Health Articles

Spring is start of outdoor allergy season

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Sharon Stoll, MD is a family medicine practitioner providing a full spectrum of primary care to her friends and neighbors out of the new Calumet Family Health Center, which is located in the Mine Street Station in Calumet. Call 483-1777 to make an appointment.

It is spring, the time of year when April showers bring May flowers, and children hunt for Easter eggs on manicured green lawns; or at least I've read about these things in books. For those of us living above the 40th parallel, it is the season sump pumps become overwhelmed by run-off, gravely snow piles keep their strong hold on north facing slopes, and you look around your yard wondering how one dog made all that mess. I would like to add, to the list of springs' rites of passage — the start of the outdoor allergy season. It begins every year in late April. The add-on slots in clinic quickly fill with stuffed up patients exclaiming "Sinus infection!" Or worse, those with red, watery eyes who have been ostracized by coworkers for fear of the dreaded "pink eye," (though actual bacterial conjunctivitis is exceedingly rare). Often a quick review of these patients' charts show they have the same set of symptoms every April, helping to identify the real culprit: environmental allergies.

Environmental allergies occur at somewhat predictable times every year: molds in April and May, followed quickly by grass and then tree pollens. There's some brief reprieve in midsummer before ragweed appears around late August. The severity varies from year to year, depending on moisture, south winds and so forth, but the symptoms are predictable: itchy, red, watery eyes, stuffy or runny noses, and for some, a worsening of asthma and cough. If this sounds like you or a loved one, read on for some cost-saving solutions and advanced treatment options.

Log your allergy symptoms and seasons. This will help guide targeted therapy, and also help identify possible cross-reactive foods, which may cause oral allergy symptoms (think really itchy mouth). For example, ragweed peaks in August, so if you find yourself with gooey eyes every August, ragweed is the likely culprit. And ragweed can be cross-reactive with foods like parsley, beans, celery and several others.

Use single-ingredient over the counter remedies geared at allergies. For itchy red eyes, over the counter antihistamine drops like Zaditor, Alaway, Zyrtec Itchy Eye Drops, Claritin Eye or generic ketotifen work wonders, at a fraction of the cost of prescription antihistamine eye drops. For stuffy or runny noses and itchy mouths, consider a non-sedating oral antihistamine like generic fexofenadine or loratadine. For nasal or sinus congestion, consider a decongestant like generic pseudoephedrine. Avoid multi-ingredient cough and cold formulas, which may have ingredients you don't need.

Consider immunotherapy. Allergy shots are the best-known form of immunotherapy in this country, but for those not interested in the high costs, time commitment or needles involved with allergy shots, sublingual immunotherapy (SLIT) may be a better option. Instead of injecting allergens into the skin to promote tolerance, allergen drops or tablets are held under the tongue to reprogram the over reactive immune system. This method has been around since the early 1900s, and was recognized by the World Health Organization as a viable alternative to shots in 2006. It is a mainstay of treatment throughout the European Union, and available in Canada. In the US, it has been used as an off-label treatment with good success. The general idea is this: when you place antigens (protein particles that cause allergic reactions) under the tongue, immune cells take them up, and train the immune system to stop generating an allergic reaction when exposed. It makes good intellectual sense: holding something under the tongue for a minute is an intentional act, and the immune system wouldn't want to react to things your higher-ranking brain has chosen as acceptable for ingestion. This is probably how raw local honey also helps combat environmental allergies, as the unprocessed pollens in the honey serve as a sort of immunotherapy.

Not sure what to make of all this? Come see your friendly local doctor. We'll help you sort it out. And however you deal with spring allergies, just remember you were shoveling in minus 20° winds a few weeks ago, so maybe some red eyes and runny noses are a small price to pay for spring. Consider this your prescription to celebrate by manning the barbeque grill in shorts when it's nary 40 degrees out.

Immunization Schedules from Birth to Adulthood

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Knowing which vaccines to take when is a good step toward living a healthy life. Below are some schedules for childhood, adolescence, and adulthood.

Other resources

These websites have a wealth of trustworthy information. 

Start your new year by making an appointment with your provider

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Dr. Todd Anderson is a board certified family medicine provider at Portage Health. Learn more about Dr. Anderson at portagehealth.org/AndersonT.

There’s nothing more important in a relationship than open and honest communication. While that’s a general truth for all relationships, it’s even more dynamic and significant when it comes to a patient-doctor relationship. That’s something I like to keep mind, and frequently remind my patients.Since arriving in the Copper Country in August, I’ve been hard at work building relationships with patients. The fresh start with some patients has been refreshing, as I’ve had many conversations with patients of all ages regarding health.

These conversations are vital to establishing a good baseline for healthcare, and something everyone should do. For anyone who doesn’t have a primary care provider, I’d highly suggest that you spend time researching your options locally, and schedule an appointment sometime in early 2014.

Even if you’re healthy presently, it’s important to begin that relationship with your provider. Actually, it might be more important to start that relationship now. By doing that, you and your provider can begin a lifelong journey together that includes proactive steps to naturally lower your risks.

For those unsure what to look for in a doctor, some things I like to suggest:

  • Look for someone you would be comfortable talking to about issues very personal to you.
  • Look for someone you can trust with your information.
  • Look for someone with the training and expertise needed to appropriately understand and diagnose whatever health concerns you have.
  • Look for someone who will be a good listener. This is especially important early on in your patient-doctor relationship.
  • Look for someone that you could see yourself working with for a number of years moving forward.

Once you have found a provider that fits your needs, and you’ve made the appointment, the next step is the most important. Your first appointment is a great opportunity to establish a meaningful relationship. Right now, I’m working with a lot of patients who are just starting their patient-doctor relationship, and there’s a lot I’ve learned from this abundance of new patients.

Below are some of the most important things I’d suggest to anyone beginning a relationship with a new primary care provider.

  • Prepare for the first appointment. Write down your previous health issues/concerns so they can be discussed, prepare a list of medications you take and write down any current concerns you have so you don’t forget to discuss them at the first appointment.
  • Honesty is absolutely crucial to the entire patient-doctor relationship. It’s impossible for your provider to effectively treat you if you’re holding back information.
  • No question is too small. If something has been on your mind, don’t hesitate to bring it up. When it comes to your health, it’s always better to be safe than sorry.

The New Year has arrived. If you don’t have a primary care provider, or if you’re looking for a fresh start with someone new, I hope you take the calendar turning as a sign to take a proactive step forward with your healthcare. Start that relationship, and remember to make an appointment each year, even if you’re in great health.

Click here to learn more about Dr. Todd Anderson.

Healthy aging more important now than ever before

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Dr. Katriina Hopper is a board certified internal medicine and geriatric medicine provider at Portage Health. Learn more about Dr. Hopper at portagehealth.org/hopper.

Tips to live healthier, longer

The growth of the number of adults over age 65 is unprecedented in the history of the United States. The National Institute of Aging reports that by 2030, almost one of every five Americans will be 65 years or older. In the next five years, 65+ year olds will outnumber children under 5. This population change is driven by the aging of the Baby Boomer generation, and an increase in life expectancy of older adults.

With this demographic shift, greater attention is being given to the healthy aging. 

What is healthy aging? 

Healthy aging is adapting to the physical, social and emotional changes that occur with age. It is preventing or managing chronic diseases that occur with age, like heart disease or dementia.

What do we know about healthy aging?

Exercise is the key to a healthy lifestyle at any age. Multiple studies have shown an association between exercise and disease prevention. It doesn’t have to be high impact running or mountain biking. Walking as little as 20-to-30 minutes a day for five days a week is beneficial. For those who cannot walk, resistance or “chair” exercises have proven beneficial.

Regular physical activity can prevent heart disease, improve blood sugar levels, prevent falls, regulate mood and may prevent some forms of dementia.

Maintaining connection to friends, family and your community is an important part of healthy aging as well. Aging is often associated with losses of loved ones and of the ability to live independently. Friendships and other social connections can help buffer the losses that we face as we age. Some studies have linked social engagement with a lower risk of dementia. Social connection can be as simple as having coffee with a friend, performing volunteer work, belonging to a club or going to church.

Stimulating your brain with new experiences, or challenging puzzles and games may reduce the risk or slow progression of dementia. Taking a community education class or attending a lecture or musical performance keeps your mind engaged. For those who have hearing and/or vision impairments that limit the ability to participate in these activities, treatment of these conditions can improve quality of life, prevent falls and improve cognitive function.

Treatment of chronic conditions like diabetes and high blood pressure will decrease risk of end-stage kidney and heart disease, and may decrease risk of dementia. Many of the lifestyle changes needed to control these diseases (like a healthy diet and exercise) also promote healthy aging. Over time, control of chronic conditions with medication and life style changes will prevent disability and lengthen life.

There are no pills or herbal remedies to reverse the aging process, but we know more about factors that affect how people age. The good news is that older adults are now living with less disability and more independence. So, if you are able, take a walk outside and enjoy the summer weather, and bring a friend. It will benefit you now and later in life.

Dr. Katriina Hopper is a board certified internal medicine and geriatric medicine provider at Portage Health. Learn more about Dr. Hopper at portagehealth.org/hopper.

Take simple steps to prevent diabetes

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“My sugar is a little high.” “I have a touch of sugar diabetes.” These are things you might remember your parents or grandparents saying about a checkup with the doctor, but they are not words your physician will tell you today. Most of us know that diabetes is a chronic illness that affects the blood sugar and can be a very serious condition. What most of us don’t know is that diabetes is a major contributor to heart disease, stroke, kidney disease, blindness and amputation.

The American Diabetes Association estimates that 17.9 million Americans have been diagnosed with diabetes, 5.7 million Americans have diabetes but don’t know it, and 57 million Americans have pre-diabetes. The good news is that early detection, along with lifestyle changes, can prevent the consequences if you already have diabetes. Even better news is that you can prevent diabetes if you know you’re at risk, and take simple measures to improve your health now.

Do you have diabetes?

The only way to tell is to have your blood tested. A normal fasting blood sugar level is below 100mg/dl. If your fasting blood sugar is between 100 and 125 mg/dl, you have pre-diabetes. If your fasting blood sugar is 126 mg/dl or higher, you have diabetes. Your doctor might order an oral glucose tolerance test to see how your body controls your blood sugar when you eat.

Are you at risk for diabetes?

If your fasting blood sugar is in the normal range, you may still be at risk for diabetes. You can prevent the disease if you make healthy lifestyle changes now. If your answer is yes to any of the following questions, you may be at risk and need to talk to your healthcare provider about regular blood sugar screening.

  • Are you 45 years of age or older?
  • Do you have a parent, brother or sister with diabetes?
  • Are you African-American, Hispanic or Native American?
  • Are you overweight?
  • Do you get too little physical activity?
  • Do you have high blood pressure?
  • Do you have high cholesterol?
  • Did you have a baby that weighed 9 pounds or more at birth?

What can you do to prevent diabetes?

  • Increase your physical activity. Start slowly and increase your activity until you’re getting in at least 30 minutes of exercise five days a week. If you want to lose weight, increase your activity to 60 minutes five days a week.
  • Eat healthy. Don’t skip meals. Eat at least five servings of vegetables and fruits per day, and slowly increase your intake to between five and nine servings per day. Eat whole fruit instead of drinking juice. Eat whole grain foods and slowly increase your fiber intake to at least 20 grams per day.
  • Lose weight. Just lowering your weight by seven to ten percent can make a tremendous difference in your body’s ability to control your blood sugar.
  • Treat your high blood pressure. Limit your salt intake to no more than 2000 mg per day, and take medication consistently.
  • Treat high cholesterol. Increase your physical activity and decrease your saturated fat intake. If you need medication, take it regularly.
  • Manage your stress. Find ways to relax, and eliminate any stress that is unnecessary.
  • Get enough sleep. Some studies have connected poor sleep with diabetes. If you regularly have trouble getting to sleep or staying asleep, or if you snore, talk to your doctor about a sleep study.
  • Quit smoking. We all know how bad smoking is for our health, and people who smoke and have diabetes or pre-diabetes are at an even greater risk for heart disease, stroke and amputation.

November is National Diabetes Month. Take the time to find out what your fasting blood sugar numbers are, and talk to your healthcare provider about your risk factors for diabetes. Portage Health offers classes for people with diabetes and pre-diabetes. Simple lifestyle changes can mean the difference in the quality of your health and life. Do it now.

Breastfeeding is the best way to feed newborns

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March is Parenting Awareness Month. The earliest choice parents can make to ensure their child gets the best right from birth is to breastfeed. It is the natural way, and as long as a mother and child are able to, it's the healthiest and most affordable choice for both mother and child.

Countless studies have shown breastfeeding is the healthiest option for infants. It decreases the risk for asthma, allergies, ear infections, respiratory infections, high blood pressure, heart disease, obesity, iron-deficiency anima, SIDS, diabetes, digestive problems, childhood cancers and dental problems. It's also been proven to reduce the chance of a mother developing diabetes, obesity, osteoporosis, breast cancer, ovarian cancer, uterine cancer, hypertensive and cardiovascular diseases.

At the Portage Health Family Birthing Center, we've been focusing on promoting breastfeeding a lot over the past year. Recently, I completed training to officially make me a certified lactation consultant, and our birthing center became a bag-free hospital, officially recognized by the good people at banthebags.org.

What that means is that Portage Health no longer gives our new parents free formula bags with formula samples. This is something we're proud of, and we hope other birthing centers will do the same. Studies prove that parents who were given these formula samples used formula much earlier in their infant's life.

At our birthing center we focus on helping mothers nurse as quickly as possible. In fact, the World Health Organization and United Nations Children's Fund Baby-Friendly Hospital Initiative suggest mothers initiate breastfeeding within one hour of birth. It might take longer to actually nurse, but we try to help mothers have that skin-to-skin contact with their children immediately.

They also suggest that artificial nipples or pacifiers should not be used until breastfeeding habits are firmly established. That's usually by three-to-four weeks of age.

Another thing we've found to be vital to a mother-child relationship while in the birthing center is keeping the baby in the room with the mother. We call this rooming-in. This encourages unrestricted breastfeeding whenever the child needs. It's important for mothers to see a baby's signs of feeding readiness.

Rooming-in allows mothers and infants to remain together 24 hours a day in the hospital. Moms can observe early feeding cues since newborns need a minimum of 10-to-12 feedings in a 24-hour period of time, often with no particular pattern of frequency. If your baby is kept in the nursery, early feeding signs may be missed and moms may have more difficulty getting a crying baby to latch.

We also suggest giving newborn infants no food or drink other than breast milk, unless medically indicated. There are medical indications for supplementing with formula (dehydration, hypoglycemia and certain types of jaundice for example) and your pediatrician will advise you on the best decision for your baby. However, supplementing with formula when there is no medical need can reduce duration of breastfeeding, increase an infant's risk for reflux, colic (Cohen-Silver) and allergies, and reduce the protective benefits of exclusive breastfeeding mentioned above.

It's also important to realize the economic benefits of breastfeeding. Families can save more than $1,000 a year in formula alone. Employers and the community also benefit with fewer health insurance claims, less employee time off for sick children and higher employee productivity.

Breastfeeding is something we should all be proud of and work together to make it more of a norm. The government is helping, including the Workplace Breastfeeding Law, which was created in 2010. This law mandates employers with more than 50 employees to provide "reasonable break time for an employee to express breast milk for her nursing child for one year after the child's birth each time such employee has the need to express the milk." In addition, the employer must provide a private place other than a bathroom.

When an expectant mother talks about breastfeeding, listen to her, support her personal breastfeeding goals and praise her for her choice. It's better for the baby, her and the entire community. When you see a mother feeding her infant at the "breast-aurant," please do not be offended, glare disapprovingly or harass and humiliate her. Breasts are made for breastfeeding and breast milk is species-specific, designed for human babies. When a mom chooses to breastfeed her child, everyone benefits.

Learn more at cdc.gov/breastfeeding.

Editor's note: Joye Battisfore is a certified lactation consultant at the Portage Health Family Birthing Center.

Be mindful of ticks ... and Lyme disease

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Lifecycle of Ticks: http://www.cdc.gov/ticks/life_cycle_and_hosts.html

Lyme disease is the most common tick-borne disease in the United States. In Michigan, there is an incident rate of about 1 per 100,000 residents. The incidence of Lyme disease is 30 times higher in our closely neighboring state, Wisconsin.

Lyme disease has been in the news more than usual this year, as the population of ticks is thought to be expanding in some areas of Michigan. I have recently been seeing an increase of patients with complaints of tick bites, and questions regarding Lyme disease.

The disease is spread only by blacklegged ticks, formerly known as deer ticks (Ixodes species), that are infected with the disease. These ticks are brown in color and the size of a poppy/sesame seed, or the tip of a pencil. Infected ticks have to be attached to their host (deer, human, etc.) and feed for the disease to be transmitted to the host. Typically the tick would have to be attached for 24 hours, and feed for an additional 36-to-48 hours before disease transmission occurs. Ticks will become engorged, or full of blood, after they have fed.

Initial symptoms of Lyme disease include rash and/or flu-like symptoms. The rash can occur several days after the tick bite, but can appear up to one month after. The rash is normally described as a “bull’s eye” rash, because it is often salmon/red in color with a central clearing. Flu-like symptoms consist of fever, chills, fatigue, weakness, headache, and muscle/joint pain. If the disease progresses without treatment there can be neurological, joint, heart or brain involvement.

The number one way to prevent Lyme disease is to prevent tick bites. I don’t expect residents of the Keweenaw to avoid our densely wooded areas where the ticks are found. Instead, take precaution. Try to stay in the middle of trails, dress accordingly, and do your due diligence after leaving the woods to check for ticks.

Dressing accordingly includes close-toed shoes or boots, a long-sleeved shirt tucked into your pants, and pants tucked into socks. Light-colored clothing will also make the ticks easier to spot. Insect repellant should be worn. While in the woods, check yourself frequently for ticks. Once out of the woods, examine yourself and your clothing closely. Ticks prefer warm moist areas such as armpit, groin and the back of knees, but often can be found on the scalp as well. It’s important to bathe as soon as you can after leaving the woods, hopefully ticks will be washed away before they have a chance to attach.

If a tick is attached, care should be taken to remove it. Do not try to burn, twist or smother the tick.

  1. Use pointed tweezers (not your hands) to grasp the tick as close to the skin surface as possible. Do not crush the body of the tick.
  2. Pull the tick straight out with slow, steady pressure.
  3. Wash the area where the tick was, and your hands, with soap and water immediately after removal.
  4. If part of the tick remains in the skin, medical attention is not required as the remaining parts are usually expelled on their own. Do not attempt to remove the remaining parts.

After removing the tick, pay attention to the skin where it attached. Also, remember only the smaller, blacklegged species of ticks can cause Lyme disease. Medical attention should be sought if a person experiences a rash or flu-like symptoms.

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