Winterize Your Skin

Cracking down on dry hands.

Winter is just around the corner, and with it come fun winter sports, cozy sweaters, and a great excuse to stay inside and watch a movie. The not-so-fun side of winter includes dry and cracked skin on your hands.  The skin on your hands is thinner and has few oil glands than the rest of your body, so we’ve got some tips to help you be extra kind to your hands during the winter months.

  1. Dust off the humidifier. When the heat comes on, the skin dries out. To help replace some of the moisture in the air, pull the humidifier out of the closet and fill ‘er up!
  2. A lot of moisturizer. We wash our hands more in the winter months to avoid illnesses, and that coupled with the cold weather is hard on your skin. To avoid cracked skin on your hands, keep bottle of moisturizer on your sink, and apply lotion every time you wash your hands. Keep another tube of moisturizer in your car or with you in a work bag or purse and apply several times a day.
  3. Bundle up! Whether you prefer gloves or mittens, get a pair that you will wear, and protect the  skin on your hands from harsh temperatures and cold surfaces.
  4. Avoid super hot water. There are few things more comforting than a hot shower after being out in the cold, but super hot water actually dehydrates your skin. Keep your shower temperature on the warm side and buy a fancy pair of rubber gloves for doing the dishes.
  5. Know when to seek help. If you are diligent about skincare, but you can’t seem to stop the peeling or cracking, it may be time to see a professional. Persistent dryness could be a sign of a health condition like eczema, psoriasis or even an allergic reaction. Sometimes store-bought moisturizers won’t do the trick, so you may need to take a different approach to treating your dry skin.

It’s easy to schedule an appointment with your provider – simply visit our online appointment tool, scroll to find your provider, and click to schedule an appointment at a time that works for your family!

Make An Appointment

Sun Safety: Protection is key for fun in the sun

Fifteen minutes. According to the Center for Disease Control, that’s all it takes for the sun’s ultraviolet (UV) rays to damage your skin. When you’re on beach or pool time, 15 minutes goes by quickly. It feels great to soak up those rays, but they are harming your skin and are putting you at risk for long-term skin damage and worse, skin cancer. Before you head out into the sun for the day, take some time and precautions to keep yourself and your family safe all summer long, and you’ll be golden for some fun in the sun!

Use Sunscreen

It’s one of the easiest ways to prevent skin cancer. Look for a sunscreen with broad spectrum protection against both UVA and UVB, an SPF of at least 30, and water resistant. When applying sunscreen, more is more. You want to be sure to get a thick layer of sunscreen on your skin in order for the SPF to do its job. For an average size person, remember the teaspoon rule, and adjust for all ages and body types:1 teaspoon to the face/neck/scalp1 teaspoon for each arm1 teaspoon to the chest and abdomen1 teaspoon to the back2 teaspoons for each leg

Sunblock lotions are the preferred choice, but if you are using a spray sunscreen, apply outside by holding the bottle close to the skin and spray on each area for approximately 6 seconds, or until the sunscreen is visible on the skin (typically, when it looks white). Then, rub it in. Don’t apply spray sunscreen directly to the face. Instead, spray generously into your hand and apply to your face as you would a lotion. Don’t forget to apply a lip balm with an SPF of 30, too!

Sunscreen will wear off throughout the day. Be sure to reapply every two hours and following exposure to water or sweat.

If you’re avoiding sunscreen because you don’t like how it feels on your skin or you had an allergic reaction, try another type or brand. There are a variety of choices by a variety of brands, so if you aren’t happy with one, try another until you find one that works with your skin. You may want to make an appointment with your primary care provider or dermatologist to discuss your individual needs. After all, the best sunscreen is the one you will wear!

Avoid exposure between 10 am and 4 pm

Have you heard of the shadow rule? If your shadow is shorten than you are in real life, the sun’s rays are strong. During this time, you should avoid exposure or follow precautions to protect yourself and your family. For our region in the Midwest, the sun is most intense from 10:00 a.m. to 4:00 p.m., so you’ll want to be the most vigilante in protecting your skin during this time.

Use Sunglasses

Your eyes will absorb those harmful rays much like your skin does. Look for sunglasses that block and absorb UVA and UVB light. The lenses should fit close to the skin and be large enough to cover your eyes and the surrounding areas. The bigger the better! Polarized lenses will help eliminate glare, which is great for driving or days in the water or snow.

Drink more water

When you’re sweating, you are losing water. Drink plenty of water throughout the day, especially in hot weather to keep dehydration at bay. Don’t wait until you feel thirsty. Also, look for signs of heat exhaustion such as; feeling overheated, tired or weak. Nausea, headaches and dizziness are also indications that it’s time to get out of the sun, cool down and drink some water. Heat stroke is a more serious condition. If you or someone in your family stops sweating, has red and/or hot skin, a high temperature, confusion or is suddenly uncoordinated, seek medical attention right away.

Go Long!: Wear Protective Clothing

Long-sleeved shirts and long pants provide an extra layer of protection while spending time out in the sun. Look for clothing made with tightly woven fabrics. Those linen pants aren’t going to protect you from the sun, so be sure to wear sunscreen underneath. When playing the water, look for bathing suits that feature a sun shirt, especially for little ones.

Hats Off ON!: Wear a Broad Rimmed hat

Wearing a hat with a full brim is a great way to protect the scalp, ears, face and neck from exposure to the sun’s UV rays. Tightly woven fabric is the key to a good hat, straw hats are cute, but don’t provide the protection you need. When purchasing sun hats for the family, be sure to pick the correct sizes for each person. Kids will pull off a hat that slips down over their eyes.Seek the shade & avoid direct sunlight

Trees or shelters block the sun’s UV rays and provide ultimate protection. Seek out these spaces when spending time outdoors to help protect yourself and your family from painful sunburns and help reduce the risk of skin cancer. When you can’t find shade, make it! Invest in a beach umbrella or tent to shield your family from the sunlight.

Be cautious of reflections

Your exposure to the sun’s rays increases when the sun shines onto and reflects off of bright surfaces, like water, sand or house paint, for example. When spending time near a reflective surface, ensure everyone is sporting sunglasses and sunscreen or protective clothing are being used consistently.

Tanning

Don’t. Tan skin is damaged skin and the impact can last or even shorten a lifetime. Tanning should not be part of a beauty regiment at any point in a person’s life.

Protection 365 Days

Skin cancer prevention is not seasonal. Sure, we wear less clothing and spend more time outside in the sun’s rays during the summer months, but protection from those rays is just as important during the winter months. UV rays reflect off snow just as they do off of sand, water and concrete. Apply sunscreen to the face and any other exposed skin, wear sunglasses and lip balm every day. When it comes to sun safety, there’s a lot of information to soak in. Download this handy checklist and keep it in your beach bag to help ensure you and your family are covered for summer skin protection.

Sun Safety Checklist

For questions concerning dangers to your skin from the sun, consult with your dermatologist.

It’s easy to schedule an appointment with your dermatology provider – simply visit our online appointment tool, scroll to find your dermatology provider, and click to schedule an appointment at a time that works for your family!

It’s easy to schedule an appointment with your provider – simply visit our online appointment tool, scroll to find your provider, and click to schedule an appointment at a time that works for your family!

Make An Appointment

Is it time for your colonoscopy?

Is Tamiflu Right For You?

 

 

KEEPING YOUR COLON HEALTH IN CHECK IS IMPORTANT FOR EVERYONE

Did you know that nearly 100,000 people are diagnosed with Colon Cancer and 40,000 with rectal cancer each year? In other words, one in 24 men and one in 22 women will develop colon or rectal cancer in their lifetimes.  March is Colon Cancer Awareness Month, a time to evaluate the state of your colon health and learn how to monitor colorectal health going forward. Stay in touch with your colon!

COLONOSCOPY 101

Unlike other cancers screening tools, colonoscopy is unique in that it can both diagnose and help prevent colorectal cancer by removing polyps before they progress to cancer.

WHO SHOULD GET A COLONOSCOPY?

Common misconceptions are that you only need a colonoscopy if you have a family history of colorectal cancer or polyps. However, 80-90% new colorectal cancer cases have no family history – this means that the vast majority of new cases will be the first person in their family to be diagnosed.

Others think that if they have no symptoms, they can’t possibly have colorectal cancer. But by the time patients develop symptoms of weight loss, abdominal pain or changes to their bowel habits, the cancer has often already progressed to a very late stage.

This is why screening is so important. We want to find polyps and early cancer that are easily treated.

WHEN SHOULD I GET MY FIRST COLONOSCOPY?

Every adult should undergo their first screening by the age of 50. Some patients should start earlier, depending on other factors. It is best to talk to your doctor about when you should start screening.

Some people delay or avoid screening because they are afraid of the test. A focus of Colon Cancer Awareness Month is to spread the word about colonoscopy – the test is not painful and is very safe.

SCHEDULE YOUR COLONOSCOPY

It’s easy to schedule your colonoscopy with IHA – simply visit our online appointment tool to request your colonoscopy appointment. Our team will verify that you’re eligible for colonoscopy screening with your primary care provider and will confirm your appointment.

The importance of colon cancer screenings

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For most adults, screening for colon cancer starts soon after turning 50. This because the chances of getting colon cancer increase as you get older. According to the CDC, 90% of cases occur in people 50 years or older. However, this doesn’t mean that adults younger than 50 can’t develop colon cancer and it’s important to know if you are at risk.

A history of colon cancer in the family means it could be genetic. If a close relative, generally your parent, sibling or child, has had colorectal polyps or colon cancer it is important to get screenings at a younger age. This risk is even higher if that family member was younger than 45-years-old when they were diagnosed with cancer, or if more than one close relative is affected. Additionally, if you have inflammatory bowel disease, your risk of colon cancer is increased.

Colon cancer forms when abnormal growths, called polyps, form in the colon or rectum. These polyps can mutate into cancer and spread throughout the colon. Thankfully, screening tests like a colonoscopy can find the polyps and your physician can remove them during a colonoscopy before they turn into cancer.

Colon cancer is one of the most treatable forms of cancer and there are a number of lifestyle factors that you can be aware of to actively reduce the risk of getting colon cancer. These include getting the recommended amount of physical activity, eating a healthy diet with fruits and vegetables, maintaining a healthy body weight and watching your consumption of alcohol and tobacco.

Even without inflammatory bowel disease or a family history of colon cancer, it is vital to listen to your body. If you think something is wrong, make an appointment with your doctor.

Coronary artery disease treatments and prevention

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Coronary artery disease (CAD) is a condition where plaque filled with cholesterol deposits in the blood vessels of the heart. As a result, your heart does not get enough blood flow and oxygen, which leads to a variety of conditions ranging from angina to heart attacks. The biggest risk factors for developing CAD are smoking, diabetes and family history. Hypertension, high cholesterol levels and poor lifestyle habits, like lack of exercise and an unhealthy diet, are also risk factors.

The best treatment of CAD is prevention. Quit smoking, control your diabetes, blood pressure and cholesterol levels. You want your LDL (bad cholesterol) to be low, and you want your HDL (good cholesterol) to be high. This can be achieved with diet, exercise and medications.

 

Symptoms of CAD can be vague. Chest pain is the most common symptom, but it can also present as jaw pain, neck pain, arm pain, back pain, shortness of breath or fatigue. Early recognition is key. Contrary to popular belief, women over 55-years-old carry a higher risk than men of the same age. The risk in younger men is higher than in older men.

There are various ways to treat CAD. Medications, lifestyle changes like quitting smoking, controlling your diabetes, blood pressure and cholesterol levels, as well as stents or bypass surgery. A stent is a device that looks like the spring of a ballpoint pen, which keeps arteries open. These are life-saving in situations of a heart attack. Nowadays, open heart bypass surgeries are reserved for extensive blockages in multiple areas of the heart, and/or when the blockage is in a critical part of the heart, which is not suitable for a stent.

The latest in stent technology is bioabsorbable stents, which disappear after their job of keeping the arteries open is done. These are currently being used by myself and other Michigan Heart physicians. If you have questions about CAD, please talk to your primary care physician or cardiologist.

 

 

Peripheral artery disease and IHA’s outpatient endovascular center

Peripheral artery disease (PAD) is a blood disease of the legs, where plaque builds up in the arteries.

Plaque is made up of fat, cholesterol, calcium and other substances in the blood. When you develop PAD your extremities, usually your legs, don’t receive enough blood flow, which causes symptoms such as leg pain or calf cramping when walking. You have a higher chance of contracting PAD if you have diabetes and/or smoke.

 

Most cases of PAD are treatable, although in very serious cases, PAD can lead to leg amputation. At IHA Vascular & Endovascular Specialists, we have an outpatient center equipped to perform the most up-to-date procedures for PAD, if it’s necessary. We try non-surgical options first, such as a medication and lifestyle changes, and work our way toward surgery if it’s needed.

In our outpatient endovascular center, we can perform many minimally-invasive procedures, which will allow the patient to avoid the hospital. We also strive to perform minimally-invasive procedures, which allows the patient less downtime and a faster recovery.

If you have leg pain when you walk or climb stairs, talk to your doctor. Some older adults associate leg pain with the aging process; however the cause of pain could be PAD.

This article was originally published on April 7, 2016, and was updated on September 19, 2016.

Teaching the Immune System to Target Cancer

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Thanks to continuous advances and breakthrough in cancer research, the medical community has been witnessing an unprecedented flow of success

stories through innovative immunotherapy and targeted therapies. Cancer specialists are now able to work successfully with their patients toward less toxic and more effective cancer treatments. Immunotherapy and targeted therapies are ushering in a new era in the fight against cancer.

 

It all starts at the cell level. Under certain series of unfortunate circumstances, some cells in our bodies become corrupted and start to grow to form cancerous cells. Normally, the immune system is supposed to patrol and detect those abnormal cells and destroy them. However, cancerous cells often find a way of evading the immune system through certain mechanisms including receptors.

What are cell receptors and what do they do? Well, certain receptors on the cell surface resemble the function of passcode or Identification Cards (ID cards). Normal cells have “good” passcodes on their surface and when those normal cells are scanned by the cells of the immune system, they are allowed to survive. However, cancer cells are often able to fool the immune system by acquiring (stealing or forging) those same “good” receptors (ID cards). As such, “impostor” cancer cells pass the scanning test of the immune system and they survive and keep growing in number.

Immunotherapy and targeted therapies specifically address this flawed issue of “fake IDs” by training and waking up the immune system to appropriately fight cancerous cells. For example, medications called “check-point inhibitors” block the interaction between particular cancer cell receptors (or fake IDs) and the immune cells “scanners” in order to uncover the true identity of cancer cells and allow the immune system to destroy them.

There are also several other mechanisms by which immunotherapy can help the immune system to detect and destroy cancer cells. The bottom line is that many patients who suffer from cancer can now be offered less toxic and more effective treatments through FDA approved immunotherapy and targeted therapy. In addition to standard therapies, patients have now more opportunities to enroll on clinical trials that are looking to uncover newer ways to teach the immune system to target effectively cancer cells without affecting the normal bystanders.

The Life-Saving Benefits of Colonoscopy Screening

National Colorectal Cancer Awareness Month is a great time to talk about one of the most preventable and treatable forms of cancer, if diagnosed early. It may seem intimidating, but a colonoscopy is a very simple test and a big reason why there are more than one million colon cancer survivors in the United States.

A colonoscopy test is a visual examination of the large intestine (colon) using a lighted, flexible video colonoscope. The scope also has a camera to help the physician document findings and notable features.

A colonoscopy is more than just a test. If a polyp is found, it can usually be removed during the exam, thereby eliminating the need for a major operation and potentially preventing the development of cancer. If a bleeding site is identified, treatment can be administered to stop the bleeding. Other treatments can be given through the colonoscope when necessary and further studies or treatments may be recommended.

Colonoscopies also can be used in the diagnosis, treatment or prevention of other issues, such as:

  • Abdominal pain, discomfort or change in bowel habits
  • Chronic diarrhea or constipation
  • Colitis (Ulcerative or Crohn’s)
  • Diverticulosis and Diverticulitis
  • Alternative tests to a colonoscopy include a barium enema or other types of X-ray exams that outline the colon and allow a diagnosis to be made. In addition, study of the stool and blood can provide indirect information about a colon condition. These exams, however, do not allow direct viewing of the colon or removal of polyps or biopsies to be done.

    If you’re at risk for colon cancer because of age, medical history or family history, talk to your doctor. They can help you determine which test is right for you.

Know Your Spots

Protect yourself by knowing the warning signs of skin cancer

Many people are familiar with melanoma, one of the most deadly forms of skin cancer, but are you aware that there are other, more common types of skin cancer that you should be watching for? As we prepare for warmer weather, it is important to know how to prevent and detect skin cancer.

An ounce of prevention

Sun avoidance is key to preventing the development of skin cancer. Ultraviolet (UV) light exposure, such as from the sun or indoor tanning beds, is a known risk factor for the development of melanoma and non-melanoma skin cancers, especially in fair-skinned individuals.

Avoiding tanning beds, staying out of peak sun exposure (during the mid-day), seeking shade, and wearing long sleeves, pants, and a wide-brimmed hat are your best bets to keep your skin looking younger for longer and for the prevention of skin cancer.

If must expose your skin to the sun, using a sunscreen is helpful. Daily use of a broad-spectrum (UVA and UVB blocking) sunscreen is recommended. In the summer months, a minimum SPF (sun protection factor) of 30 is suggested, but the higher the SPF number, the better. If you use moisturizer or make-up, look for products that contain a sunscreen, and you can skip daily application of a second product to your face. Application of an adequate amount of sunscreen is also important to achieve the desired effect. Approximately one ounce (two tablespoons) is the amount of sunscreen required for one full body application. A thin coat of sunscreen can provide one half or less of the labeled SPF. Check to make sure that your sunscreen is not expired. Even if your sunscreen is labeled as water-resistant, be sure to reapply frequently, especially if you are perspiring or swimming.

Get to know your skin

I recommend a full body self skin examination once per month. Pick a day of the month that is easy to remember, such as the first of the month, or another number of personal significance. If you “know your spots,” it is easier to recognize and treat potential skin cancers at an earlier stage.

Know the warning signs of skin cancer

The most common type of skin cancer is basal cell carcinoma. This is a slow growing skin cancer, but can be locally destructive if left untreated. This presents most commonly as a fragile, pimple-like bump that bleeds easily. This cancer fails to heal like a normal pimple would. Scaly, pink or red patches of skin that do not respond to moisturizer may also be a warning sign basal cell carcinoma.

The next most common type is skin cancer is squamous cell carcinoma. This can present as a scaly, sandpapery, rough patch of skin that fails to respond to moisturizer. It may also present as a new or rapidly growing lump on the skin, sometimes with a crusty center.

A less common, but more dangerous form of skin cancer is melanoma. An easy to remember mnemonic device highlights the warning signs of melanoma – look for the “ABCDEs.”

IHA ABCDEs for checking moles

It is also helpful to look for the “ugly duckling” or “black sheep” of your moles or spots. If you have a mole that stands out from the rest of your moles, a professional should examine it.

Other rare forms of non-melanoma skin cancer also occur, such as merkel cell carcinoma or tumors of sweat glands and oil glands.

A baseline visit with a board-certified dermatologist is recommended to screen for any potentially concerning lesions. Your dermatologist can provide further education about how to perform a self-skin examination, will discuss your individual risk factors for skin cancer, and can help you to design a plan for sun protection.

To schedule an appointment with an IHA Dermatologist, please call 734.677.DERM (3376) or make an appointment.

Resources

How to Select a Sunscreen

How to Perform a Self Exam

What to Look For

New Hope for Inoperable Aortic Stenosis: Transcatheter Aortic Valve Replacement (TAVR)

Reposted with permission; originally posted in the 2015 spring edition of Cardiac Advantage

Traditional treatment for severe aortic stenosis – a narrowing of the valve that allows blood to flow from the heart to the body- has been to open the chest, remove the fault valve and replace it with a new one.

Many patients are too sick or too frail to tolerate open-heart surgery. “For a long time, we had little to offer patients with severe aortic stenosis if they were unable to undergo open heart surgery because of their age and/or the severity of their medical condition,” said cardiothoracic surgeon Andrew Pruitt, MD, at St. Joseph Mercy Ann Arbor. “Now there is new hope. In August 2012, we began performing an exciting new procedure, transcatheter aortic valve replacement (TAVR), that is holding great promise for patients who formerly had no options.”

Some people with aortic stenosis have no symptoms at all, but for most patients symptoms include: shortness of breath, fatigue, difficulty exercising or performing other strenuous tasks, chest pain, lightheadedness or fainting.

“In its earlier stages, aortic stenosis can be treated with medication, but in more advanced form traditional surgery, and now, TAVR are the only options.”

How does TAVR work? The surgeon makes an incision in the groin (transfermorally) or through a space in the rib cage (transpically) and threads a catheter into the blood vessel to reach the aortic valve. A balloon on the end of the catheter is inflated forcing open the stiff leaflets of the damaged aortic valve. This leaves room to replace the original catheter with a second one. The second catheter not only has a balloon on the end, but also a compressed replacement valve. The replacement valve is made of cow heart tissue that is sewn onto an expandable stainless steel stent. The new valve is placed on the center of the disease valve and then expanded into proper position with the aid of the balloon. Physicians can choose replacement valves to fit a wide range of patient sizes.

A key advantage is that the procedure is performed on a beating heart and the patient does not have to put on a cardiopulmonary bypass machine, so it is far less stressful for the body. The transfemoral approach usually requires about three hours to complete; the transapical about 30 minutes less.

Developed in 2000 by a French cardiologist, TAVR was approved for use in the United States in 2011, slightly ahead of schedule when clinical trials proved remarkably successful.

However, TAVR is still relatively new and not without risk. “Currently, this approach is limited to patients who must meet very specific criteria,” said Dr. Pruitt. “TAVR brings with it its own set of side effects and has as slightly higher rate of certain complications than traditional, open-heart surgery. The FDA has only approved its use for patients with severe, symptomatic aortic stenosis who are felt to be inoperable, or at very high risk for traditional surgery by two independent cardiac surgeons.”

In addition, potential candidates must undergo a series of test to determine if they meet the physical and medical parameters to accept the device safely. “We very carefully have to weigh risks versus benefits, and for those patients who cannot tolerate open-heart surgery, TAVR can be a life saver,” said Dr. Pruitt. “TAVR not only extends patients’ lives, it can significantly improve their quality of life.”

Cardiologists and cardiac surgeons at St. Joe underwent intensive training to learn this new surgical procedure. Based on the high volume of surgeries conducted here, the expertise of our physicians and staff, and the collaborative multidisciplinary heart team that evaluates all potential cases, patients who qualify for TAVR can feel confident in the skill level and experience of their heart team.

“The message to prospective patients and their referring physicians is this: Don’t give up hope. Even for the frailest patients with extremely advanced conditions, we can offer solutions and relief,” said Dr. Pruitt. “In cases where TAVR is an option, it literally can mean the difference between life and death.”