IHA Blog – Page 5

Returning to Normal*

*For kids it’s anything but normal.

By Patrick Gaulier, LMSW & Leah Diebel, LLMSW

Last year, Michigan parents and students were faced with a very difficult adjustment from in-person education to attending school virtually. As many schools push for more time in the classroom, parents and students are again making an adjustment, this time back to in-person learning. After a year of virtual classes where students didn’t have to leave their bedroom or home, walking into a school with hundreds of other children or teens can feel like a daunting task. As a parent, dropping your (nervous) child off after months of having them home is equally daunting. Even kids and parents that normally don’t experience social anxiety (or anxiety period) may feel nervous because they are out of practice. It’s normal to feel that way and there are ways to help the return to school go more smoothly for parents and children.

Prepare for school to be different from what they remember.

The school children left last spring is not the same place they will be returning to. Everyone will be wearing masks, friends will have distance between them, there may even be plexiglass shields, and lunchtime and recess will be a very different experience. Uncertainty around what school will look like upon their return will be a source of anxiety for children and teens, so the more information they have (at their level) the better. Talk to your kids about the new rules in place and how they feel about them. Try to get answers to their questions prior to their first day back in the classroom.

Let them worry.

Collectively, we say we are returning to “normal”, but really, we’re not. Kids are returning to school, but it won’t be what they remember as normal. The most normal thing about this whole process is worrying. Everyone has worries and parents can help children to see worrying is a normal part of life. Parents can help children manage worry and anxiety by asking open-ended questions like “what happened at school today?” or “what did you do at recess today?” or “did you see anything interesting on social media today?” Children may not be ready to share their feelings or answers to their questions, but they know you are ready to listen when they are. The most important takeaway is to not minimize or discount your children’s anxiety.

Create opportunities for conversations.

As you prepare as a family for the return to in-person learning, be sure to give your children an opportunity to voice their concerns and excitement as well. Plan to sit down for device-free dinners where conversations can happen. Spend a few extra minutes tucking them in at night and ask them how they are feeling about upcoming changes. For teens a chat while driving is an opportunity to talk without forced eye contact. Schedule an outing with children either individually or as a family, depending on how your child best communicates, where they have dedicated time where they can feel heard.

Brush up on social skills.

For some kids, it’s been a while since they had face to face interactions with other students, teachers and staff at their school. For younger kids, try role playing some basic greetings and conversations they can have with someone they haven’t seen is a while. Talk about some different conversations starters and questions they can ask. They should also think about a couple things they would want to share with friends. Going into school prepared can help kids manage the anxiety that comes with the change from virtual interactions to facet-to-face.

Create a new routine and stick to it.

Since so much about the school day will be different, the daily routine should evolve, not disappear. Structure and routine will provide stability in times of uncertainty. Kids should wake up early enough to complete their morning routine and parents should model structure by also waking up and preparing for the day. It won’t be acceptable to walk around in pajamas at school, so it shouldn’t happen at home as children get ready to make the change from home learning to classroom learning. If children are returning to virtual classes, they can still go through their morning routine even if their commute is to a desk at home.

Know when they/you need more help.

If you think your child is struggling or may need more help than you are able to provide, the IHA Pediatric Behavioral Health Care team is here for you and your children. They will work in collaboration with your child’s IHA pediatrician to improve your child or adolescent’s overall health as well as helping the family understand the child’s development. IHA Pediatric Behavioral Health Specialists are available for video appointments through any IHA Pediatric practice.

IHA Pediatric behavioral health care

Bike Helmet Safety

Get the proper fit in a snap!

According to the National Highway Traffic Safety Administration (NHTSA), more children ages 5-14 go to the emergency room for bicycle-related injuries than any other sport; many with head injuries. Like car crashes, bicycle crashes can happen at any time, involving not only children, but adults, many of whom are skilled riders. In fact, middle-age adults represent the average age of bicycle riders killed and injured. When it comes to bicycle crashes, helmets are the single most effective piece of safety equipment for riders of all ages. As you get the family bicycles out for the season and dust-off last year’s helmets, here are some important reminders to ensure all riders are properly protected all season long.

Get the right fit from the start.

Helmets come in various sizes, just like hats. Size can vary between manufacturers. Download this guide from the NHTSA and follow the steps to fit a helmet properly.

When to replace a helmet.

If you’ve been in a crash with your helmet, damage to your helmet won’t always be visible. Always replace a helmet that’s been in a crash, even if it appears to be intact. And never purchase a used helmet since you can’t be sure of its history.

Your bike helmet should fit today.

When shopping for a new bike helmet, purchase one that fits now. A bike helmet is not something that you “grow into”. If the helmet is too large, it won’t fit properly and won’t provide the protection you need. With each ride, readjust the helmet as needed.

Cover your forehead.

Adjust the helmet fitting based on your helmet first being in the correct position, level on the head and low on your forehead.

Adjust straps until snug.

You’ll find chin straps and side straps on your helmet. Both should be snug before you take off.

Avoid helmet rocking.

Your helmet should not rock more than an inch forward or backward or side to side on your head. If the helmet is loose or rocking, readjust.

Love your helmet.

If you love your helmet, you’ll wear it. This means it must fit comfortably and let’s face it, it has to be pretty. It’s true for kids and adults alike, if you like the way your helmet looks and feels, you’ll be more willing to put it on.

Be a good “roll” model.

Both adults and children should wear a bike helmet each and every time they ride. Wearing a helmet will set a good example and encourage smart choices in others.

Source: National Highway Traffic Safety Administration

Colorectal Cancer Screening

Detection & diagnosis of one of the most common cancers.

March is National Colorectal Awareness Month, an observance dedicated to encouraging patients, survivors and caregivers to share their stories, advocate for colorectal cancer prevention and inform others about the importance of early detection. Regular screening begins at age 50 (or before if you are high risk for colorectal cancer) and is the key to preventing colorectal cancer, or cancer of the colon or rectum.

Why is screening important?

Precancerous polyps and colorectal cancer don’t always cause symptoms, especially at first. Evidence shows that colorectal cancer screening can reduce the risk of dying from the cancer. When detected early, colorectal cancer is one of the most curable types of cancer.

If you haven’t been screened but are having symptoms like, blood in or on the stool, abdominal pain that doesn’t go away, or losing weight and you don’t know why, talk with your doctor about getting screened.

What types of colorectal cancer screening are available?

Stool Tests:

The guaiac-based fecal occult blood test (gFOBT) uses the chemical guaiac to detect blood in the stool. It is done once a year. For this test, you receive a test kit from your health care provider. At home, you use a stick or brush to obtain a small amount of stool. You return the test kit to the doctor or a lab, where the stool samples are checked for the presence of blood.
The fecal immunochemical test (FIT) uses antibodies to detect blood in the stool. It is also done once a year in the same way as a gFOBT.
The FIT-DNA test (also referred to as the stool DNA test) combines the FIT with a test that detects altered DNA in the stool. For this test, you collect an entire bowel movement and send it to a lab, where it is checked for cancer cells. It is done once every three years.

Flexible Sigmoidoscopy

For this test, the doctor puts a short, thin, flexible, lighted tube into your rectum. The doctor checks for polyps or cancer inside the rectum and lower third of the colon. This test is done every 5 years, or every 10 years with a FIT every year.

Colonoscopy

The colonoscopy is similar to flexible sigmoidoscopy, except the doctor uses a longer, thin, flexible, lighted tube to check for polyps or cancer inside the rectum and the entire colon. During the test, the doctor can find and remove most polyps and some cancers. Colonoscopy also is used as a follow-up test if anything unusual is found during one of the other screening tests. This test is recommended every 10 years (for people who do not have an increased risk of colorectal cancer).

CT Colonography (Virtual Colonoscopy)

Computed tomography (CT) colonography, also called a virtual colonoscopy, uses X-rays and computers to produce images of the entire colon, which are displayed on a computer screen for the doctor to analyze. This test is done every 5 years.

Which screening is right for me?

There is no single “best test” for any person. The decision of which screening is best for you is best made after a conversation with your doctor. Each test has advantages and disadvantages. Which test to use depends on the following:

Your preferences
Your medical condition
The likelihood that you will get the test
The resources available for testing and follow-up

Only two-thirds of adults are up-to-date with colorectal cancer screening. If you’re eligible for screening or think you may be, talk with your doctor about scheduling your colorectal cancer screening today.

If you are younger than 50 or older than 75 and think you may be high risk for colorectal cancer, ask your physician if you should be screened.

IHA COLON & RECTAL SURGERY

Itching for Relief

April Showers bring spring allergies.

By Susanna Lin, MD

It’s that time of the year – trees and gardens “wake up” from hibernation with beautiful blooms and scents filling the air. They also bring runny noses, itchy eyes, and scratchy throats. It is allergy season. Allergies can (and do) happen all year, but for many people, when spring starts and trees and grass grow they start feeling symptoms.

Common environmental allergies can be due to dust mites, animals, pollen, grass and trees, just to name a few. Each of these allergies can happen more often in different times of the year. Grass and trees are often bothersome to people in spring, whereas pollens are in the late summer. You may experience dust mite allergies inside, all year round.

When symptoms are bad, many people turn to medications for help. There are some things you can try prior to using medications. For example, for dust mite allergies you can try using dust mite covers on your pillow and bed. Staying in air conditioning may help symptoms when the pollen count is high. You can also flush out the allergens by using a netti pot (follow safe-use guidelines) or saline eye drops. An evening shower before going to bed can also be helpful in alleviating allergy symptoms.

Masks aren’t just for protecting against viruses, try wearing your mask at times when your allergies are the worst (mowing the lawn, spring gardening). The mask could help keep your nose clear of irritating particles.

If you’re ready for medications, decongestants and antihistamines can be the most helpful to allergy sufferers. Decongestants help relieve nasal congestion symptoms once they have started. Antihistamines block the histamine reaction and help prevent symptoms from happening. They often must be taken several days to weeks prior to exposure to the allergens. Nasal steroids can also help decrease nasal congestion symptoms and work right at the source of the congestion. For itchy, water eyes, try allergy eye drops.

If you are having allergy symptoms that are not improving with over the counter medications, it is time to see your primary care doctor to discuss next steps. There may be another reason for your symptoms or other medication or treatments to consider. Allergy testing may also be needed to figure out what specifically you are allergic to so that you can avoid the allergen.

IHA Primary care

This article was originally published on March 20, 2015, and was updated March 2021.

Spring Forward

Adjusting your mind and body to the time change

This weekend, we will all adjust our clocks and spring forward, but chances are, no one will be springing anywhere for a few days. Losing an hour of sleep can really throw off your sleep cycle leaving you groggy, tired and most likely running late. Plus, the darker morning tricks your body into thinking it’s not actually time to wake up. Luckily, it only takes a day or two to adjust your internal clock to the new schedule. Although short, those couple days can be rough, so we pulled together some quick tips to get through daylight savings.

Clear your mornings.

The Monday after springing forward can be brutal. Maybe Tuesday, too. It’s no small task to get up and going on an hour less sleep, and there’s a pretty good chance you’ll be running late. If possible, block your morning schedule, so you can ease into the day rather than rushing through the morning. If working from home is an option, this would be a great day to do it.

Eat to sleep.

Avoid foods and beverages that interfere with your sleep. About four to six hours before bedtime say no to sugar, alcohol and caffeine.

Go into the light!

Light suppresses the secretion of sleep-inducing melatonin. Exposing yourself to sunlight will help with the adjustment to the time change. Open the blinds and curtains! Let the natural light in!

Conversely, when it’s time for sleep, do not expose yourself to light. If you get up at night to go to the bathroom, use a nightlight rather than turning on the lights.

Turn-off when you turn-in.

Help your body adjust to the time change, by getting good sleep. Get your mind and body ready to snooze by turning your devices off. Laying in bed on your phone or tablet stimulates your body and brain. Read a book instead, take a warm bath, listen to calming music, pick-up an eye mask – whatever you find helpful in falling to sleep.

Take your hour back.

Allow yourself some extra time leading up to the time change and try to go to bed early to make up for the hour you are about to lose. Making-up for the lost time, ahead of time, can help your body transition into daylight savings.

If you are frequently sleepy and think it may be more than an adjustment to the time change, make an appointment to talk with your primary care physician.

IHA Primary care

Originally Posted March 2020

COVID-19 Vaccines 101

Understanding how the COVID-19 vaccine works

Johnson & Johnson’s one-dose COVID-19 vaccine has become the third COVID-19 vaccine given Emergency Use Authorization (EUA) by the U.S. Food and Drug Administration (FDA). The Johnson & Johnson vaccine uses a harmless adenovirus to activate an immune response to the coronavirus spike protein. As we work to vaccinate more of our patients and communities, we’re working to increase understanding around how the different vaccines work to protect against COVID-19 and why the best vaccine is the one you can get.

How COVID-19 Vaccines Work

COVID-19 vaccines help our bodies develop immunity to the virus that causes COVID-19 without us having to get the illness. Different types of vaccines work in different ways to offer protection, but with all types of vaccines, the body is left with a supply of “memory” cells that will remember how to fight that virus in the future.

It typically takes a few weeks after your last dose of vaccine for your body to have the highest level of protection.

Sometimes after vaccination, the process of building immunity can cause symptoms, such as fever, muscle aches, feeling tired. These symptoms are normal and are a sign that the body is building immunity.

Types of Vaccines

Currently, there are two types of COVID-19 vaccines that are authorized for emergency use in the United States. None of these vaccines can give you COVID-19 because they do not contain any live COVID virus.

mRNA vaccines contain material from the virus that causes COVID-19 that gives our cells instructions for how to make a harmless protein that is unique to the virus. After our cells make copies of the protein, they destroy the genetic material from the vaccine. Our bodies recognize that the protein should not be there and build cells that will remember how to fight the virus that causes COVID-19 if we are infected in the future. (Moderna, Pfizer- BioNTech)
Vector vaccines contain a weakened version of a live virus—a different virus than the one that causes COVID-19—that has genetic material from the virus that causes COVID-19 inserted in it (this is called a viral vector). Once the viral vector is inside our cells, the genetic material gives cells instructions to make a protein that is unique to the virus that causes COVID-19. Using these instructions, our cells make copies of the protein. This prompts our bodies to build cells that will remember how to fight that virus if we are infected in the future. (Johnson and Johnson)

How the Vector COVID-19 Vaccines Work – Trinity Health

Most COVID-19 Vaccines Require More Than One Shot

All but one of the COVID-19 vaccines that are currently authorized for emergency use in the United States use two shots. The first shot starts building protection. A second shot a few weeks later is needed to get the most protection the vaccine has to offer. One vaccine (Johnson and Johnson) only needs one shot to provide protection.

The Bottom Line

Getting vaccinated is one of many steps you can take to protect yourself and others from COVID-19. Protection from COVID-19 is critically important because for some people, it can cause severe illness or death. All vaccines have been proven to prevent serious illness, hospitalization and death. It doesn’t matter which vaccine you get, just get vaccinated when it is your turn.

Stopping a pandemic requires using all the tools available. Vaccines work with your immune system so your body will be ready to fight the virus if you are exposed. Other steps, like masks and physical distancing, help reduce your chance of being exposed to the virus or spreading it to others. Together, COVID-19 vaccination and following CDC’s recommendations to protect yourself and others will offer the best protection from COVID-19.

Learn more and read frequently asked questions about the COVID-19 vaccination.

COVID-19 Vaccine FAQs

Sports & COVID-19

Youth sports are back in Michigan…with restrictions

One of the many great disappointments during the pandemic was the loss of sports. From preschool t-ball to professional sports, being active and on a team is such an important part of so many lives. And those that don’t participate, spectate! The rules of the game have changed several times since the beginning of the pandemic, most recently with the resumption of contact sports for Michigan youth.

Beginning February 8^th, in-person practice and competitions for sports leagues are now allowed…with some restrictions. For contact sports to resume, masks must be worn at all times during practices and competition. If masks can’t be worn during play, participants must be regularly tested for COVID-19, consistent with MDHHS’s Testing and Additional Mitigation Measures for Athletic Practice and Play guidance according to the state.

If your or your child’s sport of choice is non-contact and played outdoors where the athletes can maintain a social distance, masks will not be required. For all other sports, indoor or outdoor, masks or testing protocol will be required.

Following the guidance outlined by the state is crucial to stop the spread of the virus among athletes and spectators. There will be less people in the stands – up to 250 people are allowed in stadiums that seat fewer than 10,000 people, and up to 500 people are allowed at venues that seat more than 10,000 people, and those that do attend will also need to wear a mask at all times.

General Mitigation Measures for Athletics from the state of Michigan:

Wear a face mask at all times in practice and competition.*
Wash hands frequently and cover coughs and sneezes.
Use separate equipment as much as possible. Frequently clean and disinfect any shared equipment and surfaces.
See the MDHHS Guidance for Athletics for more recommendations to mitigate risk and prevent the spread of COVID-19 in sports.

*Exceptions are for athletes in contact sports where face masks pose a safety hazard. In these situations, additional mitigation measures, including testing before unmasked play, are required. Please see the MDHHS Guidance for Athletics for more information

For more details on the how COVID-19 impacts youth sports in Michigan visit: http://bit.ly/3s9XxV5

Under Pressure

Get pumped about managing Hypertension!

Considering nearly half of adults in the United States have high blood pressure, it’s a term we hear frequently, but what is it exactly? High Blood Pressure or Hypertension is when the force of blood pushing against the walls of your arteries is consistently too high. When left untreated, hypertension puts you at risk for heart disease and stroke. It’s normal for our blood pressure to rise and fall throughout the day, but when it stays high for long periods of time your heart can be damaged leading to health problems or even death. The good news is, there several steps you can take to manage hypertension and live a healthy life!

Stop Smoking.

You should do this today. Smoking is harmful for many reasons and we encourage all patients who are smokers to quit immediately. It’s often easier said than done, so check with your provider for some strategies to ensure you quit smoking for good.

Exercise.

Physical activity strengthens your heart, and a stronger heart can pump more blood with less effort, thus decreasing the force on your arteries and lowering your blood pressure. For some patients, exercise lowered blood pressure enough to quit taking medication. Daily exercise can also prevent hypertension as you grow older. If you are implementing a new exercise routine, or starting to exercise for the first time, be sure to chat with your doctor before you begin.

Eat a Heart Healthy Diet.

In other words: put down the salt shaker! Incorporating the DASH Diet (Dietary Approaches to Stop Hypertension) into your daily life can have a big impact on not just hypertension, but your health overall.

DASH DIET:

Eat more vegetables and fruit
Eat less foods that are high in saturated fat, cholesterol and trans fats
Eat more whole grains, fish, poultry and nuts
East less sodium, sugar and red meats

The diet itself is pretty simple but following it can be a challenge. Try making small changes at first and ease your way into a new diet. Add a serving of vegetables at lunch and dinner, choose fruit, plain popcorn or low-fat yogurt as your afternoon snack, switch to low-fat dairy products, limit how much butter, salad dressing or other condiments you use, and if you don’t know already, learn to read food nutrition labels and choose low sodium foods.

Take Your Medications.

You may not be able to manage you high blood pressure with diet and exercise alone, but there are medications that can help you reach your blood pressure goal. Talk with your doctor about the right approach for you. They will know when it’s time to work medications into your routine. Once you are prescribed a medication for high blood pressure, it’s important to take it exactly as directed. If you are not able to follow your physician’s instructions, be sure to discuss your options at your next appointment. Don’t make changes to your treatment without guidance from your doctor.

Monitor Your Blood Pressure at Home.

Once you implement changes into your lifestyle, it’s important to monitor your blood pressure on a regular basis to understand if you are going in the right direction. If you have been diagnosed with high blood pressure, it’s important to check it daily to ensure your numbers are stable and staying in a safe zone. Check with your provider for best practices for measuring your blood pressure at home. They can also help you find the right fit when it comes to purchasing a cuff. Once you’re ready to go, use this helpful log to keep track of your numbers for the month.

Download your blood pressure log

Don’t let COVID-19 stop you from getting the care you need. We put protocols in place to ensure your safety while visiting any IHA practice. Contact your primary care physician or cardiologist to schedule your next appointment today.

IHA cardiology

Originally posted February 2020

Flu Season 2021

We’re seeing less flu activity in the wake of COVID-19

Before COVID-19, Influenza was the virus making headlines every fall. This year however, we’re seeing unusually low flu activity at IHA, a 98% decline in positive cases in fact, but numbers are also much lower around the country according to the Centers for Disease Control (CDC).

It’s not entirely a surprise to see flu numbers drop. People are staying home more, washing their hands, wearing masks and social distancing when they do go out. Since the flu virus spreads via respiratory droplets in a similar way to COVID-19, all the protections that are in place to help stop the spread of COVID-19 are helping to curtail the spread of influenza. People are also taking more precautions when they are symptomatic with an illness and staying home. Going to work or school sick, coughing or sneezing is a thing of the past.

It’s not just Michigan seeing a drop in cases of the flu, the CDC reports that seasonal flu activity is lower than usual this year nationally. Take a look at these flu activity maps for the same week January 2020 versus January 2021. Most states are reporting minimal cases of the flu this year, while last year it dominated the map.

Perhaps the biggest contributor to the decline of influenza this year has to do with children, who have been attending school virtually across much of the state and country or at least wearing masks, social distancing and washing hands while at school. Kids are catching the flu virus in smaller numbers and are not bringing it home to their parents and families like in past years.

Source: Centers for Disease Control (CDC)

The flu season is not over and it’s not too late to be vaccinated against the flu! A flu shot is recommended for everyone ages 6 months and older. According to the CDC, getting a flu vaccine will not protect against COVID-19, however flu vaccination has many other important benefits. Flu vaccines have been shown to reduce the risk of flu illness, hospitalization and death.

Contact your primary care practice to schedule a flu shot today.

schedule Flu Shot

Kids & COVID-19

When can your kids safely return to school after a positive COVID-19 test?

It’s true fewer children have been sick with COVID-19 when compared to adults, but children can still be infected with the virus, get sick from it and spread it to others, even when they have no symptoms (asymptomatic). If you have or think you or your child might have COVID-19, it is important to stay home and away from other people both outside and inside the home. As much as possible, keep sick members of the family away from well members of the family, especially those that are more likely to become severely ill from COVID-19. Staying away from others when you are sick helps stop the spread of COVID-19. But just how long does a child need to quarantine and when can they return to school? The timing of when your child can return to school/camp/daycare/work after they had COVID-19 symptoms or exposure depends on the situation. Read on for advice from the Centers for Disease Control (CDC) on when it’s safe to return to normal life (or normal pandemic life).

Updated COVID-19 Symptoms

how to home quarantine

If your child has current symptoms of COVID-19 but did not get tested; They may return to school, camp, daycare or work when:

It has been 10 days since symptoms developed AND
24 hours with NO fever (without using any medications) AND
Symptoms such as cough and congestion are improving

If your child tested positive for COVID-19; They may return to school, camp, daycare or work when:

It has been 10 days since symptoms developed AND
24 hours with NO fever (without using any medications) AND
Symptoms such as cough and congestion are improving

We do not recommend testing without symptoms but in some cases, this is a requirement. If your child tested positive for COVID-19 and has NO symptoms; They may return to school, camp, daycare or work when:

It has been 10 days since the test was performed
IF during this time period ANY symptoms develop (fever, cough, congestion, vomiting or diarrhea) please follow the information above on when they may return to school, camp, daycare or work.

If your child had COVID-19 symptoms and tested negative for COVID-19; They may return to school, camp, daycare or work when:

24 hours with NO fever (without using any medication)
Other symptoms are improving

If your child has been in close contact with someone who tested positive for COVID-19, but your child has not been tested OR has tested negative;

Anyone who has been in close contact with someone who has COVID-19 needs to quarantine. What counts as close contact?

Your child was within 6 feet of someone who has COVID-19 for at least 15 minutes
Your child lives at home with someone who is sick with COVID-19
Your child had direct physical contact with the person (touched, hugged, or kissed them)
Your child shared eating or drinking utensils
They sneezed, coughed, or somehow got respiratory droplets on you

Steps to take: Stay home and monitor your health.

Stay home for 10 days after your last contact with a person who has COVID-19 to be sure you don’t develop symptoms. Contact your pediatrician if symptoms develop. (The local Health Department may recommend 14-day quarantine).
Continue to watch for fever (100.4°F), cough, shortness of breath or other sick symptoms that may concern you about your child, until 14 days after exposure date.
When possible, continue to wear a mask, stay 6 feet from others, especially people who are at high risk for getting COVID-19, avoid crowds, wash hands frequently.

If your child has symptoms of COVID-19 or has been exposed to someone that tested positive for COVID-19, contact your pediatrician for testing and next steps.

IHA Pediatrics