The Uncomfortable Side Effects of Menopause

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The average woman in the United States is 51 years old when she goes through menopause. Menopause marks the end of a woman’s menstrual cycle, and is diagnosed when 12 months have passed without a menstrual period.

There are several common side effects that can occur during menopause. Some are talked about often: hot flashes, night sweats, mood changes and a slow metabolism. But there are other side effects that aren’t discussed as often, perhaps because they’re uncomfortable to talk about. But the reality is, they are common for many women. Painful sexual intercourse and vaginal dryness are both likely to happen during menopause.

During menopause, estrogen levels decrease, and vaginal tissue becomes more sensitive and susceptible to injury, which can lead to pain, especially during sexual intercourse. It’s estimated that 20 to 30 percent of women experience this during menopause. In addition to fragile vaginal tissue, other factors can contribute to intercourse pain, such as injury or trauma from childbirth, pelvic surgery or any other type of accident.

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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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5 Reasons Why Wounds Don’t Heal

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There are four key phases for a wound to heal successfully:

Infographic showing five common reasons why wounds don't heal: poor circulation, diabetes, infection, nutrition deficits and repeat trauma to the wound site.

[click image to enlarge] Specialized Wound Treatment Centers have better outcomes because they bring together many disciplines to not only treat wounds, but also to address the underlying barriers to healing.

  1. Hemostasis – clotting to control bleeding.
  2. Inflammation – swelling occurs as helpful materials are transported to the wound site and invasive microbes are pushed out.
  3. Proliferation – a protective layer of tissue is formed.
  4. Remodeling – rebuilding of tissue and revascularization and reorganization of the new tissue to function like the surrounding tissue.

Any factors that interfere with one or more of these phases can prevent wounds from healing. Some of the most common factors include:

  1. Poor Circulation – Oxygen and materials needed for healing can’t get to the wound site. Dead cells and harmful materials can’t be carried away.
  2. Diabetes – Diabetes interferes with healing in many ways, including lower oxygen levels, weaker immunity and decreased ability to form new skin cells and blood vessels. Diabetic nerve damage can also make it harder to sense a wound and seek treatment.
  3. Infection – Harmful bacteria can prolong inflammation and prevent new
  4. Nutrition Deficits – Wounds need energy, protein and other vital nutrients to heal.
  5. Repeat Trauma – Wounds on feet, moving joints and any body parts that may easily get bumped, rubbed or pressured are more susceptible to reopening.

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Diabetes Can Lead to Non-Healing Wounds and Amputations

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Infographic: 29.1 million Americans have diabetes. Approximately 25% will develop a foot ulcer. 15% of diabetic foot ulcers progress to amputation. 50% of people who undergo amputation will die within 5 years.

[click image to enlarge] Every hour, ten Americans will undergo an amputation due to diabetes. Of those, 50% will die in five years. People with diabetes need to be on the lookout for non-healing wounds and seek treatment right away.

It is estimated that 25 percent of the 29.1 million people living with diabetes will develop a diabetic foot ulcer. Without treatment, these wounds can lead to amputation or even death. Every hour, ten Americans undergo an amputation as a result of diabetes.

What’s even more startling – 50 percent of people who have an amputation will die within five years.

“The statistics are truly sobering when you realize that about 60 percent of non-traumatic limb amputations are performed on people living with diabetes,” said General Surgeon James R. Shepich, M.D., medical director of the Wound Treatment Center at MidMichigan Medical Center – Midland.

But there are steps you can take to avoid becoming a statistic.

Check Your Feet

Patients with diabetes – or their caregivers  – should check their feet at least every other day to Continue reading.


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.


Peripheral Artery Disease (PAD) Can Lead to Serious Complications

This entry was posted in Wound Care and tagged , , , on by .

Infographic: 1 in 20 Americans over 50 has PAD. 1 out of 3 people over 50 with Diabetes is likely to have PAD.

[click image to enlarge] People with PAD are more likely to develop non-healing wounds that require specialized wound treatment. If you or someone you love has these symptoms or risk factors, be on the lookout for non-healing wounds.

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 PAD don’t know they have it, they have the same five-year mortality rate as people with breast and colorectal cancer.

PAD is often underdiagnosed. One in 20 Americans over age 50 has PAD, and one in three Americans over 50 with diabetes is likely to have it.

Since PAD often has no noticeable symptoms, it is important to know the factors that could put you more at risk. These include:

  • smoking
  • diabetes
  • obesity
  • high blood pressure
  • high cholesterol
  • personal history of heart or vascular disease
  • Age (people are  more likely to get PAD as they get older)
  • Race (African-Americans are twice as likely as Caucasians to have the disease.)

Just knowing your risk can help you to be on the lookout for PAD warning signs while also Continue reading.


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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Someone You Know May Have a Non-Healing Wound

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Currently, 6.7 million people in the United States are living with chronic wounds. Due to lack of awareness of advanced wound care, the vast majority of these people do not receive the treatment they need and deserve.

Who May Be Affected?

Infographic: Who Could Be Affected By a Non-Healing Wound

[click image to enlarge] People with certain conditions or factors are more likely to develop wounds that don’t heal. The most common wound types are pressure ulcers, diabetic foot ulcers, venous stasis ulcers, surgical and trauma wounds and arterial ulcers.

While anyone may be affected, the following groups are particularly susceptible to non-healing wounds. These patients and their caregivers should be on the lookout for wounds that do not heal on their own and should seek treatment right away:

  • People with diabetes
  • Those with a personal history of heart or vascular disease
  • People who have had amputations
  • Cancer survivors, especially those who have had radiation therapy
  • Those who are obese or overweight
  • Veterans
  • Patients who have been readmitted to the hospital
  • Seniors
  • Surgical patients

The most common types of wounds are: Continue reading.


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.