Month: October 2020

Breast Cancer Basics

Understanding Signs, Symptoms and Risk Factors

by Tara M. Breslin, MD

October is Breast Cancer Awareness Month and a great time to spread the word about the importance of breast health all year long. Breast cancer is one of the most common forms of cancer diagnosed in the United States, typically in women, but it occurs in men as well. In 2020 alone, an estimated 276,000 women will be diagnosed with breast cancer. Most of these new cases will occur in women older than 50, but 10% will occur in women younger than 45. Recognizing the warning signs of breast cancer and early detection will mean more treatment options and a better chance of being cured.

Be aware of changes in your breasts

  • Lump in the breast or underarm
  • Bloody discharge from the nipple
  • Indentation or retraction of the nipple area
  • Change in breast size
  • Rippling (flattening or indentation) of the skin covering the breast
  • Crustiness or rash of the nipple or areola

What to you do if you notice a new symptom

Stay up-to-date with breast screenings

Regular screening for breast cancer is done before there are any signs or symptoms and is the best way to find cancer early when it’s easier to treat. The first step(s) of screening for breast cancer typically include mammogram and/or a patient’s awareness of changes in their breast.

  • Self-Awareness: Conduct regular and frequent self-exams of your breasts. Become familiar with your breasts, so you aware of, and able to, recognize changes right away.
  • Clinical Breast Exam: This exam is done in a clinical setting, by a physician who will use their hands to look for lumps or changes in your breasts.
  • Mammogram: An x-ray of the breast and the best way to detect cancer early. A screening mammogram is done for asymptomatic women, a diagnostic mammogram is done for women with a new symptom or mammographic abnormality.

A mammogram found something suspicious, now what?

If your doctor finds something concerning on your mammogram, the first step would be diagnostic imaging to further characterize the area.  This may include: diagnostic mammogram, ultrasound, MRI.

  • Biopsy: a small sample of cells or tissue is removed and reviewed under a microscope to determine if cancer is present. There are a variety of ways to perform a biopsy. Talk to your physician about the options available to you, if you require a biopsy.
  • Diagnostic Mammogram: an X-ray test used to diagnose unusual breast changes, such as a lump, pain, nipple discharge, change in breast size or shape or previous breast cancer. If your screening mammogram does show an abnormality, you may need additional imaging like a diagnostic mammogram.
  • Breast Ultrasound: Using sound waves to produce images of the internal structures of the breast, the breast ultrasound can help a physician determine if a mass an abnormality is more likely a solid mass or fluid-filled cyst.
  • MRI: The MRI uses magnets and radio waves to produce images of the breast. These images provide more information and details than other tests. Your physician may recommend a breast MRI for you if your biopsy results were positive for cancer or if you’re considered high risk for breast cancer. The breast MRI is intended to be used along with a mammogram, not as a replacement.

Who would be considered high risk for breast cancer?

As a person ages, their risk of being diagnosed with breast cancer increases, but there are a few other risk factors that you cannot change:

  • Age: Most breast cancers are diagnosed after age 50.
  • Genetics: Inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2. Women who have inherited these genetic changes are at higher risk of breast and ovarian cancer.
  • Dense Breasts: Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get breast cancer.
  • Personal History of Breast Cancer: Women who have had breast cancer are more likely to get breast cancer a second time. Some non-cancerous breast diseases such as atypical hyperplasia or lobular carcinoma in situ are associated with a higher risk of getting breast cancer.
  • Family History of Breast Cancer: A woman’s risk for breast cancer is higher if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who have had breast or ovarian cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk.

Understanding the signs and symptoms of breast cancer and your risk factors is important for every woman and man. If you have questions or concerns about your breast health, schedule an appointment with an IHA Breast Surgeon.

IHA Breast surgery

Infinity Primary Care Finalize Integration with Two Primary Care Practices in Livonia to Join IHA in December

(October 19, 2020)–After completing the necessary due diligence and operational preparations, IHA, the area’s leading multispecialty medical group, and Infinity Primary Care, PC, have finalized terms for the integration of Primary Care Internal Medicine and the Center for Family Care into IHA.

“Our goal in integrating these practices is to partner with the outstanding providers of Infinity Primary Care with to promote high-quality, patient-centered care to the Livonia community,”states Mark LePage, MD, and CEO of IHA. “We intend to hold true to our core mission of compassionate, patient-centered carethat delights our patients.”

“We are confident that the nearly 20,000 patients under the care of these two practices will be able to count on IHA to provide access to an extensive range of high-quality services,” adds Dr LePage. “And as the Medical Group for Saint Joseph Mercy Health System, we are very excited to partner with Infinity Primary Care to extend our geographic reach into Livonia and western Wayne County as we furtherthe mission of our integrated delivery system in partnership with our hospital partner, St Mary Mercy Livonia.”

The integration with IHA brings together 15 providers and several dozen staff members from the following two IPC practices:

Primary Care Internal Medicine

  • RandallSternberg, MD
  • Lisa Harston-LeDoux, MD
  • Pranay Korpole, MD
  • Jennifer Kuc, CNP
  • Sangeetha Nathabalan, MD
  • David Steinberger, MD

Center for Family Care

  • Stacy O’Dowd, MD
  • Christine Brenner, MD
  • Andrew Gush, DO
  • Nicole Kohnen, MD
  • Mark Michaels, MD
  • Nicole Rothenberg, MD
  • David Smeenge, MD
  • Stacy Smith, MD
  • Michael Wowk, MD

“This is an important step in aligning these twoIPC practices with IHA, and their associated residency practices connected with St. Mary Mercy Livonia, toenable us tobettermeet patient needs and provide efficient, cost-effective care,” notes Rob Casalou, president and CEOof Trinity Health Michigan. “By collaborating as a truly integrated health care delivery system, we will create a unified clinical and operational infrastructure with coordinated protocols and best practices, which will lead not only to better clinical outcomes but also to an improved patient experience across the continuum of both outpatient and inpatient care.”

IHA offers a breadth of capabilities thatis virtually unrivaled in the region, giving patients a single, trusted source for more of the medical services that they need at every stage of life.

“As we see IHA continuing to welcome new partners in the Livonia area, whether primary care or specialty care, it enables all of us to expand our regional footprint of services,” adds Dave Spivey, president of St. Mary Mercy Livonia. “We are not only preparing for the April 2021 opening of the new IHA/SJMHS Livonia Medical Centeron the Schoolcraft campus, but also actively making highly specialized services such as orthopaedics and plastic surgery available to our communities now.”

The timeline for the transition of these practices into IHA is December 1, 2020.

Trick-or-Treat

COVID-19 means a more frightful Halloween

By Martha Walsh, MD, MHSA, FACOG

Halloween and everything that surrounds it – trick-or-treating, costume parades, bobbing for apples – are fun, but can spread COVID-19 or other seasonal infections, like influenza. While celebrating Halloween this year will look very different from every other year, there are still ways to enjoy all that Halloween has to offer, while protecting yourself and your family from picking up a virus.

Giving Out Candy

  • Avoid direct contact with trick-or-treaters
  • Give out treats outdoors, if possible
  • Set up a station with individually bagged treats for kids to take
  • Wash hands or use hand sanitizer before handling treats, and in between trick-or-treaters
  • Wear a cloth mask

Trick-or-Treating

  • Wear a mask
    • Make your cloth mask part of your costume
    • A costume mask is not a substitute for a cloth mask
    • Do NOT wear a costume mask over a cloth mask. It can make breathing more difficult
    • Masks should NOT be worn by children under the age of 2 or anyone who has trouble breathing
  • Wash your hands
    • Bring hand sanitizer with you and use it after touching objects or other people
    • Use hand sanitizer with at least 60% alcohol
    • Parents: supervise young children using hand sanitizer
    • Wash hands with soap and water for at least 20 seconds when you get home and before you eat any treats
  • Stay at least 6 feet away from others who do not live with you
    • Indoors and outdoors, you are more likely to get or spread COVID-19 when you are in close contact with others for a long time

Make sure you are always doing the following. Every. Single. Day.

  • Wear a mask
  • Stay 6 feet away from anyone that does not live with you – indoors and outdoors
  • Wash your hands or use hand sanitizer frequently

If you decide not to take your kids trick or treating this year, here are some ideas how you can enjoy Halloween safely.

  • Decorate and carve pumpkins
    • Decorate your home for Halloween.
    • Carve pumpkins with members of your household or outside with neighbors or friends.
    • Walk from house to house, admiring Halloween decorations at a distance.
  • Visit an orchard, forest, or corn maze. Attend a scavenger hunt.
    • Go on an outdoor Halloween-themed scavenger hunt.
    • Visit a pumpkin patch or orchard. Remember to wash your hands or use hand sanitizer frequently, especially after touching frequently touched surfaces, pumpkins, or apples.
    • Go to a one-way, walk-through haunted forest or corn maze.
  • Other Ideas
    • Hide Halloween treats in and around your house. Hold a Halloween treat hunt with household members.
    • Hold a socially distanced outdoor costume parade or contest so everyone can show off their costumes.
    • Host a socially distanced outdoor Halloween movie night with friends or neighbors or an indoor movie night with your household members.

Flu Before Boo!

Protect yourself and your family during flu season by getting your flu vaccine before Halloween. Scheduling your flu shot is easy! Click below and choose an appointment time that works for you.

Schedule Flu shot

Source: Centers for Disease Control

Flu Vaccine FAQs

Source: Centers for Disease Control (CDC)

Flu season is here, which means Flu SHOT season is also here. Getting a flu vaccine this fall will be more important than ever, not only to reduce your risk from flu but also to help conserve potentially scarce health care resources in the wake of the COVID-19 pandemic.

What are the benefits of the flu vaccination?

Receiving the flu vaccines reduces flu illnesses, sick appointments, hospital stays, and missed time from work or school. It can also be lifesaving for high risk patients like children, seniors, and pregnant women.

Can the flu vaccine give me the flu?

The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. However, you may experience some minor side effects like, soreness, redness or swelling at the shot site, a low-grade fever, and some aches.

For those that receive the nasal spray, the viruses are weakened and do not cause severe symptoms often associated with influenza illness. Side effects from the nasal spray may include, runny nose, sore throat, cough, wheezing, headache, vomiting, muscle aches, or fever.

Who should get vaccinated this season?

Everyone six months of age and older should receive a flu vaccine at the beginning of the flu season, typically every fall.

Who should not be vaccinated against seasonal flu?

A patients age, health or allergies may determine they should not receive the flu vaccine. Talk with your physician to ensure you or your children should receive the flu vaccine.

Should a flu vaccine be given to someone with a suspected or confirmed case of COVID-19?

No. Vaccination should be deferred (postponed) for people with suspected or confirmed COVID-19, regardless of whether they have symptoms, until they have met the criteria to discontinue their isolation. While mild illness is not a contraindication to flu vaccination, vaccination visits for these people should be postponed to avoid exposing healthcare personnel and other patients to the virus that causes COVID-19. When scheduling or confirming appointments for vaccination, patients should be instructed to notify the provider’s office or clinic in advance if they currently have or develop any symptoms of COVID-19.

Additionally, a prior infection with suspected or confirmed COVID-19 or flu does not protect someone from future flu infections. The best way to prevent seasonal flu is to get vaccinated every year.

Why should I get my child vaccinated?

The flu is dangerous for all people, but children under five years old are at an especially high risk when they get sick with the seasonal flu. The flu vaccine is your children’s best defense against contracting and spreading the flu.

When should I get a flu vaccine?

For people receiving one dose of the flu vaccine, the Centers for Disease Control recommends that people get the flu vaccine by the end of October. If your child requires two doses, they will need to be given four weeks apart, so chat with your pediatrician on the best time to give the first dose. Getting the vaccine in the summer months may result in reduced protection later in the flu season, especially for high risk patients.  There are benefits to receiving the flu vaccine later in the season, so it’s never too late to be vaccinated!

How effective is the flu vaccine?

The patient’s age and health status will determine the effectiveness of the flu vaccine, as well as how well the flu in the vaccine matches the flu circulating in your community. The CDC estimates that the flu vaccine reduces the risk of flu illness by between 40% and 60% among the overall population, when the seasonal flu circulating is well-matched with the flu vaccine. 

Besides vaccination, how can people protect themselves against the flu?

Getting the flu vaccine every year is your best defense against the flu. People should also take preventive actions every day. These include, frequently washing hands, covering coughs using the inside of your elbow, not your hand, and avoid having contact with people who are sick (even if they haven’t been diagnosed with the flu).

Where can I get the flu vaccine?

This year’s flu shot is available at IHA Primary Care and Ob/Gyn practices and pediatric doses are available at IHA Pediatric practices. Adults and children may receive the flu shot at any IHA Urgent Care location. Click below to schedule your flu shot.

Can the flu vaccine prevent COVID-19?

No, the flu vaccine cannot prevent you from becoming infected with COVID-19. You and your family should continue practice CDC recommendations to minimize your risk of contracting COVID-19, including, wearing masks outside of your home, social distancing and frequent hand washing.

What is the difference between Influenza and COVID-19?

Influenza (Flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a new coronavirus (called SARS-CoV-2) and flu is caused by infection with influenza viruses. Because some of the symptoms of flu and COVID-19 are similar, it may be hard to tell the difference between them based on symptoms alone, and testing may be needed to help confirm a diagnosis. Flu and COVID-19 share many characteristics, but there are some key differences between the two.

There are some key differences between flu and COVID-19. COVID-19 seems to spread more easily than flu and causes more serious illnesses in some people. It can also take longer before people show symptoms and people can be contagious for longer. Another important difference is there is a vaccine to protect against flu. There is currently no vaccine to prevent COVID-19. The best way to prevent infection is to avoid being exposed to the virus.

Can getting the flu shot increase your risk of getting COVID-19?

Currently, there is no evidence that getting the flu vaccine can increase your risk of getting COVID-19.

Is it safe to go out to get the flu shot during the COVID-19 pandemic?

Yes. Getting a flu vaccine is an essential part of protecting your health and your family’s health this season. To protect your health when getting a flu vaccine, follow CDC’s recommendations for running essential errands and doctor visits, like wearing a mask outside of your home, social distancing and frequent hand washing. Continue to take everyday preventive actions.

What is IHA doing to ensure it’s safe for me and my family to come into the office for a flu vaccine?

Patient safety is, now more than ever, our top priority. We’re taking several precautions to minimize your risk of exposure to COVID-19 while visiting an IHA practice in person, including:

  • requiring all patients, guests, staff, and providers to wear masks in our practices
  • providers and staff wear personal protective equipment
  • taking the temperature of all patients, providers, and staff upon entry into our practices
  • limiting the number of people in our practices, which means you may be asked to wait in your car instead of our waiting room
  • spacing the timing of patient appointments
  • maintaining an acceptable (greater than 6 foot) distance between patients in all common areas
  • following the cleaning protocols laid out by the Centers for Disease Control (CDC) to ensure safe, sanitized environments
  • in pediatric practices, we’re scheduling sick and well patients at different times of the day

Scheduling your flu shot is easy! The flu shot is available at IHA and St. Joe’s Medical Group primary care and OBGYN practices, as well as, urgent care locations.  Click below to find a time and location that work for you.

schedule your flu shot