Category Archives: Healthy Living

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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An Occupational Therapist’s Top 5 Outdoor Work Tips

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Planning on getting some work done outdoors? Keep these tips from Occupational Therapist Sam Penkala, O.T.R.L. in mind.

  1. Examine your body mechanics of the shoulder when your arms are elevated.
  • Above the shoulder internal rotation can cause irritation in the shoulder called shoulder impingement
  • Try to avoid internal rotation of the shoulder, essentially making a thumbs down motion
  • Keep your arm activity below the shoulder, if possible
  • Take breaks, especially if above the shoulder activity is necessary, to give your muscles a chance to rebound, and analyze the effect your task is having on your body
Don’t
Do

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What’s Wrong with My Vision?

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Having trouble seeing things clearly? Is it difficult to watch TV, scroll on your phone, look at your computer, read a book or complete close-up tasks such as cross-stitching? Does it make you dizzy when you try to do any of these things? Have you been told you have a lazy eye? Does it seem like your glasses aren’t working well? Has your eye doctor told you there’s nothing wrong with your current glasses prescription?

If you’ve answered yes to any of these questions, you may have a problem with your visual or vestibular system, such as a condition of convergence insufficiency or unilateral or bilateral vestibular hypofunction.

The visual sensory system consists of the receptors in our eyes that detect light and the colors of objects, and the ability to have fine discrimination and visual acuity through the pupil. In other words, it helps us see things clearly.

The oculomotor system is a motor component of the eye function. It helps bring targets onto the fovea, found in the pupil, and keeps the targets on the fovea. This system uses six muscles that we have in each eye to move the eye in all positions. The eye movements perform two functions. First, it holds the image on the retina, and second, it allows the gaze or focus to be shifted.

One of the two functions of the eye movements is that it holds the images in the retina. There are three ways that oculomotor control works with eye movements to hold images onto the retina.

  • Visual Fixation: Where the retina holds the image of a stationary object on the fovea while your head is stationary, for example, reading a posted sign while standing to look at it.
  • Vestibular Ocular Reflex: Where images of the seen world are held steady on the retina during brief head rotations, for example, following a flying insect or animal.
  • Optokinetic Reflex: Where images of what we see in the world are held steady on the retina during sustained low frequency head rotation, such as driving and looking out the window at passing objects or reading.

The second function of the eye movement allows your gaze to be shifted. There are three types of gaze shifting.

  • Smooth pursuit: Holds the image of a moving target on our eyes
  • Saccades: Where there is rapid movements of the eyes, for example, when we’re watching a tennis match
  • Vergence: Moving the eyes in opposite directions to provide depth perception such as when reading a book or looking at your computer or phone.

Vestibular hypofunction occurs when the vestibular nerve is not responding to movement at an accurate rate. The person experiencing this can feel “off,” dizzy, unbalanced and may have trouble focusing. Vestibular therapy and exercises can help with these conditions.

Occupational Therapist Dawn Wylie, O.T.R.L., is a vestibular and balance specialist and part of MidMichigan Health’s Rehabilitation Services team. She sees patients in Alma.

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Don’t Let a Wound Limit Your Summer Fun

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One of the best parts of summer is spending time outdoors with family and friends. Whether you enjoy backyard cookouts, picnics at the park or swimming at the pool, lake or beach, you should take extra care to help identify and prevent common summer skin wounds.

Check for Wounds on Your Feet and Legs Every Day

This is especially important for people living with diabetes, vascular disease or other coexisting health conditions that may affect the body’s ability to heal. A small blister can quickly develop into a non-healing wound. Puncture wounds have a high rate of infection. Seek medical care if you have a wound that is not healing or shows signs of infection such as redness, fever or chills.

Prevent Bug Bites and be Aware of Allergies

Most insect bites are harmless and can be avoided with bug repellent and protective clothing. If you have a bug bite, use a topical anti-itch cream to avoid scratching your skin. Watch for signs of an allergic reaction. Seek emergency care if you are experiencing chest pain, difficulty swallowing or breathing, nausea, cramps, vomiting or severe swelling.

Protect Against Sunburn and Skin Cancer

Skin cancer is more common than all other types of cancer combined. You can help prevent cancer and sunburn with the right sunscreen, clothing and shade. Mild sunburns can be treated with over-the-counter remedies. Seek medical attention if you experience chills, dizziness, rapid breathing, nausea, extreme thirst, faintness or a rash.

Avoid Summer Shoes Like Sandals or Flip-Flops

Choose supportive shoes with closed toes and flat heels. Sandals, flip-flops and other open-toed styles do not provide good support and often cause blisters. Always wear socks. Ask your physician or podiatrist to check if your shoes are a good fit.

Seek Specialized Wound Care

A non-healing wound can limit your ability to enjoy your summer. If you are living with a health condition, such as diabetes, vascular disease, obesity or advanced age, you may be at greater risk for chronic wounds. The longer a chronic wound goes without proper care, the greater the risk of infection, hospitalization and amputation.

This article was originally published by Healogics, Inc. Through a partnership with Healogics, MidMichigan Health is able to offer expanded specialized wound care and hyperbaric oxygen therapy. Healogics is the nation’s leading wound care management company, providing high-quality wound care and consulting services to more than 500 hospitals across the United States. Member hospitals have access to advanced healing technologies including hyperbaric oxygen therapy (HBOT) management.

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Understanding Neuroscience of Trauma for Effective Healing

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It is common knowledge that past traumas change people. It is well known that trauma increases the chance of anxiety and depression, and disrupts functioning in a number of ways. But it may not be so common to think about how this change happens. It is through changes in our brain that trauma disrupts our thought patterns, emotions and behaviors. Recent research has dug deep to understand the details of these changes and what needs to be done to heal the brain so that we can experience less disruptive symptoms. According to researcher Jennifer Sweeton PsyD, M.S., M.A., (www.jennifersweeton.com) the goal of therapy is to change the brain.

There are several areas of the brain that become overactive or underactive because of traumatic experiences. These are then manifested in disruptive symptoms. The primary area that becomes overactive is the amygdala. It is the ‘smoke alarm’ of the brain. It asks, ‘Is this dangerous?’ Working with the memory center, it determines if something is dangerous and begins the stress response, which can be experienced as anxiety, or any of many physical symptoms. It also suppresses the higher thinking. When someone has repeated dangerous events the amygdala can become overactive and hypersensitive, resulting in an overreaction to even small events that would not normally be considered dangerous. When the amygdala completely hijacks the rational thinking it can cause a blackout or amnesia.

To heal from trauma the amygdala needs to be calmed and relearn what is truly dangerous, and what is not. This can be done within a safe therapeutic setting where the person learns to turn off the danger signals and can think through triggers that had set them off, to relearn that they are not really a threat.  

There are several areas of the brain that become underactive due to repeated trauma. The hippocampus is one of these areas. It is the storage area for autobiographical memory. It is the memory center that the amygdala works with to decide what is dangerous. With repeated trauma there can be atrophy in the hippocampus, which can cause memory problems. People can help the hippocampus to stop sending danger signals by working with memories that used to feel dangerous, learning that they are not dangerous. Bringing the memory up in a safe environment, and doing something with it, like telling the story, can reduce the sense of danger, because every time we remember something we remember the last time we remembered it, not the original, so we are reconsolidating each time. The hippocampus can also be strengthened with physical exercise, Omega 3 and meditation.

Another area of the brain that is underactive after repeated trauma is the insula. The insula is the part of the brain involved in awareness of the body and internal states including emotions. During trauma people learn to turn this awareness down or off as a way to protect themselves from the pain, either physical, sexual or emotional.  Turning it down can become a habit resulting in the feeling of numbness or, when turned off completely, can cause dissociation. Spikes in insula functioning can create flashbacks. This area of the brain needs to be on for healing to happen. Low insula functioning is the main reason attempts at therapeutic change fails, according to Dr. Sweeton. Use of sensory awareness exercises like movement, stimulation and mindfulness exercises can improve insula functioning.

Two more areas that are underactive after repeated trauma are the cingulate cortex and the prefrontal cortex. The cingulate cortex is involved in emotional regulation and decision making. The prefrontal cortex is the center for rational thoughts, goal-making and decision-making. When the amygdala senses danger it deactivates both of these areas. When the amygdala is over sensitized and habitually turned on, then both of these decision making areas are chronically turned off. They need to be activated to make good decisions. They can be strengthened with cognitive work, like talk therapy, once the insula has been activated and the amygdala has been calmed in a safe environment.  

It is more clear than ever that trauma in a person’s past has real changes in their functioning based on the direct effect of the trauma on the brain. It is also clear that there are many positive and effective treatments that can improve a person’s life and functioning. These therapeutic interventions are generally done within the support of individual therapy. Some people have found self-help tools that address many of these symptoms. For those who need more support than either of these approaches MidMichigan Health provides a Partial Hospitalization Program at MidMichigan Medical Center – Gratiot. Those interested in more information about the PHP program may call (989) 466-3253. Those interested in more information on MidMichigan’s comprehensive behavioral health programs may visit www.midmichigan.org/mentalhealth.

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Adjustment Disorders

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All humans face stressful life events. Sometimes these stressful events are navigated with little difficulty. At other times they cause troubling symptoms. Adjustment Disorder may be diagnosed when a stressful event triggers symptoms. An Adjustment Disorder is a psychological response to stressors that results in clinically significant emotional or behavioral symptoms.

This may include a decrease in performance at school or work, substance use, changes in relationships and somatic complaints. Somatic complaints are complaints about the body including pain, nausea, headaches and body aches, which often have no medical explanation. This reaction to the stressful event is marked by distress that is in excess of what would be expected given the nature of the stressor, or causes a significant impairment in social or occupational functioning.

When these emotional or behavioral symptoms develop within three months from the onset of the stressor it may be an Adjustment Disorder. Symptoms may be present for several weeks and may last up to several months. The Adjustment Disorder may be considered acute when symptoms last less than six months, or chronic when longer than six months. They may occur at any age.

Adjustment Disorders are relatively common and require an identifiable stressful event that can be of any severity. This is different than Post-Traumatic Stress Disorder, which is a more familiar, but less common diagnosis that requires the presence of an extreme stressor.

Examples of the variety of triggering stressors that may lead to Adjustment Disorder include:

• Single events, like a termination of a relationship

• Multiple stressors, like business difficulties or marital problems

• Recurrent stressors, including seasonal problems at work

• Continuous stressors, like living in an area where there is frequent crime

• Developmental events, like getting married, becoming a parent, or going away to school

Adjustment Disorder may include emotional symptoms, like a depressed mood or anxiety, or both. It can also include disturbances of conduct, like angry outbursts or lying. Or, it can include both disturbances of emotions and conduct.

Adjustment Disorder is considered a short-term illness. With time and proper treatment it is likely to resolve and allow the person to return to their normal functioning. The treatment of Adjustment Disorder may include both medication and therapy. Often therapy alone can be effective in helping the person to improve their ability to cope with the stressor. These improved coping skills often include learning to use support systems more effectively, changing negative thinking and changing unhealthy behaviors.

The setting for such therapy may include outpatient therapy with a counselor or psychologist. Or, for more severe cases, it may include an Intensive Outpatient Program (IOP) or a Partial Hospitalization Program (PHP). IOP treatment is generally three hours of therapy three times a week. PHP treatment is six hours of daily therapy five times a week. It is rare that Adjustment Disorder requires inpatient psychiatric treatment. The needed level of care is determined by the severity of the symptoms and the amount of disruption to the person’s functioning. No matter what level of care a person needs there is no reason to feel ashamed for seeking treatment. Part of being human is leaning on other when there are struggles. And all humans struggle at times.

MidMichigan Medical Center – Gratiot has a Psychiatric Partial Hospitalization Program (PHP) for those who need this level of treatment. Those interested in more information about the PHP program may call (989) 466-3253. Those interested in more information on MidMichigan’s comprehensive behavioral health programs may visit www.midmichigan.org/mentalhealth.

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