Author Archives: MidMichigan Health

Strep Throat in Children

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Strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus (group A strep). Overall, viruses are the most common cause of a sore throat. However, most viral infections are self-resolving.

How do people get this infection?

Group A strep live in the nose and throat and can easily spread to other people. It is important to know that all infected people do not have symptoms or seem sick. People who are infected spread the bacteria by coughing or sneezing, which creates small respiratory droplets that contain the bacteria.

People can get sick if they:

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Our Perception of Pain

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People have pain for all sorts of reasons. Sometimes it’s because of an injury, other times it’s a result of repetitive overuse. Sometimes we don’t know why someone’s in pain. It’s important to note that pain is a perception that our brain experiences. Did you know that the way we experience pain can be affected by other variables in our lives?

Our brain’s perception of pain can change with an alteration in different factors, such as when our bodies get warmer or colder. An increase in stress or anxiety can exacerbate our pain. Perhaps a particular movement similar to how we injured ourselves excites our pain response. Even our immune system and cardiovascular system can have an effect on the way we perceive pain.

Our bodies become sensitive to pain once we become injured, or once we hurt. We have a heightened awareness of this negative feeling and we almost come to expect it whenever we have an experience that reminds us that we “should” be having pain. However, sometimes when a pain becomes chronic, our pain threshold lowers and even the smallest of stimuli can be perceived as painful.

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Back to Sleep, Tummy to Play

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A question I always ask during the initial physical therapy evaluation of an infant is, “How is tummy time going?” The majority of the time, the response from the parents is a muttered, “Not well.”

Since the Back to Sleep campaign was initiated in the early 1990’s to decrease the risk of Sudden Infant Death Syndrome (SIDS), babies have been spending more and more time on their backs. While it is very important that an infant be placed on his back to sleep, as it has reduced the incidence of SIDS by 40 percent, it is equally important to a baby’s development that he be given frequent episodes of supervised tummy time throughout the day.

Most infants find tummy time difficult, and will often fuss and cry during it, making parents less likely to place their infants in tummy time positions.

Tummy time promotes the development of muscles in the neck, shoulders and back. It helps build the strength and coordination needed for rolling, crawling, reaching, and playing, and helps improve body awareness.

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Why is Meningitis Still Causing Death on U.S. Campuses?

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This year alone there have been three outbreaks of meningococcal disease on college campuses around the United States. In response to these outbreaks Rutgers University, Columbia University and San Diego State University, along with their respective municipal health departments, have recommended vaccination of at-risk populations.

But what is meningococcal disease? Why is dealing with it so important to college communities?

Meningococcal disease refers to any illness that is caused by a type of bacteria called Neisseria meningitides. There are several serogroups, including A, B, C, Y and W-135. The illnesses they cause are often severe and include infections in the lining of the brain and spinal cord (meningitis) and bloodstream infections. Up to 15 percent of people who contract it die, usually within 24 hours.

It is a vaccine-preventable disease.

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Peripheral Arterial Disease Can be Silent but Serious

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Peripheral Arterial Disease (PAD) is a narrowing of the arteries that reduces blood flow to the legs. It affects between eight and 12 million people in the United States. While the majority of people with the condition don’t know they have it, they have the same five-year mortality rate of those with breast and colorectal cancer.

M-8338-PAD-Infographic (edited) (2)PAD is often underdiagnosed by health care professionals. One in 20 Americans over age 50 has PAD, and one in three Americans over 50 with diabetes is likely to have it. If left untreated, PAD can lead to chronic non-healing wounds, lower limb amputation and even death.

“Often there are no symptoms of PAD, so it is important to be aware of factors that put you more at risk,” said James Shepich, M.D., general surgeon and medical director of MidMichigan’s Wound Treatment Center in Midland. “These include smoking, diabetes, obesity, high blood pressure, high cholesterol or a personal history of heart or vascular disease. People are also more likely to get PAD as they get older, and African-Americans are twice as likely as Caucasians to have the disease.”

Though many people may not have noticeable symptoms, the following could be warning signs of PAD. If you have any of these symptoms, you should tell your doctor:

  • Leg pain or cramping while walking that goes away after resting
  • Leg or foot pain that keeps you from sleeping
  • Feet that are pale, blue or cold to the touch
  • Toenails that do not grow as well as before
  • Decreased hair growth on the toes and legs

Treatments for PAD may include lifestyle changes such as diet and exercise, physical therapy, medications, and in extreme cases, surgery.

PAD can also lead to ulcers on the legs and feet that are stubborn and difficult to heal. The Wound Treatment Center at MidMichigan Health specializes in treating chronic, non-healing wounds like those related to PAD.

With locations in Alpena, Alma, Clare, Midland and West Branch, MidMichigan’s Wound Treatment Centers take a multi-disciplinary approach to treat not only the wound, but also the underlying conditions that can otherwise block healing. These include diabetes, vascular conditions, infectious disease and more. The Centers have specialized equipment and protocols that result in a median healing  time of 28 days and 94 percent patient satisfaction, placing them in the top 21 percent of nearly 800 Healogics (R) centers nationwide.

Treatments for leg ulcers may include dressings, compression therapy and hyperbaric oxygen therapy to increase the blood flow and reintroduce the body’s innate ability to heal.


If you or someone you love is living with a non-healing wound, don’t wait – seek specialized care. Call the Wound Treatment Centers toll free at (877) 683-0800.


Is My Child Talking Normally?

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Is my child speaking normally? Should he or she be saying more words, or understanding me more?

If these are questions that you’ve asked yourself, then it’s time to have a talk with your child’s pediatrician. He or she will be able to refer you, if necessary, to an American Speech Language Hearing Association (ASHA) certified speech language pathologist. This type of therapist specializes in the diagnosis and treatment of all speech, language, social and swallowing disorders in children and adults.

There are some general guidelines that you and your child’s doctor can discuss regarding your child’s development.

We expect infants to have a differentiated cry very early in life (tired, hungry, etc.), between birth and three months of age.

What should you feed your baby when he or she cries?

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Preventing Container Baby Syndrome

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Container Baby Syndrome (CBS) is a term used to describe a variety of conditions that can result from a baby spending too much time in a positioning device. These devices can include car seats, strollers, Bumbo seats, bouncy swings, rocker sleepers, bouncer seats, jumpers, ExerSaucers, activity gyms and centers, free standing or doorway jumpers and walkers.

Increased time in these containers lead to delays in the development of movement, cognition, social skills and can even cause skeletal deformity. They restrict a baby from being able to move all parts of his or her body. Although a baby may seem to enjoy these spaces and parents like them for providing a confining place for a child to play, this kind of ongoing immobilization can lead to delays in achieving gross motor milestones, such as rolling, sitting, crawling and walking.

Many parents may feel that these devices assist in teaching their children skills, but containers actually prevent babies from sitting or standing in correct alignment, which prevents them from activating important muscles needed for motor development. In addition, prolonged container use can also cause:

  • A flat head shape (known as plagiocephaly) due to lack of movement
  • Facial asymmetries
  • Torticollis
  • Decreased movement, strength and coordination
  • Issues with speech, vision, hearing and thinking
  • ADHD
  • Increased weight/obesity

When infants are held in their caregiver’s arms, they can practice the development of head control. In a container, an infant’s head is constantly resting against a surface, so there’s no need for the baby to work on head control. Tummy time and the ability to learn to move in space is essential to normal development. Tummy time strengthens the muscles of the neck and trunk, promotes a rounded head shape and facilitates the development of movements and coordination. A baby may fuss with tummy time, but that is generally because it is hard work for a baby to lift his or her head off the floor. Increased frequency of tummy time practice throughout the day will make this skill easier over time.

But, let’s be realistic for a moment! Sometimes, you must place your baby in a container for safety while you shower, make dinner, care for siblings, etc. A good rule of thumb is that for every hour that a baby spends in a container, they should spend one hour playing on the floor.

The following guidelines, as recommended by the American Physical Therapy Association, can be used to prevent CBS:

  • Limit your baby’s time in containers, such as car seats and strollers, to only when the baby is being transported somewhere.
  • Increase frequency and duration of awake tummy time opportunities with supervision.
  • Hold your baby in your arms or in a sling for short periods of time throughout the day.
  • Let your baby play freely on the floor in a safe environment.

If you have any concerns or questions regarding Container Baby Syndrome, please speak to your child’s pediatrician. Physical therapists can also help address problems that result from Container Baby Syndrome through positioning strategies, stretches, strengthening activities and facilitating age appropriate development.

Kristin Andraka, D.P.T., is a physical therapist at MidMichigan Health.


What is TMJ, and How is it Treated?

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Temporal Mandibular Joint Dysfunction, or TMJ, is a condition that limits jaw function, leading to difficulty with eating, talking and chewing. It can be painful, too.

Symptoms of TMJ can include jaw pain, jaw fatigue, ringing of the ears, dizziness, headache, jaw popping, neck pain, a locking jaw and difficulty opening your mouth. If you’re suffering from any of these, talk to your dentist. Your dentist will send you to your primary care provider if appropriate, who can then refer you to a physical therapist.

A physical therapist can provide treatment for TMJ using manual therapy, stretching and strengthening exercises, ultrasound, ice massage, electrical stimulation and more.

In addition, there are a few things you can do if you suffer from TMJ that may help ease your symptoms.

  • Avoid eating hard or chewy foods.
  • Do not open your jaw too wide.
  • Avoid smoking.
  • Place your computer screen at eye level and keep documents directly in front of you when working on them.
  • Avoid sleeping on your stomach, which forces your neck to rotate in one direction in order to maintain an open airway, increasing stress on your jaw.
  • Avoid repetitive chewing, such as chewing gum.
  • If you’re on the phone for long periods of time, use a headset that allows the neck and jaw to remain in a restful or neutral position.
  • Maintain good oral hygiene and tooth health.

Rob Gallagher, D.P.T., is part of MidMichigan Health’s Rehabilitation Services team in Alpena. He provides physical therapy in his hometown community, and specializes in orthopedics, ankle/foot pain, TMJD, back and knee pain, hip and neck pain and sports therapy. To make an appointment, contact his office at (989) 356-7248.


Survivorship Care and Fitness for Cancer Patients

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After undergoing cancer treatment, patients may hesitate or shy away from any exercise program, whether it’s because they’re scared, nervous, not sure what to do or where to start and question what types of exercises are safe.

An oncology fitness program, however, can improve the quality of a patient’s lifestyle at the time of their diagnosis through and beyond their cancer treatment. Exercise is medicine for both the mind and the body. The benefits of an exercise program include reducing pain and fatigue, as well as allowing the patient to regain movement, strength and aerobic fitness.

The program can help patients improve their quality of life while regaining or improving physical, emotional and social health. An initial consultation provides a base of knowledge of the patient to the clinician so he or she can provide the best quality care. Joint movement, strength and balance will be assessed, and the patient’s goals and interests taken into consideration.

From there, a personalized exercise program will be developed for each patient. Each patient will be taught proper techniques, and will be coached on how to become independent and comfortable with their exercise program.

MidMichigan Health’s Oncology Fitness Program is a cash-based service, and not billable to insurance. It’s offered in MidMichigan Medical Center – Midland’s Campus Ridge Fitness Center. Those who have questions or who would like to schedule an appointment may contact Jan DeVrieze, P.T.A., at (989) 837-9146 or email


Kinesio Taping: It’s Not Just for Athletes

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What is Kinesio Tape?

Kinesio tape is a type of elastic adhesive tape that can be used in all populations from pediatrics to geriatrics to elite athletes. Kinesio tape is latex-free, hypoallergenic, water resistant, and is able to be worn for multiple days at a time. One of the differences with Kinesio tape compared to other athletic tapes is that it does not restrict or limit range of motion. Therefore, the tape should be applied to allow for full range of motion.

What does Kinesio Tape Do?

Kinesio tape microscopically lifts the skin and can help to facilitate lymphatic drainage, decrease inflammation and increase space. The tape should be applied once an evaluation has been completed to determine limitation and target area. The taping application varies depending on the target tissue and the result that the practitioner is looking to achieve. The tape can also be applied in various cuts based on the results that the practitioner is looking for. Based on the way that the tape is cut and the stretch placed when applying the tape, Kinesio tape is able to decrease inflammation, improve circulation, promote lymphatic drainage and assist with healing and for neuromuscular re-education. Kinesio tape can also be applied in combination with other modalities during a treatment session.

When using Kinesio tape, it is important to perform a full assessment with each patient to determine the desired outcome. It’s also important to educate each patient on the tape application, how to remove it and what to do in case of an adverse reaction. Kinesio tape has been shown to have positive effects of multiple systems of the body and can be used in any stage of rehabilitation.

Lauren Gillette, P.T., D.P.T., is a physical therapist and certified Kinesio taping practitioner at MidMichigan Medical Center – West Branch.