Diabetes Awareness and Chronic Wounds

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During Diabetes Awareness Month in November, we’re reminding our patients who are living with diabetes to keep up with daily foot checks. The American Diabetes Association recommends daily foot checks because nearly 1 in 4 people with diabetes will experience a diabetic foot ulcer. During the pandemic, wound-related amputations rose nearly 50% globally.

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Seasonal Affective Disorder

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It is that time of year again when we must confront the cyclic moods we call Seasonal Affective Disorder, or S.A.D. Each year during the winter months, some individuals experience depression that is cyclic and predictable. This mood change usually starts sometime around October or November and subsides around March or April. Symptoms may include: 

  • A drop in energy level
  • Difficulty concentrating
  • Becoming increasingly irritable
  • Experiencing a change in appetite, craving sweets or carbs
  • Oversleeping
  • Increased fatigue
  • Weight gain

While depression can be caused by major life changes, certain medications, or alcohol and other drugs, S.A.D. is believed to be caused by a change in circadian rhythm. The circadian rhythm is the repeating cycle that regulates day and night activities and is fueled by the secretion of melatonin from the pineal gland in response to darkness. Whereas melatonin induces sleep, the hormone serotonin produces energy and feelings of happiness, and increases with exposure to bright light.

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Fear, Pain and Joy

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There is a famous example of the fear, pain and joy concept told by Howard Schubiner, M.D., a leading pain researcher, of a construction worker who stepped on a nail that went through the sole of his boot and came out the top of the boot. Upon seeing the nail emerge through the top of his boot, the man began to scream in pain. He was taken to the emergency room, where he was given strong pain medication before they were able to get the boot off his foot. When they got the boot off his foot they discovered that the nail had gone between his toes and left no mark on his foot at all. So why did he experience pain? Because his brain was expecting it based on what he saw. That is the power of the brain – to create the sensation to protect the body from perceived danger. 

This is an example of the power of the brain to create pain based on fear and expectation. It neuro-circuits in the brain causing the pain responding to danger signals. Because the sensation of pain is one of the brain’s responses to danger signals, any experience that increases the potential of danger signals can increase the possibility of pain signals.

Fear is one of those things that can increase the danger signal. For example, if a person has had an injury in their foot that resulted in pain while weight bearing, then they may, very understandably, fear bearing weight in the future. That fear will then turn on the danger signal in the brain and increase the likelihood of pain being experienced. It can become a vicious cycle.

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October Remembrances Honor Pregnancy and Infant Loss

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Each year, more than a million families in the United States experience a miscarriage, stillbirth or death of an infant. Yet because these events can be emotionally difficult to discuss, there is little public awareness, so families may not always get the support they need. October is Pregnancy and Infant Loss Awareness Month, a time to show support for these families, highlight available resources and build understanding of how family, friends and the community can help.

If you visit a MidMichigan Health facility during the month of October, you may notice staff wearing pink and blue ribbons to show their support. We will also participate in the International Wave of Light, a worldwide remembrance event on October 15, 7 to 8 p.m. During this time, candles will be lit at the entrances of MidMichigan’s Medical Centers in Alma, Alpena, Midland and West Branch (the sites of our four Maternity Centers) to honor babies gone too soon and their families. Patients, staff and community members are welcome to attend.

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Basic Anxiety Management Tools

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Everyone experiences anxiety from time to time. Some people experience it more frequently, in a way that interferes with functioning. Whether it is an occasional inconvenience or a daily struggle, learning tools to manage anxiety can be very helpful. Understanding how anxiety works in the body can help harness the power of the tools.

Anxiety is the body’s reaction to a perceived threat. It is a normal and good reaction when there really is a threat. Anxiety gives the body the energy to respond quickly to the threat. It is part of the sympathetic nervous system, otherwise known as the “fight or flight” system.

All mammals have a sympathetic nervous system that helps them survive when being chased by a predator or facing a disaster. Humans, like all animals, need this response when real danger happens. But humans are a bit different.

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A Look at MidMichigan’s Virtual Care Options During Telehealth Awareness Week

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Telehealth Awareness Week™ – September 19 – 25, 2021 – is a landmark event highlighting the central role that telehealth now plays in delivering health care. MidMichigan Health is celebrating this week with a look at how telehealth services have expanded in recent years and what’s on the horizon. We asked Virtual Care Manager Steven W. Blodgett, M.B.A., C.P.M., C.T.C., C.H.A.M., for an inside look at what his team has been working on.

“MidMichigan has been investing in telehealth capabilities for several years, but the pandemic has brought a heightened need and many new innovations,” Blodgett said. “For example, one challenge all health systems are facing right now is a nationwide staffing shortage, and especially a shortage of highly specialized physicians. Telehealth can help alleviate those shortages by bringing patients and providers together without the need for travel. Patients can see our own MidMichigan Health experts from any hospital bed or provider’s office in our health system, and we also partner with providers at other hospitals in Michigan and throughout the nation to ensure patients get the specialized expertise they need.”

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Speech Therapy for Patients with Parkinson’s Disease

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According to studies, up to 89 percent of people with Parkinson’s disease develop difficulty communicating and up to 95 percent develop difficulty swallowing.

For patients who are experiencing difficulty with their speech, voice or swallowing, it is optimal to begin speech therapy as soon as possible to postpone and help prevent this decline. The SPEAK OUT! & LOUD Crowd program has been scientifically proven to improve speech, voice, swallowing and overall quality of life.

SPEAK OUT! is a therapy program specifically designed to preserve the voice and swallowing function of people with Parkinson’s disease and related neurological disorders. This program will teach patients how to speak with intent to improve overall communication and quality of life. SPEAK OUT! usually consists of 12 individual therapy sessions over the course of four weeks, and patients then transition to LOUD Crowd.

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Trauma Informed Living

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Trauma is more prevalent that most people realize. According to the U.S Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration’s website, two-thirds of people have experienced at least one traumatic event by age 16. In 2015, for every 1,000 children, 9.2 experienced some sort of child abuse or neglect. Their research suggests that 54 percent of U.S. families have been affected by some type of disaster. Many people have multiple or repeated trauma. The more intense and frequent a trauma is, the more likely it is to have an impact on people.    

Trauma has both short-term and long-term effects. In children this might be fear of being separated from a caregiver, excessive crying or screaming, weight loss and nightmares. In older children it could be poor concentration, feelings of guilt or shame, anxiety, depression, difficulty sleeping, eating disorders, self-harming behavior, sexual acting out or use of drugs or alcohol, among other things.

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Mental Health and Athletes: What You Need to Know

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Olympic athletes train to be the best in the world at their respective sports. They are determined, talented, capable, and display a level of grit and determination qualifying them for the highest stage of competition. They spend years working toward a few simple ultimate goals: giving their best performance, honoring their country and leaving the court, mat, field or track with a medal in their hand.

When gymnast Simone Biles recently withdrew from the Olympic Games, it came to many as a surprise. What may have come as even more of a surprise to some is the reason she withdrew: her mental health.

This latest example of the courage of an athlete to stand up and let the world know that mental health is health has brought incredible awareness to the importance of mental health in all people, even Olympians.

If you’re an athlete, or if you have kids who play sports, you might be worried and wondering what you can do to address potential mental health struggles related to sports. Consider these suggestions when it comes to sports and mental health:

  • Talk, talk, talk. If you find yourself experiencing stress, anxiety or depression related to a sport, consider finding a qualified counselor/therapist to discuss these issues. If you’ve got a child who plays sports, keep an open dialogue with them. Have regular, open and honest conversations about how they’re feeling, both mentally and physically.
  • Watch for warning signs. This is especially important if you have a child or adolescent in sports. Keep an eye out for things like mood, sleep, or behavior changes that seem concerning.
  • Find balance. It’s okay to admit that you need help or that you need to take a break from practicing or competing. If you feel overwhelmed consider meditation, trying new things or giving your body a rest.
  • Ask for help. There is no shame in seeking out help, whether it be with a therapist, psychiatrist or other medical health professional. Treating a mental illness is just as important as treating a physical one.

Protecting and prioritizing your overall health is essential for all levels of athletes. It’s not rare to have an athlete pull out of a race, game or event due to a physical injury. Seeing an athlete withdraw for mental health reasons is much less common, however, its recognition is just as important. The hope going forward is that we assist athletes in all aspects of performance and recognize that mental health is health.

Thomas Bills, M.D., is a psychiatrist with a special interest in sports psychiatry. Dr. Bills is welcoming athletes to his office in the Towsley Building, located on the campus of MidMichigan Medical Center – Midland. Those who would like to make an appointment may call the office at (989) 839-3385.

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The History of Mental Health Treatment

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The history of mental health treatment is a long story. The first private hospitals, known as almshouses, for those with severe symptoms of mental illnesses and the infirmed elderly, were created in the early 18th century. In the early 19th century, a new idea about care for the mentally ill called “moral treatment” emerged, which focused on the belief that kindness and quietness in treatment would help with recovery.

In the 1840’s, Thomas Kirkbride developed the “Kirkbride Plan” for moral treatment that included sunshine, fresh air, privacy and comfort. Throughout the 1850s and ’60s Dorothea Dix traveled throughout the country promoting this approach. By the 1870s virtually all states had such asylums. By the 1890s, private almhouses were sending people to the asylums. This influx overwhelmed both space and resources of the asylums and threatened their attempts at humane treatment. 

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