sophisticated version of the MACI procedure.

Becoming a major referral center

When Lattermann joined UK Orthopaedics and Sports Medicine a decade ago, he was tasked by Dr. Darren Johnson, chair of UK Orthopaedic Surgery and Sports Medicine, and UK Executive Vice President for Health Affairs Dr. Michael Karpf, with building the Center for Cartilage Repair and Restoration. The goal was to make UK a referral center for complex and difficult-to-treat injuries in patients at the crossroads between joint restoration and joint replacement.

“We have been on the forefront of treating these defects for several years,” Lattermann said. “Every year, a couple of thousand patients in the U.S. require a true cartilage restoration, and we have become a major referral center for these patients and, at this point, regularly serve patients from Kentucky, Tennessee, West Virginia, and parts of Ohio and Indiana.”


Next steps:

In recognition of her work at UK CTAC, the National Child Traumatic Stress Network has appointed Ginny Sprang as a member of its steering committee.

UK leader in child trauma appointed to national steering committee

Ginny Sprang, PhD

Ginny Sprang, PhD, professor of psychiatry and a co-founder of the UK Center on Trauma and Children (CTAC), has fought child maltreatment for almost two decades. In recognition of the work she has done as executive director of CTAC, the National Child Traumatic Stress Network (NCTSN) has appointed Sprang to its steering committee for the next two years.

Sprang was invited to the NCTSN’s steering committee because of her dedication to improving clinical services for children experiencing trauma. She said the appointment will only help strengthen CTAC’s role as a national leader in the field.

“Raising the standard of care is very much in line with the goals of the center and the UK College of Medicine,” Sprang said.

Researching and improving care for 18 years

Beginning in 1999, a series of research and clinical projects were funded at UK to understand child maltreatment and improve the care these victims receive. Eight years later, the UK Board of Trustees voted to establish a center that would encourage scientists and clinicians to conduct clinical research and provide evidence-based services to children and families who have been exposed to a wide range of traumatic events. Since then, the CTAC has been a leader in studying and treating children who have experienced trauma.

The NCTSN, established by Congress in 2000, includes 79 centers of excellence that work to implement policy, improve clinical care and develop products. Ten years ago, CTAC was awarded membership in the network.

Bringing the latest innovations to the Commonwealth

Two living laboratories in UK CTAC enable clinicians and researchers to test and adopt clinical strategies for reducing the harm associated with violence exposure. The assessment lab includes families referred through the court system or child protective services. The federally funded treatment lab brings the latest innovations in child trauma treatment to Kentucky and provides a venue for investigating the harms associated with specific types of traumatic experiences.

Assessing the impact of traumatic events on children isn’t the only kind of research currently being conducted at CTAC. The center also runs a Secondary Traumatic Stress (STS) Practice Lab, aimed at improving the work environment for care providers. STS is caused by frequent indirect exposure to traumatic material and can lead to post-traumatic stress disorder symptoms in trauma providers. The STS Practice Lab is a place where CTAC can develop and test new tools and interventions to address STS.

“Raising the standard of care for traumatized children mandates that the child-serving workforce be protected as well,” Sprang said.


Next steps:

  • Find out how research being done at UK CTAC is helping combat child trauma and improve care.
  • Learn more about the Kentucky Children’s Hospital, which provides more than 30 advanced sub-specialty programs in children’s health.
UK Shriners

Watch: UK Advanced Eye Care doctors discuss new state-of-the-art clinic

The experts at UK Advanced Eye Care provide comprehensive care for patients of all ages  from routine eye exams to treatment for the most complex ophthalmic issues.

Later this month, we’re opening a new state-of-the-art clinic, allowing us to provide even better care for our patients. Starting March 20, all UK Advanced Eye Care appointments will be located in the leased space within the new Shriners Medical Center building, just across South Limestone from the UK Albert B. Chandler Hospital.

We sat down with a few of our eye care providers to talk about the beautiful new space and what patients can expect when they visit. Check it out!


Next steps: