Category: PAD

Right Now, We Can Still Diagnose Your Vein Disease!

Our health system is inundated with COVID-19 patients, so you want to avoid hospitals if possible. As such, it’s important to stick with preventative health care. Being proactive about your vein health can help you avoid a medical emergency at this trying time.

So, if your legs are tired, heavy or cramping, your may be need a diagnostic ultrasound from your vein specialist. If that is the case, you may be wondering: how will an ultrasound uncover what’s going on inside my legs? Isn’t that kind of technology more common in Obstetrics offices?

Well, you’re partially correct: interventional radiologists use a different kind of ultrasound to diagnose conditions like Peripheral Arterial Disease (PAD.) The technology we use is known as a Doppler ultrasound. And in this post, we’ll teach you how it helps us detect many different kinds of vein disease.

What conditions can a Doppler ultrasound detect?

Doppler ultrasounds check your blood flow. They help us discover whether you have problems like narrowing, leaking or blockages in your blood vessels.

This type of ultrasound uses sound waves to check how well blood flows through your legs. Those waves bounce off your moving blood cells, giving your doctors a better picture of the speed and health of your blood flow. Doppler ultrasounds involve hand-held devices; screenings are pain free and non-invasive.

Using a Doppler ultrasound, vein specialists can detect disruptions in your blood flow, hardening of your arteries and even potentially life threatening conditions like Deep Vein Thrombosis (DVT), a blood clot that develops in the deep veins of your legs that rest well below the skin’s surface.

When should I get a Doppler ultrasound?

We may recommend an ultrasound if there are signs that your blood flow has been reduced. These symptoms can include changes in the appearance of the skin on your legs, leg pain that appears with movement, hair loss on your legs or even wounds that won’t heal.

If you’ve had a blood clot, or we suspect you have one, a Doppler ultrasound can quickly confirm this diagnosis.

We may also recommend a Doppler ultrasound if you’ve recently had a stroke or heart attack. That way, we can determine whether compromised blood flow or clots may be putting you at risk for a repeat problem.

What’s involved in a diagnostic ultrasound for vein disease?

You’ll typically lie down for your ultrasound. Your ultrasound technician may measure pressure in certain areas of your body by apply blood pressure cuffs at points like your ankles, calves or thighs.

Next, your technician will apply lubricant to the  ultarasound guide (called a transducer). Then he or she will move the device over your skin until we receive a good image of your blood flow.  A Doppler ultrasound typically takes up to 45 minutes. Once it’s done, you are usually free to get up and go back to your daily activities.

When you have an ultrasound in our Houston area vein clinics, your results will be reviewed and delivered to you by one of our highly trained team members. If a problem is detected, we will then take the time to discuss and explain your diagnosis, and walk you through all your possible treatment options.

 

Here’s the Deal on PAD, Workouts and Coronavirus

If you have Peripheral Arterial Disease (PAD) you may experience painful leg cramps. That’s because, with PAD, your atherosclerosis (hardened or narrowed arteries) limits blood flow to your legs. And this lack of blood flow leads to leg pain, especially when you walk or exercise.

Surprisingly, even though it hurts to move, increasing your movement can help manage and reduce your PAD pain. That’s why physical activity is so important for anyone living with this condition. And it’s why many of you likely had a regular gym routine…until, that is, we started facing the new reality of COVID-19 (a.k.a the novel coronavirus.)

Social Distancing, Gym Closures and PAD

Now that our country is in the grips of this coronavirus outbreak, many gyms have closed. And even if your gym is still open, you might prefer to stay home in an effort to avoid community spread. That makes a lot of sense, especially if you have compromised health because of underlying conditions like PAD. But, it doesn’t mean you have to give up on your exercise routine. It just needs to change a little.

In fact, there’s great reasons to keep exercising, even in these scary times. Research suggests that getting mild to moderate exercise, every day, can boost your immune system and help control your PAD symptoms. Just remember, for both this outbreak and your PAD, “moderate” is the key. Anything too intense could leave you hurting, and reduce your immune response.

Smart Exercises for Trying Times

Since walking is one of the best workout options for people with PAD, why not simply take your workouts outside? Pick a quiet outdoor spot and stroll away. Bonus: exercising outdoors gets you in nature, which can help calm anxiety—something many of us are grappling with right now.

Go for as long as you can, even working up to a slow jog if you’ve discussed this with your vein specialist. Just keep your distance from any other outdoor workout warriors—six feet is the recommended length. This way, we can work together to prevent the spread of disease, without sacrificing your personal fitness.

Eat This Now: Your Guide to Healthy Veins

Did you know that your body’s circulatory system stretches over 60,000 miles long? It plays an integral role in maintaining your overall health. Keeping it strong and nourished is vital for managing or avoiding venous diseases—including varicose veins—as well as for living a long and healthy life.

Thankfully, nourishing your veins is easier than you might think. A daily dose of moderate exercise combined with following these three diet tips will ensure that you and your veins are keeping your body’s circulatory system strong.

Your Guide to Healthy Veins

#1: Eat the Rainbow

What do rainbows have to do with your veins? Bioflavonoids, also known as Vitamin P, are the source of vibrant colors in certain fruits and vegetables. More significantly, Vitamin P also helps protect these fruits and veggies against microbes and insects. Studies have proven that a long-term diet rich in bioflavonoids not only improves the appearance of varicose veins, it also strengthens the walls of your blood vessels. And when those blood vessel walls are strong, veins are subject to much less of the stress that leads to and exacerbates venous diseases. When searching for foods high in bioflavonoids, look for brightly colored fruits and veggies like red bell peppers, oranges, strawberries, spinach, and peaches.

#2: Don’t Forget Fiber

You’re probably aware of the digestive benefits of a high-fiber diet. But did you know that fiber can also help strengthen your veins? Soluble fiber, the kind that can’t be digested, stays intact when passing through your intestine and prevents constipation. Frequent constipation puts a large amount of undue stress on your veins. Foods that are high in fiber include oats, buckwheat, peas, apples, and berries. If you have trouble incorporating these foods into your diet, mixing flavorless psyllium powder into your morning glass of tea or water works just as well. Keep in mind that drinking a sufficient amount of water is a necessary accompaniment to a high-fiber diet because it ensures that the fiber will be pushed through your system.

#3: Vitamin C is Key

Perhaps the most important dietary tip for healthy veins is to eat foods that are high in Vitamin C. This is because Vitamin C keeps veins toned and has been proven to help improve circulation. Luckily, many foods that are high in Vitamin P are also good sources of Vitamin C. These include fruits like oranges, oranges, tangerines, mangos, grapefruits and papayas. Vegetables such as spinach, broccoli, kale, and bell peppers are also rich in Vitamin C. When consumed together with vitamin E, Vitamin C’s effects on veins are said to be even more pronounced. For your daily dose of Vitamin E, reach for almonds, peanuts, or avocado.

#4 Consider Cocoa

Like brightly colored fruits and veggies, cocoa is rich in flavonols. In fact, cocoa flavanols, including epicatechin,  can help people with PAD walk more comfortably. More specifically, cocoa can help target therapy directly to your legs (limb perfusion) and improve cell and muscle regeneration in your legs. So grab a cup of hot cocoa, just make sure it’s cocoa powder with a concentration higher than 85%.

When it comes to your veins, you are what you eat!

The key takeaway here is that preventing varicose veins starts with proper nutrition. The best foods for varicose veins are those rich in bioflavonoids, fiber and vitamins. So if you want healthier veins, replace junk food with a fresh and balanced diet rich in fiber and flavonoids. Add in some exercise (for inspiration, check out our Move it Monday series) and you’ll be on the path to stronger, healthier veins.

Sources: Journal of Circulation Research

Check out this Exciting Discovery About Cocoa and PAD

You guys, guess what? Researchers have discovered that drinking hot cocoa could help improve your gait if you have peripheral arterial disease (PAD.) PAD is a serious condition that sets in when athelosclerosis (hardened arteries) limit blood flow to your lower limbs. One of the worst PAD symptoms is sudden pain with walking, so this tasty discovery is exciting for a whole lot of reasons! Let’s take a closer look.

Flavanols: Cocoa’s Secret Super Power

First things first: let’s clear up our cocoa discussion. Cocoa is rich in flavonols, which is why it can help PAD patients. But not all cocoa is created equally. As study author Mary McGrae McDermott explains, “A large amount of chocolate available without a prescription is alkalized, which improves taste [but destroys] the beneficial cocoa flavanols that have therapeutic effects.”

What does that mean? You need powder with more than 85% cocoa content to get health benefits. Simply grabbing some Nesquick at the super market just won’t cut it—even though your cocoa will probably taste pretty great.

Still, the right kind of cocoa has lots of healing properties. According to the study, cocoa flavanols, including epicatechin, “have therapeutic properties that can improve performance when walking in people with PAD.” More specifically, cocoa can help target therapy directly to your legs (limb perfusion) and improve cell and muscle regeneration in your legs. Finally, McDermott notes, previous studies have also discovered that blood flow and muscle health improve with cocoa consumption.

Now we know why cocoa is such a valuable ingredient, let’s take a closer look at how you can leverage cocoa to improve your PAD symptoms.

How Cocoa Helps Fight PAD

The purpose of this study was to see if cocoa could help PAD patients walk longer distances before experiencing leg pain. And, happily, it did! To reach their findings, McDermott’s team studied 44 patients aged 60 and older. Every day, participants drank either cocoa or a placebo drink. By the end of the study period, cocoa drinkers found it much easier to walk for six minutes, as compared to their placebo-drinking counterparts. People who drank three cups a day saw the best results.

In presenting her findings, McDermott explained, “Our study showed better health in the blood flow to the legs, improvements in the 6-minute walking distance and also improved the health of the calf skeletal muscle. Since people with PAD have difficulty walking due to blood flow problems, we think that this particular therapy can be particularly beneficial.”

While these findings are certainly exciting—for our taste buds and our symptom management—don’t start planning to ditch your meds. As mentioned, you’d have to have the exact cocoa makeup included in the study. Plus, while cocoa can help with symptom relief, it’s unlikely to clear up your underlying disease trigger. So, by all means, talk to your doctor about including cocoa in your diet. But don’t give up on any of your other PAD medications. And be sure to explore PAD treatment options with your Houston area vein specialists—real relief could be available, and sooner than you think.

Sources: Journal of Circulation Research

That Pain in Your Legs? It Could Mean a Blood Flow Problem

So many people are quick to brush off a little pain in your legs. But that tendency is the reason so many people with peripheral artery disease (PAD) have delayed or missed diagnoses.  You see, PAD is a condition that develops slowly and with few symptoms. Inside your body, your blood vessels are slowly narrowing due to atherosclerosis, a build-up of fatty deposits that keeps enough blood and oxygen from getting to your legs. And it’s that lack of oxygenated, nutrient-rich blood which can make your legs feel uncomfortable and crampy. Which in turn is why you should never ignore leg pain that appears for no apparent reason.

Now you know why ignoring leg pain can be so dangerous to your health. Next, let’s take a closer look at ways you can increase the flow of blood to your lower extremities.

This is How to Reduce PAD Symptoms with Improved Blood Flow

If you want to avoid PAD, or reduce existing symptoms, your best bet is to keep your arteries and blood vessels clear of blockages. You also need to work on improving your blood circulation.

The first step in this process? Get moving! Physical activity encourages blood flow. Plus, it helps you maintain a healthy weight, which can also help your body provide sufficient blood to your extremities.

Still, moving more isn’t enough. Diet is also a crucial part of preventing atherosclerosis, the “hardening of the arteries” that causes PAD. That’s because, through a healthy diet, many individuals may be able to lower their cholesterol levels. And high cholesterol is linked to the build-up of plaque in your arteries. (Keep in mind that some people may require medication to lower cholesterol levels. Discuss all changes to your diet with your healthcare provider.)

Regardless of whether or not you also need medication, people with PAD should focus on proper nutrition. As it turns out, many of the foods you eat can actually help improve your blood flow and boost the health of your veins and arteries.

Foods That Boost Blood Flow

If you’re worried about blood flow, take a peek at your diet. Try adding beets and beetroot juice–their nitrate content converts into nitric oxide, which improves blood pressure and blood flow. Onions and garlic are also great choices because they help relax your blood vessels. Want a protein option? Fatty fish, rich in omega-3s, boosts blood flow by preventing blockages. 

Spices are another easy way to improve your flow: both turmeric and cayenne are helpful. Rounding out the diet powerhouse? Include pomegranate, oats, beans, and wholegrains. Add nuts, eggplants, apples, berries and citrus fruit, too. Before you know it, that blood will be flowing in tip-top shape!

Even if you don’t have PAD, adding these foods to your diet and increasing your weekly movement can help prevent problems. But, if your legs hurt; or if you notice changes like discolored legs or loss of hair on your legs, you may already have PAD. If that’s the case, don’t delay: make an appointment to see a vein specialist in your area right away.

Sources: BelMarraHealth.com, WebMD

Here’s What you Need to Know about Blood Clots

In our Houston vein practice, we know how serious a threat blood clots pose to your health. When we treat patients with Deep Vein Thrombosis (DVT), a condition in which blood clots form in the deep veins of your legs, we face a medical emergency. That’s because, if a blood clot breaks free and travels to other parts of your body—especially to your lungs—it can threaten your life.

But, many people want to know: why do I get blood clots? And, what are they exactly? Is there anything I can do to prevent them? So, in this post, we will try to answer all of those questions. Just keep reading to learn more.

Why do blood clots form? stages of PAD

When things are working properly, your blood flows freely through your body, delivering oxygen to your organs and flushing out the waste products created by your body’s metabolic processes. But, if you get a cut, scrape or injury, blood in your arteries and veins (veins return blood from the body to the heart; arteries transport blood away from your heart) will clot to block your blood vessels and stop you from bleeding out.

But, when your arteries or veins get blocked when you aren’t injured, you need medical intervention. Otherwise, you can face complications such as strokes, heart attacks, organ damage and even limb loss. In certain occasions, as we mentioned earlier, blood clots can kill you by travelling to your lungs (pulmonary embolism), interfering with your ability to breathe.

Blood clots form in blood vessels—either your deep veins or your arteries. Typically, they form after your blood vessels get damaged, triggering a reaction in your body. This reaction involves a mix of platelets and clotting factor proteins.

Why Do Blood Clots Cause Health Problems?

As we mentioned, problematic blood clots form when the connection between platelets and clotting factor proteins goes awry. Platelets are objects in your blood that group together and stick to the walls of your blood vessels when needed.

Clotting factors are proteins in the blood that trigger a reaction to makes platelets and red blood cells stick together. Typically, other proteins in your body make that reaction stop, so your clot only reaches the size needed to prevent excess bleeding.  But when damage to your blood vessels impacts that reaction, clots may grow unchecked, leaving you at risk for clotting conditions like DVT.

Why would I get an arterial blood clot or a DVT?

We can’t always predict who will be affected by blood clots, or when those clots will form. But we do know certain factors that can increase your risk for clots:

·         Prolonged immobility, as with long airplane flights

·         Arm or leg surgery

·         Casting a broken bone

·         Trauma

·         Smoking

·         Being pregnant

·         Diabetes

·         Obesity

·         High blood pressure

·         High cholesterol

·         Age

·         A family history of peripheral artery disease (PAD), stroke or heart disease or stroke

New research has revealed an additional risk factor for blood clots, and it’s one that you unfortunately can’t control. In fact, your blood type can contribute to that risk, according to a study published in the Journal Arteriosclerosis, Thrombosis, and Vascular Biology. 

The research, which began in 2017, found that people with types A or B blood had a combined 8% higher risk of heart attack, and a 10% increased risk of heart failure, as compared to people with type O blood. So, knowing your blood type could help you understand your risk for developing a blood clot. 20

Diagnosing and Treating Blood Clots

The best way to treat blood clots is to prevent their formation. Maintaining a healthy lifestyle, staying mobile even on long trips, and using compression therapy can all help protect you from DVT. Even if you develop a DVT, compression therapy—especially within 24 hours of the clot’s formation—can help manage your risk of further complications.

So, as with many other vein and arterial conditions, timeliness is key when it comes to treating blood clots. The sooner you see a vein specialist, the better the outcome you will likely enjoy.

 

Sources: American Heart Association

 

Got Leg Pain? It Could Be PAD

If you have unexplained leg pain, especially after you walk or exercise, you could be one of the eight to ten million people in the United States who suffer from Peripheral Artery Disease (PAD). This condition is often difficult to diagnose, leaving many sufferers untreated, which is a serious problem due to the danger that it can pose.

PAD symptomsWhat is PAD?

Peripheral Artery Disease is caused by a narrowing of the peripheral arteries. While it most commonly affects the legs, it can also be found in the stomach, arms, and even your head. Arteries begin to narrow when plaque, which is made up of cholesterol, calcium, fibrin, and fatty substances, builds on the walls of the artery. The disease restricts the amount of blood flow and raises blood pressure. In severe cases, a blood clot can form and completely stop your blood flow, which can result in a stroke or heart attack.

Risks & Symptoms of PAD

You could have PAD and not notice any symptoms until your disease progresses. Others may mistake their PAD symptoms for another condition. To avoid misdiagnoses and missed diagnoses, it is important to learn the most commonly observed symptoms of PAD. They include:

  • Leg pain during exercise, and also when at rest
  • Leg numbness or weakness
  • Wounds (ulcers) of the legs, foot, or toes that do not heal easily
  • Legs or feet that are cold to the touch
  • Slow nail growth on toes or lack of hair growth on the leg
  • Some men experience erectile dysfunction

Patients are more at risk for peripheral artery disease when they:

  • Smoke cigarettes
  • Have diabetes
  • Are obese
  • Have high blood pressure & cholesterol
  • Are over 50 years of age
  • Have a family history of heart issues or strokes

How is PAD Diagnosed?

Diagnosing peripheral artery disease is painless. And there are many ways to test for PAD, so your health care provider will perform a physical examination to determine which to choose. In addition, your doctor may perform:

Ankle Brachial Index: This compares the blood pressure in your feet to the blood pressure in the arms. It determines if your blood pressure is faltering in one area or throughout the body. Next, there are ultrasounds, which use sound waves to measure blood flow and visualize blockages in your arteries. Alternatively, you may need angiography: you’ll get a colored dye injection in your blood vessels. Then, we’ll trace the dye with an imaging device, so we can follow your blood path and determine where the problems lie. Finally, you may need blood tests to determine if your symptoms are the result of diabetes or other issues.

Sources: Mayoclinic.org

New Stem Cell Discovery May Help Cure Vein Disease

The world of vein treatments are constantly evolving, and it seems like every week there’s an exciting new discovery! Recently, Nature magazine revealed a new one: they’ve identified the stem cells responsible for growing new blood vessels in embryos. Why is that so exciting? If the cells can be studied and applied to adults, scientists could also grow healthy new blood vessels. And those vessels could repair or replace old, damaged ones.

New Veins Could Transform Circulatory Treatments

Vein disease sufferers will obviously benefit from newly-grown veins. But so will other people. In fact, this development would improve treatments for heart disease. It could also help manage circulatory conditions like peripheral arterial disease.

Until now, scientists thought that dividing endothelial cells created embryo blood vessels. But this new research proves that the opposite is true. In short, stems cells in the blood create and grow endothelial cells.

Of course,  we can’t yet grow new blood vessels. So we can’t yet apply this discovery to help treat vein disease. In order for that to happen, researchers will have to determine whether the stem cells can grow endothelial cells throughout life. Because there’s a chance this only happens during the embryo stage of development.

Moving Forward with Embryo Research

Unfortunately, we don’t yet have the methods necessary to track down these tiny stem cells in fully grown humans. And, even once those methods are developed, scientists will need to determine if the endothelial cells that come from these stem cells have their own functions. They will also need to figure out the best way to apply them for use in regenerative medicine.

Even with all the work that’s left to be done, the Associate Medical Director of the British Heart Foundation, Professor Metin Avkiran, is positive about the discovery. He says, “Using stem cells to treat patients with heart and circulatory disease has huge potential. But taking positive findings from the lab to patients has often been very challenging. These scientists have looked at how blood vessels develop in the embryo, and their findings have shed important new light on our understanding of the origin of growing blood vessels. Getting these fundamentals right is essential for finding stem cell treatments which will work in patients. These findings could pave the way to new discoveries in regenerative medicine and allow scientists in the future to grow new blood vessels and repair those that are damaged in many forms of heart and circulatory disease.”

Sources: University College London, Nature Magazine

Here’s One Smart Reason to Grab That Beer!

‘Tis the season to toast, and, as it turns out, that might not be such a bad thing after all. In fact, according to new research, picking up your wine glass or beer mug may have a very beneficial effect on your health. Especially when it comes to your risk of contracting certain circulatory conditions, including Peripheral Arterial Disease (PAD.)

How Wine and Beer Consumption Can Help Your Heart

Now, this information isn’t entirely new. We’ve all heard rumbles about how red wine—in moderation—is good for your heart. So what’s new about this research out of Cambridge and University College London (UCL)?

For one thing, the researchers are giving us updated quantities. Now, they recommend drinking about 1.5 bottles of wine each week, or seven  beers. But that’s not all the research suggests. As it turns out, drinking moderate amounts of alcohol is actually better than not drinking at all.

How did they reach this conclusion? Researchers analyzed data from close to 2 million United Kingdom residents. They discovered that avoiding alcohol and drinking a lot gave you a higher risk for seven different heart conditions. And those conditions include PAD, heart attacks and strokes.

Lead researcher Steven Bell explained that moderate alcohol intake reduces inflammation while boosting good cholesterol levels. Plus, moderate drinking can be social. And connecting with peers improves your overall well-being, including your heart health.

The Impact of Alcohol Avoidance

Now, researchers discovered the benefits of moderate drinking. But, they also found problems with avoiding alcohol completely. In fact, as compared to moderate drinkers, people with zero alcohol intake were more likely to experience angina, heart attacks, sudden coronary death, heart failure, strokes due to lack of blood flow, abdominal aneurysms and peripheral arterial disease.

There was, however, a silver-lining for sober people: not-drinking had no impact on the risk of experiencing cardiac arrest or strokes unrelated to blood flow problems. And, for those who have good reason to avoid alcohol, the researchers noted that alcohol isn’t the only path to decreased risk of heart problems. If you have a good reason not to drink (and there are plenty) you can improve your heart health and decrease your risk of disease with many other lifestyle factors, including diet and exercise. But, if you’re all about moderate, social drinking, take “heart” in these findings, which both Harvard Medical School and John Hopkins Public School of Health have signed off on. In fact, you could use this post to feel even better about the extra glass or two you’re bound to enjoy as you wind down the holiday season and ring in the New Year!

Sources: British Medical Journal (BMJ)

PAD vs. CVD: This is How You Tell the Difference

When you are experiencing leg pain, it can be difficult to know what’s causing your discomfort. That’s because two different conditions—Peripheral Arterial Disease (PAD) and Chronic Venous Disease (CVD) can make your legs hurt. So, how can you tell the difference between these problems? Just keep reading for our handy guide!

What is Peripheral Artery Disease?

PAD is a condition in which your arteries harden because of plaque build-up on the walls. This hardening narrows your arteries, making it more difficult for blood to flow through. And when this happens, you may experience symptoms in your legs, including: pain, numbness, or heaviness. These symptoms typically appear when you are active, and usually resolve when you rest.

What is Chronic Venous Disease?

Chronic Venous Disease is a way of describing conditions that develop when your veins aren’t functioning properly. These include varicose veins, ulcers, and edema. But, sometimes, venous disease shows up in less obvious ways. In fact, many symptoms of CVD are very similar to those associated with PAD. So, the question remains, how can you tell the difference between the two?

Ruling out PAD as a Diagnosis

Because PAD symptoms are so similar to those associated with CVD, it can be difficult to diagnose. But here’s the key factor to note when you talk to your doctor. When you have PAD, you will likely only experience symptoms like leg pain and heaviness when you are active. If you have Venous Disease, resting will likely not improve your symptoms. Also, when you have CVD, visible symptoms like spider veins will usually show up fairly quickly.

Finally, timing can be a major clue as well. With CVD, leg pain tends to show up at the end of a long day. Especially if you spent extended periods on your feet. But, with PAD, pain shows up day or night, and, as we mentioned, is typically tied to movement.

Of course, the easiest and best way to determine the cause of your leg pain is to see your vein specialist. But, clearly identifying your symptoms can help your healthcare provider quickly reach a diagnosis. So, take note of your symptoms and make an appointment today for a diagnostic ultrasound.

 

Sources: veinforum.org, Cardiovascular Institute of the South

A message regarding COIVD-19

We are keeping a close eye on COVID-19 developments in the greater Houston area, and encourage you to do the same.

To ensure that our patients are able to receive the care they need, Texas Endovascular/Houston Fibroids will remain open and accessible. Because we are not a primary care or hospital environment where sick patients would go for testing or treatment for COVID-19, we feel that the risk of exposure in our office is low. To supplement our rigorous standard precautions for health and safety, please refer to the following guidelines:

Please refer to the guidelines set by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) for the most current information. The CDC reminds us to follow best practices, including washing hands often with soap and water, not touching our eyes, nose, or mouth with unwashed hands, avoiding contact with people who are sick, and limiting personal contact, including shaking hands. Learn more about the CDC recommendations here.

website logo