Watch Less, Play More: Setting limitations on screen time

Omkar Karthikeyan, MD

How did anyone ever parent before smartphones? We all know the scenario: a family is sitting at a restaurant eating dinner and a young child gets restless. A parent hands over a phone or a tablet to keep them occupied while they finish their meal and have a nice conversation. This seems innocent enough, but we are learning that when we hand over screens or place a child in front of the TV, we are doing it at the expense of their language and socio-emotional development as well as physical exercise.

Time that a child spends staring at a digital device, or screen time, is time they are not interacting with other people. Learning to bond and interact with others is crucial for children starting at a very early age. Now, I’m not saying that parents need to engage in deep conversations or read books every time they interact with their child. Simple conversations with a young child, even narrating your activities helps. Screen time is a strictly passive activity. Kids are rarely, if ever interacting with a screen in a meaningful way. However, even the most basic of activities, such as building and knocking down towers of blocks, doing puzzles together or scribbling with crayons on a piece of scrap paper (or a napkin) help teach kids cause and effect, and foster human interaction. These are invaluable for stimulating language development and creating a healthy emotional foundation.

A child that has more than the recommended exposure to screens at a young age is more likely to lead a more screen-filled, sedentary lifestyle as a teenager and beyond. This often goes hand in hand with mindless, unhealthy eating. Kids playing video games all day aren’t usually reaching for apples and carrots. People with active lifestyles that include regular exercise and exposure to the outdoors tend to be more physically and mentally healthy in the long run. My recommendation to parents is to turn of the television and put handheld devices away. This is true for both kids and adults. It’s hard to ignore a TV that’s on or a phone that’s blinking with a notification. Parenting without screens is certainly more challenging, especially in the early years, but it’s definitely worth the investment in the long-run. Teaching your child to entertain him/herself without the aid of screens will benefit them throughout their childhood.

So, what are the age-based recommended limitations on screen time? Below are the recommendations from The American Academy of Pediatrics. Remember though that at ALL ages, less is more, especially in preschool/early elementary-aged kids.

Under 2 years of age: No screen time

Ages 2-5: Limit to one hour of screen time per day

Ages 5 and up*: Consistent limitations on screen time, ensuring children have healthy physical activity and sleep schedules as well as personal relationships and interactions.(*Notice this says “and up”. Screen time limitations are for everyone, not just children. It’s important for adults to limit the amount of time they spend plugged-in, not only for their own well-being, but to set a great example for children).You can start by being aware of just how much time your family is spending in front of a screen. Jot down the number of minutes per day on a piece of paper on your refrigerator, or try this tool from the American Academy of Pediatrics, to create a customized family media plan: Family Media Plan


Originally posted July 2019

IHA Begins Construction on New Medical Center in Chelsea

An architectural rendering of the new IHA Chelsea Medical Center, which began construction in June 2021.

CHELSEA, Mich. (June 23, 2021) –  On Wednesday, June 16, IHA, the area’s leading multispecialty medical group, celebrated the start of construction on the new IHA Chelsea Medical Center at a groundbreaking ceremony. IHA has been providing exceptional care to the Chelsea community for nearly 40 years. This new medical center will be designed to enrich the overall patient experience and provide coordinated care across multiple practices and throughout IHA’s extensive delivery care network in Southeast Michigan.

“This building is the continuation of a critical development strategy for IHA. Over the past 15 years, we have actively consolidated practices to regional facilities where we can provide convenient, multi-specialty services to our patients,” said Lowell Sprague, Director of Facilities and Real Estate Management. “This building, in particular, will allow IHA to bring together and expand the existing primary care services IHA provides in Chelsea under one roof.” 

This new medical center is scheduled to open in July of 2022 and will bring together three established IHA practices including IHA Chelsea Primary Care, IHA Obstetrics & Gynecology Chelsea, and IHA Chelsea Pediatrics. When complete, the building will be over 18,000 square feet and will provide capacity for three practices, 14 providers and over 40 support staff.

The Chelsea Medical Center project has been a long time coming for IHA. Planning for the medical center began in 2015 and more than 10 locations across the Chelsea area received consideration before this site was selected. The new building will be located on Old US 12 and was established in partnership with St. Joseph Mercy Chelsea and Silver Maples of Chelsea. “We are excited to have the opportunity to open this new medical office building alongside our partners at St. Joseph Mercy Chelsea to collectively provide affordable and high-quality healthcare to Chelsea and the surrounding communities,” said IHA CEO, Mark LePage, MD, who gave remarks at the groundbreaking event.

About IHA

Established in 1994, IHA is one of the largest multi-specialty medical groups in Michigan delivering more than one million patient visits each year, practicing based on the guiding principle: our family caring for yours. Led by physicians, IHA is committed to providing the best care with the best outcomes for every patient and an exceptional work experience for every provider and employee. IHA offers patients from infancy through senior years, access to convenient, quality health care with extended office hours and urgent care services, online patient diagnosis, treatment and appointment access tools. IHA is based in Ann Arbor and employs more than 3,000 staff, including more than 700 providers consisting of physicians, nurse practitioners, physician assistants, care managers and midwives in more than 100 practice locations across Southeast Michigan. IHA serves as the Medical Group for Saint Joseph Mercy Health System and a member of Trinity Health. To learn more about IHA, visit www.ihacares.com.

Summer (Fruit) Snacks

Thirst-quenching and healthy snacks perfect for hot days

School is wrapping up for the year and families are heading outside to enjoy the summer. All that time out in the sun means sweating, which may put you at risk for dehydration, vitamin and mineral deficiencies, as well as skin sensitivities. Eating fresh, in-season fruit is a great way to combat the effects of summer heat. Try one – or several – of these picks next time you head out(side).  

  • Watermelon: It’s a summer picnic staple and at 90% water means it’s great for hydrating. Watermelon is also high in cramp fighting potassium, the antioxidant lycopene and immune-booster gluathione.
  • Grapes: At 90% water, grapes are the perfect summer snack. They are also a great source of vitamin K and manganese. Plus, with a bit of fiber, they keep you feeling full.
  • Blackberries: This powerhouse of a fruit contains a lot of polyphenols, chemicals that can help cut inflammation that leads to heart disease. They also help your lower intestine break down sugar which could lower your odds of developing type 2 diabetes.
  • Bananas: Before you go bananas working out, be sure you have a banana on hand. They can help your body recover from tough workouts, and some cyclists said having a banana before they ride helped them go faster and recover faster than those that only had water.
  • Pistachios: Rich in protein, fiber, and vitamins and minerals, this small, but mighty snack is also high in antioxidants and may help with inflammation. Plus, about 20 of them is only around 80 calories and less than a gram of saturated fat. You may even burn a couple calories cracking them open!
  • Lemons: Not just a pretty garnish, lemons and limes are packed with antioxidants like vitamin C and flavonoids. Try one in your next glass of water.
  • Kiwis: This little fruit is mean, green, germ-fighting machine! Rich in vitamins C, E and K, high in fiber and contains lutein which may protect eyes from some diseases. Like the banana, the kiwi also has some potassium, a must have for heart, muscles, nerves and more.
  • Strawberries: This summer staple if full of vitamin C, fiber, antioxidants and folic acid.
  • Blueberries: When it comes to antioxidants, this is a blue-ribbon berry. They give the digestive system a boost, with up to 14% of your daily fiber intake and contain vitamin c you need to promote healing and give your immune system a boost.
  • Peaches:  You’ll feel peachy after you have one. A single peach can give you 10% or more of the vitamin C you need each day. A great way to boost your immune system and help your body’s ability to heal.
  • Pineapple: This fruit tray favorite is full of vitamin C, has some fiber to help your digestive track, bromelain, an enzyme that may ease inflammation, and manganese for muscle tone and bone health. Plus, one cup contains only 82 calories!
  • Avocados: Another great source of potassium. Avocados are full of heart-healthy fats and fiber, vitamins
  • Cherries: Delicious as they are healthy, grab a bag of cherries and you’ll get the anti-inflammatory effects of the antioxidant quercetin. Not to mention, help kill cancer cells, control blood sugar and help prevent heart disease.
  • Cantaloupe: Sliced, cubed or blended into a smoothie, the cantaloupe is rich in potassium, vitamin C and beta-carotene. Chilled, it’s the perfect summer afternoon treat.

Tick, Tick, Boom

Cicadas have been getting all the buzz this season with their big emergence after 17 years, but another insect is experiencing an uptick in its population. With the warm, wet weather early this spring, we are seeing a boom in the tick population here in Michigan.

Where do ticks live?

When visiting grassy, bushy or wooded areas, you can expect to find ticks. You may also find them in your backyard if you live close to areas like this or in places where there are animals. Activities like walking outside with your dog, gardening and hunting can expose you and your family to ticks.

How do I avoid ticks?

  • When possible avoid wooded and bushy areas with high grass or leaf litter
  • Walk in the center of trails and don’t veer off paths into the woods
  • Treat clothing or exposed skin with insect repellents when venturing into areas where ticks may be present. The Environmental Protection Agency (EPA) provides a list of registered insect repellents to help you find the product that best suits your needs: https://www.epa.gov/insect-repellents/find-repellent-right-you Always follow product instructions. Do not use products containing OLE or PMD on children under 3 years old.
  • Animals may also bring ticks into your home. Be sure to use tick repellant on your dogs and cats too. There are many tick treatments available including collars, oral medications and topical medications.

What should I do when I come inside?

If you’ve been outside walking or working in an area that may have ticks, there are a few things you can do when you come in to help avoid a tick bite.

Check your clothing for ticks. Ticks may be carried into the house on clothing. Any ticks that are found should be removed. Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors. If the clothes are damp, additional time may be needed. If the clothes require washing first, hot water is recommended. Cold and medium temperature water will not kill ticks.

Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and daypacks.

Shower soon after being outdoors. Showering within two hours of coming indoors has been shown to reduce your risk of getting Lyme disease and may be effective in reducing the risk of other tickborne diseases. Showering may help wash off unattached ticks and it is a good opportunity to do a tick check.

Check your body for ticks after being outdoors. Conduct a full body check upon return from potentially tick-infested areas, including your own backyard. Use a hand-held or full-length mirror to view all parts of your body. Check these parts of your body and your child’s body for ticks:

  • Under the arms
  • In and around the ears
  • Inside belly button
  • Back of the knees
  • In and around the hair
  • Between the legs
  • Around the waist
Source: Centers for Disease Control (CDC)

What is the best tick repellant?

The CDC recommends using Environmental Protection Agency (EPA)-registered insect repellents external icon containing DEET, picaridin, IR3535, Oil of Lemon Eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone. Remember always follow product instructions. Do not use products containing OLE or PMD on children under 3 years old.

What are the risks of a tick bite?

The most common disease spread by ticks is Lyme Disease. According to the Centers for Disease Control, symptoms often include “fever, headache, fatigue and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart and the nervous system.”

While there are many other tick-borne illnesses, many of them are not common in the state of Michigan. If you plan to travel visit https://www.cdc.gov/ticks/tickbornediseases/overview.html to know what to look for if you experience a tick bite in other parts of the country.

What should you do if you find a tick attached to your skin?

If you find a tick attached to your skin, there’s no need to panic—the key is to remove the tick as soon as possible. There are several tick removal devices on the market, but a plain set of fine-tipped tweezers work very well.

How to remove a tick:

  1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
  2. Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
  3. After removing the tick, place it on a plain background and take a photo of it. It helps to have a photo of the actual tick that bit you to show your healthcare provider, in the event you develop symptoms of a tick-borne illness.
  4. Thoroughly clean the bite area and your hands with rubbing alcohol or soap and water.
  5. Never crush a tick with your fingers. Dispose of a live tick by putting it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet.

Source: Centers for Disease Control (CDC)

What should you do if you develop symptoms of a tick-borne illness?

If you develop a rash or fever within several weeks of removing a tick, make an appointment with your primary care or pediatric healthcare provider. Be sure to tell the doctor about your recent tick bite, when the bite occurred, and where you most likely acquired the tick. If you were able to take a photo of the tick that bit you, be sure to share that with your provider as well.

Print this handout from the CDC to keep in your car or on your refrigerator for a quick tick refresher.