In this episode of Health Matters, we talk with physiatrist Dr. Nick Canzanello about why back pain happens, when it may be serious, and what you can do to prevent it in the first place.

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On this episode of Health Matters, dermatologist Dawn Marie Davis, M.D., joins us to explain the different types of dermatitis, how to manage symptoms, and what actually works when it comes to skin care. She also helps separate common myths from evidence-based guidance so you can make more informed decisions about your skin health.

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On this episode of Health Matters, we continue our conversation on the intersection of art and medicine. First, Dr. Shelley Noland — a hand and peripheral nerve surgeon and medical director of the Center for Humanities in Medicine — joins us to explore what the science says about the healing power of the arts. Then, we talk with Tane Danger, artist-in-residence at Mayo Clinic, about how he uses improv to help clinicians deliver better care.

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On this episode of Health Matters, we’re joined by artist Robin Anderson, who brings creativity directly to patients’ bedsides, and patient-turned-artist Katie White, who left Mayo Clinic with not just a new heart, but a new creative passion.

Together, they share how art can offer comfort, connection and even a sense of control during some of life’s most challenging moments — and why creativity may play a meaningful role in the healing process.

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On this episode of Health Matters, Mayo Clinic dietitian Tara Schmidt rejoins us — one year after our original GLP-1 episode — to talk about what we’ve learned so far, what’s surprised researchers and patients, and what questions still need answers.

On this episode of Health Matters, oncologist Dr. Tanios Bekaii-Saab joins us to explain what makes cancer so challenging to cure, how we are treating it today, and what is giving him real hope for the future.

In this episode of Health Matters, gastroenterologist Dr. Xiao Jing Iris Wang shares practical guidance on healthy bowel habits, how to manage constipation and diarrhea, and whether there really are “right” or “wrong” ways to poop.

Check out Dr. Wang's children's book, Boo Can't Poo, at mcpress.mayoclinic.org/product/boo-cant-poo.

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On this episode of Health Matters, Steven Furr, M.D., of the American Academy of Family Physicians draws on more than 40 years of experience practicing rural medicine. He explains what makes rural populations unique, how closely connected rural health systems are, and the daily challenge of balancing evidence-based treatment with what patients can realistically afford.

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On this episode of Health Matters, neurologist James Klaas, M.D., explains how stroke treatment has evolved, what signs and symptoms require immediate attention, and how timely care can improve outcomes for yourself or a loved one.

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You can order your print copy of the book from Mayo Clinic Press, or keep listening to the audiobook on Audible, Libro.fm, Audiobooks.com, or wherever you get your audiobooks.

Or in other words, on this episode of Health Matters, we talk with aerospace medicine specialist Dr. Jan Stepanek about what medicine looks like in outer space. Buckle up, strap yourself in, and let's go the stars!

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On this episode of Health Matters, we talk with dermatologist Dr. Naiara Sbroggio Barbosa about Vitamin D, choosing the right sunscreen, and how and when to soak up those summer rays.

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On this episode of Health Matters, we talk with sports medicine specialist Dr. Amy Beacom about the sweating, the shivering and whether this should be part of your routine.

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On this episode of Heath Matters, we sit down with Dr. Bobbi Pritt to talk about brain-eating amoebas, what they are, how concerned we should be about them, and ways to avoid infection.

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On this Ask the Mayo Mom edition of the Q&A podcast, host Dr. Angela Mattke is joined by Dr. Brittni Scruggs, an ophthalmologist at Mayo Clinic Children’s Center. Dr. Scruggs is a physician, surgeon, and scientist with a research laboratory at Mayo Clinic studying gene therapy and stem cell therapy for retinal degenerations, including for children. 

She treats all ages, ranging from newborns to adults. Dr. Scruggs is a member of the national workgroup developing ACMG evidence-based guidelines for diagnosis and clinical management of inherited retinal diseases.
Dr. Mattke and Dr. Scruggs explore retinal issues in children and discuss eye safety and health. 

"There are acute and chronic leukemias, explains Dr. James Foran, an oncologist at Mayo Clinic. "The chronic ones tend to happen slowly over many years. You can watch it for a period of time until it really becomes active. The acute leukemias come on more quickly and cause people to get sick more quickly. Hence, the word acute."

AML occurs when a bone marrow cell develops mutations in its DNA that cause the cell to continue growing and dividing. When this happens, blood cell production becomes out of control. The bone marrow produces immature cells that develop into leukemic white blood cells called myeloblasts. These abnormal cells are unable to function properly, and they can build up and crowd out healthy cells.

Signs and symptoms of AML include:

• Fever
• Bone pain
• Lethargy and fatigue
• Shortness of breath
• Pale skin
• Frequent infections
• Easy bruising
• Unusual bleeding

Treatment of acute myeloid leukemia depends on several factors, including the subtype of the disease, and a person’s age and overall health. 

At the time of diagnosis, a bone marrow biopsy is performed, and testing is done to determine the subtype of AML. Genetic testing on leukemia cells helps oncologists plan treatment that will give patients the highest chance of remission.

"There have been massive advances in the last five or seven years," explains Dr. Foran. "We understand that almost everybody with acute myeloid leukemia will have some genetic abnormality in the leukemia cells. Some mutations predict for a lower remission rate with standard chemotherapies. Those are situations where we're looking for new therapies that would be more effective, new strategies — whether that's an immune treatment, a targeted therapy, a different type of chemotherapy. So those mutations really helped guide us on how to apply the new strategies." 

Dr. Foran says Mayo Clinic is a leader in ongoing research and clinical trials to refine and improve targeted and immune therapy treatments. New approaches include expanding the use of bone marrow transplants and using CAR-T cell therapy. 

"Mayo Clinic is in the front of the field, I believe. We're studying more targeted treatments to go after cells with mutations, to try to spare side effects, and get the most benefit in treating leukemia," he says. "We're continually and actively looking for new strategies to improve outcomes for patients."

On this Mayo Clinic Q&A podcast, Dr. Foran discusses acute myeloid leukemia, including the latest research and advances in treatments.

In fact, Jan. 17 is the date that the average America breaks their New Year's resolution.

Dr. Stephen Kopecky, a Mayo Clinic preventive cardiologist, says a better approach is to focus on small steps that add up over time.

"The answer, I think, is to make small, sustainable steps that you can live with," says Dr. Kopecky "And when I say small steps, like for diet, I tell patients one bite, one bite of something healthy. Take some processed meat or foods off your plate, and put on something like a legume or a bean. After a couple of years, that one-bite difference will lower your risk of having a heart attack."

In his book, "Live Younger Longer: 6 Steps to Prevent Heart Disease, Cancer, Alzheimer's and More,"  Dr. Kopecky shares strategies for making changes, including thinking of a compass of habits:

• N — Nutrition
• E — Exercise
• W — Weight
• S — Sleep, stress, smoking and spirits (alcohol)

Healthy eating

Eating lots of fruits and vegetables provides antioxidants and anti-inflammatory nutrients that help the immune system fight infections. Dr. Kopecky recommends fruits, vegetables and healthy fats from olive oil and nuts, all found in the Mediterranean diet. 

Exercising

Regular moderate exercise increases the activity of virus-killing immune cells.

“Exercise has been shown to give the immune system a boost by maximizing the body's ability to take in and efficiently use oxygen, among other things,” says Dr. Kopecky. “Moderate exercise, where you can talk but not sing while exercising, is enough to increase the activity of virus-killing cells both in the short term and long term. Even 20 minutes daily can help quell inflammation and boost immunity, and exercise can be divided up during the day. The best part about exercise is that it can be done anywhere. Leg lunges, sit-ups, squats and stair-climbing are all easy exercises you can do at home."

Managing stress 

Calming activities and supportive relationships minimize stress, reduce cortisol production and enhance the immune system's function. "Concern about the health of our loved ones, our jobs, children's schooling and other stressors will cause an increased production of the hormone cortisol in the body, which in turn can suppress the immune system," says Dr. Kopecky. "Practicing mindfulness and stepping away from what's causing anxiety can help us stay grounded. Exercises that have calming or meditative qualities, such as qi gong and yoga, also are beneficial."

Getting enough sleep

Adequate sleep boosts the number of immune cells circulating in the body and improves infection outcomes. The interaction between the immune system and sleep is a two-way street. "When your immune system response kicks in, it changes your sleep,” explains Dr. Kopecky. “You may find yourself sleeping longer, for example, as your immune system stages an attack against a virus. When you're not sleeping well, you may notice that you get sick more easily. Getting adequate sleep can help support the way your immune system functions by increasing the number of immune cells circulating in your body." 

Making positive changes in these areas can help improve health and longevity.

"We cannot prevent aging. We can slow aging," says Dr. Kopecky. "But we can prevent disease. It's certainly possible to do. And if you adopt a certain healthy lifestyle, you can affect that."

On the Mayo Clinic Q&A podcast, Dr. Kopecky discusses developing healthy habits one small step at a time.

"It's very uncommon for any pituitary tumor to be a malignancy or what one would commonly think about as a cancer or something that would travel elsewhere," says Dr. Jamie Van Gompel, a Mayo Clinic neurosurgeon. "Almost all of these are benign tumors." 

Pituitary tumors are categorized as functioning or nonfunctioning, depending on if they are producing hormones.

The signs and symptoms of nonfunctioning pituitary tumors, those that don't make hormones, nonfunctioning are related to their growth and the pressure they put on other structures.

"Out of all pituitary tumors, about half of them aren't making any kind of a substance," explains Dr. Van Gompel. "And those are called nonfunctioning adenomas or tumors. And they cause problems by putting pressure on things nearby. So they'll either take up enough room where the pituitary gland is so that it doesn't function well, and you have to get medications to replace some of that function. Or you may start to lose vision. That's another very common presenting symptom with these. "

Pituitary tumors that make hormones, called functioning, can cause a variety of signs and symptoms depending on the hormone they produce.

"Functioning tumors cause distinct syndromes," says Dr. Van Gompel. "The three most common are prolactin-secreting tumors, Cushing's and acromegaly." 

Dr. Van Gompel explains overproduction of prolactin from a pituitary tumor can cause breast milk to develop in women, even when they aren't postpartum. In men, it often affects sexual function. 

In Cushing syndrome, the body creates too much cortisol. The hallmark signs of Cushing syndrome are a fatty hump between the shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome also can result in high blood pressure, bone loss and, sometimes, Type 2 diabetes. 

Acromegaly is a hormonal disorder that develops when the pituitary gland produces too much growth hormone during adulthood, causing bones to increase in size. In childhood, this leads to increased height and is called gigantism. But in adulthood, a change in height doesn't occur. Instead, the increase in bone size is limited to the bones of the hands, feet and face.

There are various options for treating pituitary tumors, including removing the tumor, controlling its growth and managing your hormone levels with medications. 

Surgery often is needed if a pituitary tumor is pressing on the optic nerves or if the tumor is overproducing certain hormones. Most often, surgery is done endoscopically through the nasal cavity. The neurosurgeon removes the tumor through the nose and sinuses without an external incision. No other part of the brain is affected, and there's no visible scar.

Mayo Clinic is one of the largest pituitary centers in the U.S., evaluating and treating more than 1,600 people with pituitary tumors every year. Dr. Van Gompel explains that being treated at a referral center that sees a high volume of pituitary tumors is important.

"Here at Mayo, we have huge expertise, and a group of people that know how to manage these adenomas," explains Dr. Van Gompel. "We're fortunate to have excellent colleagues in neuroradiology because the imaging matters to help locate the tumors. We also have a team of endocrinologists who focus specifically on treatment and management of pituitary tumors. And we have surgeons, like me, who focus on adenomas. We're constantly working together studying our outcomes to make sure they're as good, if not better, than they were last year, to improve care for our patients." 

On the Mayo Clinic Q&A podcast, Dr. Van Gompel discusses options for treating pituitary tumors.

On this Ask the Mayo Mom edition of the Q&A podcast, host Dr. Angela Mattke is joined by Dr. Martha Hartz.  Dr. Hartz is a Pediatric Allergist-Immunologist at Mayo Clinic Children's Center and is also an Assistant Professor of Medicine and Pediatrics who will also discuss what is on the horizon in the world of allergy treatment.

"During cancer treatment, sometimes lymph nodes need to be removed, and the lymphatic system that travels around and through these lymph nodes, gets damaged as well," explains Dr. Antonio Forte, a Mayo Clinic plastic surgeon. "It's impossible to remove the lymph nodes without damaging the system."

Lymphedema most commonly affects the arms or legs, but can also occur in the chest wall, abdomen, neck and genitals. Severe cases of lymphedema can affect the ability to move the affected limb, increase the risks of skin infections and sepsis, and can lead to skin changes and breakdown. 

An estimated 20% to 40% of patients undergoing an axillary lymph node dissection — removal of lymph nodes from the armpit, which is a common part of surgery for breast cancer — will develop lymphedema.

Nonsurgical treatment options include compression bandages or garments, massage, and careful skin care. If compression treatment isn't successful, a microsurgery technique, known as lymphovenous bypass, may be an option.

Microsurgery refers to the fact that the surgery is done using powerful microscopes that are magnified 20 to 25 times. Using special dye injected under the skin to identify the lymphatic pathways, surgeons then use small incisions to reroute the lymphatic system by connecting tiny lymphatic vessels to tiny veins, creating a detour around the damaged lymph nodes. The new connection restores the body's ability to drain lymphatic fluids. 

Dr. Forte specializes in lymphovenous bypass surgery and has seen great benefits for patients. He points out that it's a minimally invasive procedure that can be done in an outpatient setting. The incisions are small, scarring is minimal, and patients can see significant reduction of their swelling.

"A very good study that was published almost a decade ago looked at patients that had lymphovenous bypass, and on average, 42% of the swelling improved over one year," says Dr. Forte. "Now there are patients that will have much more improvement than that. And some other patients will have very little improvement. But, on average, patients that have lymphovenous bypass surgery improve by 42%."

On this Mayo Clinic Q&A podcast, Dr. Forte explains the lymphovenous bypass procedure, who is a candidate for the surgery, and the risks and benefits of this lymphedema treatment.

Related Articles:

• "A regenerative detour for lymphedema."
• "Video: Lymphovenous Bypass Surgery for Lymphedema."

Recently, the Centers for Disease Control and Prevention (CDC) issued a health alert about the fall season increase in cases of influenza and RSV infection, primarily affecting young children.

To help protect against severe disease and hospitalization, the CDC recommends vaccinations against influenza and COVID-19 for all eligible people 6 months or older. 

While not yet available, there is good news on the vaccine front for fighting RSV, too.

"A number of vaccine manufacturers have developed vaccines, including a couple of them through phase three trials," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "Very likely, certainly before this time next year, I think we'll have a licensed RSV vaccine for adults, and then they'll move clinical trials down to kids. So we're definitely making progress there."

In addition to available vaccines, the toolkit for stopping the spread of viruses is familiar now after two years of battling COVID-19. The most basic protection measure, masking, is still effective, but many have grown tired of using it.

"Most people now are not wearing a mask, they're embarrassed to wear a mask, they're fatigued of it," explains Dr. Poland. "Over these holiday wintertime periods, it's very likely we'll have a surge of influenza and COVID-19 related to this kind of behavior. Don't let fatigue and letting your guard down be the reason that you get infected and suffer a complication."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest news on RSV, COVID-19 and this year's flu season.

Related articles:

• "Early increase of flu, RSV viruses affecting children — when to seek help"
• "Care tips for upper respiratory infections in children"
• "RSV season: What parents need to know"

Business Development has two divisions:

• Mayo Clinic Ventures, which is Mayo’s technology development and commercialization group, responsible for assisting Mayo innovators in advancing their invention ideas into actual products. 
• Corporate Development, which is focused on creating opportunities such as partnerships, joint ventures, and new company formation.

"Mayo has about 7,000 active inventors across its campuses, which is quite incredible," says Dr. Clark Otley, medical director for the Department of Business Development at Mayo Clinic. "Every week, I receive a list of the new invention ideas and technologies that they think up, and I am frankly in awe of their creativity and drive to help our patients."  

Mayo Clinic Ventures works hand in hand with all three shields at Mayo Clinic — Research, Practice and Education — to advance the best ideas to the marketplace.  

"In many parts of health care, a 10% success rate is considered standard," explains Dr. Otley. "Mayo’s success rate in achieving at least some degree of commercial success is closer to 30%, thanks to our amazing inventors and the hard work of our Mayo Clinic Ventures staff."  

Mayo’s key invention activities and innovations align with the strategic plan to "Cure. Connect. Transform." Business Development supports key activities in each of those areas:

• In Cures, Business Development is partnering with our Research and Practice innovators to advance technologies aimed at restoring vision, diagnosing cancers bodywide through a blood test, manipulating the proximal small intestine to reverse diabetes, controlling recalcitrant seizures and regenerating organs that have worn out, and many more areas.
• In Connect, Business Development is partnering with innovators in the practice, Center for Digital Health and Mayo Clinic Platform to advance the care of patients with serious or complex diseases in the comfort of their home, caring for pregnant patients in more effective and less disruptive ways, and even extending cancer care beyond the walls of Mayo Clinic.
• In Transform, Business Development is partnering with Mayo Clinic Platform to advance new, transformative, data-science-based platform solutions that aim to extend Mayo’s expertise, powered by artificial intelligence, to patients across the world, in conjunction with colleagues from Mayo Clinic International.

Past successes help support future endeavors at Mayo Clinic.

"The big news is that Mayo is about the hit a milestone related to inventing," says Dr. Otley. "Sometime this winter, Mayo will reach the $1 billion milestone of revenue brought back from our inventing activity, supported by Mayo Clinic Ventures. And the beautiful thing is that those proceeds are reinvested back into our three-shield mission of Practice, Education and Research to maintain the virtuous cycle of invention in patient care."

On the Mayo Clinic Q&A podcast, Dr. Otley joins host, Dr. Halena Gazelka, to share an inside look at invention at Mayo Clinic.

When facial paralysis occurs in children, it impairs a child’s ability to move their facial muscles and show facial expression. Surgery can be done to reanimate the face and give children back the ability to show their smiles and expressions on the outside. 

The Facial Paralysis and Reanimation Clinic at Mayo Clinic Children's Center brings together a team of experts including neurologists, plastic surgeons, optometrists and physical therapists to develop a treatment plan tailored to each child.

On this Ask the Mayo Mom edition of the Q&A podcast, host Dr. Angela Mattke is joined by two experts— Dr. Samir Mardini, a plastic surgeon and chair of the Division of Plastic Surgery and co-director of the cleft and craniofacial clinic at Mayo Clinic Children's Center, and Dr. Waleed Gibreel, a craniofacial and pediatric plastic surgeon at Mayo Clinic — to discuss facial reanimation surgery in children.

Treatment with medications or sometimes surgery can control seizures for the majority of people with epilepsy. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age.

Medications for epilepsy have improved and remain the most common way to treat epilepsy. Open surgery to remove the portion of the brain that's causing the seizures is still an important treatment option for epilepsy that isn't controlled by medication. In recent years, new treatment options for epilepsy, including minimally invasive options, have developed. The latest treatments include:

• Deep brain stimulation. This is the use of a device that is placed permanently deep inside the brain. The device releases regularly timed electrical signals that disrupt seizure-inducing activity. This procedure is guided by MRI. The generator that sends the electrical pulse is implanted in the chest.
• Responsive neurostimulation. These implantable, pacemaker-like devices can help significantly reduce how often seizures occur. These responsive stimulation devices analyze brain activity patterns to detect seizures as they start and deliver an electrical charge or drug to stop the seizure before it causes impairment. Research shows that this therapy has few side effects and can provide long-term seizure relief.
• Laser interstitial thermal therapy (LITT). This is less invasive than resective surgery. It uses a laser to pinpoint and destroy a small portion of brain tissue. An MRI is used to guide the laser.
• Minimally invasive surgery. New minimally invasive surgical techniques, such as MRI-guided focused ultrasound, show promise at treating seizures with fewer risks than traditional open brain surgery for epilepsy.

"The game is much different now," says Dr. Jamie Van Gompel, a Mayo Clinic neurosurgeon. "We've really improved the outcomes for patients. I think it's important to explore treatment options because they can have substantial, meaningful impacts in people's lives."

Dr. Van Gompel encourages people with epilepsy to check in with their primary care provider or neurologist about their current treatment, and don't hesitate to seek a second opinion at an epilepsy center, especially if you have side effects from your medications or are continuing to have seizure events.

“If you haven’t seen a specialist in the last five years, you should see an epileptologist at a specialized care center,” says Dr. Van Gompel. "Epilepsy treatments are changing so rapidly right now with the introduction of robotics and stereotactic techniques that there might be something new that can help you with your seizures or epilepsy management."

Research in the field continues to focus on seizure prevention, prediction and treatment. Dr. Van Gompel predicts that the use of artificial intelligence and machine learning will help neurologists and neurosurgeons continue to move toward better treatment options and outcomes.

"I think we will continue to move more and more toward removing less and less brain," says Dr. Van Gompel. "And in fact, I do believe in decades, we'll understand stimulation enough that maybe we'll never cut out brain again. Maybe we'll be able to treat that misbehaving brain with electricity or something else. Maybe sometimes it's drug delivery, directly into the area, that will rehabilitate that area to make it functional cortex again. That's at least our hope."

On the Mayo Clinic Q&A podcast, Dr. Van Gompel discusses the latest treatment options for epilepsy and what's on the horizon in research.

The short answer is no. 

"By and large, when kids are generally healthy, when they're growing well, when there is no big concern, there's really no need for any extra vitamins or supplements," says  Dr. Erin Alexander, a Mayo Clinic gastroenterologist. 

Experts agree that most kids should get their vitamins from food, not supplements. The American Academy of Pediatrics states that healthy children receiving a normal, well-balanced diet do not need vitamin supplementation over and above the recommended dietary allowances that they get from the foods they eat. 

While many young children may be selective about what they eat, that doesn't necessarily mean that they have nutritional deficiencies. Many common foods — including breakfast cereal, milk and orange juice — are fortified with important nutrients, such as B vitamins, vitamin D, calcium and iron. So your child may be getting more vitamins and minerals than you think.

Nutrition for kids is based on the same ideas as nutrition for adults. Everyone needs the same types of things, such as vitamins, minerals, carbohydrates, protein and fat. Children need different amounts of specific nutrients at different ages.

Food packed with nutrients — with no or limited sugar, saturated fat, or salt added to it — is considered nutrient-dense. Focusing on nutrient-dense foods helps kids get the nutrients they need while limiting overall calories.

Nutrient-dense foods include:

• Protein. Choose seafood, lean meat and poultry, eggs, beans, peas, soy products, and unsalted nuts and seeds.
• Fruits. Encourage your child to eat a variety of fresh, canned, frozen or dried fruits. Look for canned fruit that says it's light or packed in its own juice. This means it's low in added sugar. Keep in mind that 1/4 cup of dried fruit counts as one serving of fruit.
• Vegetables. Serve a variety of fresh, canned, frozen or dried vegetables. Choose peas or beans, along with colorful vegetables each week. When selecting canned or frozen vegetables, look for ones that are lower in sodium.
• Grains. Choose whole grains, such as whole-wheat bread or pasta, oatmeal, popcorn, quinoa, or brown or wild rice.
• Dairy. Encourage your child to eat and drink fat-free or low-fat dairy products, such as milk, yogurt and cheese. Fortified soy beverages also count as dairy.

"When we're thinking about a child's nutrition, it's really important that we think very broadly," says Dr. Dana Steien, a gastroenterologist and director of pediatric nutrition at Mayo Clinic Children's Center. "Macronutrients — protiens, carbohydrates and fats — are where we get our calories. Micronutrients are all our minerals and vitamins." 

Another important part of a healthy diet is limiting a child's calories from added sugars, saturated fats and salt. Check nutrition labels on food products for information on calories and serving sizes.

While most kids get what they need from the foods they eat, there are certain medical situations or conditions where children need nutrient supplementation or specialized diets. For instance, babies born prematurely may require nutritional supplements to help them grow. Some children may develop iron, vitamin D or calcium deficiencies that require supplementation. 

Another common issue is kids who develop allergies or food intolerances that may require them to follow a modified diet such as gluten-free, low fructose or low lactose. These special diets should be supervised by a dietitian or your child's health care team.

On this "Ask the Mayo Mom" edition of the Q&A podcast, Drs. Alexander and Steien join host, Dr. Angela Mattke, to talk about nutrition, supplements and special diets for children.

Related Articles:

• "Should I give multivitamins to my preschooler?"
• "Nutrition for kids: Guidelines for a healthy diet."
• "Kids and sodium: Serious risks, alarming realities."

"Probably the best advice I give patients with lung cancer is to build your village of support around you," says Dr. Shanda Blackmon, a Mayo Clinic thoracic surgeon. "Always see if you can have somebody come with you for your appointment, just to help you emotionally deal with things, to help you record what's being said, to help you collect that information, and then to also advocate for you."

If the cancer is confined to the lungs, surgery may be an option for treatment. Surgery is performed to remove the lung cancer and a margin of healthy tissue around the cancer site. Procedures to remove lung cancer include:

• Wedge resection to remove a small section of lung that contains the tumor along with a margin of healthy tissue.
• Segmental resection to remove a larger portion of lung, but not an entire lobe.
• Lobectomy to remove the entire lobe of one lung.
• Pneumonectomy to remove an entire lung.

The surgeon also may remove lymph nodes from a patient’s chest to check them for signs of cancer. The type of operation used for lung cancer treatment depends on the size and location of the cancer as well as how well a person’s lungs are functioning. 

Dr. Blackmon recommends that patients explore all their surgical options.

"When you look at actual surgical options, you have minimally invasive surgery, or open surgery," explains Dr. Blackmon. "And the minimally invasive surgery has a lot of different options as well. Not every lung cancer surgery can be done minimally invasively. But if it can, certainly, the patient benefits."

Another important consideration is having your lung cancer surgery performed at a center that does a high volume of cases and is familiar with the type of procedure needed.

"When you go to have your car worked on — you go to the dealership that deals with your car specifically and someone who does it every day — they're going to be doing a better job than going to someone who's never even seen that type, make or model of car," says Dr. Blackmon. "I think we do that in life all the time. And it makes sense to do it in medicine, and in surgery especially." 

After surgery for lung cancer, patients are often worried about short-term side effects, like shortness of breath and pain, as well as long-term worries about cancer recurrence. Both should be addressed as part of a cancer survivorship plan.

"Survivorship is part surveillance and part symptom management," says Dr. Blackmon. "The survivorship program here at Mayo Clinic really focuses on treating the whole patient. We have things like massage therapy. We have acupuncture. We have meditation. We have all kinds of resources that help patients to get their life back, get back in shape, and get all the parts of their body whole again as they start to heal from this really big surgery. But one thing that is so important is to continue to go back for that survivorship care with continued symptom monitoring and continued surveillance. That five-year period after the lung cancer surgery is so critically important."

On this Mayo Clinic Q&A podcast, Dr. Blackmon discusses what people can expect after surgery for lung cancer, and how to achieve the best quality of life.

Mayo Clinic Hospice is a partner of the We Honor Veterans Program run by the National Hospice and Palliative Care Organization. The Hospice team provides the high level of medical, emotional, spiritual and social care that those who have served in the U.S. armed forces deserve. Team members recognize and honor the hospice patient’s military service with a veteran pinning ceremony. Ceremonies are provided after approval by the patient and family and can include anyone whom the military member and family would like to participate, along with the hospice team.

“It's just a small, simple way of saying thank you to a veteran,” says Loren Olson, a chaplain with Mayo Clinic Hospice. “We bring a pillowcase that represents their branch of the service and a small pin that they could put on a lapel, or a lot of them put them on their military hats. We bring a coin and a certificate from Mayo Clinic expressing our appreciation and we invite them to share their experiences in the military.”

Building on the We Honor Veterans program, Charlie Hall, a Mayo Clinic security operations supervisor, helped develop a "Final Honor Walk" for deceased veterans at his Mayo Clinic Health System location in La Crosse, Wisconsin.

Hall served in the Army as an active-duty rifleman with a combat tour to the Balkans and as a paratrooper with close to 100 military parachute jumps. In addition to his role as a security supervisor, Hall and his team in La Crosse meet with families of deceased veterans to arrange a “Final Honor Walk," where family and staff line the hallway to honor veterans while they are moved out of the hospital room in a flagged-draped cart. 

“The final honor walk is something that I wanted to develop,” explains Hall. “I had worked with the We Honor Veterans program in Rochester, with hospice, and the near-end-of-life things with veterans, all the great things they do there. I had the privilege of doing that, but I saw us being able to do a little bit more in an inpatient setting.” 

In addition to care at the end of life, it's important to acknowledge the unique needs of veterans every day in the clinical setting. Issues including post-traumatic stress disorder (PTSD) and substance use disorders are more common among veterans than the general population, and they often go hand in hand. More than 2 in 10 veterans with PTSD also have a substance use disorder, according to the U.S. Department of Veterans Affairs. 

“If a veteran is wearing a hat that signifies their veteran’s status if you will, that to me is the OK to come up and thank them for their service,” says Hall. “And I do that routinely here. It's usually a surprise to the veteran. They're usually extremely grateful. Probably the No. 1 thing is to acknowledge them. It's so important to make people feel at ease when care is coming, especially when there are some complex situations with medical care. There are some very sensitive conversations that have to happen. We all know that happens so much easier when we have great rapport with our patients.”

“Honoring veterans is part of the culture at Mayo Clinic, at least in my experience,” says Olson. “One of the first things I learned as I came to work the hospice program was that We Honor Veterans partnership with the Veterans Administration is important to us. We want to spend time honoring our veterans. So I do think we have developed a corporate culture that just helps us to think of the specific needs of our veterans.” 

On this special Veterans Day edition of the Mayo Clinic Q&A podcast, Olson and Hall join host, Dr. Halena Gazelka, for a conversation on caring for veterans.

"The stomach is well designed to handle highly acidic conditions," explains Dr. James East, a gastroenterologist at Mayo Clinic Healthcare in London. "But the esophagus is not designed to cope with acid. And so when acid comes up, that acid reflux damages the cells, replacing them with more acid-resistant cells that develop into Barrett's esophagus." 

While frequent heartburn may be a sign, many people with Barrett’s esophagus have no symptoms. Having Barrett's esophagus does increase your risk of developing esophageal cancer. Although the cancer risk is small, it's important for people with Barrett's esophagus to have regular checkups to check for precancerous cells. 

Those at highest risk for Barrett's esophagus include: 

• White men over the age of 50.
• People with family history of Barrett's esophagus or esophageal cancer.
• People who smoke. 
• People with excess abdominal fat. 
• Patients with long-standing reflux lasting more than five years. 

"If you have three of those risk factors, then you should have a screening endoscopy for Barrett's esophagus, according to current guidelines," says Dr. East. 

To screen for Barrett's esophagus, a lighted tube with a camera at the end, called an endoscope, is passed down the throat to check for signs of changing esophagus tissue. A biopsy is often done to remove tissue and confirm the diagnosis.

Treatment for Barrett's esophagus depends on the extent of abnormal cell growth in your esophagus and your overall health. Treatments in the early stages can include lifestyle measures and medications to help reduce acid reflux and therefore, the esophageal acid exposure. 

If the cell damage is more extensive, radiofrequency ablation may be be used. In this technique, a balloon is used to heat the abnormal esophagus tissue and burn it away. Another technique, cryotherapy, applies cold liquid or gas to destroy the abnormal cells.

The best way to prevent Barrett's esophagus is to address acid reflux and GERD through lifestyle changes.

"Lifestyle measures that reduce the risk of reflux are the key here because once Barrett's esophagus develops, it's a permanent change unless we use some of the ablation techniques," says Dr. East. "So absolutely quit smoking, and limit alcohol and caffeine. And even losing a small amount of weight can really help reduce reflux symptoms."

On the Mayo Clinic Q&A podcast, Dr. East discusses diagnosing and treating Barrett’s esophagus. 

Seizure symptoms can vary widely. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn't mean you have epilepsy. At least two seizures without a known trigger (unprovoked seizures) that happen at least 24 hours apart are generally required for an epilepsy diagnosis.

Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages. When a child is diagnosed with epilepsy, families may need support to adjust to this new diagnosis. Parents and schools can partner with the medical team to help.

"One of the things that's really important for families to remember is they are not fighting this battle on your own," explains Dr. Elaine Wirrell, a pediatric neurologist and chair of Child and Adolescent Neurology at Mayo Clinic Children's Center. "You need to share the diagnosis and inform those who are caring for your child — teachers, daycare, coaches — so they are prepared to help." 

Medication is generally the first course of treatment for epilepsy. Finding the right medication or combination of medications, and the optimal dosages, can be complex. Many children with epilepsy who aren't experiencing epilepsy symptoms can eventually discontinue medications and live a seizure-free life.

For some children with drug-resistant epilepsy, surgery is an option. Epilepsy surgery, which is considered when at least two anti-seizure medications have failed to work, removes or alters an area of the brain where seizures originate.

Experts at Mayo Clinic Children's Center also are studying neurostimulation treatments for epilepsy, an alternative treatment for children with severe epilepsy or for those who cannot have surgery. This treatment applies electricity to the central nervous system with the goal of reducing seizure frequency and severity.

On this Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. Wirrell for a discussion on epilepsy in children.

Related articles:

• "Consumer Health: Treating children with epilepsy."
• "Mayo Clinic Q&A podcast: Epilepsy Awareness Month."

Bone marrow transplant is used to treat blood cancers and related disorders by infusing healthy blood-forming stem cells into your body to replace unhealthy bone marrow. A bone marrow transplant is also called a stem cell transplant. Bone marrow transplants may use cells from your own body, called autologous transplant, or from a donor, known as allogeneic transplant. 

Autologous stem cell transplants are typically used in people who are producing enough bone marrow but need to undergo high doses of chemotherapy and radiation to cure their disease. These treatments are likely to damage the bone marrow. Prior to treatment, healthy bone marrow cells are collected, frozen and stored for later use. After treatment, the stem cells are infused back into the patient to repopulate the bone marrow.

Allogeneic bone marrow transplant is used when there is underlying bone marrow failure syndrome or for certain types of bone cancers and blood cancers. In those cases, donor bone marrow is needed to replace the diseased bone marrow.

One common complication of allogenic transplant is developing graft versus host disease. This condition occurs when the donor stem cells see the body's tissues and organs as something foreign and attack them. Researchers have now discovered metabolic markers that can predict a person's risk for developing severe graft versus host disease, allowing for a more personalized treatment approach.

"Graft versus host disease occurs in patients that have had an allogeneic transplant from a donor," explains Dr. William Hogan, director of the Mayo Clinic Blood and Bone Marrow Transplant Program in Minnesota. "And this is where the donor immune system doesn't just recognize the leukemia that we're trying to treat — which is what we want — but it also attacks the patient's normal tissues. This can be anything from a relatively mild to a very devastating problem that can occur after transplant. And one of the challenges was that, by the time that has been fully developed, then it's harder to treat. So one of the goals of research in the last few years has been to develop markers that will tell us which patients are at risk of having the most severe graft versus host disease, and allowing us to target more effective treatment toward those patients."

Other recent advances in blood and bone marrow transplant include the use of mismatched donors and the ability to use bone marrow transplant in older, more frail patients thanks to improvements in antibiotics, antifungal drugs and other medications.

Another cellular therapy that is helping treat blood disorders and cancers is chimeric antigen receptor-T cell (CAR-T) therapy. CAR-T involves taking the T cells from a person and reengineering them to recognize and destroy cancer cells.

"CAR-T therapy is a very interesting therapy," says Dr. Hogan. "It's really come to fruition in the last five to 10 years. This is similar to bone marrow transplant, but not quite the same. It's a cellular-based therapy, so not a drug, but using cells that are modified in order to try and treat leukemias and other cancers. And basically, what it does is it takes our native immune system — and then the T cells specifically — and modifies them so that they are much more effective at recognizing targets that are on leukemia cells or other malignant cells. And that really kind of allows us to use the native immune system in a much more effective way of trying to kill leukemias." 

Dr. Hogan says CAR-T therapy also is being developed for noncancerous conditions, like aplastic anemia, and research is looking at CAR-T as a treatment for a particular form of inflammatory multiple sclerosis. 

"Things have really been transformed over the last five to 10 years with the advent of CAR-T therapy which has been groundbreaking," says Dr. Hogan. "The field of blood and bone marrow transplant continues to move forward, creating more effective treatments with less toxicity for many patients." 

On the Mayo Clinic Q&A podcast, Dr. Hogan discusses advances in bone marrow transplant and cellular therapy, including CAR-T.

"The mantra is 'time is brain,'" explains Dr. James Meschia, a Mayo Clinic neurologist and stroke expert. "The sooner they get treatment, the better patients do."

World Stroke Day is recognized each year on Oct. 29. The aim is to teach the public about stroke risk factors and stroke prevention, and to raise awareness about the warning signs of stroke so people recognize when a loved one may be having a stroke and can take action.

To recognize the warning signs of stroke, Dr. Meschia says remember the acronym, BE FAST:

• B stands for balance. Watch for the sudden loss of balance.
• E stands for eyes. Vision loss in one or both eyes is a warning sign. 
• F stands for face. Facial droop or if the face looks uneven is a sign of stroke.
• A stands for arm, but it can be sudden weakness of an arm or leg.
• S stands for speech, including trouble speaking, slurring words or difficulty understanding speech.
• T stands for time. This represents both noting the time the symptoms occur and reducing the time it takes to receive medical care by calling 911.

There are two main types of strokes: ischemic and hemorrhagic. An ischemic stroke happens when there is a loss of blood supply to an area of the brain. A hemorrhagic stroke happens when there is bleeding into the brain when a blood vessel ruptures. Eighty-five percent of all strokes are ischemic.

Globally, 1 in 4 adults over 25 will have a stroke in their lifetime, according to the World Stroke Organization. More than 110 million people in the world have experienced stroke, but thanks to the development of clot-busting drugs and procedures to remove clots using a catheter, outcomes for people who have a stroke are improving.

"The first big treatment revolution happened in the 1990s. And in 1995 we finally closed in on a dose and a time window to give a clot-busting drug known as tissue plasminogen activator or, tPA," says Dr. Meschia. "Then in 2015, the added benefits of mechanical thrombectomy were clearly established. That is where a catheter is inserted, and, under guidance by an X-ray camera, the tip of the catheter is positioned in or near the clot and the clot pulled out. So used in combination or by themselves, thrombolysis and thrombectomy have been major advances in the therapy."

After emergency treatment, most stroke survivors go through a rehabilitation program. Stroke care focuses on helping people recover as much function as possible, with the goal of returning to independent living. The impact of the stroke depends on the area of the brain involved and the amount of tissue damaged.

If the stroke affected the right side of the brain, movement and sensation on the left side of the body may be affected. If the stroke affected the left side of the brain, movement and sensation on the right side of the body may be affected. Brain damage to the left side of the brain may also cause speech and language disorders.

Dr. Meschia encourages stroke victims to realize that the effects of a stroke are worse at the beginning, and that there is hope for rehabilitation.

"One of the important points with stroke is that it is sudden in onset, and often maximally severe at onset," says Dr. Meschia. "There are some exceptions, but I would say about 9 out of 10 are maximally severe at onset. And then, over the course of one to three months with appropriate rehabilitation — be it speech, physical or occupational therapy, or a combination thereof — patients do rally and improve significantly. And it is one of the things to be aware of because sometimes patients and families can feel like giving up. I think that would be tragic because, at least in the short term, the prognosis is favorable for some level of recovery."

Many strokes can be prevented in the first place by minimizing risk factors. Maintaining a healthy body weight, staying physically active and controlling blood pressure reduce the risk of stroke. Other stroke prevention steps include stopping smoking, eating a healthy diet and managing blood sugar levels. 

On the Q&A podcast, Dr. Meschia discusses stroke prevention, the warning signs of stroke and the latest in stroke treatments. 

But the approach is changing.

"For many years, we had the understanding that giving a little bit of radiation each day and spreading that treatment out over multiple weeks was the gentlest on the normal tissues, and that would lead to the least side effects," says Dr. Robert Mutter, a Mayo Clinic radiation oncologist. "But over the last decade or two, there's been a lot of research. We found we might be better off giving bigger doses each day and finishing in a shorter period of time. And that might be better at destroying the cancer cells, while limiting side effects of the normal tissue."

The use of proton beam radiation therapy is one way the treatment of breast cancer is advancing. Unlike traditional X-ray radiation, proton beam therapy can more precisely target tumors, sparing more normal tissue.

The Mayo Clinic Proton Beam Therapy Program uses pencil beam scanning, which Mayo investigators have shown reduces radiation exposure to healthy tissue. This highly targeted therapy is ideal for people with tumors close to or in vital organs, and for young people, whose organs are still developing. 

Mayo Clinic offers proton beam therapy in Arizona and Minnesota. Recently, Mayo Clinic announced a $100 million gift from the Fred C. and Katherine B. Andersen Foundation to expand Mayo Clinic’s proton beam therapy services in Minnesota.  “Protons have this ability to stop on a dime. And that's because they're charged, and they have a mass,” explains Dr. Mutter. “And so we can actually give them just enough energy to travel to the tissue and have them stop. And so all that tissue behind the tumor or the target is spared of radiation exposure. But we're very excited to be able to study proton therapy and to be able to offer proton therapy for patients that we think may benefit, including breast cancer.”

In this Mayo Clinic Q&A podcast, Dr. Mutter expands on Mayo Clinic's research and the development of new therapies to minimize patient side effects from radiation, including the increased use of proton therapy. Dr. Mutter also talks about the patient concerns about relapses and how Mayo is using medicines in combination with radiation to reduce relapse risks.

"Endometriosis is a very common condition," explains Dr. Tatnai Burnett, a gynecologic surgeon at Mayo Clinic. "Most of our studies, which are looking at women who have symptoms, would suggest that about 1 in 10 women, so 10% or so have endometriosis. Now, the difficulty here is that some women do not have significant symptoms and wouldn't go to a doctor, or they minimize their symptoms or think what they are experiencing is normal. So, if anything, that estimate is probably on the low side of what actual reality is."

With endometriosis, the endometrial-like tissue acts as endometrial tissue would — it thickens, breaks down and bleeds with each menstrual cycle. But because this tissue has no way to exit the body, it becomes trapped. Endometriosis can cause pain, which is sometimes severe, especially during menstrual periods. Fortunately, effective treatments are available. 

Imaging, including ultrasound and MRI, is an important step in evaluating patients with endometriosis and can impact treatment options and surgical planning. 

"Ultrasound is a great way to start the evaluation of the female pelvis because it's easily accessible," says Dr. Wendaline VanBuren, a Mayo Clinic radiologist who specializes in gynecologic imaging. "And it gives us a lot of information about the ovaries and the uterus. The problem with endometriosis is that, while it can involve the ovaries, it can involve all these sites on the surface of the uterus, the bowel, the ureters and all the structures around it. So, MRI gives us a little bit more of a global perspective of the pelvis. So that's the advantage of using MRI." 

To better coordinate care for patients with endometriosis, Drs. Burnett and VanBuren instituted an MRI-based interdisciplinary conference at Mayo Clinic that brings together radiology and gynecology.

"For endometriosis, we realized that a multidisciplinary approach where we review things together was just in the best interest of the patient because it gives us the best coordination of care between the radiologist and the gynecologist," says Dr. Burnett. "It gives us a nuanced interpretation of what the imaging means for the patient. And then it allows us to apply what we see in the imaging to our surgical plan and to the surgical team. We use all the information that we gather to really make the best plan for the patient in regard to the patient's goals and what they need."

The team at Mayo Clinic has been sharing the success of this collaborative model and educating other experts through the publication of their research findings and participation in a disease-focused endometriosis panel through the Society for Abdominal Radiology.

"We all have our own expertise," says Dr. VanBuren. "And when we're able to collaborate and share, hearing the clinical stories, looking at the imaging, putting it together, the considerations for management, whether that be medical or surgical planning, we're really able to make a huge impact. It's exciting to see now collaborations between societies, from gynecology and radiology together."

On the Mayo Clinic Q&A podcast, Drs. Burnett and VanBuren discuss the multidisciplinary approach to diagnosing and treating endometriosis.

HIPEC uses high-dose chemotherapy to kill microscopic cancer cells inside the abdominal cavity. The HIPEC procedure is performed immediately after a surgeon has removed all visible cancer in the abdomen. HIPEC is well studied in several types of cancer and being explored as a potential treatment in others. 

"So really any cancer that's just localized in the abdomen on the surface of the peritoneum could be a candidate," explains Dr. Travis Grotz, a Mayo Clinic surgical oncologist. "We know for sure, based on studies and data that HIPEC works well for cancers of the colon, cancers of the appendix, cancer to the ovaries, cancer of the stomach, and there's even a cancer of the lining of the peritoneum, called mesothelioma. So those would be the cancers I think that are well studied and well accepted. Then, there are more rare tumors that we have less data for, such as cancer to the pancreas or gallbladder or small intestine, that we don't know yet if that's the right treatment."

The specific type of chemotherapy used for HIPEC varies depending on the type of cancer being treated. The abdominal cavity is bathed with hot chemotherapy to kill any microscopic cancer cells that might still be present. Heating the chemotherapy enhances its effectiveness because, when it’s hot, chemotherapy penetrates the tissue more deeply, increasing the number of cancer cells it can reach.

On this Mayo Clinic Q&A podcast, Dr. Grotz explains what HIPEC is, how it is performed, and the risks and benefits of the treatment.

Related Articles:

• "New therapies bring hope for ovarian cancer."
• "Alternative chemotherapy offers hope for late-stage cancers."
• "Aggressive treatment turns tide in fighting colon cancer."

For kids, getting the recommended amount of sleep on a regular basis is linked with better health, including improved attention, behavior, learning, memory, the ability to control emotions, quality of life, and mental and physical health.

Mayo Clinic experts recommend these general sleep guidelines for each age group:

Infants 4 months to 12 months 12 to 16 hours per 24 hours, including naps
1 to 2 years 11 to 14 hours per 24 hours, including naps
3 to 5 years 10 to 13 hours per 24 hours, including naps
6 to 12 years 9 to 12 hours per 24 hours
13 to 18 years 8 to 10 hours per 24 hours
Adults 7 or more hours a night
Creating good sleep habits is important. Dr. Julie Baughn, a Mayo Clinic pediatric sleep medicine specialist at the Mayo Clinic Children's Center, suggests the follow do's and don'ts for healthy sleep:

Healthy sleep "Do's"

Have an age-appropriate bedtime.
Have a bedtime routine that is relaxing and consistent.
Have the environment quiet and dark.
Have your child be active during the day.
Have regular meals.
Have the same bedtime weekdays and weekends.
Healthy sleep "Don't's"

Get rid of the crib too early.
Expect your young child to “sleep in.”
Use electronics before bed.
Dr. Baughn remind parents that setting expectations is key to helping children develop a healthy bedtime routine.

"Kids are really good at knowing what you're going to say yes to at bedtime," says Dr. Baughn. "And they're just having kind of normal bedtime resistance, which is a normal part of growing up, of testing limits, trying to stay up later. Consistency is key."

On the Mayo Clinic Q&A podcast, Dr. Baughn joins Dr. Angela Mattke, a Mayo Clinic pediatrician and host of #AsktheMayoMom to answer some common questions about sleep problems in children, including getting your child to go to sleep and stay asleep, the safety of melatonin for kids, and determining when should your child see a sleep specialist.

Thanks to improved surgical techniques and an aging population, the number of shoulder replacement surgeries is increasing.

"The rate of usage of shoulder replacement in the United States has increased dramatically," explains Dr. Joaquin Sanchez-Sotelo, a Mayo Clinic orthopedic surgeon. "And I think there are two reasons. One is that implants are better. And also, that patients now are more active with their upper extremities later in life. So, they need the procedure because they want to have a life where they can enjoy activities pain-free."

Traditionally, shoulder replacement removes damaged areas of bone and replaces them with standard parts made of metal and plastic. Joint replacement surgery could be a challenge if some of the bone is missing, the bone quality is poor, or if a bone graft is not accurate. 

Now, thanks to new technology, there is another option. Using CT scans and 3D-printed models, some patients can receive joint replacements that are created to be custom fit to their anatomy. 

"The benefit is you are guaranteeing the patient that the implant is going to fit his or her shoulder, No. 1," says Dr. Sanchez-Sotelo. "No 2., it decreases surgical time tremendously. Because in the past, you had to get exposure and then prepare the bone until it fits one of the off-the-shelf implants. Now you know that the implant is going to fit the patient right out of the box. So surgery time is less." 

There are some limitations to use of the new implants. People with severe deformities may not be candidates, and people who require surgery quickly may not have time to wait for a custom implant to be built. 

Despite these limitations, Dr. Sanchez-Sotelo says, like artificial intelligence and mixed reality, custom-fitted joints could be another game-changer in orthopedics and another tool for surgeons to help patients.

"I think this is going to transform our practice," says Dr. Sanchez-Sotelo. "Technology is advancing so fast in medicine and orthopedic surgery. I'm just excited to see how we can change the operation, make it faster, make it easier, and lead to a much better outcome."

On the Mayo Clinic Q&A podcast, Dr. Joaquin Sanchez-Sotelo, discusses advances in shoulder replacement surgery, including custom-fitted implants.

The custom-fitted shoulder implant discussed in this podcast is produced by Strkyer. Dr. Sanchez-Sotelo and Mayo Clinic receive consulting fees and royalty payments from Stryker for shoulder arthroplasty products; however, Dr. Sanchez-Sotelo and Mayo Clinic do not have any relevant financial conflicts with this specific device.

"The most recognized, the most common symptom of heart failure is breathlessness," says Dr. Gosia Wamil, a cardiologist at Mayo Clinic Healthcare in London. "And the type of breathlessness that patients would describe most often is the inability to lie flat, waking up in the middle of the night or gasping for air."

Heart failure is often thought to be a disease of advanced age, but it can actually develop at any time in life. In many cases, heart failure can be prevented or treated if people are aware of the risk factors and warning signs. 

Coronary artery disease is the main cause of heart failure. Stiffening of the heart muscle is mostly a result of poorly controlled hypertensionor diabetes. Proper treatment can improve the signs and symptoms of heart failure and may help some people live longer. Lifestyle changes — such as losing weight, exercising, reducing salt (sodium) in your diet and managing stress — can improve your quality of life. 

"All the risks of developing heart attack, if we reduce those risks, we improve their lifestyle," explains Dr. Wamil. "If we reduce the risk of diabetes, hypertension, stop smoking, this will reduce the risk of heart attacks, but at the same time, will reduce the risk of heart failure."

Dr. Wamil's research efforts include studies aimed at understanding the connection between diabetes and heart disease and using novel medical imaging techniques to identify heart failure early on. Other research underway at Mayo Clinic includes the use of artificial intelligence and machine learning tools to detect heart failure early.

"An area of research interest at Mayo Clinic is the use of large databases, such as randomized controlled trials, electronic health care records, and applying not only statistical methods but also AI, machine learning models and algorithms to try to identify how we can detect early signs of heart failure risks," explains Dr. Wamil. 

On the Mayo Clinic Q&A podcast, Dr. Wamil, discusses warning signs of heart failure and advances in early detection of heart disease.

Related posts:

• "Mayo Clinic London Healthcare expert shares heart failure signs, symptoms people may not be aware of."
• "Mayo Clinic Q&A podcast: Understanding the connection between diabetes and heart disease."
• "AI-guided screening uses ECG data to detect a hidden risk factor for stroke."
• "Mayo researchers use AI to detect weak heart pump via patients’ Apple Watch ECGs."

"Surgical resection of the tumor from the breast and also evaluation of the lymph nodes are used for the vast majority of patients with breast cancer, in particular, those patients where the disease is limited to the breast," says Dr. Judy C. Boughey, a surgical oncologist at Mayo Clinic. "One of the areas where often breast surgery does not have a role is if the breast cancer has spread or metastasized to other areas of the body. So for patients with stage 4 breast cancer, surgery has a much more questionable role."

Surgery is used to treat most stages of breast cancer, but it is rarely used to treat metastatic breast cancer — breast cancer that has spread to other parts of the body. Breast cancer surgery may be used alone or in combination with other treatments, such as chemotherapy, hormone therapy, targeted therapy and radiation therapy. 

Breast cancer surgery includes different procedures, such as:

• Surgery to remove the entire breast (mastectomy)
• Surgery to remove a portion of the breast tissue (lumpectomy)
• Surgery to remove nearby lymph nodes
• Surgery to reconstruct a breast after mastectomy

Which breast cancer operation is best for an individual depends on the size and stage of the cancer, other treatment options available, and the goals and preferences of each patient.

For people with a very high risk of breast cancer, a preventive (prophylactic) mastectomy may be an option to reduce the risk of future breast cancer. 

With so many options and decisions to be made, preparing for breast cancer surgery can be a challenge. It's important to be comfortable with your surgeon and to have the support of family and loved ones.

"Starting on the breast cancer journey is always a very challenging time," says Dr. Boughey. "Lean on your closest loved ones that you let into your inner circle and talk to them about your diagnosis, your treatment and your journey."

Dr. Boughey also encourages people to remember that everyone's journey is unique and to rely on your care team for trusted information.

"I think one thing to be very aware of with breast cancer is it is a very common disease, and every one of us knows someone or someone's relative that has been affected by this disease," explains Dr. Boughey. "Truthfully, breast cancer really is not one disease. And so I would just caution against hearing about your friends and their experience because it may have been a different size tumor and may have been treated a different way. And most importantly, it was likely a different tumor biology. And so you don't necessarily always have to listen to everybody's story and experience because that doesn't mean that yours will be the same. Share with your doctors some of the concerns that you've heard from your friends, from your colleagues, what you may have read on the internet, so that if they're not true, your team can dispel those myths for you and make you feel more comfortable."

On this Mayo Clinic Q&A podcast, Dr. Boughey discusses how surgery is used in the treatment of breast cancer.

While the Somos Latinos MERG is based at Mayo Clinic in Rochester, Minnesota, Hispanic and Latino MERGs also are active elsewhere across Mayo.

"Resource groups are the response to promoting inclusivity as well as championing a team-based approach for all staff," explains Carlos Rodriguez Jr., a senior strategist at Mayo Clinic and chair of the Somos Latinos MERG. "Essentially, our task is simple: to create a community that people feel a part of. And that's what we work to achieve every day."

The work of MERGs supports several initiatives underway at Mayo Clinic to improve the experience for Hispanic and Latino patients. For example, Mayo is using in-person interpreters when possible, as well as video and phone interpretation, and making patient education materials available in Spanish. Another support option for patients is the Spanish-speaking patient coordinator program. 

"The patient coordinator programs are meant to have an individual whose job it is to help the patient navigate the health care system," says Dr. Enid Rivera-Chiauzzi, a Mayo Clinic OB-GYN and physician chair of the Somos Latinos MERG. "It's really complicated to figure out where you're supposed to be for an appointment, where you're supposed to park, who you were supposed to call, and really understanding what happened during your visit. And even if you are proficient in English and Spanish, it's just the culture. Maybe where you grew up is different than here. So the person who is matched with you is a bilingual individual who can help you navigate the health care world." 

Mayo Clinic also offers support to patients from Latin America who seek care. Representative offices in several countries — Colombia, the Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Panama and Peru — are staffed by people who speak the local language, and can answer questions, help request appointments and make travel arrangements. 

"If you think about a patient representative on the ground in a given country, it really affords the patient the opportunity to connect with Mayo Clinic and start the process before they get to us," explains Rodriguez. "One of the differentiating propositions of Mayo Clinic is the integrated approach. The overall health care system is difficult to navigate, particularly when you're not familiar with the environment. So starting that conversation and engagement early is key to making the long-term relationship with Mayo Clinic a positive one."

Closer to home, work is underway at Mayo Clinic to build a Latino mentorship program for clinical staff that will ultimately benefit patients.

"We want to create a community of physicians and health care professionals who have been supported along their journey by other Latino and Latina health care professionals, therefore increasing our numbers," explains Dr. Rivera-Chiauzzi. "Our aim is to have more of us in these positions, which will help our patients see more people who look like them, or at least be as equally represented as they are in the community in general. That doesn't mean, 'Oh, I can only see a doctor that looks exactly like me and is exactly like me.' But we want to be in an environment where we can see all kinds of people and then whatever excellent person takes care of me, I feel like 'Oh, this person welcomes me.' That's important." 

To celebrate Hispanic Heritage Month, which takes place Sept. 15-Oct. 15, Dr. Rivera-Chiauzzi and Rodriguez join the Mayo Clinic Q&A podcast to discuss Mayo Clinic's efforts to support Hispanic and Latino patients and staff.

Biologics are therapies that come from human sources — cells, blood, enzymes, tissues, genes or genetically engineered cells — for use in medicines. Biomanufacturing is focused on manufacturing commercial grade biologically based medicines for treatment. Some examples include the use of stem cells, gene therapy and cell therapy, and 3D printing of tissues and organs.

"The important thing is that there's an opportunity to use these type of therapies to cure rather than just treat patients as we move forward looking at different ways of being able to use these products," says Dr. Julie Allickson, the Michael S. and Mary Sue Shannon Family Director of Mayo Clinic's Center for Regenerative Biotherapeutics. "It's definitely a bright future." Dr. Allickson also is the Otto Bremer Trust Director of Biomanufacturing and Product Development in the Center for Regenerative Biotherapeutics.

Mayo Clinic is working to move cellular discoveries from the lab to clinical trial and into commercially available therapies. To move technologies forward, partnerships are key.  

Mayo Clinic has formed a strategic collaboration with National Resilience Inc. to establish Rochester, Minnesota as a center for biomanufacturing regenerative technologies. Mayo also has manufacturing facilities in Jacksonville, Florida and Phoenix.

Recently, Mayo Clinic, Hibiscus BioVentures, and Innoforce announced the launch of Mayflower BioVentures, a cell and gene therapy accelerator dedicated to identifying and forming companies around technologies that address unmet patient needs. All three organizations have a financial interest in the Mayflower collaboration. Mayo Clinic will use any revenue it receives to support its nonprofit mission in patient care, education and research.

"There is a lot of investment in the field," says Dr. Allickson. "And Mayo Clinic is certainly prioritizing this across the enterprise, to allow the patients here to have treatments focused on rare and complex diseases. Here at Mayo Clinic, we want to make sure that that happens."

On the Mayo Clinic Q&A podcast, Dr. Allickson discusses the near- and long-term future of biomanufacturing and biotherapeutics.

Experts encourage parents and caregivers to get comfortable with having difficult conversations about race and bias. 

"It's important for all children to have these discussions, and as an adult in any child's life, everything that you're doing is modeling for them what's okay and isn't okay," says Dr. Emily McTate, a Mayo Clinic pediatric psychologist. 

Parents may be surprised to find out that a baby's brain can notice race-based differences as early as 6 months, according to the American Academy of Pediatrics. By age 12, many children become set in their beliefs. 

When children have questions about racial differences, it's important to keep a child's developmental stage in mind and tailor age-appropriate messages. The American Academy of Pediatrics offers these strategies for helping children understand and deal with racial bias:

• Talk to your children and acknowledge that racial differences and bias exist.
• Confront your own bias and model how you want your children to respond to others who may be different than them. 
• Encourage your children to challenge racial stereotypes and racial bias by being kind and compassionate when interacting with people of all racial, ethnic, and cultural groups.

Another important step is teaching kids to be critical consumers of media. 

"I always think about all the moments, whether you're reading books together or watching animated movies together, whatever it is, and hit the pause button and talk about what's going on," says Dr. Daniel Hilliker, a Mayo Clinic pediatric psychologist. "Why is this person being represented in this fashion? And that can kind of open up the conversation about exploring some different perspectives." 

On this Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. McTate and Dr. Hilliker for a discussion on talking to kids about racism.

Additional resources:

• "Talking to Young Children About Race and Racism."
• "Coming Together: Celebrating Every Child's Race, Ethnicity, Culture!" 
• "Talking About Race: Who am I?"

Also called endometrial cancer, uterine cancer begins in the layer of cells that form the lining, or endometrium, of the uterus. The American Cancer Society estimates that about 65,950 new cases of uterine cancer will be diagnosed in the U.S.this year, and about 12,550 people will die from the disease.

Researchers recently reported the results of a study of 208,587 women ages 40 and older with uterine cancer. The study showed death rates for all types of uterine cancer increased significantly by 1.8% per year from 2010 to 2017. Death rates remained stable for the most common form of uterine cancer — Type 1 endometrial cancer — but increased by 2.7% per year for a rarer, more aggressive form called Type 2 endometrial cancer.

"We do see a rise in diagnosis of uterine cancer," says Dr. Kristina Butler, a Mayo Clinic gynecologic oncologist. "And we feel like that is because there's also a rise of some other illnesses such as diabetes, hypertension and obesity, which are risk factors for uterine cancer. And because we're seeing more people experience those types of illnesses, uterine cancer rates are rising." 

The study also revealed racial disparities in uterine cancer death rates. Death rates from uterine cancer increased 6.7% annually among Hispanic women, 3.5% among Black women, 3.4% among Asian women and 1.5% among White women. Despite representing less than 10% of cases, nearly 18% of all deaths from uterine cancer occurred in Black women.

"Addressing health disparities is a huge priority of our national organization, the Society of Gynecologic Oncology," explains Dr. Butler. "I think it's very clear that there are disparities as it relates to patient access to care. Also, opportunities to train providers in cultural competency, so that patients feel very comfortable coming and having that patient-doctor relationship. And we need to improve health care access for women in rural communities and take education to those communities so that those women feel comfortable reaching out to us when they need care." 

On this Mayo Clinic Q&A podcast, Dr. Butler discusses uterine cancer, disparities related to the disease, and what people can do to reduce their risk of developing this type of cancer.

“A lot of people still don't know what to do if a child is diagnosed with cancer or where to go,” explains Dr. Wendy Allen-Rhoades, a Mayo Clinic pediatric hematologist and oncologist. “We want people to know that we know that a cancer diagnosis is scary. We know that it’s life-altering. But we also want you to know that there's hope, that we are doing really good things here at Mayo Clinic and elsewhere. And there is hope for a cure, and there is life after childhood cancer.”

Dr. Allen-Rhoades says funding is needed for more pediatric cancer research to continue to improve treatments. One area of focus for her has been sarcomas. Sarcoma — the term for a group of cancers that begin in the bones and in the soft or connective tissues — is one of the more common types of childhood cancer. 

Fortunately, recent treatment advances have increased survival rates. Of children diagnosed with cancer, 84% now survive five years or more. One of the advances in treatment has been improvement in radiation therapy techniques and the use of proton beam therapy to treat pediatric cancers.

"Radiation therapy works very well for sarcomas," says Dr. Wendy Allen-Rhoades, a Mayo Clinic pediatric hematologist and oncologist. "And the difference between conventional radiation and proton therapy radiation is that our radiation oncologists are able to contour a little bit tighter with proton therapy. Therefore, the surrounding tissue that is normal is spared from some of the side effects. This is really important in children who are growing because we want them to be able to grow normally."

In addition to sparing healthy tissue from the effects of radiation, people who must undergo radiation therapy early in life are less likely to have long-term side effects and complications, such as secondary cancers, with proton beam therapy than with conventional radiation therapy.

While treatments and cure rates for sarcomas have improved, Dr. Allen-Rhoades hopes for even better results in the future.

“Sarcomas have been a tough nut to crack for sure in terms of research and novel innovative therapies,” says Dr. Allen-Rhoades. “We still have a ways to go, but we're doing much, much better than we were 20—30 years ago. But until we can cure everyone, it will never be enough.”

On the Mayo Clinic Q&A podcast, Dr. Allen-Rhoades discusses pediatric sarcomas and the importance of funding for research and support of families dealing with pediatric cancer.

Peripheral artery disease usually involves pain in the lower limbs caused by reduced blood flow due to narrowing of the arteries. Its symptoms, like reduced ability to walk due to leg pain, often are brushed off as signs of aging. While age is a factor, younger people with diabetes or who smoke also should be checked for the disease. 

"If you have risk factors for lower-extremity PAD — diabetes, tobacco use, high cholesterol, high blood pressure, as well as age — it's really important to have those conversations with your provider about your ability to exercise or walk if you are having any limitation," explains  Dr. Amy Pollak, a Mayo Clinic cardiologist. 

Peripheral artery disease is detectable and treatable, but it's often not diagnosed early enough. This means patients are often not treated with the most aggressive therapies. Health disparities play a big role, with the highest rates of peripheral artery disease occurring in Black men and women.

"There is an amputation epidemic," says Dr. Pollak. "And I don't use that word epidemic lightly. In today's climate, I use it intentionally. Depending upon where you live in our country, you may be at a higher risk of having an amputation for lower-extremity PAD, and not always be offered a revascularization procedure. So there is a lot of work that needs to be done to raise awareness of PAD, both for patients and health care providers."

A new PAD Action Plan spearheaded by the American Heart Association is hoping to do just that. 

The plan serves as a roadmap for reducing the burden of peripheral artery disease by improving the awareness, diagnosis and treatment of PAD. The plan also highlights the many gaps and opportunities in PAD research to further reduce preventable complications and deaths for future generations.

"The incidence of PAD is set to triple in the United States in the coming years," says Dr. Pollak, who is a co-chair of the PAD Action Plan. "So we have an important opportunity to not only prevent that from happening, but to prevent heart attacks and strokes to help people live longer lives with a greater degree of functional ability by diagnosing and treating PAD. When it comes to the health disparities, we need to be doing even more outreach to populations that have been historically not focused on with that important information about what PAD is, how it can present, and what treatment options there are."

On the Mayo Clinic Q&A podcast, Dr. Pollak discusses the importance of early diagnosis of PAD to reduce the risk of amputation, heart attack and stroke.

Related posts:

• "Mayo Clinic Minute: How is peripheral artery disease diagnosed?"
• "Peripheral artery disease can signal cardiovascular trouble for heart, brain and legs." 

Pediatric brain tumors are masses or growths of abnormal cells that occur in a child's brain, or the tissue and structures near the brain. Of the many types of pediatric brain tumors, some are noncancerous, or benign, and some are cancerous, or malignant.

Common brain tumors in infants, children and teenagers include:

• Gliomas
  These tumors begin in the brain or spinal cord. Types of gliomas include pilocytic astrocytomas, ependymomas and oligodendrogliomas.
• Medulloblastoma
  A medulloblastoma is the most common cancerous brain tumor in children. It starts in the lower back part of the brain, called the posterior fossa, and tends to spread through spinal fluid.

Treatment and chance of recovery depend on many factors: the type of tumor, its location within the brain, whether it has spread, and the child's age and general health. 

"The good news is that the really bad tumors are fairly rare," says Dr. David Daniels, a Mayo Clinic pediatric neurosurgeon. "When we look at tumors, we look at their type or classification, and then a grading that goes along with that."

Often, a biopsy of the tumor is performed to determine its type and grade. This information helps guide the course of treatment, which can include surgery, radiation therapy and chemotherapy.

"The biggest thing is that grading," explains Dr. Daniels. "Is this a grade one tumor, which is very benign, or is this a grade four tumor, which is really aggressive? And so our treatment has to match the aggressiveness of that tumor, so to speak." 

Because new treatments and technologies are continually being developed, several options may be available at different points in treatment. As part of the Mayo Clinic Children's Center, pediatric specialists in Mayo's Pediatric Brain Tumor Clinic work together as a team to develop an individual treatment plan for each child. 

Typically, a pediatric neuro-oncologist specializing in brain tumors is the child's primary doctor. This doctor coordinates access to other specialists from the pediatric brain tumor treatment team, including pediatric neurology, pediatric neurosurgery, neuroradiology, pediatric endocrinology, neuropathology, pediatric radiation oncology, pediatric oncology, child psychology and pediatric rehabilitation.

On this Mayo Clinic Q&A podcast, pediatrician and Ask the Mayo Mom host, Dr. Angela Mattke, is joined by Dr. Daniels to discuss common pediatric brain tumors. Dr. Daniels covers treatment, including when surgery may be an option, and highlights the latest in brain tumor research.

"Cancer survivorship visits can be very beneficial for the patients," says Dr. Meghna Ailawadhi, a Mayo Clinic general internist specializing in cancer survivorship. "They can provide a bridge between your primary care and your oncologist, and help patients sort out the posttreatment journey a little bit easier."

Cancer survivorship clinics may focus on a specific cancer type or a specific age group, such as children, adults, or adolescents and young adults (ages 15 to 39). Many different specialists may be involved, including medical oncologists; rehabilitation specialists; nutritionists; and other specialties, like cardiology and gastroenterology, if needed. 

These clinics often help cancer survivors develop a survivorship care plan — a plan tailored to the individual survivor to make sure that person gets the most out of life after a cancer diagnosis. The care plan also can help inform the primary care physicians who care for these patients after active treatment is finished.

"A survivorship care plan entails the details of their treatment, the details of their cancer journey, their pathology reports, and what kind of treatment — radiation, chemotherapy — they have received," explains Dr. Ailawadhi. "And there's also an assessment and a care plan for the future of how often these patients need to have their surveillance scans, what labs to look for, what signs to look for. It also addresses some of their long-term needs if they are suffering from peripheral neuropathy, chronic diarrhea or other posttreatment effects. So it's an extremely useful document both for the patient and for their primary care providers."

On this Mayo Clinic Q&A podcast, Dr. Ailawadhi discusses Mayo Clinic’s cancer survivorship clinics, what services they offer, and how to find similar services in your area.

Also, check out these cancer survivorship articles:

• "Mayo Clinic Q&A podcast: Cancer survivorship needs are unique to each survivor."
• "Consumer Health: Reconnecting with loved ones after cancer treatment."
• "Mayo Clinic Q&A podcast: Living as a prostate cancer survivor."
• "Consumer Health: Managing your emotions after cancer treatment."
• "Mayo Clinic Q&A podcast: Diet and nutrition help cancer survivors return to good health."
• "Consumer Health: Life after cancer."
• "Mayo Clinic Q&A podcast: Meeting the unique needs of adolescent and young adult patients with cancer."
• "Mayo Clinic Q&A podcast: Life after lymphoma."

The new boosters are bivalent vaccines, meaning they target more than one strain of the virus. The new formulation targets the BA.4 and BA.5 omicron variants, in addition to the original coronavirus strain. BA.5 is responsible for nearly 90% of all new COVID-19 cases in the U.S., according to the CDC. 

The Pfizer bivalent booster is approved for people 12 and up if they have already received their primary COVID-19 vaccine series and it has been at least two months since their last vaccine dose. The Moderna bivalent booster is available on the same timeline to people 18 and up.

"This booster recommendation is in anticipation that there will be yet another surge as college students, grade school and high school students are gathering back together," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "We're also preparing for cooler weather, meaning more indoor activities, family gatherings and the holidays — often without masks, unfortunately. We still need to take COVID seriously."

Another big concern for vaccine experts is the upcoming flu season. The Southern Hemisphere is often an indicator of what's to come for the U.S. Australia's flu season exceeded its five-year average, particularly affecting children under age 5, according to a recent report. 

Experts worry that the relaxing of masking and social distancing recommendations that were in place for COVID-19 purposes the past two winters will be a factor. These measures also protected people from the flu.

"When cold weather moves us indoors, a high viral circulation occurs in schools and other indoor settings. I think we are very likely to see a bad flu year," says Dr. Poland. "Now I know we've been predicting that for two years, but for the most part, people wore masks and it didn't happen. I don't think that'll be the case this year. People are not wearing masks, and we are very likely to get hit hard by influenza."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news and touches on other news, including monkeypox, polio and the upcoming flu season.

Setting up students for success at school includes parents and caregivers helping kids develop routines and good habits for time management, nutrition and sleep.

"Having routines is so important not only for our kids, but actually for our families and for us as adults, as well," explains Dr. Tina Ardon, a family medicine physician at Mayo Clinic in Florida. "And routines focusing on sleep are a huge part of how we can do well in an academic setting, but also really important for health in general for our kids. That's why kids grow. That's when brain development can happen. So focusing on a really good sleep schedule and routine is just so important for us to be prioritizing as families."

Another important step to prepare for school is to make sure that a child's vaccinations are up to date.

"With any illness, but particularly for our kids, if we want to keep them from missing school, from missing things that we can prevent, then we should take advantage of the tools we have available," says Dr. Ardon. "So vaccines are one of those great tools that we have, at helping either prevent disease or helping us not get quite as sick from disease." 

In addition to routine childhood vaccinations, Dr. Ardon recommends all children age 6 months and up be vaccinated against COVID-19 and also receive a flu vaccination when it's available. 

Another important part of preparing for school is dealing with the anxiety about the unfamiliar — a new environment, a new school, a different classroom. So how can parents help kids navigate the uncertainty?

"Keeping open lines of communication with your kids is so important," says Dr. Ardon. There are lots of ways for us to kind of prepare ourselves for either a new classroom or a new school. We can look online at pictures of the new school. We can take advantage of return-to-school activities where you can meet the teacher and walk around preparing your child for that first day. We can talk about what they're maybe excited about or nervous about. Is it homework? Is it new friends, old friends? Just allowing your child to have that conversation with you can alleviate a lot of that stress, as well."

On the Mayo Clinic Q&A podcast, Dr. Ardon offers tips on helping kids prepare for back to school.

"It's important to let our kids know that it's really normal to feel this way," says Dr. Marcie Billings, a Mayo Clinic pediatrician. "Just try to support your kids and let them talk through their fears, talk through their challenges that they're dealing with. And don't think that you need every answer. It's really just about listening." 

Another common concern for parents is mental health and wellness and preparing their children to deal with the challenges of a new school year. 

Adding to the challenge is the fact that this is now the third school year affected by the COVID-19 pandemic. Parents and students will need to understand masking and vaccination recommendations to help navigate the classroom setting as safely as possible.

In addition to COVID-19 vaccinations, it is important to make sure children are up to date on other childhood immunizations, including preparing to get a flu shot as soon as it is available this fall.

"Being vaccinated against COVID-19 and current on all childhood vaccinations is a really important part to returning to school safely," says Dr. Nipunie Rajapakse, a Mayo Clinic pediatric infectious diseases physician.

Dr. Rajapakse points out that masking recommendations may differ by school and region based on levels of transmission, but children who choose to wear masks should be supported by staff and other students.

"There are certain children, for example, children with weakened immune systems or children who have people in their family with a weakened immune system, who may still choose to mask even if community transmission is low," explains Dr. Rajapakse. "I think it's important to recognize that anyone who wants to wear a mask in an indoor setting should be supported in doing so." 

On the Mayo Clinic Q&A podcast, "Ask the Mayo Mom" host Dr. Angela Mattke, a pediatrician in Mayo Clinic Children’s Center, is joined by Dr. Billings and Dr. Rajapakse for a discussion on back to school topics, including COVID-19, monkeypox, mental health in kids and teens, nutrition and sleep.

When amyloid collects in the heart muscle, it causes irreversible thickening of the heart wall and disrupts heart function. It reduces your heart's ability to fill with blood between heartbeats, resulting in less blood being pumped with each beat. This can result in shortness of breath. Cardiac amyloidosis also can affect your heart's electrical system, resulting in a disturbed heart rhythm.

Cardiac amyloidosis typically presents as a form of congestive heart failure. It is often overlooked because the symptoms can masquerade as other conditions. Unfortunately, there aren't any preventive strategies for cardiac amyloidosis, says Dr. Melissa Lyle, a Mayo Clinic cardiologist.

"So the key, really, is early detection," says Dr. Lyle. "We want to make sure that we can detect these patients earlier, to get them on the right treatments." 

Dr. Lyle says it's important that patients bring any concerning symptoms to their health care provider as soon as possible.

At Mayo Clinic, people with symptoms that indicate they might have cardiac amyloidosis are diagnosed and treated by a team of experts in the Cardiac Amyloidosis Clinic. This specialized care is available at Mayo Clinic’s locations in Arizona, Florida and Minnesota.

“This approach is a collaborative effort amongst several different specialties, including hematology, cardiology, transplant cardiology, as well as neurology and nephrology,” explains Dr. Lyle. “And our goal is really to provide an efficient evaluation for our patients so that we can quickly come to the correct diagnosis and offer the best treatment option. And we're engaging all of our different specialties for this comprehensive visit to provide the best overall care.” 

On the Mayo Clinic Q&A podcast, Dr. Lyle discusses diagnosis, standard treatment options and new therapies for treating cardiac amyloidosis.

Skin cancer is the abnormal growth of skin cells. While it most often develops on skin exposed to the sun, but it also can occur on areas of skin not ordinarily exposed to sunlight. Skin cancer is the most common form of cancer in the U.S.

"And the incidence of skin cancer is rising," says Dr. Dawn Davis, a Mayo Clinic dermatologist. “We all want to be on the Earth longer, and we appreciate time and aging. But the older we are, the higher our risk for skin cancer.” 

The three major types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. Early detection of skin cancer gives you the best chance for successful skin cancer treatment.

While it is common to have freckles and moles develop over time, it is important to know your skin and recognize when changes occur.

"It's important to know what skin lesions you have," explains Dr. Davis. "Know what they look like, so that if they change, you can come to the dermatologist or health care provider for evaluation."

Melanoma is the most serious and deadly form of skin cancer. Dr. Davis says the "melanoma alphabet" can help with early detection:

• Asymmetry 
  Look for moles with irregular shape.
• Border 
  Look for moles with irregular, notched or scalloped borders.
• Changes in color 
  Look for growths with different or uneven colors.
• Diameter 
  Look for new growth of more than one-quarter of an inch in diameter.
• Evolving 
  Look for changes over time.

While melanoma is more common with age, pediatric melanoma can occur.

“Often, it's not on everyone's radar because we don't believe that children can have skin malignancy, but that is not true,” says Dr. Davis. “It's simply less common. When children get melanoma, they can present with the same signs and symptoms as adults. However, they can also have different symptoms. Pediatric melanoma tends to be skin-colored or amelanotic more commonly than dark or pigmented. So, if a child develops a skin-colored, pink or red bump, or something that used to be flat and then becomes raised, that would be of concern.” 

On the Mayo Clinic Q&A podcast, Dr. Davis discusses skin cancer detection and treatment. Dr. Davis also recommends steps to take to protect your skin including avoiding ultraviolet rays, and wearing sunscreen and protective clothing.

The American Cancer Society estimates there are more than 1.5 million survivors of colorectal cancer in the U.S. 

But what happens after treatment for colorectal cancer is complete? Do survivors of colorectal cancer return to life as they knew it before their diagnosis?

"I think there are three main things that I see our patients really concerned with when they start thinking about finishing their treatment for colorectal cancer," says  Dr. David Etzioni, a colorectal surgeon and chair of the Department of Surgery at Mayo Clinic in Arizona. "The first and biggest concern they have is whether or not their disease will completely go away and stay gone. And this is, I think, a fundamental concern for any patient treated for cancer of any kind." 

Dr. Etzioni explains the other two common concerns for survivors of colorectal cancer are how the treatment will affect their day-to-day quality of life, and whether or not they will need an ostomy bag temporarily or permanently.

An ostomy is a surgically created opening in your abdomen that allows waste or urine to leave your body and be collected in a bag or pouch. For survivors of colorectal cancer, this may be temporary to give the colon time to heal. But, depending on the extent of surgery to remove the cancer and the location of the cancer, sometimes a permanent ostomy bag is needed.

Dr. Etzioni says education can alleviate the fears patients have about needing an ostomy bag.

"When I do have a patient who's worried what the bag is and what it might mean for their life — it might be a temporary or permanent bag — we have a lot of educational resources here at Mayo available to them. We often will send them to our osteo nurses, so they can actually try just wearing the appliance before they've undergone the surgery. They can see what it might be like to wear that underneath their clothes," explains Dr. Etzioni. 

"We also have a support group that consists of patients who have an ostomy. They discuss with each other what challenges they faced, and they're very supportive with each other. And I have a group of patients who are now with an ostomy who I can call on to reach out to a new patient of mine and talk about what it might mean to live with an ostomy. And that's something that I found to be very effective and can really help patients to get over that hump to accept that possibility for cancer treatment."

Finally, Dr. Etzioni says the support of family, friends and loved ones is an important part of the journey for patients with colorectal cancer.

"The patients who undergo treatment with a strong, consistent, omnipresent support system, they simply do better — not just emotionally, but also just in terms of the ability to tolerate treatment," says Dr. Etzioni. "I think they literally have better medical and surgical outcomes."

On this Mayo Clinic Q&A podcast, Dr. Etzioni discusses what people can expect after colorectal cancer treatment ends, and how to achieve the best possible quality of life.

Of course, sports nutrition goes beyond simply what you eat. When you eat is important, too. 

Understanding the right balance and timing of taking in carbohydrates, proteins and hydration can help athletes play their best. Eating a healthy diet ensures that athletes are getting all the nutrients their bodies need to produce energy to perform and to keep muscles, bones, joints and tendons healthy.

Parents and kids should know the basics of sports nutrition and understand how supplements work and which products are beneficial. They also should be wary of supplements and products marketed to athletes because many products do not live up to their claims to increase strength, speed, and athletic skills. 

"Before you even consider supplement, you've got to make sure your diet and the foundation of that diet is solid," explains  Luke Corey, a registered dietician and sports medicine expert with by Mayo Clinic Children’s Center. "What I tell my athletes is that unless you have a solid diet in place, eating every couple of hours consuming nutrient dense foods hydrating, well, supplements are not going to do for you what you think they're going to do." 

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Luke Corey to discuss sports nutrition for young athletes. Topics discussed include what to eat before and after a workout; supplements and drinks including protein, creatine, electrolytes, and pre-workout caffeinated drinks; and concerns about calorie restrictive diets for athletes in some sports including wresting and gymnastics.

More than 262 million people globally are affected by asthma, and more than 461,000 have died due to the disease, according to the World Health Organization.

In childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers, such as inhaling pollen or catching a cold or other respiratory infection. Childhood asthma can cause bothersome daily symptoms that interfere with play, sports, school and sleep. In some children, unmanaged asthma can cause dangerous asthma attacks.

Childhood asthma isn't a different disease from asthma in adults, but children face unique challenges. The condition is a leading cause of emergency department visits, hospitalizations and missed school days.

Unfortunately, childhood asthma can't be cured, and symptoms can continue into adulthood. But with the right treatment, children can keep symptoms under control and prevent damage to growing lungs. Maintaining good day-to-day asthma control is the key to keeping symptoms at bay and preventing asthma attacks.

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Mayo Clinic Children’s Center expert, Dr. Manuel Arteta, a pediatric pulmonologist, to discuss asthma in children.

While breastfeeding benefits for the baby are well-known, the mother also benefits.

"It's definitely a great healthy choice for moms to breastfeed," explains Rebekah Huppert, a lactation consultant and nurse at Mayo Clinic. "We know that with breastfeeding, we see a reduction in mom's risk for cancer, primarily breast and ovarian cancer; we see a reduced risk for diabetes; and a reduced risk for cardiovascular issues later in life. It can help reduce bleeding right after delivery by causing some contractions of the uterus. Evidence that shows that breastfeeding helps with weight loss, as well. It just takes a lot of calories to make breast milk, so we burn through those quickly when we're lactating. Those are just a few of the benefits, but they're big ones for moms."

The American Academy of Pediatrics recommends exclusive breastfeeding of infants for the first six months of life before introducing nutritious complementary foods. The organization also encourages social and systemic changes to support mothers who choose to breastfeed.

This summer, the American Academy of Pediatrics released new recommendations supporting mothers to continue breastfeeding for two years or beyond. These recommendations align with guidelines provided by the World Health Organization and the American Academy of Family Physicians. 

Huppert advises women to not feel undue pressure with these new guidelines.

"It's a sensitive topic for women, especially those who want to do more and find that their body isn't cooperating or sometimes their job isn't accommodating," says Huppert. "So it is important to make sure that moms know that there are multiple ways we nourish our babies. We nourish them by holding them, and by talking to them and reading to them. It isn't just food. And at the end of the day, maternal health — having a mom who is happy and healthy — is going to be the most important thing for a child's growth and development." 

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Mayo Clinic Children’s Center lactation expert Rebekah Huppert to discuss practical approaches to breastfeeding.

Cancer rehabilitation involves many types of specialists working together to develop a personal rehabilitation plan that considers a person's preferences, strengths and goals.

"Cancer rehabilitation aims to help patients maintain function, restore function, and, more broadly, maintain personhood," says Dr. Andrea Cheville, a Mayo Clinic specialist in physical medicine and rehabilitation. "We obviously don't want the process of curing cancer to leave patients with lasting issues that are going to compromise the quality of their life." 

Cancer rehabilitation can include help from a wide variety of specialists, including physical medicine and rehabilitation, physical and occupational therapy, speech and language pathologists, and psychologists. 

"All these specialists work in close partnership to develop an individualized program for each unique individual that meets their needs, goals and preferences," explains Dr. Cheville.

Dr. Cheville encourages people with cancer to include their family and caregivers in the cancer rehabilitation process. It is important for caregivers to understand the patient's goals and can support the work needed to reach them.

"The ideal for a cancer rehab team is the full engagement of the caregiver or partner," says Dr. Cheville. " It truly is a partnership and a team effort."

On the Mayo Clinic Q&A podcast, Dr. Cheville discusses what's involved in cancer rehabilitation and how it can help people with cancer cope with the challenges that come with cancer diagnosis, treatment and recovery.

"I was the first one to register as a donor," says Tim Kelly, Carly's father. "And I was so blessed to be a match. Carly and I have the exact same blood type: AB negative. There are so many people out there that are waiting for kidney and other organs. It is such a long waitlist, and to be able to give my daughter a kidney right off the bat was so fortunate for both of us."

At age 8, Carly had her first organ transplant, receiving a kidney from her father. In 2019, Carly went into liver failure she received a liver transplant on May 2, 2019. 10 months later, Carly received her second kidney transplant. All three transplants have taken place at Mayo Clinic in Rochester, Minnesota.

Now 27 years old, Carly is doing well and hasn't let her transplants slow her down. She and her father will compete in the 2022 Transplant Games of America, which will take place July 29-Aug. 3 in San Diego. The games are open to transplant recipients, living donors and donor families in different categories.

Carly and Tim will be part of Team MN-DAK, which is sponsored by LifeSource. This will be their third time competing in the games, taking part in cycling, pickleball and cornhole. They've been preparing together for the event.

"Every day, we'll bike, or we'll go for a walk, or we'll play pickleball or we'll throw some bags," says Carly. "Being together and preparing, it's something just my dad and I do, which is really cool. It's not really about competing. It's more about honoring your donor." 

There are nearly 106,000 people in the U.S. waiting for a lifesaving organ transplant. Tim and Carly both say that competing in the games is not only about honoring the donors, but also raising awareness. 

"Please registered to be a donor," implores Tim. "One person can save up to eight lives. And it's easy thing to do. Carly wouldn't be here without multiple donors." 

To register to be a donor, visit the Donate Life America website. 

On the Mayo Clinic Q&A podcast, Carly and Tim Kelly share their story.

"Drug shortages are not new to health care," explains Dr. Mary Gilmer, director of pharmaceutical supply and procurement for Mayo locations across the Midwest. "But, really, over the last two years with the COVID-19 pandemic, the shortages have really exposed the vulnerability of our global drug supply chain. And these drug shortages remain high, despite decades of continued and increased awareness, effort and significant resource investment in these drug shortage programs at the highest level." 

At Mayo Clinic, the Pharmacy and Theruapuetics Committee has strategies and an organized approach to managing each drug shortage that's encountered.

"We engage our staff right down to the front-line team members when we're experiencing a shortage," says Dr. Gilmer. "When we place an order for a medication, and we do not receive sufficient quantities of what we're needing to take care of our patients, that's when we start escalating it, and really coordinating around how we understand and identify shortages so that we can best proactively manage them. So that's getting everybody on board for awareness, and any changes in our electronic health system that we need — or engaging our formulary colleagues to understand what alternatives or substitutes we can use." 

In addition to work done internally, Mayo Clinic also has taken a leadership role in combating drug shortages across the U.S., including joining the End Drug Shortages Alliance. The coalition is a collaboration of health system, supply chain and industry partners seeking to prevent drug shortages by solving pharmaceutical supply challenges and increasing transparency.

Mayo was also a founding member of Civica Rx, a nonprofit generic drug company whose goal is to reduce shortages of essential medications that hospitals use. Civica Rx recently announced plans to manufacture and distribute affordable insulin. 

"We often talk about mitigating the impact of a drug shortage, but our goal is really to get further upstream and actually end them and stop them from happening,"says Dr. Eric Tichy, chair of the Division of Pharmacy Supply Solutions at Mayo Clinic. "So we do a lot of advocacy with the government and different regulatory agencies. And anytime someone says they want to help end or manage drug shortages, we're always interested in what that opportunity is."

On the Mayo Clinic Q&A podcast, Drs. Gilmer and Tichy discuss Mayo Clinic's work to combat drug shortages.

"The factors that define when you're going to get your first period really is when did mom get her first period, so genetic factors, but there are a lot of lifestyle factors, too" says Dr. Asma Chattha, chair of Pediatric Gynecology at Mayo Clinic. "Definitely weight gain and rate of weight gain plays into it as well. New research is suggesting socio-economic factors and adverse childhood experiences also affect when you get your first period. So that's probably why there's such a variation and when you'll first get your period."

Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy menstrual bleeding is a common concern, most women don't experience blood loss severe enough to be defined as menorrhagia.

While what's considered normal covers a wide range, heavy bleeding during menstrual cycles can be a concern. In these cases, teens and their parents should reach out to their health care team for an evaluation.

"From a hematology standpoint, we always worry that there's some kind of predilection to bleeding," explains Dr. Asmaa Ferdjallah, a Mayo Clinic pediatric hematologist. "And there's a few inherited bleeding disorders that are not that uncommon in the population, honestly. And sometimes their only presentation is heavy periods. At times, many of these girls and young women go their whole life, and they just don't know that they have these deficiencies, or bleeding propensities, and those are fairly easy to screen for."

Another common issue is menstrual cramps. 

Menstrual cramps, or dysmenorrhea, are throbbing or cramping pains in the lower abdomen. Many girls and women have menstrual cramps just before and during their menstrual periods.

For some, the discomfort is merely annoying. For others, they can be severe enough to interfere with everyday activities for a few days every month. Menstrual cramps that aren't caused by another condition tend to lessen with age and often improve after giving birth.

There are hormonal and non-hormonal treatment options and products to help girls and young women cope with heavy periods.

"I know it's hard to talk about these things, but talk to your health care team with any question you have about heavy periods," says Dr. Ferdjallah. "Ask all your questions. None of them are dumb, and we will do our best to help you. More often than not, we can find you a solution to make your periods better." 

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Mayo Clinic Children’s Center experts Drs. Chattha and Ferdjallah to discuss misconceptions about, and treatment options for, heavy menstrual cycles.

More resources:

Dads, daughters and talking about menstruation — advice from an expert.

Any cancer can spread to the central nervous system, but the types most likely to cause such metastases are lung, breast, colon and kidney cancers, and melanoma.

Treatment for brain and spinal cord metastases can help ease symptoms, slow tumor growth and extend life. 

To determine which treatment might work best for a person's tumor type, some health care professionals now use liquid biopsies. When a metastatic tumor is in a place in the body that cannot be reached through surgery for a tissue biopsy, liquid biopsies are especially helpful.

A liquid biopsy involves collecting fluid and analyzing it for tumor biomarkers that can help health care professionals determine the tumor's molecular structure and individualize treatment for the best outcome. 

"So we have excellent drugs for different cancer types that are really based off of your specific cancer," explains Dr. Wendy Sherman, a Mayo Clinic neurologist. "So, not just your lung cancer, but does your lung cancer have a specific mutation? And there are drugs that match up to the mutation that have been very effective."

Dr. Sherman explains that halfof the time when a cancer travels to a different part of the body, particularly to the brain, the cancer may change and lose its mutation. 

"So, if you treat someone based off of the information that you had a couple years ago from where the cancer started, that may not reflect the current state of your cancer and what it looks like," says Dr. Sherman. And, so, our treatment really depends on that. And with a lot of these new-generation treatments that are going after these mutations, it has been very beneficial to look for those in the spinal fluid. And it absolutely has improved how people deal with this from a symptom standpoint because we're often able to give them often drugs that are better tolerated because they're more targeted."

Research is underway to further expand the use of liquid biopsies.

"We want to learn more about the use of liquid biopsy, particularly as it pertains to spinal fluid for not just brain metastases but also for cancers that start in the brain," explains Dr. Sherman. "And then also, can we use other fluids in the body? Those samples — urine and blood — are being collected and tested so that hopefully we can make progress toward that use."

On this Mayo Clinic Q&A podcast, Dr. Sherman discusses the use of liquid biopsy in caring for people with breast, lung and gastric cancer that has spread to the brain and spinal cord.

Experts are concerned because this particular variant appears to be good at evading the immune system. 

"This BA.5 variant is hypercontagious, and right behind it, new variants are coming," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "We will continue to generate these variants until people are masked and immunized." 

Dr. Poland explains that the transmissibility of BA.5 represents the evolution of the virus to become more contagious and able to evade immune protection from previous infection or vaccination. 

"Whether you've been vaccinated, whether you've been previously infected, whether you've been previously infected and vaccinated, you have very little protection against BA.5 in terms of getting infected or having mild to moderate infection," says Dr. Poland. "Thankfully, you still do have good protection against dying, being hospitalized or ending up on a ventilator if you are up to date on your vaccinations." 

Due to the consequences of reinfection, including the possibility of long COVID-19, Dr. Poland urges people to continue to take precautions to protect themselves.

"The reality is, it's important to be up to date on the COVID-19 vaccinations that are recommended for your age group, health condition, etc.," says Dr. Poland. "Sometime this fall, we may well have a variant-focused vaccine, so get it when it becomes available. And wear a proper mask properly when you are indoors around people who are not your family or in a crowded outdoor venue."

On the Mayo Clinic Q&A podcast, Dr. Poland shares the latest COVID-19 news and answers listener questions.

"Multiple sclerosis — the term means multiple scars — is a disease that leads to damage of the central nervous system, which is the brain, the spinal cord and the optic nerve," explains Dr. Eoin Flanagan, a Mayo Clinic neurologist. 

Signs and symptoms of MS vary widely. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms. 

Most people with MS have a relapsing-remitting disease course. They experience periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These relapses are followed by quiet periods of disease remission that can last months or even years.

While there is no cure, treatments can help modify the course of the disease and manage symptoms.

"In the last five to 10 years, we really have strong medications that can keep MS very quiet," says Dr. Flanagan. "We're hopeful that will prevent a lot of the long-term damage that patients used to get in the past where after many years of having an MS diagnosis they may struggle with walking or have additional disability that would develop from those scars. And I think with these new medications we're going to be able to stop MS in its tracks. So it's a really hopeful time for all of our patients with MS."

In addition to medications to manage MS, Dr. Flanagan notes that patients with MS can be monitored in new ways. New technologies include a digital floor mat to monitor a patient's waking, an optical scan that can measure microscopic nerve damage, and a blood test to measure inflammation levels and response to treatments.

"We really are trying to embrace technology here at the Mayo Clinic," says Dr. Flanagan. "We're using these new technologies to both learn more about MS and see how we can better help our patients because, at the end of the day, the needs of the patient come first."

On the Mayo Clinic Q&A podcast, Dr. Flanagan discusses advances in the management of MS.

Many common school-age activities — such as playing on playground equipment and jumping rope — help kids get the recommended amout of exercise. Organized sports are a great way to stay fit, too, but team sports aren't the only options. Nature hikes, walking, biking or even dancing to their favorite music can get kids moving. 

Including physical activity in a child's daily routine sets the foundation for a lifetime of fitness and good health. And beyond the physical benefits, there are cognitive benefits as well.

"The literature really speaks to the benefit on cognition from cardiovascular exercise," says Dr. Tanya Brown, a Mayo Clinic neuropsychologist. "So we can see a positive benefit on how a child's emotionally feeling as well as cognitively functioning. The brain is developing throughout childhood, so it is really primed to be improved." 

Children who get regular exercise have lower levels of depression and stress and higher levels of positive self-image, according to the American Psychological Association. Exercise also is linked to better thinking skills, which leads to improved behavior, attention and academic performance.

Even a short burst of exercise can help.

"To get the cognitive benefits of exercise, it's important to get the heart rate up," says Brandi Brian, a physical therapist at Mayo Clinic and certified neurologic clinical specialist. "Getting the heart rate up for as little as four minutes will have short-term benefits that can kind of help in the moment. Then longer term, improving physical fitness through aerobic activity will have longer-term implications on cognition."

On the Mayo Clinic Q&A podcast, Dr. Brown and Brian join pediatrician and host Dr. Angela Mattke for a discussion focused on the cognitive benefits of exercise for children.

"This age group is one that can't wear a mask or anything else reliably," explains Dr. Nipunie Rajapakse, a Mayo Clinic pediatric infectious diseases specialist. "And so this is one of the really important layers of protection for them. Vaccinations will help protect the child, the family and the community." 

Dr. Paige Partain, a Mayo Clinic pediatrician, says while parents may wonder if getting their young children vaccinated against COVID-19 is necessary, it is important to recognize the benefits. 

"When I look at our primary goal, which is keeping kids out of the hospital, keeping them from dying from COVID, we know that vaccines do that very well," explains Dr. Partain. "And we don't have a good way to predict whether your child might be in that small percentage that gets really sick from COVID, so we want to make sure that we give them the best protection. Even for folks that have already had COVID, because the natural immunity that we get from these infections doesn't last as long as we would like. So when we can combine that immunity with the immunity from a vaccine, what we're really doing is giving kids the best protection and the best chance to do well if they do get COVID." 

Dr. Partian says the benefits of vaccinating kids younger than 5 goes beyond preventing severe disease and hospitalizations.

"Having our kids vaccinated decreases the chances that they might pass COVID along to someone else, maybe more vulnerable adults that they spend time around or other children under 6 months who aren't old enough to get their vaccine yet."

On the Mayo Clinic Q&A podcast, Dr. Rajapakse and Dr. Partain from the Mayo Clinic Children’s Center join pediatrician and host Dr. Angela Mattke for a discussion on COVID-19 vaccinations for children ages 6 months to 5 years.

Bone cancer is a rare disease, accounting for just 0.2% of all cancers. An estimated 3,910 new cases of sarcoma of the bones and joints will be diagnosed in 2022, according to the National Cancer Institute. 

Some types of bone cancer occur primarily in children, while others affect mostly adults. 

"When we think of sarcomas of the bone, the common types are chondrosarcoma, Ewing sarcoma, and osteosarcoma," says Dr. Safia Ahmed, a radiation oncologist at Mayo Clinic. "While sarcoma can happen in any bone in the body, the most common sites include the pelvis, the spine, and the skull base for most of these tumors."

Treatment for sarcoma varies depending on sarcoma type, location and other factors. Treatments can include surgery, chemotherapy and radiation therapy. 

Proton beam therapy is a type of radiation therapy that is more precise than traditional X-ray treatment, which delivers radiation to everything in its path. Proton beam therapy uses positively charged particles in an atom — protons — that release their energy within the tumor. Because proton beams can be much more finely controlled, specialists can use proton beam therapy to safely deliver higher doses of radiation to tumors. This is particularly important for bone cancers.

"When we treat these tumors in the bone with radiation, they need much higher doses of radiation than, say a sarcoma that arises purely in the muscle, what we call a soft tissue sarcoma," explains Dr. Ahmed. "And these high doses of radiation often exceed what the normal tissues around the area can tolerate. So proton therapy allows us to give this high dose of radiation while protecting the normal tissues."

July is Sarcoma Awareness Month. On this Mayo Clinic Q&A podcast, Dr. Ahmed discusses sarcoma diagnoses and treatment options, including proton beam therapy.

People with diabetes can experience significant complications from the disease, including heart disease, chronic kidney disease, nerve damage and vision loss. While advances have been made in diabetes treatments, many people with diabetes struggle with the disease.

"Diabetes is an abnormality in consuming or metabolizing blood glucose," says Dr. Tambi Jarmi, a Mayo Clinic nephrologist. "So diabetic patients have a hard time adjusting their blood sugar to the level that their cells needed. It could be a result of a deficiency in the production of the insulin that comes from the pancreas or it could be a result of resistance to that insulin."

To restore normal insulin production and improve blood sugar control, a pancreas transplant may be an option.

Most pancreas transplants are performed to treat Type 1 diabetes. A pancreas transplant can potentially cure this condition. But such a transplant is typically reserved for those with serious complications of diabetes because side effects can be significant.

In some cases, a pancreas transplant also can treat Type 2 diabetes. A pancreas transplant is often performed in conjunction with a kidney transplant in people whose kidneys have been damaged by diabetes.

"The idea of a pancreas transplant is to actually cure the diabetes," says Dr. Jarmi. "While treatment with a mechanical pump does a great job, it is not a cure. An organic pump, meaning a pancreas transplant, does cure diabetes." 

Pancreas transplants are sourced from a deceased donor, and the organ to be transplanted must match the blood type of the recipient. With the replaced function of the pancreas and natural ability to produce insulin, Dr. Jarmi says patients no longer are diabetic.

On the Mayo Clinic Q&A podcast, Dr. Jarmi discusses pancreas transplant as a cure for diabetes.

"Regenerative medicine is the idea that we can reestablish form and function," says Dr. Saranya Wyles, a Mayo Clinic dermatologist. "So when we are born, we have that baby skin. And as we age, that sort of shifts and changes over time. So how do we utilize regenerative technologies to get that skin to go back to regenerating or restoring that form and function?" 

Mayo Clinic's Center for Regenerative Medicine is leading efforts to integrate new regenerative biotherapeutics into clinical care. Dr. Wyles explains the regenerative medicine "toolkit" includes stem cells and platelet-rich plasma, and the latest tool: exosomes.

"I think it's these new technologies within regenerative medicine that we are going to look to directly be playing against that root cause of aging," explains Dr. Wyles.

Products to repair aging skin are in demand, but Dr. Wyles cautions people to make sure there is science-based evidence and not just hype. The focus of Dr. Wyles' lab is to provide a validated scientific approach to conditions such as wrinkles, age spots and thinning skin. Her studies examine the role of cellular senescence as a biomarker of skin aging.

"I think that this is a very exciting time, and we're seeing a convergence of longevity and aging science and regenerative medicine," says Dr. Wyles. "I would just advise you to really ask about the research that's being done and really know the science — and then decide on a product that would be best fitting for you." 

On the Mayo Clinic Q&A podcast, Dr. Wyles discusses regenerating damaged skin.

During the pandemic, the number HIV diagnosis decline, but that decline is most attributed to declines in testing, according to the Centers for Disease Control and Prevention. Experts attribute this decline to less frequent visits to health centers, reduced outreach services, and shifting of public health staff to COVID-19 response activities. 

June 27 is National HIV Testing Day, a day to encourage people to get tested for HIV, know their status, and get linked to care and treatment.

But who should be tested?

"The CDC recommends that everyone over the age of 13 be tested for HIV at least once in their lifetime," says Dr. Stacey Rizza, an infectious diseases specialist at Mayo Clinic. "This is endorsed by the Center for Medicare & Medicaid Services and paid for by all private insurance companies. So no matter what your background is, if you've never been tested for HIV, you should get tested. And that's because many people with HIV have no idea they have it. They can be completely asymptomatic for a very long time and not only have the virus causing ill effects on themselves, but they're at risk of potentially transmitting it to others. We need to do a better job in the U.S., particularly as health care providers, to follow that recommendation, and to make sure that every adult has had an HIV test at least once in a lifetime." 

If HIV is not treated, it can lead to AIDS. But effective therapies can control HIV, which is why getting tested and seeking treatment is so important.

"We know now that if somebody is on effective HIV therapy, and the virus in their body is suppressed, it's not gone. But it's suppressed. Their risk of transmitting it to somebody else is close to zero," explains Dr. Rizza. "So if you just pause for a minute and think about that implication. That means if every human on planet Earth who had HIV were diagnosed, linked with health care, and on effective therapy, then HIV would be gone from the human race in one generation."

Like many other areas of health care, health disparities play a significant role when it comes to testing, diagnosis and treatment of HIV. Those disparities have been exacerbated by the COVID-19 pandemic. Improving awareness and community outreach can help combat these disparities.

"It's the same old thing that works for every disease state," says Dr. Rizza. "Its education, engagement and role-modeling within the communities. That education is essential. And it needs to be done in the community. We can't wait for people to come to us, and then we'll teach them, we need to get into those worlds, with people who are leaders in those communities, and have ways to bring diagnosis, treatment and preventive measures to them." 

Dr. Rizza says disparities in diagnosing HIV face an additional challenge that some other diseases do not: stigma.

"It is just heartbreaking," says Dr. Rizza. "And the stigma that had been around HIV for a very long time is part of what prevents people from coming forward, from taking the initiatives to prevent the disease, to prevent the infection — and also to be diagnosed — out of fear of the answer. And, so, we also need those community leaders to help break down the stigma issue in addition to educating and bringing diagnosis and treatment closer to home."

On the Mayo Clinic Q&A podcast, Dr. Rizza discusses the importance of HIV testing and improvements in therapies to treat HIV.

Nearly 13% of women in the U.S. will be diagnosed with breast cancer at some point, according to the National Cancer Institute. Fortunately, thanks to earlier detection and advances in diagnosis and treatment, most people diagnosed with breast cancer will survive. Understanding what to expect can make the cancer journey smoother.

"It's important for people to know the road map," explains Dr. Daniela Stan, an internist with the Mayo Clinic Breast Diagnostic Clinic. "What treatments are they expected to have and what's the timeline? What will the side effects be? How can they prepare?" 

People who survive breast cancer can have unique needs depending on their cancer type and stage, but there are some experiences many breast cancer survivors will share after treatment.

"Survivors on a daily basis learn how to deal with their cancer, how to pace themselves, how to get help from family and friends, and how to go forward during and after the treatment is completed," says Dr. Stan. "Luckily, there are many, many resources available to deal with the physical and psychological issues of cancer survivorship."

Dr. Stan encourages cancer survivors to talk with their health care team about how nutrition, exercise and controlling stress can help with the long-term effects of cancer treatment and even help prevent cancer recurrence.

On this Mayo Clinic Q&A podcast, Dr. Stan discusses what people can expect after completing breast cancer treatment and how to achieve the best quality of life.

The steady increase in COVID-19 infections is due to changing, highly contagious variants, explains Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. Dr. Poland says it’s still important to take the precaution of mask-wearing in public areas, even if you have been vaccinated and have received your boosters. 

"I can’t say it enough. This is so hypercontagious that, regardless of having had three or four doses of vaccine or of having previous COVID-19, you still run an appreciable chance of getting COVID," explains Dr. Poland. "The risk in that case is not of death or hospitalization, but of the complications and long-haul symptoms of COVID-19. And that’s what we’re trying to prevent in people."  

For parents, there is positive news this week, as the Food and Drug Administration (FDA) advisory panel voted unanimously to authorize emergency use of the Pfizer and Moderna COVID-19 vaccines for children under 5. For this age group, the Pfizer vaccine will be given in three doses while the Moderna vaccine will be given in two doses. 

The FDA panel's recommendation now goes to the Advisory Committee on Immunization Practices (ACIP) at the Centers for Disease Control and Prevention for approval before shots can be administered, possibly beginning as early as next week. 

On the Mayo Clinic Q&A podcast, Dr. Poland shares the latest COVID-19 news, answers listener questions, and discusses another infectious disease outbreak: monkeypox.

People in the LGBTQ community often experience barriers to accessing health care and preventive services, which can result in disparities in both cancer risk and treatment. 

"Many of those disparities are rooted in stigma and discrimination that have really historically been an issue for this population," says Dr. Jewel Kling, chair of the Women's Health Center at the Mayo Clinic in Arizona.

Dr. Kling encourages people who identify as LGBTQ to find a health care professional they trust, as open and honest communication is important.

"Once they find a provider they trust, then hopefully they feel that they can disclose everything about themselves, including their health behaviors, their challenges, the things that are impacting their social determinants of health," says Dr. Kling.

On the Mayo Clinic Q&A podcast, Dr. Kling discusses cancer screening, prevention and treatment for people who identify as LGBTQ, and the importance of finding a trusted health care team.

Because ear infections often clear up on their own, treatment may begin with managing pain and monitoring the problem. Sometimes, antibiotics are used to clear the infection. Some people are prone to having multiple ear infections. This can cause hearing problems and other serious complications.

If your child has repeated, long-term ear infections or continuous fluid buildup in the ear after an infection has cleared up, your child's doctor may suggest ear tubes.

On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom," pediatrician and host Dr. Angela Mattke is joined by Dr. Shelagh Cofer, a Mayo Clinic otolaryngologist, to discuss when ear tubes may be necessary, their traditional surgical placement, and outline a newer procedure that might be an option for some patients.

"The palliative care team really focuses on addressing symptoms and needs so that we can help people feel as comfortable as they can as they go through their treatment for cancer," says Dr. Deirdre Pachman, a palliative medicine expert at Mayo Clinic. "We do this by focusing and talking about some different interventions. They might be medications, or they might be other procedures for pain that some of our colleagues do. Palliative care is a very team-based approach, so we may involve our nurses, our physical therapists, our social workers really to all be there to help support the patient and make sure that we're addressing their symptoms and their needs." 

Palliative care is designed to fit the life and needs of each individual patient. It may include symptom management, support and advice, care techniques that improve comfort and well-being, referrals to other specialists, and advance care planning. Palliative care also offers support for families and those caring for people with cancer.

"The goal of palliative care, along with helping patients manage their symptoms and improving quality of life, is really providing that support to their loved ones or their caregivers, so that they have time to care for themselves and feel well-supported so that they can continue to give to others," says Dr. Pachman.

Research indicates that early use of palliative care services can improve quality of life for people with serious illness, decrease depression and anxiety, increase patient and family satisfaction with care, and in some cases even extend survival.

On this Mayo Clinic Q&A podcast, Dr. Pachman discusses how palliative care can improve quality of life for people with cancer.

Involving children in meal planning and teaching kids to cook can have multiple benefits. Not only is cooking a necessary life skill, learning how to cook teaches math, science and creativity. Using fresh fruits and vegetables encourages healthy eating and children are more likely to eat food they've helped prepare. 

Other tips include:

• Let your child pick which fruits and vegetables to make for dinner or during visits to the grocery store or farmers market. 
• Read kid-friendly cookbooks together and let your child pick out new recipes to try.
• Toddlers and children can help with some cooking tasks — with supervision — including sifting, stirring, counting ingredients, picking fresh herbs from a garden or windowsill, and “painting” on cooking oil with a pastry brush.

On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom" pediatrician and host Dr. Angela Mattke is joined by Kate Zeratsky, a Mayo Clinic registered dietitian nutritionist, and Jen Welper, Mayo Clinic executive chef, for a discussion on teaching children how to nourish their bodies with healthy foods, encouraging kids to try new foods, and getting kids involved in cooking.

"The initial diagnosis is often based on appearance," explains Dr. Denise Klinkner, a pediatric surgeon at Mayo Clinic Children’s Center and practice chair of the Division of Pediatric Surgery at Mayo Clinic. "Then when we try to grade the severity, using what's called the Haller index."

The Haller index is calculated by measuring the width of the chest and dividing that width by the distance between the sternum and the vertebral column. This calculation can be performed using a chest X-ray or chest CT scan.

In severe cases of pectus excavatum, the breastbone may compress the lungs and heart. Signs and symptoms can include:

• Decreased exercise tolerance.
• Rapid heartbeat or heart palpitations.
• Recurrent respiratory infections.
• Wheezing or coughing.
• Chest pain.
• Heart murmur.
• Fatigue.
• Dizziness.

Surgery can correct the deformity. 

The two most common surgical procedures to repair pectus excavatum are known by the names of the surgeons who first developed them:

• Nuss procedure 
  This minimally invasive procedure uses small incisions placed on each side of the chest. Long-handled tools and a narrow fiber-optic camera are inserted through the incisions. A curved metal bar is threaded under the depressed breastbone, to raise it into a more normal position. In some cases, more than one bar is used. The bars are removed after two or three years.
• Ravitch technique 
  This older procedure involves a much larger incision down the center of the chest. The surgeon removes the deformed cartilage attaching the ribs to the lower breastbone and then fixes the breastbone into a more normal position with surgical hardware, such as a metal strut or mesh supports. These supports are removed after 12 months.

Many pain control options are available after surgery to improve recovery. Cryoablation temporarily freezes the nerves to block pain after surgery, and can help with recovery and decrease postoperative pain for four to six weeks.

"With the addition of cryotherapy, patients need less narcotic pain medicine and have been able to go home the next day after surgery," says Dr. Klinkner. 

On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom" focuses on minimally invasive pectus repair in children. Dr. Angela Mattke, a Mayo Clinic pediatrician and host, is joined by Dr. Klinkner to discuss options for pectus excavatum repair and what patients can expect after surgery.

"Community engagement is an ongoing process," explains Dr. Chyke Doubeni, director of Mayo Clinic’s Center for Health Equity and Community Engagement Research. "It's a partnership or collaboration among organizational entities and members of the community. And the sole purpose of this is to solve problems and address priorities that a community sees as being priorities for them."

The Center for Health Equity and Community Engagement Research focuses on disparity-related health promotion and disease prevention in areas including cancer, cardiovascular disease and metabolic illness. One initiative Mayo Clinic is taking part in is the National Institutes of Health's (NIH) Community Engagement Alliance Against COVID-19 Disparities (CEAL) research program. This research program focuses on working with communities hardest hit by the pandemic to provide trustworthy information and improve diversity and inclusion in COVID-19 research.

Eula Dean is a community leader who leads the Arizona CEAL consortium community engagement work group. She is also a member of Mayo Clinic in Arizona's Community Engagement in Research Advisory Board.

"I think that one of the things that helped was we identified individuals in the community who have respect and who already worked in the community," says Dean. "Whether they were located in our churches or they have positions of power in terms of their work, it opened some doors for us to really be able to reach our community." 

By partnering with community leaders, the CEAL program was able to reach those who were otherwise reluctant to use the health care system, sometimes due to past experiences. 

"We had to honor and listen to those concerns," explains Dean. "We had to explain that we want you to know what's happening with COVID-19, so we are bringing this information to you. And we allowed them to ask their questions. And I think it made a difference. We understand that we still have struggles, but I believe that the manner in which we started with a humble heart to say: 'This is what I've learned. Here's my expertise. I love my family. I want my family to be healthy.' I think those were the things that made a difference."

Dr. Doubeni agrees that building trust is key to the successful partnership between researchers and the community.

"What we want to do as researchers is to be able to build trust and be trustworthy so that people can believe in science and can believe in and trust the health care they need to get," says Dr. Doubeni. "So building that trust through community engagement in research can allow us to be stronger for when the next crisis may come along."

On the Mayo Clinic Q&A podcast, Dr. Doubeni and Dean discuss the work of the CEAL program and the importance of engaging underserved communities in research.

To learn more, read the Raising Up Community Voices in Research blog series, including Eula Dean's essay.

A stroke occurs when the blood supply to part of the brain is interrupted, depriving the brain of oxygen. It's important to recognize the warning signs of stroke, because prompt treatment can minimize brain damage. Every moment is crucial. 

"Strokes commonly occur in people of all ages," says Dr. Robert D. Brown, Jr., chair of Mayo Clinic's Division of Stroke and Cerebrovascular Diseases. "And, so, it's very important that people know what is a stroke, what are the symptoms, and what are the risk factors for stroke." 

May is National stroke Awareness Month. In this Mayo Clinic Q&A podcast, Dr. Brown explains the importance of remembering the F.A.S.T. acronym to recognize a stroke: 

• Face drooping.
• Arm weakness.
• Speech difficulty. 
• Time to call 911.

Learn more about recognizing the signs of stroke: 

• Read Consumer Health: Do you know the warning signs of stroke?
• Watch Mayo Clinic Minute: Think 'FAST' when recognizing stroke symptoms

"Unfortunately, ovarian cancer often presents with very common symptoms, and these common symptoms are things that everybody will complain about at some point," explains Dr. John Weroha, a Mayo Clinic medical oncologist. "For example, constipation, bloating, maybe a little weight gain. These are very common symptoms, and oftentimes, people just kind of blow it off as being normal. So, that's how it hides and grows."

Once ovarian cancer is detected, treatment depends on the stage when the disease is diagnosed. Stage 1 — the lowest stage — indicates that the cancer is confined to the ovaries. At this stage, a cure may be achieved with surgery alone. By stage 4, the cancer has spread to distant areas of the body. At this point, treatment is more complex, often involving drug therapies and potentially immunotherapy, which uses the immune system to attack cancer cells.

Dr. Weroha encourages patients to explore all their treatment options, including clinical trials. 

"I think one of the biggest misconceptions that I see with patients is that clinical trials are supposed to be a last resort, and that is absolutely not true," says Dr. Weroha. "What we do at Mayo, and really everywhere else, is we try to bring clinical trials to our patients — not because we want to test whether or not this brand-new drug works, but we already believe the drug works. We think it's going to work, and we want to give that to our patients because they can't get it any other way, except through a clinical trial." 

On the Mayo Clinic Q&A podcast, Dr. Weroha discusses the latest treatments for ovarian cancer.  

"Because the majority of testing is being done at home, we can no longer tell you accurately about the positivity rate for a given community for a given state like we used to be able to," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "And this is problematic. It means that we lose our ability to understand what's called genetic epidemiology — the ability to trace how these variants are moving, how fast they're moving, and whether they're changing and evolving into yet different subvariants or new variants. We've lost that ability now."

The most recent omicron subvariant, BA 2.12.1, has cases on the rise again and the U.S. passed a tragic milestone last week, reaching 1 million COVID-19 deaths in the country.

In an effort to capture a more accurate picture, the latest tool being used by public health officials to track COVID-19 infection rates is wastewater surveillance. By looking for the presence of the COVID-19 virus shed by people, wastewater surveillance can give a more accurate picture of how much virus is in the community. This detects virus not only from those who test at home, but also from people who are asymptomatic and, therefore, didn't get tested.

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the current state of COVID-19 in the U.S., including what we know about the latest subvariants.

The two main types of polycystic kidney disease, caused by different genetic flaws, are:

• Autosomal dominant polycystic kidney disease (ADPKD). Signs and symptoms of ADPKD often develop between the ages of 30 and 40. In the past, this type was called adult polycystic kidney disease, but children can develop the disorder.Only one parent needs to have the disease for it to pass to the children. If one parent has ADPKD, each child has a 50% chance of getting the disease. This form accounts for most of the cases of polycystic kidney disease. 
• Autosomal recessive polycystic kidney disease (ARPKD). This type is far less common than is ADPKD. The signs and symptoms often appear shortly after birth. Sometimes, symptoms don't appear until later in childhood or during adolescence.Both parents must have abnormal genes to pass on this form of the disease. If both parents carry a gene for this disorder, each child has a 25% chance of getting the disease.

Polycystic kidney disease also can cause cysts to develop in the liver and elsewhere in the body. The disease can cause serious complications, including high blood pressure and kidney failure.

The disease varies greatly in its severity, and some complications from polycystic kidney disease are preventable. Lifestyle changes and treatments might help reduce damage to the kidneys from complications, but long-term interventions, including dialysis or kidney transplant, are sometimes needed.

On this special Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. Christian Hanna, a pediatric nephrologist with Mayo Clinic Children’s Center to discuss PKD in children.

Treatment for early stage melanomas usually includes surgery to remove the melanoma. Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains. 

"Mohs surgery is essentially skin cancer removal," explains Dr. Nahid Vidal, a dermatologic surgeon at Mayo Clinic. "It's a surgical removal process that's highly specialized, where we're removing the skin cancer with a goal of not only removing all of it, but also leaving behind as much healthy tissue as possible."

Mohs surgery allows surgeons to verify in real time through pathology that all cancer cells have been removed at the time of surgery. This increases the chance of a cure and reduces the need for additional treatments or additional surgery.

On the Mayo Clinic Q&A podcast, Dr. Vidal discusses skin cancer and the use of Mohs surgery to treat early stage melanoma.

"Throughout the pandemic, our nurses have continued to be there for their patients," says Ryannon Frederick, Mayo Clinic's chief nursing officer. "Our patient satisfaction actually increased during the COVID-19 pandemic. And that's really due to the excellence from our nursing staff. When you just imagine all the stress and strain they were feeling, and they continued to excel."

Mayo Clinic's multidisciplinary approach relies on nurses to be an integral part of the care team. Frederick says nurses are the closest touch point to the patient, and they often identify opportunities to improve care. 

"We encourage nurses to speak up and advocate on behalf of the patients," explains Frederick. "Then we engage them to be part of the solution — to make sure that once we identify the problem, we also have a solution for it," says Frederick. "And our nurses do this each and every single day. "

Each year, May 6-12 is designated National Nurses Week. This week acknowledges and celebrate nurses and the care they provide for their patients. 

On the Mayo Clinic Q&A podcast, Frederick shares her own professional journey at Mayo Clinic — from nursing student to chief nursing officer. She also discusses the role nurses will play in leading the future of health care, including the role of nursing research.

Hepatitis is inflammation of the liver. It is most commonly caused by a viral infection, although there are other potential causes. A common adenovirus is being investigated as a potential cause for this hepatitis outbreak. Adenoviruses are a group of viruses that typically cause respiratory and GI tract infections. 

On this special Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke discusses the recent hepatitis outbreak in children with Mayo Clinic Children’s Center experts Dr. Nipunie Rajapakse, a pediatric infectious diseases expert, and Dr. Sara Hassan, a pediatric transplant hepatologist and gastroenterologist.

In children, endoscopy can be used to look for causes of unexplained abdominal pain, to diagnose swallowing disorders or to identify conditions including Crohn's disease, ulcerative colitis and polyps. 

Undergoing any type of procedure can be stressful for kids, parents or caregivers. Dr. Pua Hopson, a pediatric gastroenterologist at Mayo Clinic Children’s Center, explains endoscopy is a relatively quick and painless procedure.

"An upper endoscopy typically takes 10 minutes, while colonoscopy may take 30 minutes," says Dr. Hopson. "I tell the kids it takes longer to put them to sleep with anesthesia or sedation than the actual procedure. And once you wake up, your parents will be right by your side."

One condition Dr. Hopson commonly treats in children is eosinophilic esophagitis (e-o-sin-o-FILL-ik uh-sof-uh-JIE-tis), known as EoE. This is a chronic immune system disease in which a type of white blood cell (eosinophil) builds up in the lining of the esophagus. This buildup, which is a reaction to foods, allergens or acid reflux, can inflame or injure the esophageal tissue. Damaged esophageal tissue can lead to difficulty swallowing or cause food to get stuck when you swallow. EoE is diagnosed through biopsy using an upper endoscopy.

On this Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. Hopson to discuss how and why endoscopy is used in children.

"This was a convenient sample. In other words, people who were having blood drawn for other reasons were tested,"explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "That does not reflect the full population or differences by race or geographic location. And the detection of antibodies does not necessarily mean that you are protected from infection. So, there's a lot of nuance around understanding that headline." 

The research study looked at more than 200,000 blood samples and found that signs of past infection rose dramatically during the omicron surge between December 2021 and February.

Other COVID-19 news this week includes a push to make treatments more available, the rising incidence of new omicron subvariants, and changes in mask recommendations. Dr. Poland cautions that COVID-19 is still present and encourages wearing a mask in crowded spaces, even when there isn't a requirement to do so.

"If only one of us is wearing a mask and the other one isn't and is infected, you still have pretty high protection — but not the same level of protection as if both of us wearing one," says Dr. Poland. "So, it's it is not futile to be the only one wearing a mask. In fact, I think it sends a message."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news and answers listener questions.

"One of the advances that we've seen in the last 20 or 30 years in the treatment of head and neck cancers certainly has to do with the reconstruction," says Dr. Kevin Arce, an oral and maxillofacial surgeon at Mayo Clinic. "Often, we have to remove not only the cancer, but also the surrounding tissue that is normal. And to replace that can be quite challenging. We now have better abilities to reconstruct the structures that have been lost." 

Dr. Arce explains advances in the treatment of head and neck cancers now allow surgeons to bring in tissues from different areas of the body and reconstruct a tongue or rebuild a jaw. And the anatomical lab and 3D printing allow surgeons to perform patient-specific reconstruction that helps maintain function. 

"With these advancements, patients can obviously not only look the same, but speak and eat as they did prior to the surgery," says Dr. Arce. "At Mayo Clinic, we can do that all in house. We have a group of neuroradiologists and biomedical engineers who are a part of the institution, and we collaborate with them in these types of reconstructions."

Early detection of oral cancer can lead to better treatment options and outcomes. 

April is Oral Cancer Awareness Month, aimed at reminding the public about the steps to take to reduce your risk of developing oral cancer. The two main risk factors are tobacco and alcohol use.

"Awareness of oral cancer is important," says Dr. Arce. "It's important to maintain that relationship with either your dentist or your primary care physician so they do at least an annual screen of the oral cavity to make sure that there is nothing unusual or a lesion that needs more attention."

On the Mayo Clinic Q&A podcast, Dr. Arce discusses oral cancer treatment and prevention.

"Patients are our North Star," says Dr. Vijay Shah, chair of the Department of Medicine at Mayo Clinic. "We're all about patients all day, every day. So, all of our strategies cascade out of that."

Dr. Shah explains those strategies include practice innovations, digital transformation and internal and external partnerships. Internal partnerships include working alongside the Mayo Clinic Cancer Center, the Center for Digital Health, Mayo Clinic Platformand others focused on improving patient care and developing cures.

These partnerships are leading to innovations in teleheath and at-home care models, as well as new ways to use health data to improve treatments. 

And at the core of it all?

"The most important pillar is our people and our culture," explains Dr. Shah. "Because our people are our greatest asset, and we're nowhere without them."  

On the Mayo Clinic Q&A podcast, Dr. Shah and Natalie Caine, associate administrator, discuss the innovations happening in the Department of Medicine at Mayo Clinic.

Patient navigators are active members of the health care team, assessing and addressing a patient's immediate needs and identifying obstacles that might prevent them from getting the care they need. Patient navigators help patients and their families access cancer information, find resources to meet day-to-day needs, and offer emotional support. 

"Our role as patient navigators is to support with a lot of the nonclinical sides of their cancer journey, whether that's logistics, transportation or issues with lodging when they're coming to a Mayo Clinic site for care," explains Laura Kurland, a Mayo Clinic Cancer Center patient navigator. "Oftentimes, we're helping them understand the finances, whether that's insurance, or other things that are going to be coming up that are going to be financial stressors for them as they're going through their cancer care. And certainly, we're there to lend an ear and offer support as they're learning how to truly navigate the medical system."

The Mayo Clinic Cancer Center has both general patient navigators who assist all patients and patient navigators who serve specific cultural patient populations. Mayo Clinic currently has navigators on staff serving these communities: Hispanic/Latino, American Indian/Alaskan Native and African descent. 

Kurland serves the Hispanic/Latino population and explains the important role the culture-specific patient navigators play.

"The patient populations that we work with come with different experiences," says Kurland."So our goal is to understand the values they bring and support them with what their needs are. Whether there are language barriers, or there are just gaps in cultural misunderstandings, our role is to help bridge those gaps, clarify misunderstandings and also be advocates to those populations."

On the Mayo Clinic Q&A podcast, Kurland discusses the importance of patient navigators, why culture-specific navigators are needed, and how she helps patients access the care and support they need.

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Dr. Molly Herr, a pediatric anesthesiologist at Mayo Clinic Children’s Center to discuss climate change and its effects on children's health. 

In addition to her clinical care for children, Dr. Herr has been an advocate and leader in Mayo Clinic’s Green initiatives. She has also been involved with creating sustainable practices at Mayo Clinic and medical student education related to these topics.

One big concern for people with diabetes is the connection between diabetes and cardiovascular disease. People with diabetes are more likely to develop heart disease and are at higher risk of premature death.

"In people with diabetes, the risk of death due to heart diseases is approximately four or five times higher than in general population," explains Dr. Gosia Wamil, a cardiologist at Mayo Clinic Healthcare in London. "And this, obviously, is a major concern. There is now a strong research and scientific evidence about this link and association between cardiovascular disease and metabolic diseases, especially diabetes." 

So what can be done to help patients?

Dr. Wamil explains that research has shown positive lifestyle changes such as quitting smoking, losing weight, exercising more, developing a healthy diet and controlling blood pressure, can all contribute to better heart health.

"We try to develop personalized management plans, we listen to our patients and try to understand what are the steps that they can take to improve their quality of life and to improve their future life and their health, " says Dr. Wamil.

On the Mayo Clinic Q&A podcast, Dr. Wamil discusses the diabetes and heart disease connection.

"We were taught to help people in need, and we were blessed with good health in our family," says Ted. "And I am well aware that there are a lot of people that aren't as fortunate. Being kind to people and helping people in need has always been the most important thing to me."

When Ted heard about living liver donation, he applied at Mayo Clinic, but expected he might get denied because he has one kidney and is in his 50s. But Ted was accepted, and in October 2021, the transplant happened in Rochester, Minnesota. The recipient reached out a few days later to thank him and told Ted he was her "guardian angel."

"My own personal experience as a double living organ donor, personally, it's changed my life for the better," says Ted. "When you help someone in need, you're naturally going to feel better. I feel as though I've been blessed and that I am the one who received a gift." 

April is National Donate Life Month to raise awareness of the need for organ donors. In honor of Donate Life Month, Ted joins the Mayo Clinic Q&A podcast to share his story.

"If you think about the kinds of things that people in this age group are going through, there's a lot of life transition happening there," explains Dr. Allison Rosenthal, a Mayo Clinic hematologist and oncologist. "So this group really has a lot of unique needs as far as psychosocial development."

AYA patients are 15-39. They may be students in high school or college, may be living on their own, and often are caught between losing coverage under parental health insurance and finding their own. Another common issue is the desire to start a family as fertility can be impacted by cancer and its treatment, which makes conversations about fertility preservation very important.

"There's never a convenient time to be diagnosed with cancer, but particularly inconvenient in this group," says Dr. Rosenthal. "And they often get overlooked because I think people just don't recognize that cancer is really common in this age population as well."

Dr. Rosenthal is leading an effort at Mayo Clinic Cancer Center to change that. The adolescent and young adult cancer center program aims to help AYA patients receive access to age-appropriate care and support. This multidisciplinary approach will include not only cancer specialists but also social workers, health psychologists, and financial and vocational counselors. Another important piece is helping AYA patients transition from pediatric to adult care and plan for cancer survivorship.

"One of the most important things is having survivorship care that focuses on the needs of these patients as they move forward," says Dr. Rosenthal. "We're really fortunate that the majority of young adult patients who get cancer care are going to do well. Thankfully, there are going to be a lot of long-term survivors." 

April 4-10 is Adolescent and Young Adult Cancer Awareness Week. On the Mayo Clinic Q&A podcast, Dr. Rosenthal discusses the needs of AYA patients with cancer.

"Think of a fighter pilot in a jet that has a visor over their eyes that's displaying electronic data that is overlaid over what they're seeing in the real world," explains Dr. Michael Taunton, a Mayo Clinic orthopedic surgeon. "So don't confuse this with virtual reality that your kids have at home, that they're playing video games with their eyes covered."

Augmented reality technology superimposes digital content, including data and 3D images, onto the user's view. Surgeons use this information to be precise and receive real-time feedback when removing bone and cartilage, and placing a knee implant. Dr. Taunton explains augmented reality is a new advancement beyond computer-assisted knee replacement. 

"We've had computer-assisted surgery for a while where we take data from the patient's own leg and enter that into a computer, and have it display some of this information to help us understand how best to remove the correct amount of bone in the right angle to make the knee replacement fit better, and have better alignment of the limb after surgery," says Dr. Taunton. "The problem with some of those computer-assisted programs is that there is a screen or computer that we're looking at across the room. So we're having to take our eyes off the patient during surgery." 

The first augmented reality knee replacement at Mayo Clinic was performed in fall of 2021, and the technology is not yet widely available. Research is ongoing to study whether augmented reality can reduce the length of surgery and improve patient outcomes. 

On the Mayo Clinic Q&A podcast, Dr. Taunton discusses the advantages of using augmented reality for knee replacement surgery.

"When you look around the nation, all of the metrics, with the exception of BA.2, have fallen precipitously," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "But we need to be very cautious about pretending that the pandemic is over." 

Dr. Poland explains that each time there has been a waning number of COVID-19 infections, people have let down their guard and relaxed precautions, which has led to another surge. Dr. Poland still recommends masking in crowded indoor settings and urges people to be fully vaccinated and boosted against COVID-19 to reduce the chance of infection.

"We're just coming down into a quiet period," says Dr. Poland. "But every time we've seen this set of markers in the past, we've had a new variant that's caused a surge. The question is, will it be BA.2, one of the newer variants that have been identified, or something completely unexpected? We just don't know."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news including potential changes to booster recommendations, data on vaccine protection for pregnant women and the latest information on COVID-19 vaccines for children under 5.

Research disclosures for Dr. Gregory Poland.

Mayo Clinic BioPharma Diagnostics collaborates with biopharmaceutical, diagnostic, and other biotech companies to enable precision medicine through advanced diagnostics. Diagnostic testing can help find the right answers for each individual patient.

"A laboratory test can either help in making a diagnosis for a disease, or it can help guide the clinician to the right diagnosis or to the right treatment," explains Dr. Alicia Algeciras-Schimnich, medical director of BioPharma Diagnostics.

Accurate and rapid diagnostic testing has many benefits, says Dr. Algeciras-Schimnich.

"The faster we reach the right diagnosis for a patient, the faster we get to the right treatment. It not only improves their outcome, but it has been shown that the overall cost of health care is also reduced by providing the right answers faster."

On the Mayo Clinic Q&A podcast, Dr. Algeciras-Schimnich discusses diagnostic testing, precision medicine and what it means for patients.

Cerebral palsy is a group of disorders that affect movement and muscle tone or posture. It's caused by damage that occurs to the immature, developing brain, most often before birth. Signs and symptoms appear during infancy or preschool years. In general, cerebral palsy causes impaired movement associated with exaggerated reflexes, floppiness or spasticity of the limbs and trunk, unusual posture, involuntary movements and unsteady walking, or some combination thereof.

For children with cerebral palsy, the care team likely will include a pediatrician or physical medicine and rehabilitation specialist, a pediatric neurologist, and a variety of therapists and mental health specialists. These experts give special attention to needs and issues that are more common in people with cerebral palsy, and they can work together with the primary care provider to develop a treatment plan.

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Mayo Clinic Children’s Center expert Dr. Joline Brandenburg, a physical medicine and rehabilitation specialist, to discuss important aspects of health for children with neurodevelopmental disabilities and what families and health care professionals can do to offer support.

While regular colonoscopies and lower rates of smoking have reduced colorectal cancer rates in older adults, cancers of the colon and rectum are now a leading cause of cancer death among people under 50 in the U.S., according to the National Cancer Institute. The rates of new diagnoses continue to climb in this age group, with the largest increase seen among Alaska Natives, American Indians, and white people.

"We've seen about a 50% relative increase in the percent of patients under the age of 50 who have been diagnosed with colon cancer," says Dr. Jeremy Jones, a Mayo Clinic oncologist. "Unfortunately, there is not an age where I would say you're too young to have colon cancer."

Dr. Jones explains that health care professionals don't yet know what's causing this increase in colorectal cancer rates among younger people. It may be related to an increase in risk factors for colorectal cancer among this age group, such as obesity, a lack of exercise and an unhealthy diet. 

Regular screening tests for colorectal cancer can help prevent colon cancer by identifying and removing polyps before they turn into cancer. 

National guidelines recommend people of average risk of developing colorectal cancer begin screening at age 45, but those with increased risk factors should consult with their health care team.

On the Mayo Clinic Q&A podcast, Dr. Jones discusses his experiences caring for younger people with colorectal cancer, and why you should talk to your health care team about screening for colorectal cancer by age 45, or sooner if you're at higher risk.

The most common type of sickle cell disease is sickle cell anemia. Red blood cells usually live for about 120 days before they need to be replaced. But sickle cells typically die in 10 to 20 days, leaving a shortage of red blood cells, or anemia. Without enough red blood cells, the body can't get enough oxygen, and this causes fatigue.

For a baby to be born with sickle cell anemia, both parents must carry a sickle cell gene. In the U.S., sickle cell anemia most commonly affects people of African, Mediterranean and Middle Eastern descent. 

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Mayo Clinic Children’s Center experts Dr. Asmaa Ferdjallah, pediatric hematologist and bone marrow transplant physician, and Dr. Emily McTate, pediatric psychologist, to discuss managing sickle cell disease in pediatric patients and the latest advancements in treatment of sickle cell disease, including bone marrow transplant.

"China, Hong Kong, Ireland, the U.K. and Denmark are seeing surges back up again," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "These countries, many of us experts believe, prematurely dropped mask-wearing and nonpharmaceutical interventions, and really have stopped pushing and encouraging people to get vaccinated. I think that's a mistake."

Dr. Poland explains that public health measures — and vaccination and boosters — are still the best way to protect yourself from COVID-19. 

"What can I say but what we have said all along," implores Dr. Poland. "Hands, face, space and vaccines. It works."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news, including a study on the true death toll of COVID-19, an update on the BA.2 variant and the latest on vaccines for children under 5.

Research disclosures for Dr. Gregory Poland.

Healthy plasma cells help the body fight infections by making antibodies that recognize and attack germs. In multiple myeloma, cancerous plasma cells accumulate in the bone marrow and crowd out healthy blood cells. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause complications.

Immunotherapy, which uses the body's immune system to fight cancer, is now a standard treatment option for multiple myeloma. Immunotherapy works by interfering with cancer cells' ability to produce proteins that help them hide from the immune system.

"Immunotherapy is really one of the major backbone of now our current treatment for multiple myeloma," explains Dr. Yi Lin, a hematologist at Mayo Clinic. "We have some new agents that really help extend the amount of time that patients are able to live with multiple myeloma."

While there is no cure, treatment options for multiple myeloma are advancing quickly and new immunotherapies, including chimeric antigen receptor (CAR)-T cell therapy, are improving outcomes for patients.

"We always want to strive towards the treatment that we think can offer the longest period of remission," says Dr. Lin. "But balancing that with side effects because we want to keep patients not only living as long as they can with multiple myeloma, but hopefully also with good quality of life." 

March is Myeloma Awareness Month. On this Mayo Clinic Q&A podcast, Dr. Lin discusses the use of immunotherapies and other novel approaches to treating multiple myeloma.

Peshut donated a kidney on behalf of his wife, Annie, in February 2019. Peshut tried to be a direct donor, but he was not a match for his wife. Through paired-organ donation, he became part of a six-kidney donation chain, allowing Annie to receive a kidney. 

In paired donation, two or more organ-recipient pairs trade donors so that each recipient gets an organ that is compatible with his or her blood type. 

Peshut recently met his recipient, who credits him with giving her more time with her family, including her 13 grandchildren.

More than 90,000 people in the U.S. await a lifesaving kidney transplant. An estimated 20 people die every day because a needed is not donated in time.

Now Peshut is focused on sharing his story and encouraging others to become organ donors. The Mount Kilimanjaro climb is a public way to show that living organ donation doesn't limit the donor.

"Don't be afraid. Don't sit on the sidelines," says Mike. "If you're healthy, you can donate a kidney to help save someone else's life. It's really, really rewarding." 

On the Mayo Clinic Q&A podcast, Peshut join host Dr. Halena Gazelka, a Mayo Clinic anesthesiologist, to share his message about organ donation.

"There is a large spectrum of disease," says Dr. Leslie Cooper, chair of the Department of Cardiology at Mayo Clinic in Florida. "Not only can you have the common heart attack, or blood clots in the veins or the lungs, but also less common diseases like myocarditis or pericarditis occur at a higher rate in patients who have had COVID-19."

The study found that increases in cardiovascular problems were evident across different ages, races and sexes.

"Almost all of the complications from a cardiac standpoint were significantly elevated following COVID a year after symptom diagnosis in women and men, and all the age groups," explains Dr. Cooper. 

Research is underway to look at better ways to treat heart issues related to COVID-19 and alleviate the long COVID-19 symptoms.

"We think that because there are specific mechanisms at work, in the future we will be treating more specifically with anti-inflammatory therapies if inflammation is an ongoing cause of the symptoms," says Dr. Cooper. "Multiple research studies are ongoing in this area."

On the Mayo Clinic Q&A podcast, Dr. Cooper discusses cardiac complications from COVID-19.

To help children prepare for a visit with their health care team, it is important that parents and caregivers understand the reason for the visit and what tests or procedures are likely to occur. Child life specialists, who are trained in child development, can help guide families and minimize the stress of the medical environment for children and teens.

"We want to make sure kids feel empowered," explains Jennifer Rodemeyer, manager of Child Life at Mayo Clinic Children’s Center. "We're open and honest with them so they know what they are about to experience."

On this Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Jennifer Rodemeyer and Tara Lodermeier, also a child life specialist at Mayo Clinic's Children's Center, to discuss helping children cope with medical experiences.

"What we're observing is a pretty dramatic suppression of cases," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "This is good news, but we need to be cautious."

Dr. Poland warns that there are still people who are vulnerable to COVID-19 infection, including people who are immunocompromised; children under 5 who cannot yet be protected by COVID-19 vaccination; and the more than 30% of the U.S. population that is not fully vaccinated against COVID-19, according to Mayo Clinic's COVID-19 tracking tool data.

"'I'm as weary of COVID-19 as everybody else," says Dr. Poland. "But we still need to take this seriously." 

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news, including new COVID-19 vaccines coming for approval; the latest on long COVID; and his recent commentary with his colleague, Dr. Richard Kennedy, a Mayo Clinic internist, on the need for more research infrastructure and research funding in order to maintain public confidence in vaccines.

Research disclosures for Dr. Gregory Poland.

Understanding terms like EKG, echocardiogram, coronary angiogram or stress test may help alleviate the fear.

"Whenever we order these tests, we don't want you to have anxiety," says Dr. Christopher DeSimone, a Mayo Clinic cardiologist. "These tests are all done for a reason: to get you a diagnosis and to help you feel better. "

As American Heart Month wraps up, Dr. DeSimone joins the Mayo Clinic Q&A podcast to break down the terminology and explain what to expect during cardiac testing and evaluation.

"And the incidence of skin cancer is rising," says Dr. Dawn Davis, a Mayo Clinic dermatologist.

The three major types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. Early detection of skin cancer gives you the best chance for successful skin cancer treatment.

While it is common to have freckles and moles develop over time, it is important to know your skin and recognize when changes occur.

"It's important to know what skin lesions you have," explains Dr. Davis. "Know what they look like, so that if they change, you can come to the dermatologist or health care provider for evaluation."

Melanoma is the most serious and deadly form of skin cancer. Dr. Davis says the "melanoma alphabet" can help with early detection:

• Asymmetry 
  Look for moles with irregular shape.
• Border 
  Look for moles with irregular, notched or scalloped borders.
• Changes in color 
  Look for growths with different or uneven colors.
• Diameter 
  Look for new growth of more than one-quarter of an inch in diameter.
• Evolving 
  Look for changes over time.

On the Mayo Clinic Q&A podcast, Dr. Davis discusses skin cancer detection and treatment. Dr. Davis also recommends steps to take to protect your skin including avoiding ultraviolet rays, and wearing sunscreen and protective clothing.

People who require a second or even third heart surgery often fall in to three groups: 

1. Patients with aortic dissections 
   For patients with aortic dissections, emergency lifesaving surgery is performed initially. Then additional surgeries are often needed to repair the aorta.
2. Patients who receive tissue valves 
   Tissue valves typically last a decade before a reoperation is needed to replace the deteriorated valve.
3. Adults with congenital heart disease 
   Patients with congenital heart disease often have surgery as a newborn or infant. As they grow and age, additional operations may be necessary.

Cardiac reoperations are even more complex than first surgeries, due to scar tissue and other underlying conditions that develop. It is important to have a surgeon with a highly advanced set of surgical skills and techniques. Mayo Clinic surgeons perform more than 300 cardiac reoperations each year.

On the Mayo Clinic Q&A podcast, Dr. Alberto Pochettino, a Mayo Clinic cardiovascular surgeon, discusses cardiac reoperations and reinterventions.

Specialists at Mayo Clinic's Center for Congenital Heart Disease use catheter-based procedures to treat some heart valve replacements and many other conditions, including tetralogy of Fallot, patent ductus arteriosus, patent foramen ovales, and atrial septal defects. 

On the Mayo Clinic Q&A podcast, Dr. Jason H. Anderson, a Mayo Clinic pediatric interventional cardiologist, joins Ask the Mayo Mom host Dr. Angela Mattke to discuss innovative procedures to treat congenital heart defects.

"Both the acute indicators — number of cases — and the lagging indicators — hospitalizations and then deaths — are all dropping slowly, but they're surely dropping," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. 

Experts warn that caution is still needed to protect yourself in certain situations, including masking in crowded indoor settings and making sure you are up to date with your COVID-19 vaccinations and boosters.

While the latest surge wanes, COVID-19 research continues. 

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news, including a new study on the long-term effects of COVID-19 on the heart and why Pfizer is delaying the request for emergency use authorization of its COVID-19 vaccine for children under 5. 

Research disclosures for Dr. Gregory Poland.

Researchers and health care providers have made progress in minimizing the side effects of cancer treatment without reducing its effectiveness, allowing many cancer survivors to have children after spontaneous recovery of fertility. However, some cancers require rigorous treatment that almost always leads to permanent infertility. But there is hope for those families through fertility preservation.

Mayo Clinic's Fertility Preservation Program offers several options for fertility preservation, depending on the child's age, stage of puberty, diagnosis and proposed treatment plan. Both ovarian and testicular tissue cryopreservation is possible.

"We hope the pediatric Fertility Preservation Program brings a lot of optimism for the future for these children," says Dr. Asma Chattha, chair of Pediatric Gynecology at Mayo Clinic. "They're obviously fighting an uphill battle. It's a very difficult time in their lives. But barring none, I've always found the conversation surrounding fertility preservation to be a source of hope for families." 

In recognition of International Childhood Cancer Day on Tuesday, Feb. 15, Dr. Chattha joins the Mayo Clinic Q&A Podcast to discuss what patients and their families should consider when making decisions related to fertility preservation, and the steps involved in the process.

Parents of children younger than 5 years of age are feeling especially concerned, as vaccines have not yet been approved in this age group. But that may change soon, as Pfizer has recently submitted a request to the Food and Drug Administration for emergency use authorization of its COVID-19 vaccine for kids 6 months to 5 years old.

Beyond the direct effects of COVID-19 infections on children are the psychosocial and mental health effects of the pandemic. Isolation and socioeconomic stressors on families affect children, too.

"One in 6 children has sought mental health services in the past two years," says is Dr. James Gaensbauer, a pediatric infectious diseases physician at Mayo Clinic Children’s Center. "The American Academy of Pediatrics has declared a mental health emergency during this pandemic."

Dr. Gaensbauer points out it is important for parents to keep an open dialogue and be empathetic with kids about their fears and anxieties. Resources are available to help families, including the Mayo Clinic Family Stress Resource Center. 

On the Mayo Clinic Q&A podcast, Dr. Gaensbauer joins Ask the Mayo Mom host Dr. Angela Mattke to discuss how children and their families have been affected by the COVID-19 pandemic. 

"Black history is American history, and everyone should celebrate our history 365 days a year," explains Dr. Folakemi Odedina, a Mayo Clinic prostate cancer scientist and global health equity researcher.

This year's theme for Black History Month is "Black Health and Wellness." This theme acknowledges the legacy of Black scholars and medical practitioners. 

"It is really about time that we focus on Black health and wellness because our community is disproportionately experiencing health disparities," says Dr. Odedina. "We have to recognize that there are multiple dimensions of wellness."

According to Dr. Odedina, dimensions of health and wellness include physical, mental, emotional, intellectual, spiritual and environmental, and social health. 

On the Mayo Clinic Q&A podcast, Dr. Odedina discusses the factors responsible for health disparities in the Black community and shares how her work supports health and wellness for Black people.

Integrative oncology helps people with cancer feel better by reducing the fatigue, nausea, pain and anxiety and other symptoms that come with cancer and cancer treatment.

"Integrative oncology is a practice where we are using lifestyle medicine," explains Dr. Stacy D'Andre, a Mayo Clinic medical and integrative oncologist. "We combine all of these modalities to help our cancer patients, not only with the quality of life, but also to hopefully improve outcomes as well."

Focus on diet, exercise and sleep are important parts of integrative medicine, and can help patients during each stage of their journey. This includes managing symptoms and treatment side effects. 

"The great thing about this type of practice is that it really empowers the patient, and patients become very active in their care," says Dr. D'Andre. "And because they're the ones doing the work — they're working on their die and they're doing the exercise — we're just guiding them. These are things that they can do and they can control to improve their health and outcomes."

On the Mayo Clinic Q&A podcast, Dr. D'Andre explains how integrative oncology helps people with cancer and discusses integrative medicine research underway at Mayo Clinic.

Some congenital heart defects in children are simple and don't need treatment. Others are more complex and may require several surgeries performed over a period of several years.

Improvements in imaging, monitoring and surgical techniques have improved outcomes for pediatric heart surgery patients. 

A prenatal diagnosis is scary for parents, but support and care from the cardiology team continue through the child's life and on into adulthood. And support from others, including patient organizations, also helps.

"It can feel like you're alone, especially if the diagnosis is new," says Dr. Elizabeth Stephens, a pediatric cardiovascular surgeon at Mayo Clinic. "It can feel very daunting. But there are many families out there who are not just dealing with congenital heart disease, they're thriving with it. These kids are incredibly resilient."

On the Mayo Clinic Q&A podcast, Dr. Stephens joins Ask the Mayo Mom host Dr. Angela Mattke for a discussion on congenital heart defects and new treatment options.

"As a nation, it looks like we've kind of gotten to the peak and are now starting on the decline, but it's very uneven," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "That's what's happening in the big Northeast cities, and maybe in L.A., for example. But if you look at the rest of the nation, it's not clear that they have peaked yet."

And on the heels of the latest surge, a new omicron subvariant — BA.2 — is emerging. Early indications are that the new subvariant may be more transmissible, but it does not appear to cause more severe disease than the original omicron strain.

Mayo experts, including Dr. Poland, continue to urge COVID-19 vaccinations and boosters as the best defense against the latest variants. 

"By getting two doses of vaccine and a booster, or a dose of Johnson & Johnson and a booster, you move yourself into a category of maximal protection such that if you have a normal immune system, you are probably going to have trivial or even asymptomatic disease if you get infected with COVID-19," explains Dr. Poland. 

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest information on COVID-19 and answers listener questions.

Research disclosures for Dr. Gregory Poland.

"It's a really good problem to have, if you will, on how to manage some of these short- and long-term effects of lymphoma treatment," explains Dr. Carrie Thompson, a Mayo Clinic hematologist. "As we effectively treat more and more patients, we have more and more patients surviving and more and more patients living with chronic lymphoma, as well."

Lymphoma is a cancer of the lymphatic system, part of the body's germ-fighting network, which includes the lymph nodes, spleen, thymus gland and bone marrow. Lymphoma can affect those and other organs throughout the body. 

Of the many types of lymphoma, the main subtypes are Hodgkin's lymphoma and non-Hodgkin's lymphoma. Lymphoma treatment is based on the type and stage of the disease, and the goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission. 

Lymphoma survivors need to be monitored for cancer recurrence. Some lymphoma treatments, such as chemotherapy and radiation, can put patients at risk of developing a secondary cancer. 

"The No. 1 concern patients have is really the risk of relapse," says Dr. Thompson. "Once somebody has been through treatment, they certainly don't want to don't want to be faced with having to do that all over again. The fear of recurrence sometimes spills over to really being very appropriately vigilant about all health issues and finding that balance between watching for symptoms that may suggest recurrence versus living without uncertainty and a comfortable way to move forward from what's been a really challenging part of somebody's life."

On the Mayo Clinic Q&A podcast, Dr. Thompson discusses what people can expect after treatment for lymphoma and how to achieve the best quality of life.

But what if these people could anticipate a seizure and take action? A recent Mayo Clinic study tested a technology to do just that. 

"One of the most disabling aspects of seizures is the unpredictability," says Dr. Benjamin Brinkmann, a Mayo Clinic epilepsy scientist. 

The study found patterns could be identified in patients who wore a special wristwatch, allowing about 30 minutes of warning before a seizure occurred. This worked well most of the time for five of six patients studied.

The next step is a larger research study and collecting more data.

"We are putting in for funding to do a larger study and we will spend some time and effort improving our algorithms," says Dr. Brinkmann. "One of the things in this new era that we live in with AI (artificial intelligence) and machine learning is that data is king. We really need to collect lots of data so we can train our algorithms to find these subtle signals."

On the Mayo Clinic Q&A podcast, Dr. Brinkmann discusses how seizure forecasting might help patients in the future.

"PCR tests are really sensitive, meaning we can detect really low levels of the virus in a sample," explains Dr. Matthew Binnicker, director of Clinical Virology at Mayo Clinic. "They're very specific, meaning we shouldn't get many false positive results with PCR tests."

At-home antigen tests use a nasal swab and can produce results in 15 minutes, but they also have an increased chance of false-negative results, depending on when you test. 

"At-home rapid antigen tests look for a viral protein in the patient sample," says Dr. Binnicker. "So they're quick and easy, but they also have some important limitations."

So if you're worried you might have COVID-19, what test should you take and when? 

On the Q&A podcast, Dr. Binnicker walks through various scenarios and makes testing recommendations for what to do if:

• You think you’ve been exposed but I don’t have symptoms.
• You have symptoms of COVID-19.
• You had COVID-19 and want to know if you're “in the clear” to return to work, school or activities.

At Mayo Clinic, physicians from orthopedics and anesthesiology have been working together on this initiative as part of the OASIS project. Oasis stands for Orthopedic Surgery and Anesthesiology Surgical Improvements.

"This is a team approach to practice optimization," explains Dr. Hugh M. Smith, a Mayo Clinic anesthesiologist. "One of our first targets was to try to bring down that length of stay." 

A decade ago, a patient who had a knee replacement or hip replacement would likely stay in the hospital for a week, says Dr. Smith. Even four years ago, the average hospital stay was around four days. Now some patients are able to go home the same day.

"It's a patient satisfier," says Dr. Matthew Abdel, a Mayo Clinic orthopedic surgeon. "You recuperate with your family. You recuperate in your own home environment. You don't feel like you're institutionalized. You feel like you're a part of a well model of care, not a sick model."

On the Mayo Clinic Q&A podcast, Drs. Abdel and Smith discuss the OASIS project and outpatient arthroplasty.

The most common chest wall deformity, pectus excavatum, is a sunken breastbone that can be repaired with surgery. Another deformity, pectus carinatum, causes the breastbone to protrude out. It is typically treated with bracing. A third, difficult-to-diagnose condition, is slipped rib syndrome. This occurs when cartilage grows abnormally and the ribs rub together, causing nerve pain. Medical and surgical options can be used to treat slipped rib syndrome.

On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom" focuses on chest wall deformities in children. Dr. Angela Mattke a Mayo Clinic pediatrician and host of "Ask the Mayo Mom" is joined by Dr. Denise Klinkner, a pediatric surgeon and practice chair of the Division of Pediatric Surgery at Mayo Clinic, and Dr. Stephanie Polites, who is also a pediatric surgeon at Mayo Clinic Children’s Center.

"One of the many negatives about saying, 'Well, I'll just go ahead and get infected and get it over with' is you can spread the virus to highly vulnerable people," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "Parents, grandparents, people too young to be immunized, and people whose immune systems might not be working well are all at risk of more severe disease. While your case may be mild, theirs may not." 

Dr. Poland cautions that the sheer number of infections is stressing the health care system, and treatments for omicronare more limited than they were for the delta variant.

"The role of testing and of getting boosted is critical to our response to this, and remember, even though you might have mild disease, every time this virus infects somebody, it is the opportunity for further mutation." says Dr. Poland. 

Vaccination, boosting and masking are all necessary to prevent the spread of omicron.

"Your best chance of protecting yourself is to be fully vaccinated, wear a proper mask properly when in public, and to avoid crowded indoor settings," says Dr. Poland. 

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the omicron surge and answers listener questions.

Research disclosures for Dr. Gregory Poland.

"Taking care of patients is my passion," says Dr. A. Noelle Larson, a Mayo Clinic orthopedic surgeon. "So it really comes naturally to be interested and involved in my patients' lives."

Dr. Larson's clinical and research focus is scoliosis. She has become involved with Curvy Girls Scoliosis, a global support group. Two years ago, she attended their national meeting. Spending time with families and children affected by scoliosis gave Dr. Larson a new perspective.

"So often, our encounter in clinic is quite short, and you don't get a sense of the impact of what our treatment has on that child's overall life and well-being," explains Dr. Larson. "These patients know more about living with their condition than the physician does at some level."

Beyond the connections patients and physicians make, the medical community benefits in other ways, as well. Support groups can help organize and inform patients about clinical trials that can lead to innovation.

Dr. Larson has seen this in her own practice. Feedback from patients led to a Mayo Clinic study on vertebral body tether implant as a surgical alternative to fusing the spine.

"That partnership between the families, the patients, and the researchers and doctors, all working together is really critical," says Dr. Larson.  "If we really want to make new drugs, new devices, and new treatments, we all have to work together. Because at the end of the day, we all want to get to the same place, which is better care for patients." 

On the Mayo Clinic Q&A podcast, Dr. Larson discusses the role of advocacy groups and the patient-physician connection.

"When we're focusing on well-being, intention, accountability and commitment are all important concepts," says Dr. Moain Abu Dabrh, a Mayo Clinic integrative medicine physician and board-certified health and wellness coach. "What is our motivation to make this change? What is the outcome we desire? And then, an important step is to create accountability to making that change."

Health and wellness coaches partner with patients, using evidenced-based strategies to help them identify their vision to live their best life. 

"Health coaching is still a relatively new process, and it has been integrated into our practice because we believe that a patient's life is still a person's life," says Dr. Abu Dabrh. "We don't just focus on illness care. We need to look at the 360-degree view, including illness and wellness care."

On the Mayo Clinic Q&A podcast, Dr. Abu Dabrh discusses how health coaching can help patients reach their goals.

"People often get their news from social media," says Dr. Melanie Swift, a Mayo Clinic preventive medicine physician. "And that's probably the worst way to get your news, because you get a mix of valid information, opinion and, frankly, propaganda."

When evaluating information online, the surgeon general recommends a quick health misinformation checklist: 

• Did you check with the Centers for Disease Control and Prevention (CDC) or the local public health department to see whether any information is available about the claim being made?
• Did you ask a credible health care professional, such as your health care professional, if they have any additional information?
• Did you type the claim into a search engine to see if it has been verified by a credible source?
• Did you look at the About Us page on the website you're referencing to see if you can trust the source?
• If you’re not sure, don’t share.

Dr. Swift urges people seek to out reliable sources for scientific information. " The CDC, the National Institute for Allergy and Infectious Diseases (a branch of the National Institutes of Health), and Mayo Clinic and other academic medical centers, maintain websites that can be trusted sources for COVID-19 information," says Dr. Swift.

On the Mayo Clinic Q&A podcast, Dr. Swift offers tips for finding credible health information online.

"Race is a social construct. There really isn't a genetic difference that is causing Black women to, unfortunately, die at higher rates of cervical cancer," explains Dr. Olivia Cardenas-Trowers, a Mayo Clinic urogynecologic surgeon and women's health provider. "It really has to do more with the historical background of racism and systemic racism. These disparities have infiltrated the health care system and have affected these women's access to resources, and therefore some of the health care that they need. And this trickles down into poor outcomes, essentially."

Disparities that affect a women's access to health care can include transportation, health literacy and trust in their health care provider. 

Dr. Cardenas-Trowers says addressing barriers to health care is key, so that all women, including Black women, receive regular routine screening. Screening helps identify cancer early, which leads to better outcomes. 

"It's important to address the factors that lead to poor outcomes for Black women — making sure that they have support and access to screening, access to the results, and resources if any follow up or intervention is needed," says Dr. Cardenas-Trowers.

On the Mayo Clinic Q&A podcast, Dr. Cardenas-Trowers discusses why disparities exist and what Black women can do to reduce their risk of cervical cancer.

In children, hernias usually occur in one of two places: 

• An inguinal hernia occurs in the groin area. 
• An umbilical hernia occurs near the belly button. 

Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia will be visible only when an infant is crying, coughing or straining during a bowel movement. 

An inguinal hernia isn't necessarily dangerous, but surgery may be recommended to fix an inguinal hernia that's painful or enlarging. Inguinal hernia repair is a common surgical procedure and can be performed as an open or minimally invasive procedure. 

Umbilical hernias are most common in infants, but they can affect adults as well. In an infant, an umbilical hernia may be especially evident when the infant cries, causing the bellybutton to protrude. This is a classic sign of an umbilical hernia.

Children's umbilical hernias often close on their own in the first two years of life, though some remain open into the fifth year or longer. Umbilical hernias that appear during adulthood are more likely to need surgical repair.

On this edition of the Mayo Clinic Q&A podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of "Ask the Mayo Mom," discusses treating hernias in children with Dr. Stephanie Polites, a pediatric surgeon in the Mayo Clinic Children’s Center.

"This is spreading unlike anything we've seen in the U.S.," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group.  "Over the last seven days, we're now averaging about 400,000 or so new cases a day."

While people who are fully vaccinated can get breakthrough infections and spread the virus to others, COVID-19 vaccines effectively prevent severe illness. Mayo Clinic experts urge people to protect themselves by getting vaccinated and wearing a mask. Being fully vaccinated, including getting a booster when eligible, offers the highest protection possible against COVID-19. 

"The good news is, for those who are immunized and boosted, we are winning the battle," says Dr. Poland. "Getting immunized is basically a weapon against this virus."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the omicron surge and the importance of vaccines and boosters for COVID-19.

Research disclosures for Dr. Gregory Poland.

"The COVID-19 pandemic has really had an adverse effect on us recruiting and collecting blood donors in general," says Dr. Justin Juskewitch, associate medical director of Mayo Clinic Blood Donor Services. 

Millions of people need blood transfusions each year. Some may need blood during surgery. Others depend on it after an accident or because they have a disease that requires blood components. Blood donation makes this possible. 

"The inventory of today was the donations of yesterday," explains Dr. Juskewitch. "So paying it forward is also a really great way of helping take care of others. And then those others will be there for you when you meet your time of need. It's a great way to start the new year."

On the Mayo Clinic Q&A podcast, Dr. Juskewitch discusses how to become a blood donor.

"I think the thing that I look back on is the amazing speed with which science moved," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "When this all began in 2020, COVID-19 was absolutely blank slate. Now we have three vaccines in the U.S., and antiviral and monoclonal antibody treatments. That's really incredible."

Despite the rapid scientific advancements, the U.S. still reached a grim milestone of 800,000 deaths from COVID-19 and more people died of the disease in 2021 than in 2020. 

COVID-19 has affected all aspects of life including the way people live, work, and go to school.

"It has been a profound wake-up call. I think we've developed an awareness of how fragile life and human health is. I think good things will come out of this," reflects Dr. Poland. 

On the Mayo Clinic Q&A podcast, Dr. Poland joins host Dr. Halena Gazelka, a Mayo Clinic anesthesiologist, for a COVID-19 pandemic year in review.

Research disclosures for Dr. Gregory Poland.

Sexual side effects from cancer treatment are common for men and women. Cancer in their pelvic area, including bladder, prostate, rectal, cervical, vaginal or vulvar cancer, can make it difficult to resume sex after treatment. 

"A surgical procedure, especially to the pelvis, can really impact the nerve endings and pelvic muscles that are directly involved in our sexual response," explains Dr. Jennifer Vencill, a Mayo Clinic psychologist and sex therapist. 

Chemotherapy and radiation also can have direct effects on sexual function. Other cancer treatment effects on sexuality may be less direct.

"We see these as a cascade effect of treatment," says Dr. Vencill. "This commonly comes up with loss of libido or decreased desire for sexual activity that could be indirectly related to anything from fatigue to nausea because of chemotherapy to body image concerns. Loss of libido could also be related to pain that has come from a surgery. We see these indirect effects often with our patients."

Having cancer also affects emotions. For instance, people with cancer may feel anxious and worn out about their diagnosis, treatment or prognosis. These emotions also can affect their attitude toward sex and intimacy with a partner.

Dr. Vencill explains that feelings of stress, anxiety and depression are common for cancer patients and their families. 

"In general, psychological and emotional stresses are barriers to sexual health. Of course, cancer and cancer treatment are a major life stressor," says Dr. Vencill.

Dr. Vencill suggests that patience, exploration and support are key to sexual health after cancer.

On the Mayo Clinic Q&A podcast, Dr. Vencill discusses how cancer and cancer treatment can affect sexuality and why it is important to be your own advocate.

Racial and ethnic minority groups are being disproportionally affected by COVID-19, due to a long list of factors.

"Race is a particularly important aspect of COVID-19 in terms of diagnosis and treatment, mainly because people of color and people of ethnic minorities are often in jobs that make it harder for them to access health care," says Dr. Abinash Virk, a Mayo Clinic infectious diseases physician. "They may also have difficulty accessing testing. Therefore, there's a delay diagnosis."

The Centers for Disease Control and Prevention defines social determinants of health as the conditions in the places where people live, learn, work, play and worship that affect their health risks and outcomes.

Dr. Virk explains that community engagement is an important step to developing trust and improving equity in health care.

"As healthcare providers, it's important for us to listen to people's individual concerns and to continue to educate people with scientific, nonbiased information so they can believe in us," says Dr. Virk. "What we've found through the COVID-19 pandemic, particularly through the vaccination program that we've had over the last year, is that community engagement has been really important in terms of getting people to understand how COVID-19 affects them and how they can mitigate their risk." 

On the Mayo Clinic Q&A podcast, Dr. Virk discusses racial and gender equity during the COVID-19 pandemic.

"Many of the diseases that we think about as neurological diseases are diseases of circuitry in the brain," says Dr. Kai Miller, a Mayo Clinic neurosurgeon. "And one way we can interact with those circuits in order to have patients have improvement in their symptoms is to use electrical stimulation." 

Brain stimulation treatment also may help people with psychiatric illness and direct brain injuries, such as stroke. But understanding how brain networks interact with each other is complicated. To improve and expand treatment options, Mayo Clinic and Google Research are using artificial intelligence (AI) to develop a new algorithm to improve brain stimulation devices.

"Artificial intelligence is a set of mathematical and statistical tools that we can use to distinguish different types of brain measurements," explains Dr. Dora Hermes, a Mayo Clinic biomedical engineer and researcher on the project. "There is a lot we can do with artificial intelligence or machine learning tools. And in this case, we used it to distinguish different types of inputs to a particular brain area in an automated fashion." 

On the Mayo Clinic Q&A podcast, Drs. Miller and Dr. Hermes, first author and senior author on the AI algorithm study, respectively, discuss the use of artificial intelligence to improve brain stimulation treatments.

Read more about the work of Mayo Clinic and Google Research on AI and brain stimulation devices.

RSV can cause severe infection in some people, especially premature infants, older adults, people with heart and lung disease, or anyone with a weak immune system.

In severe cases, RSV infection can spread to the lower respiratory tract, causing pneumonia or bronchiolitis — inflammation of the small airway passages entering the lungs. Signs and symptoms may include: 

• Congested or runny nose
• Dry cough
• Low-grade fever
• Sore throat
• Sneezing
• Headache

Treatment for RSV generally involves self-care measures, but hospital care may be needed if severe symptoms occur.

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, Mayo Clinic pediatrician, is joined by Dr. Jay Homme, a Mayo Clinic pediatrician, and Dr. Jim Homme, a Mayo Clinic pediatric emergency medicine physician, to discuss what parents and caregivers should expect for RSV and bronchiolitis this season.

Early research suggests that a booster dose of the Pfizer COVID-19 vaccine improves protection against severe disease caused by the omicron variant, according to Pfizer.

Mayo Clinic experts say, regardless of the variant, prevention of infection works. Getting a booster offers the highest protection possible against COVID-19.

"Omicron infection rates are picking up rapidly," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "If we do not take the proper precaution over the holiday, we are going to see a January omicron surge."

Dr. Poland explains that there are two threats — delta and omicron COVID-19 variants — but there is a solution. "Masking and boosting — those are key to protecting yourself and your family."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest on COVID-19 variants and shares advice on how to stay safe this holiday season.

Research disclosures for Dr. Gregory Poland.

"Psoriasis and eczema are both skin reactions to the inflammation or immune system coming to the skin and causing a reaction," says Dr. Dawn Davis, a Mayo Clinic dermatologist.

Psoriasis is thought to be an immune system problem that causes the skin to regenerate at faster-than-normal rates. This rapid turnover of cells results in scales and red patches.

Eczema results from irritants or allergens. It's common in children, but can occur at any age. And people with eczema often have other sensitivities, including asthma, hay fever or food allergies.

Both are long-term chronic conditions that don’t have a cure but can be treated. It is important for people with psoriasis or eczema to seek care to control flares-ups and improve their quality of life.

"Anticipate a lifelong relationship with your dermatologist or primary care provider so that we can take care of your skin over time and keep track of the treatment and management of your condition," explains Dr. Davis.

On the Mayo Clinic Q&A podcast, Dr. Davis helps explain the similarities, differences and treatments for psoriasis and eczema.

Dr. Stephen Kopecky, a Mayo Clinic preventive cardiologist, says a better approach is to focus on small steps that add up over time.

"The answer, I think, is to make small sustainable steps that you can live with," says Dr. Kopecky "And when I say small steps, like for diet, I tell patients one bite, one bite of something healthy. Take some processed meat or foods off your plate, and put on something like a legume or a bean. After a couple of years, that one-bite difference will lower your risk of having a heart attack."

In his new book, "Live Younger Longer: 6 Steps to Prevent Heart Disease, Cancer, Alzheimer's and More,"  Dr. Kopecky shares strategies for making changes, including thinking of a compass of habits:

• N — Nutrition
• E — Exercise
• W — Weight
• S — Sleep, stress, smoking and spirits (alcohol)

Making positive changes in these areas can help improve health and longevity.

"We cannot prevent aging.  We can slow aging," says Dr. Kopecky. "But we can prevent disease, it's certainly possible to do. And if you adopt a certain healthy lifestyle, you can affect that."

On the Mayo Clinic Q&A podcast, Dr. Kopecky discusses developing healthy habits one small step at a time.

Sometimes called “long haulers” or “long COVID," these patients can have fatigue, shortness of breath, brain fog and other symptoms long after the time of their infection.

Post-COVID-19 syndrome conditions are generally considered to be effects of COVID-19 that persist for more than four weeks after you've been diagnosed with COVID-19 infection.

A recent Mayo Clinic study on post-COVID-19 symptoms found that more women than men suffer long-term effects. Women predominantly showed symptoms of fatigue, followed by muscle pain and low blood pressure, while men primarily experienced shortness of breath.

Research is also underway to better understand what may be causing post-COVID-19 syndrome.

"We do have some research now that shows that some of the cells that are used to create immunity after an infection, they may be malfunctioning in this condition in patients with long-haul COVID," says  Dr. Greg Vanichkachorn, director of Mayo Clinic’s COVID Activity Rehabilitation Program. "We also now have some research that shows that patients with this condition can have antibodies against themselves, otherwise known as an auto-antibody. And this may be associated with the long-haul COVID state, so immune dysfunction and auto immunity, they may be at play here."

The COVID Activity Rehabilitation Program at Mayo Clinic helps people experiencing post-COVID-19 syndrome by working with patients to decrease symptoms and improve overall functioning and quality of life. 

On the Mayo Clinic Q&A podcast, Dr. Vanichkachorn discusses how treatment can help patients who suffer from post-COVID-19 syndrome.

Diet and nutrition recommendations for cancer survivors are no different from the recommendations for anyone who wants to improve their health: Eat a balanced diet with an emphasis on vegetables, fruits and whole grains; drink alcohol moderately, if at all; and maintain a healthy weight.

"Both the American Cancer Society and the American Institute for Cancer Research recommend the same exact diet for cancer survivors that we recommend for cancer prevention," says Dr. Dawn Mussallem, a Mayo Clinic hematologist and oncologist. "A low fat-diet is recommended. That's a predominantly whole food, plant-based diet that is rich with vegetables; whole grains; colorful fruits; and things like beans, lentils, seeds and nuts. This is really the essential diet that's good for all health and health-related diseases, not just cancer." 

Maintaining a healthy weight is important to overall health, but some cancer survivors may struggle to maintain weight during and after treatment due to nausea or lack of appetite.

"For underweight patients, it is very important that they work with a dietician," says Dr. Mussallem. "These patients need healthy, high calorie-dense foods and they may need to eat smaller portions throughout the day."

On this Mayo Clinic Q&A podcast, Dr. Mussallem, discusses what cancer survivors should know about diet and nutrition.

Cleft lip and cleft palate are openings or splits in the upper lip; the roof of the mouth, or palate; or both. Cleft lip and cleft palate result when facial structures that are developing in an unborn baby don't close completely.

Treatment involves surgery or a series of surgeries to repair the defect and therapies to improve any related conditions. Treatment seeks to improve the child's ability to eat, speak and hear normally, and achieve a normal facial appearance.

On this edition of the Mayo Clinic Q&A podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of "Ask the Mayo Mom", discusses cleft lip and cleft palate with three Mayo Clinic Children’s Center experts: Dr. Samir Mardini, chair of the Division of Plastic and Reconstructive Surgery; Dr. Shelagh Cofer, a pediatric otolaryngologist and head and neck surgeon; and Dr. Waleed Gibreel, a craniofacial and pediatric plastic surgeon. 

The emergence of omicron is a reminder to take important steps to protect yourself against COVID-19.

"The answer is masking and boosters," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. 

Dr. Poland is encouraged by vaccine booster rates in the U.S. "In a relatively short period of time, about 36% of adults who are eligible have indeed gotten a booster," says Dr. Poland. "There's plenty of vaccine available. So in the strongest possible terms, I would recommend getting that booster."

Adults who are six months past completing their initial Moderna or Pfizer COVID-19 vaccination series are eligible to receive a booster dose, as are adults who are two months past completing their initial dose of the Johnson & Johnson vaccine.

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the omicron variant and COVID-19 boosters, and he answers some listener questions.

Research disclosures for Dr. Gregory Poland.

Approximately 5.8 million people in the U.S. age 65 and older live with Alzheimer's disease. Of those, 80% are 75 and older. Of the approximately 50 million people worldwide with dementia, between 60% and 70% are estimated to have Alzheimer's disease.

For those living with Alzheimer's and their caregivers, common questions include: 

• When it comes to memory, what is typical aging? 
• What is the difference between Alzheimer's disease and other forms of dementia? 
• How can you keep your brain healthy? 

On the Mayo Clinic Q&A podcast, Dr. Jonathan Graff-Radford, a behavioral neurologist at Mayo Clinic, and Angela Lunde, an investigator in Mayo Clinic's Alzheimer's Disease Research Center — both co-authors of the second edition of "Mayo Clinic on Alzheimer's Disease and Other Dementias: A Guide for People With Dementia and Those Who Care for Them" — share stories of those living with dementia and offer practical advice for caregivers.

When looking for answers and help, Vigile and his family turned to Mayo Clinic. Thanks to science, research and an innovative procedure performed by the man who developed it, Justin got his life back. 

At Mayo, Dr. Hartzell Schaff, a cardiovascular surgeon, gave Vigile an alternative to heart transplant in the form of apical myectomy, a surgical procedure to relieve symptoms caused by the thickening of muscle in the apex of his heart. 

It's a procedure that Dr. Schaff developed at Mayo Clinic in 1996. Vigile feels grateful for the surgery and the surgeon. 

"Dr. Schaff changed my life, which is obvious. But it also changed the lives of my friends and family. I was able to meet the woman that I fell in love with. I've been able to pursue my dreams." Those dreams include writing music for NFL films and becoming a podcaster.

Now, almost 10 years later, Vigile and Dr. Schaff reunite on the Mayo Clinic Q&A podcast. Also on the program, Justin's podcast partner, Darrell Campbell, joins the conversation to talk about the Everyman Podcast and how they've found silver linings along the way.

Ashley received palliative and hospice care over the course of her life, and Ashley's mom, Lynn Evenson, wants people to know about the benefits of hospice care.

"To keep Ashley’s memory alive, I want to tell her story," says Evenson. "And I want to make it open to people to understand and learn what hospice is really about and how it can make a big difference — not just for the patient but for the caregiver, as well."

People are often confused about the difference between palliative care and hospice care. Palliative care is for anyone who has been diagnosed with a chronic illness. When a cure is not possible, a shift to hospice care can offer supportive measures for the patient and the family.

And an early referral to hospice can help everyone involved. 

"Hospice can provide so much care and comfort in all aspects of the end of life experience for both the patient and the family, says Jennifer Larson LaRue, a Mayo Clinic psychotherapist. "So it helps that very difficult, painful time go more smoothly, I think."

November is National Hospice and Palliative Care Month, a time to recognize the important work these programs do to help patients and their families when a cure is not possible. 

On the Mayo Clinic Q&A podcast, Larson LaRue joins Evenson, who shares her family's journey through illness and their wish to help educate others about the advantages of hospice care.

The advantages of spinal anesthesia include a less time in the operating room and a quicker postop recovery. And since children are never fully sedated, they can feed or eat as soon as they return to the recovery room.

Before surgery, numbing cream is used and preop medication is delivered to the child through the nose. Spinal anesthesia is given using a needle into the patient’s back. This numbs and blocks movement below the belly button. 

Because spinal anesthesia only lasts no more than two hours, it is being used for shorter urologic procedures. During the surgery, the child's oxygen, temperature and blood pressure are monitored closely.

On the Mayo Clinic Q&A podcast, Dr. Candace Granberg, a pediatric urologist and surgeon-in-chief of Mayo Clinic Children's Center, and Dr. Dawit Haile, chair of the Division of Pediatric Anesthesia at Mayo Clinic, discuss spinal anesthesia for pediatric urologic surgeries.

"I have consistently said what's very likely to happen as we get to the cooler weather and see the trends in travel is that we will have another surge," says Dr. Poland. "We're in this unusual situation where the pandemic is actually getting worse because humans don't want to believe that the pandemic is just as important now as it was a year ago."

In this Mayo Clinic Q&A podcast, Dr. Poland answers several listener questions and talks more about being vigilant against COVID-19 as the U.S. heads into a second winter with this coronavirus. He also addresses the recent news that wild deer have shown evidence of COVID-19 infection and what that might mean in the battle to eliminate the disease.

Research disclosures for Dr. Gregory Poland.

Living after a cancer diagnosis is often called "survivorship." The survivorship experience is different for every cancer survivor, but it's possible to predict some of what the survivor might experience based on the type of cancer. For example, both prostate cancer and its treatment can cause urinary incontinence and erectile dysfunction.

"I think survivorship is just a critical issue in prostate cancer management," says Dr. Matthew Tollefson, a Mayo Clinic urologist. "The location of the prostate is a factor, so many men are concerned about urinary function and sexual function, and to some extent bowel function, because these are all in the the general region of the prostate." 

After treatment, men may be hesitant to discuss their side effects or be self-conscious about sharing their feelings and worries. Health care providers can help.

"It's absolutely critical to have that discussion with your doctor, says Dr. Tollefson. "We have effective treatments to manage almost all the side effects that can come up, whether they be issues with body composition, or sexual function or urinary control. It's important to understand that that these are common things and recognize that your physician has likely heard this from many people before and really is well-equipped to help manage and get through some of the issues that that do arise."

On the Mayo Clinic Q&A podcast, Dr. Tollefson discusses what men can expect after treatment for prostate cancer and how they can improve their quality of life going forward.

"The Center for Digital Health has the vision of bringing Mayo Clinic to a global community so that we can deliver Mayo Clinic anywhere in a manner that is simple," says Dr. Bradley Leibovich, medical director for Mayo Clinic's Center for Digital Health.

Current projects at the Center for Digital Health include developing a digital front door and improved consumer experience for patients, expanding virtual care, and transforming health care delivery through data and analytics.

One example is Mayo Clinic's advanced care at homeprogram, which provides comprehensive care to patients in the comfort of their own homes. Partnering with Medically Home, technology-enabled services company, some patients with conditions previously managed in a hospital now have the option to transition to a home setting for care and recovery services. 

"This enables people who traditionally would need to be in the hospital for a serious condition to stay in their home, having nurses and physicians checking on them via technology, and having data streamed to those providers from their home," explains Dr. Leibovich. "It allows people to stay in their homes more, with their families more. It will enable them to continue working more. It will cure them faster. It will do so with less expense, less frustration. And everybody benefits if we can accomplish that."

On the Mayo Clinic Q&A podcast, Dr. Leibovich discusses work that is underway at Mayo Clinic's Center for Digital Health to improve the patient's health care experience.

Organ damage can lead to health complications that linger after being infected with COVID-19. People with heart disease are at an increased risk of more severe complications from COVID-19, but anyone infected with COVID-19 could be at risk for heart problems. 

"Not only have we learned that COVID-19 can cause cardiac injury through multiple mechanisms, but the virus in rare cases, particularly in young males, can cause myocarditis, a specific form of cardiac injury," says Dr. Leslie Cooper, chair of the Department ofCardiology at Mayo Clinic in Florida. 

Many people who are infected with COVID-19 experience shortness of breath, which could be a sign of heart complications and needs further investigation. 

"The illness itself leads to deconditioning because you're not as active you normally are," explains Dr. Cooper. "So going back to activity take time." 

It's hard for the individual to tell which is the cause of their symptoms. Is it the heart, the lungs or deconditioning? I would recommend seeing a medical provider if you've still got symptoms. We can sort that out with generally noninvasive and simple testing," says Dr. Cooper.

While there is a slight risk of myocarditis as a temporary side effect of vaccination for COVID-19, particularly in young males, the Centers for Disease Control and Prevention still recommends vaccination for everyone 5 and up.

Dr. Cooper agrees.

"The likelihood of a bad thing happening — a hospitalization or dying from the virus itself — is greater with the virus than it is with a vaccine in every case, every analysis, in every study done."

On the Mayo Clinic Q&A podcast, Dr. Cooper discusses COVID-19 infection and the heart.

A lung transplant is a surgical procedure to replace a diseased or failing lung with a healthy lung, usually from a deceased donor. Depending on your medical condition, a lung transplant may involve replacing one or both of your lungs. In some situations, the lungs may be transplanted along with a donor heart. 

For patients with diseases that damage the lungs, an early referral to a transplant center is an important step.

"If you have a disease that you think could merit or benefit from lung transplant, it's extremely important to talk to your physician early in the process," says Dr. Tathagat Narula, a Mayo Clinic transplant medicine physician. "The physician can refer you to a transplant center, where you can receive a complete evaluation. There's nothing wrong in getting established with a transplant center relatively early in the process of your lung disease. " 

On the Mayo Clinic Q&A podcast, Dr. Narula discusses evaluation for lung transplant and research working to make more lungs available to those on the transplant waitlist.

The American Academy of Pediatrics recommends healthy forms of discipline, such as positive reinforcement of appropriate behaviors, limit setting, redirecting, and setting future expectations. The American Academy of Pediatrics recommends that parents not span, hit, slap, threaten, insult, humiliate, or shame children.

On the Mayo Clinic Q&A podcast, pediatrician and #AsktheMayoMom host Dr. Angela Mattke discusses positive ways to discipline your child with Dr. Chris Derauf, a Mayo Clinic pediatrician, and Dr. Arne Graff, a Mayo Clinic family medicine physician, who both specialize in child abuse at the Mayo Center for Safe and Healthy Children and Adolescents.

"It's important that we reach a very high level of vaccination rates to achieve kind of a wall of immunity that could prevent transmission and prevent us from these repeated peaks that we've been dealing with over the last year and a half during this pandemic," says Dr. Berbari. 

In this Mayo Clinic Q&A podcast, Dr. Berbari also talks about the rare cases of myocarditis and how the Food and Drug Administration is monitoring those cases. Dr. Berbari also addresses additional COVID-19 vaccine doses for immunocompromised people, the importance of masking, even if vaccinated, and he answers a number of listener questions.

Where the cancer occurs in the stomach is one factor doctors consider when determining treatment options. Treatment usually includes surgery to remove the stomach cancer. Other treatments may be recommended before and after surgery, including immunotherapy. 

"Over the past three years, we've incorporated immunotherapy into the treatment of stomach cancer. This type of therapy boosts the immune system to go after the cancer," says Dr. Lionel Kankeu Fonkoua, a Mayo Clinic medical oncologist. "Cancer cells are very smart and find ways to evade or put brakes on the immune system. Immunotherapy is designed to release those brakes and unleash the immune system to go after the cancer. And when that's effective, we've seen some dramatic and durable responses in some of these patients." 

November is Stomach Cancer Awareness Month. On the Mayo Clinic Q&A podcast, Dr. Kankeu Fonkoua discusses risk factors, the latest treatments and steps you can take to prevent stomach cancer.

For parents, it can be challenging to know how to support a gender-nonconforming or transgender child.

Most children typically develop the ability to recognize and label stereotypical gender groups, such as girl, woman and feminine, as well as boy, man and masculine, between 18 and 24 months. In many cases, children will say how they feel, strongly identifying as a boy or girl — and sometimes — neither or both. While children might go through periods of insisting that they are the opposite gender of their birth sex, if they continue to do so, it was likely never a phase.

It is important to discuss your child's gender identity and gender expression with his or her health care provider to address the health concerns that transgender people face. The health care team also should include a counselor or therapist with training in transgender needs.

On the Mayo Clinic Q&A podcast, Dr. Aida Lteif, a Mayo Clinic pediatric endocrinologist; Nicole Imhof, a pediatric social worker; and Katherine Ley, a pediatric endocrinology nurse, discuss medical care for transgender children.

Additional resource: Trans Student Educational Resources

For people who received Moderna or Pfizer vaccines, booster vaccinations are recommended 6 months or more after finishing the initial two-dose series for those age 65 and older and for younger adults 18 and older who work or live in high-risk settings or have underlying medical conditions that increase their COVID-19 risk. 

For people who got the J&J COVID-19 vaccine, booster vaccinations are recommended for those 18 and older and who were vaccinated two or more months ago.

"What mix-and-match means is that regardless of what you got for your primary series, you could get any of the other three vaccines available for use in the U.S. as your booster if you're eligible for a booster," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. 

So how do you know which booster vaccination to choose?

"All of the boosters will dramatically boost your antibody response," says Dr. Poland. "I would make the decision about a booster based on how did you respond to whatever you got originally? And are there any unique risk factors that you have?"

People who responded well to the first vaccine with minimal side effects can choose to get the same brand for their booster vaccination. But there are reasons someone might choose a different vaccine. For example, a younger man who initially got the Moderna or Pfizer vaccine might want a J&J booster, because the mRNA vaccines are linked with a slight risk of heart inflammation called myocarditis. And a woman under age 50 might prefer to get a Moderna or Pfizer booster, because the J&J vaccine is linked with a slightly higher risk of a rare blood clotting condition in younger women.

In this Mayo Clinic Q&A podcast, Dr. Poland walks through the recent booster recommendations and the likely timeline for COVID-19 vaccine approval for kids ages 5 — 11.

Research disclosures for Dr. Gregory Poland.

Across the U.S., people have been living with a heightened level of stress for more than 18 months due to the ongoing pandemic. Nearly 4 in 10 adults in the U.S. say that worry and stress related to the threat of COVID-19 have played a negative role in their mental health, according to a recent survey.

"We think of just the wear and tear that the pandemic has had on all of us. We kind of think about it almost like an erosion effect over time, with the amount of stressors and different uncertainties that we've been going through," says Dr. Craig Sawchuk, chair of the Division of Integrated Behavioral Health at Mayo Clinic. 

"That wear and tear gets to us, and if there hasn't been an opportunity to do some more restorative things, then after a while, people may start to get a little bit more edgy, a little bit more irritable, a little less patient." 

Dr. Sawchuk explains that it's important to acknowledge the feelings of anger, frustration and fatigue, and then find strategies to better cope with those feelings. Relaxation exercises that can be done quickly and from anywhere may help you change your mindset.

"As emotions get cranked up, flexibility in our thinking and our ability to problem solve actually goes down," says Dr. Sawchuk. "This is true for all emotions — anger included. So relaxation-related exercises help us focus on things we can control."

On the Mayo Clinic Q&A podcast, Dr. Sawchuk discusses strategies for managing your mental health, and he offers tips for navigating family gatherings during the holidays.

Colorectal cancer, also known as bowel cancer, typically affects older adults, although it can happen at any age.

Screening for colorectal cancer is important to identify precancerous polyps that could develop into cancer, and several screening options are available to patients. 

But which screening tool is right for you?

"The best screening tool is the one you're willing to get," says Dr. James East, a gastroenterologist at Mayo Clinic Healthcare in London. "There's no point in being set up for a colonoscopy if you're not willing to come for it. And there are a wide range of options now for bowel cancer screening — all of which provide substantial protection against bowel cancer."

Screening test options for colorectal cancer include:

• Colonoscopy.
• Stool DNA test.
• Fecal immunochemical test. 
• Virtual colonoscopy, or CT colonography.

While effective screening tools exist, research using artificial intelligence (AI) to develop better techniques to detect polyps is hoping to improve screening even further.

"I think the role of AI in endoscopy is huge. And it's it's coming to clinical care," says Dr. East. "This is really translating facial recognition technology, but instead of recognizing faces, the AI recognizes polyps at an astonishing rate during a live colonoscopy. This is really a game changer for us." 

On the Mayo Clinic Q&A podcast, Dr. East discusses advances in colorectal cancer screening.

"The fact that recommendations are changing is not evidence people don't know what they're doing," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "It's evidence that they do know what they're doing and are paying close attention to new data that's coming along. Then they're adjusting recommendations based on the latest data."

Dr. Poland continues to urge people to get the latest COVID-19 news from credible sources. 

In this Mayo Clinic Q&A podcast, Dr. Poland walks through the recent recommendations, corrects misperceptions and answers a number of listener questions.

Research disclosures for Dr. Gregory Poland.

"The goal of systemic therapy is simply to either inhibit the growth of cancer cells or to kill them and to eradicate them from the body," says Dr. Matthew Goetz, a medical oncologist at Mayo Clinic. Dr. Goetz is also co-leader of the Mayo Clinic Cancer Center Women’s Cancer Program.

"If you can imagine a patient who is diagnosed with breast cancer, and those cancer cells have spread to other parts of the body, such as the liver, or the bone or the lung, we refer to this as stage 4 breast cancer," says Dr. Goetz. "For those patients, systemic therapy really is the predominant therapy that we would use to slow down, eradicate and eliminate those cancer cells."

While patients have many systemic therapy options, Mayo Clinic research seeks to improve on these treatments and develop new drugs to treat and prevent cancer.

"We're one of six centers in the country that has a specialized program of research excellence, which means that we have a large group of individuals doing research in the area of drug development," explains Dr. Goetz. "For example, we have a group that's developing new vaccines to actually prevent breast cancer. We're excited to see the results of that study."

On the Mayo Clinic Q&A podcast, Dr. Goetz discusses advances in using systemic therapies to treat breast cancer.

Heart arrhythmias, also called heart rhythm problems, occur when the electrical impulses that coordinate your heartbeats don't work properly. This causes your heart to beat too fast, too slow or irregularly.

Arrhythmias may feel like a fluttering or racing heart, and they may be harmless. However, some heart arrhythmias may cause bothersome — sometimes even life-threatening — signs and symptoms. 

It is important to find the cause, says Dr. Elijah Behr, a cardiologist at Mayo Clinic Healthcare in London. "It's very straightforward to investigate," says Dr. Behr. "And we have treatments that can prevent risk, prolong life, and can maintain quality of life for people."

Treatment can include medications, catheter procedures, implanted devices or surgery to control or eliminate fast, slow or irregular heartbeats. A heart-healthy lifestyle also can help prevent heart damage that can trigger certain heart arrhythmias.

On the Mayo Clinic Q&A podcast, Dr. Behr discusses the warning signs of heart arrhythmias and how they are diagnosed and treated.

"On Oct. 14 the Federal Drug Administration is going to look at COVID-19 boosters for Moderna. On Oct. 15, (the FDA will review) boosters for Johnson & Johnsons' COVID-19 vaccine. And on Oct. 29, the FDA will look at extending emergency use for the Pfizer COVID-19 vaccine for children down to 5 years of age," says Dr. Poland. He adds that vaccinations of children could begin within a couple of weeks of the emergency use authorization.  

Dr. Poland also says approval of Merck's antiviral COVID-19 pill is expected soon, too.

"We're excited about this because it's oral," says Dr. Poland. "The nice part about this is you can take it at home, and it fits with the same paradigm we already have in clinical medicine — treating influenza with an antiviral."

In this Mayo Clinic Q&A podcast, Dr. Poland also talks about waning immunities and the approval possibility of mixing and matching COVID-19 booster vaccines being approved. And he reminds women who are pregnant to get a COVID-19 vaccine.

Research disclosures for Dr. Gregory Poland.

Mayo Clinic Cancer Center is designated by the National Cancer Institute (NCI) as a comprehensive cancer center. At comprehensive cancer centers, staff coordinate innovative cancer care delivery for patients; conduct team-based cancer research to develop better means to prevent, detect and treat cancer; involve communities and patients in research; and train the next generation of cancer health professionals. Mayo Clinic Cancer Center offers its patients access to hundreds of clinical trials in all phases that test new and improved cancer treatments. 

"We have a menu of over 300 cancer clinical trials every year that are testing new drugs and bringing treatments to patients," says Dr. Willman. "Cancer clinical trials are essential to advancing our knowledge in cancer care."

Work is underway at Mayo Clinic Cancer Center to grow the Cancer Care at Home program and engage local communities, which can help address disparities in health care. Other initiatives include making advances in radiation therapy techniques and using genomics to develop individualized care for patients.

Mayo Clinic Cancer Center also is expanding the use of patient navigators, allowing cancer patients to have one point of contact to help them navigate the complexities of cancer care that often involves many specialists. 

"For a breast cancer patient, for example, that would include breast cancer surgeons, medical oncologists who give chemotherapy, radiation oncologists who give radiation, but also physical medicine and rehabilitation, nutrition, psychosocial support, and access to clinical trials," says Dr. Willman. "A patient navigator becomes the primary contact person for a patient we're caring for and truly navigates them through all of their providers."

On the Mayo Clinic Q&A podcast, Dr. Willman discusses the innovations taking place at Mayo Clinic to improve cancer care for patients.

But breastfeeding can be challenging.

New parents may worry about whether their child is getting enough milk and wonder how often they should breastfeed. And mothers may wonder how their diet affects their breast milk. 

New parents shouldn't be afraid to ask for help.

Maternity nurses or a hospital lactation consultants can offer breastfeeding tips, starting with how to position the baby and how to make sure he or she is latching on correctly. Your health care provider, or your baby's health care provider, might offer breastfeeding tips, too.

On the Mayo Clinic Q&A podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of Ask The Mayo Mom, discusses breastfeeding tips with Dr. Leslie Kummer, a Mayo Clinic pediatrician.

"What happens is that people read the news and say: 'We're done. We're free. It's over,'" says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "This generally goes in cycles of two to three months and people say, as the caseload starts falling: 'You know what, I don't need that booster. I don't need to wear a mask. We can travel again. And there's no need for distancing.' And within a couple of months of that, we have another surge." 

He says he knows people are emotionally fatigued, but the only way to defeat the COVID-19 pandemic is to be fully vaccinated and wear masks. 

In this Mayo Clinic Q&A podcast, Dr. Poland also talks about COVID-19 booster vaccinations and why people who have been infected with COVID-19 still need to be vaccinated. He also explains three benefits of pregnant women being vaccinated for COVID-19. And Dr. Poland answers listener questions about monoclonal antibody therapy, a COVID-19 vaccine called Novavax and more misinformation about ivermectin.

Research disclosures for Dr. Gregory Poland.

"Research has shown that Blacks and Hispanics are less likely to be diagnosed with liver cancer at an earlier stage, compared to whites," says Dr. Sumera Ilyas, a Mayo Clinic gastroenterologist. "And that, in turn, means the odds of being eligible for potentially curative treatments are lower for these patients."

These disparities are due to many potential reasons.

"These differences in diagnosis may be due to differences in access to primary or subspecialty health care. They may also be due to differences in surveillance," explains Dr. Ilyas. 

The National Cancer Institute estimates that more than 42,000 new cases of liver cancer will be diagnosed in 2021, representing 2.2% of all new cancer cases in the U.S. 

The most common type of primary liver cancer is hepatocellular carcinoma. Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common. 

"The vast majority of liver cancers — over 90% — occur in patients who have a chronic liver disease," says Dr. Ilyas. "Cirrhosis, or advanced scarring of the liver, is the strongest risk factor for hepatocellular carcinoma."

Chronic infection with the hepatitis B or hepatitis C viruses also increases your risk of liver cancer.

A wide range of treatment options for primary liver cancer are available. Which treatment is used depends on the stage of the disease. 

On the Mayo Clinic Q&A podcast, Dr. Ilyas discusses liver cancer diagnoses and treatment options, and the importance of prevention.

The Centers for Disease Control and Prevention (CDC)recommends everyone 6 months and older get vaccinated for flu each year. The CDC also says people who are eligible can be vaccinated for flu and COVID-19 at the same time. 

Currently, children ages 12 and older are permitted to get vaccinated for COVID-19 using the Pfizer COVID-19 vaccine under terms of the Food and Drug Administration's emergency use authorization. Experts anticipate that the Pfizer COVID-19 vaccine will soon be approved for emergency use authorization for children 5-11.

On the Mayo Clinic Q&A podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of Ask The Mayo Mom, discusses children and vaccines with Dr. Robert Jacobson, a Mayo Clinic pediatrician. Dr. Jacobson co-chairs the AskMayoExpert Knowledge Content Board on Immunizations and Vaccinations, and he is medical director for Mayo Clinic's Primary Care in Southeast Minnesota Immunization Program.

"This is a confusing set of recommendations," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "So let's look at the four groups approved for only the Pfizer booster, thus far. If you got a primary series of the Pfizer vaccine, you're 65 and older, and it's been six months or more, you are eligible for a booster. If you're 50–64 and you have medical conditions that place you at high risk, you are eligible for the booster. If you're 18–49, you may be able to get a booster based on a medical condition and if you talk with your health care provider to weigh risks and benefits. And, finally, for people 18–64 years old, who are health care providers in congregate living situations or who have occupations that place them at high risk for transmission, such as school teachers, they also may be eligible. That should happen very soon."

In this Mayo Clinic Q&A podcast, Dr. Poland talks more about the approval process for COVID-19 vaccine boosters, including for the Moderna and Johnson & Johnson COVID-19 vaccines. He also discusses the possibility that emergency use approval for children, down to age 5, could come before the end of October.

Research disclosures for Dr. Gregory Poland.

On the Mayo Clinic Q&A podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of Ask The Mayo Mom, will discuss treatment options for brain tumors in children with guests Dr. Soumen Khatua and Dr. Jonathan Schwartz — both Mayo Clinic pediatric neuro-oncologists — and Dr. David Daniels, a Mayo Clinic pediatric neurosurgeon. This conversation is part of Childhood Cancer Awareness Month.

FDA approval is just one step in determining whether booster shots will be made available. The Advisory Committee on Immunization Practices (ACIP) will refine the recommendations for booster shots and provide guidance to health care providers, pharmacies and other COVID-19 vaccine providers. ACIP has scheduled a meeting for Sept. 22-23.

 "It's a bit of a complicated path," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "But we're exercising caution before we proceed into boosters for everyone, and the reason for that is because we do our best to follow the science." The FDA panel requested more safety data on the use of boosters.

On the Mayo Clinic Q&A podcast, Dr. Poland discusses booster recommendations and other COVID-19 updates.

Research disclosures for Dr. Gregory Poland.

Asthma is one of the most common long-term diseases in children, but adults can have asthma, too. Symptoms of asthma include:

• Shortness of breath.
• Chest tightness or pain.
• Wheezing when exhaling, which is a common sign of asthma in children.
• Trouble sleeping caused by shortness of breath, coughing or wheezing.
• Coughing or wheezing attacks worsened by a respiratory virus, such as a cold or the flu.

"People with asthma have an irritable, hyperresponsive airway," says Dr. John Costello, a consultant pulmonologist at Mayo Clinic Healthcare in London. "Many asthmatics will tell you that if they laugh, or if there's strong fumes from the back of a car or something like that, that will make them cough much more easily than a normal person."

For some people, asthma is just a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Maintaining good day-to-day asthma control is the key to keeping symptoms at bay and preventing asthma attacks.

On the Mayo Clinic Q&A podcast, Dr. Costello discusses how to manage asthma in adults.

While many types of lymphoma exist, the main subtypes are Hodgkin's lymphoma and non-Hodgkin’s lymphoma.

Knowing exactly which type of lymphoma you have is key to developing an effective treatment plan.

"The main problem with lymphoma is accurate diagnosis," says Dr. Jose Villasboas Bisneto, Mayo Clinic hematologist. "It is a rare cancer in proportion to the other cancers, so most cancer doctors will not see many lymphoma patients in any given month, or even a given year."

Tests used to diagnose lymphoma include imaging tests, such as PET, CT or MRI scans, as well as biopsies of the lymph nodes and bone marrow.

What treatment is best for a patient depends on the lymphoma type and its severity.

On the Mayo Clinic Q&A podcast, Dr. Villasboas Bisneto discusses the various types of lymphoma and how they are treated.

Dr. Poland discusses the mu variant, understanding breakthrough infections and the importance of flu vaccinations this fall. 

"The symptoms of COVID-19 and the symptoms of influenza overlap so much that it can be hard to distinguish one from another," says Dr. Poland. 

What can the public do to protect themselves this flu season? 

"Everybody aged 6 months and older should get a flu vaccine. And as we've talked about, get a COVID-19 vaccine whenever you are eligible, and wear a mask indoors in public."

Research disclosures for Dr. Gregory Poland.

While some types of prostate cancer grow slowly, and may need minimal or even no treatment, other types are aggressive and can spread quickly.

So if you’ve been diagnosed with prostate cancer. Now what?

"It's very important to know the extent or stage of the cancer," says Dr. R. Jeffrey Karnes, a Mayo Clinic urologist and chair of the Division of Community Urology at Mayo Clinic in Rochester, Minnesota.

Diagnosis and staging are done using tests, including ultrasound, MRI and biopsy.

Prostate cancer that's detected early — when it's still confined to the prostate gland — has the best chance for successful treatment. Prostate cancer treatment options depend on several factors, such as how fast the cancer is growing, whether it has spread, as well as the potential benefits or side effects of the treatment.

On the Mayo Clinic Q&A podcast, Dr. Karnes discusses treatment options for prostate cancer and the latest in clinical trials and research.

Fetal surgeons at Mayo Clinic Children's Center treat many conditions, including: 

• Spina bifida (myelomeningocele).
• Twin anemia-polycythemia sequence (TAPS).
• Twin reversed arterial perfusion (TRAP) sequence.
• Twin-twin transfusion syndrome (TTTS).
• Lower urinary tract obstruction (LUTO).

On the Mayo Clinic Q&A podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of Ask The Mayo Mom, is joined by Dr. Mauro Schenone, a Mayo Clinic maternal fetal surgeon, to discuss advances in technology and treatments. Dr. Schenone is also the director of the Fetal Diagnostic and Intervention Center at Mayo Clinic in Rochester, Minnesota, and chair of the Division of Maternal Fetal Medicine.

Sarcoma — the term for a group of cancers that begin in the bones and in the soft or connective tissues — is one of the more common types of childhood cancer. 

Fortunately, recent treatment advances have increased survival rates. Of children diagnosed with cancer, 84% now survive five years or more. One of the advances in treatment has been improvement in radiation therapy techniques and the use of proton beam therapy for treating pediatric cancers.

"Radiation therapy works very well for sarcomas," says Dr. Wendy Allen-Rhoades, a Mayo Clinic pediatric hematologist and oncologist. "And the difference between conventional radiation and proton therapy radiation is that our radiation oncologists are able to contour a little bit tighter with proton therapy. Therefore, the surrounding tissue that is normal is spared from some of the side effects. This is really important in children who are growing because we want them to be able to grow normally."

In addition to sparing healthy tissue from the effects of radiation, people who must undergo radiation therapy early in life are less likely to have long-term side effects and complications, such as secondary cancers, with proton beam therapy than with conventional radiation therapy.

September is Childhood Cancer Awareness Month. On the Mayo Clinic Q&A podcast, Dr. Allen-Rhoades discusses pediatric sarcomas and the importance of funding for research and support of families dealing with pediatric cancer.

Watch: Dr. Allen-Rhoades disscuss pediatric cancer.

Now advancements in microsurgery are making it possible to harness the body's ability to regenerate muscle strength after surgery to remove soft tissue sarcoma. Mayo Clinic orthopedic oncologists are teaming up with plastic surgeons in a procedure they've coined "onco-regeneration", with a goal of improving a patient’s function and quality of life after surgery. 

"Advancements are changing the way we approach patients," says Dr. Matthew Houdek, a Mayo Clinic orthopedic surgeon. "And a big part is the teamwork required to take care of these patients."

Orthopedic surgeons partner with plastic surgeons to deconstruct and reconstruct the tumor location. That includes removing and replacing muscles, nerves and the lymphatic system.

"Advancements in microsurgery techniques have made what we can repair and what we can restore much better," says Dr. Steven Moran, a Mayo Clinic plastic surgeon. "The latest technology now allows us to tension and insert the muscle directly back into the bone. That has been very favorable to restoring function, and it helps us get these patients back to doing what they want to do."

On the Mayo Clinic Q&A podcast, Drs. Houdek and Moran discuss advances in treating soft tissue sarcoma.

The main cause of COPD in developed countries is tobacco smoking. In the developing world, COPD often occurs in people exposed to fumes from burning fuel for cooking or heating in poorly ventilated homes. People with COPD are at increased risk of other diseases too, such as heart disease, lung cancer and a variety of other conditions. Although COPD is a progressive disease, it is also treatable. 

"If you catch it at an early phase, treatment may consist of helping the patient to stop smoking or taking the patient away from the polluted environment that may be contributing to the disease," says Dr. John Costello, a consultant pulmonologist at Mayo Clinic Healthcare in London. "For those with more advanced disease, long term rehabilitation programs have been very successful in centers that specialize in pulmonary disease."

As a part of rehabilitation, treatment for advanced COPD can include the use of medications, inhalers and oxygen therapy.

On the Mayo Clinic Q&A podcast, Dr. Costello discusses how COPD is diagnosed and the treatment options for COPD.

"We have over 101,000 Americans in the hospital with COVID-19," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "Many of them fighting for their lives in ICUs and on ventilators. We are having over 160,000 new cases and just below 1,000 deaths reported each day."

Dr. Poland says the people who have been vaccinated for COVID-19 have substantially protected themselves, including against the delta variant. 

"But for those who are unvaccinated, there is a grave concern," says Dr. Poland. "In fact, if you look at the latest model, in the next three months, it suggests that another 100,000 Americans are likely to die of COVID."

Dr. Poland also responds to concerns that some people are choosing to take an animal medication called ivermectin.

"If I said to you, 'Instead of an FDA-approved vaccine that's been tested in hundreds of thousands of people, let's take a drug that's used to treat parasites — that hasn't been studied, which makes people sick, can cause hallucinations and coma, and can cause birth defects — what would you say?'" asks Dr. Poland.

In this Mayo Clinic Q&A podcast, Dr. Poland talks about waning antibody levels, COVID-19 vaccine boosters, teenagers needing to be vaccinated, and the sharp increase in COVID-19 cases and hospitalizations for young people. He also answers several listener questions.

Research disclosures for Dr. Gregory Poland.

"Diabetes is an abnormality in consuming or metabolizing blood glucose," says Dr. Tambi Jarmi, a Mayo Clinic nephrologist. "So diabetic patients have a hard time adjusting their blood sugar to the level that their cells needed. It could be a result of a deficiency in the production of the insulin that comes from the pancreas or it could be a result of resistance to that insulin."

To restore normal insulin production and improve blood sugar control, a pancreas transplant may be an option.

Most pancreas transplants are performed to treat Type 1 diabetes. A pancreas transplant can potentially cure this condition. But such a transplant is typically reserved for those with serious complications of diabetes because side effects can be significant.

In some cases, a pancreas transplant also can treat Type 2 diabetes. A pancreas transplant is often done in conjunction with a kidney transplant in people whose kidneys have been damaged by diabetes.

"The idea of a pancreas transplant is to actually cure the diabetes," says Dr. Jarmi. "While treatment with a mechanical pump does a great job, it is not a cure. An organic pump, meaning a pancreas transplant, does cure diabetes." 

On the Mayo Clinic Q&A podcast, Dr. Jarmi discusses pancreas transplant as a cure for diabetes.

But injuries in young runners are common, often are caused by improper technique or lack of strength and conditioning training. Another cause of injury is increasing mileage too quickly.

Common injuries include patellar tendonitis, Osgood-Schlatter disease, illiotibial band syndrome, and shin splints. 

In this "Mayo Clinic Q&A" podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of #AskTheMayoMom, discusses injury prevention in young runners with Dr. David Soma, a Mayo Clinic sports medicine specialist and pediatrician; Dr. Luke Radel, a Mayo Clinic pediatrician; and Dr. Stephanie J. Lopez, a Mayo Clinic sports physical therapist.

"I cannot tell you the emotional toll this has taken on us as physicians, nurses, respiratory therapists, and many, many others," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. 

"One of my colleagues said, 'I walk around now and can see people with comorbidities, not wearing a mask, and I can tell you what size tracheal tube they're going to need.' We don't normally think like that, but it's illustrative of the steady 18-month drumbeat of seeing people sick and dying of something we can prevent," says Dr. Poland.

In this Mayo Clinic Q&A, Dr. Poland talks more about FDA approvals for COVID-19 vaccines, goes into detail about the COVID-19 virus replication rate and he answering a listener question about the reliability of home COVID-19 tests. Dr. Poland also explains and speaks to the importance of "cocooning" for protection, especially with newborns and toddlers.

Research disclosures for Dr. Gregory Poland.

Organs from deceased donors are screened thoroughly, and donated organs that tested positive for hepatitis C were previously discarded. But research at Mayo Clinic has changed that. 

A recent Mayo Clinic study found that livers from donors exposed to hepatitis C can be safely used for transplant, thanks to improved treatments for hepatitis C infection. New antiviral drugs are so effective that recipients are protected from the infection.

Now, Mayo Clinic Transplant Center has expanded the protocol to use in other organ transplants.

"We were able to expand to kidney transplant, heart transplant and lung transplant within the past few years, and we have been able to do close to 150 kidney transplants, and 25 heart and lung transplants, using organs from donors with hepatitis C," explains Dr. Bashar Aqel, medical director of the Liver Transplant Program at Mayo Clinic in Arizona. "We had in place a treatment protocol and we treat them for hepatitis C immediately after transplant. Treatment was well tolerated, and everybody was cured from the infection. So more than 200 lives saved with organ transplant from donors with hepatitis C, and everybody has achieved the outcome that we are looking for."

On the Mayo Clinic Q&A podcast, Dr. Aqel discusses progress in expanding the donor pool for lifesaving solid organ transplants.

In this "Mayo Clinic Q&A" podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of #AskTheMayoMom, is joined by two experts in pediatric infectious disease to discuss the important precautions families can take to keep their kids safe and in school. Also on the program, tips from an elementary school principal to help your child prepare for the school year.

"A vaccine booster dose is generally an additional dose above and beyond the primary series needed to achieve protective immunity," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "So the dose that was approved this past week would be better classified as an “additional dose” for those who are moderately to severely immunocompromised." Dr. Poland says those people will have already received two doses but need the additional dose in order to improve their immune response to the vaccine.

Dr. Poland continues, "If we got to the point where we would offer a third dose of the same vaccine to older adults, health care providers and essential workers that would be a booster dose. Then if we used a variant-specific vaccine, which researchers are working on, that would be called a variant booster dose."

In this Mayo Clinic Q&A podcast, Dr. Poland talks extensively about additional and booster doses of the COVID-19 vaccines, he discusses the latest COVID-19 research regarding pregnancy and fertility.

He also addresses concerns about the variants that experts are predicting will come after the current delta variant. "So, for the unvaccinated, they keep moving into more and more dangerous phases of the pandemic, as each new variant arises," says Dr. Poland.

Research disclosures for Dr. Gregory Poland.

But what about the toll this takes on the caregiver themselves? 

"I think the self-care for the caregiver is something that we often forget about, and we often don't emphasize enough on the clinical side," says Dr. Joan Griffin, a researcher in Health Care Delivery at Mayo Clinic. "And it's really important, because it's a long, hard marathon to be a cancer caregiver."

Extended periods of providing care for someone else can affect the caregiver's own quality of life, including their sleep and mood. It can even lead to depression.

On the Mayo Clinic Q&A podcast, Dr. Griffin shares what caregivers of cancer patients can expect and offers tips on how to take care of themselves at the same time. 

"When we're under stress, we revert back to what's comfortable," says Dr. Benjamin Lai, a Mayo Clinic family medicine physician. "COVID-19 has brought unpredictability and a sense of loss of control. So, we fall back to what's familiar. Some eat for comfort. Some seek alcohol. Some spend too much time on social media. It all boils down to dealing with chronic stress."

So how can these bad habits developed during the pandemic be broken?

On the Mayo Clinic Q&A podcast, Dr. Lai discusses strategies for getting back to healthier habits.

At Mayo Clinic, decades of research have led to development of a new vaccine platform — a single-cycle adenovirus nasal vaccine — that is now being tested in a phase 1 clinical trial for COVID-19.

“Single-cycle is particularly potent as a nasal vaccine, fighting SARS (severe acute respiratory syndrome) at its site of entry,” says Dr. Michael Barry, director of Mayo Clinic’s Vector and Vaccine Engineering Laboratory.

On the Mayo Clinic Q&A podcast, Dr. Barry discusses the research behind vaccine development and the possibility of future applications for the new vaccine platform.

And thyroid disease is common.

"We know that about 10% of people have some degree of thyroid dysfunction," says Dr. Juan Brito Campana, a Mayo Clinic endocrinologist.

There are several different types of thyroid disease, including hyperthyroidism, or overactive thyroid; hypothyroidism or under active thyroid; and Hashimoto’s disease, where the immune system attacks the thyroid gland. Hypothyroidism is the most common thyroid disease. Treatment for hypothyroidism involves daily use of levothyroxine, a synthetic thyroid hormone that restores adequate hormone levels.

Levothyroxine is one of the most common prescription drugs in the U.S., but a new study by Mayo Clinic researchers suggests it is significantly overused in people with mild hypothyroidism or no apparent thyroid dysfunction. These results were published in JAMA Internal Medicine.

On the Mayo Clinic Q&A podcast, Dr. Brito Campana discusses diagnosis and treatment for thyroid disease, and what the research on the overuse of levothyroxine means for patients.