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Ask Dr. Vieder

Every month, Dr. Sandy Vieder of Lakes Urgent Care answers your questions about timely health issues.

From asthma to flu shots, sports injuries to seasonal health topics, Dr. Sandy Vieder, Medical Director and co-owner of Lakes Urgent Care, answers questions submitted by patients every month. If you’ve got a health-related question that you’d like to see answered here, click the button below to submit your own.

Ask Dr. Vieder a Question



Most-Recently Answered Questions

Ticks and Lyme Disease

Ticks are skillful at attaching themselves to skin. When they do, it is difficult to remove them. Use fine tweezers to grasp the tick as close to the skin surface as possible and pull at a perpendicular angle to the skin surface until they let go. Removal should be attempted as quickly as possible to decrease the length of exposure.  Avoid “breaking” the tick so that no small pieces are left in the skin which could cause a localized infection. In rare instances where a tick bite does lead to an infection, initial signs and symptoms include itching, burning and redness in a circular fashion around the tick bite. Sometimes that rash can proceed to what is called a bull’s-eye lesion with concentric red circles around the bite area. If the disease is going to progress, you’ll start to have flu-like symptoms including muscle aches, fatigue, headache and fever. If you begin to experience any of these symptoms following a possible tick bite, get evaluated by your primary care physician or go to a certified urgent care like Lakes Urgent Care to initiate prompt diagnosis and treatment.

Most ticks don’t carry diseases and most tick bites don’t cause serious health problems.

But several diseases are attributed to bacteria transmitted by tick bites including Lyme Disease and Rocky Mountain Spotted Fever. Ticks can act as a transmitter of disease for both humans and many domesticated animals. When ticks latch onto their host to obtain a blood meal, they transmit these potentially infectious bacteria through their saliva. If you have a dog that likes to run in the woods, he will be at higher risk for having a tick join him. Your veterinarian can recommend either a monthly flea and tick preventative chew tablet or topical medication to reduce the risk of your dog becoming infected with ticks or bringing them into your home.

Tick infestations and activity in the lower Peninsula of Michigan has been increasing over the past few years and there are some specific things you can do to stay safe. When on a hike, walk in the center of the trail. Wear light colored clothing to make ticks easy to spot. Apply an insect repellent containing at least 20% DEET. Consider wearing clothing treated with permethrin when hiking or working in wooded areas. Also consider placing your clothes in a dryer on high heat for at least 60 minutes upon returning from potential exposure areas to kill the ticks. In our region, the greatest time of risk is from April through September.

All Questions

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Allergies

Have a seasonal allergy action plan and think preventative. When you use medications early, you may ease your symptoms all spring. Finding the right combination of treatment might take a bit of trial and error:

Antihistamines can help if you’re sneezing, have a runny nose, or your nose and eyes are itchy.

Decongestants can come to the rescue when you’re all stuffed up because they shrink the lining of the passages in your nose. You can try a nasal spray or a pill format, but be aware of potential rebound effect with long-term use, as they are best used for periodic relief.

Nasal corticosteroid sprayed into your nose, can give you relief from stuffiness and sneezing. These are very effective when used regularly, but they may take a few days or weeks to kick in.

Always consult with your primary care physician if you take other routine medications to avoid potentially problematic interactions.

Category: Allergies

Unfortunately, the answer is yes.  An earlier and longer growing season for trees and plants will increase pollen levels, which in turn could significantly exacerbate allergies, asthma and other chronic respiratory illness. Our March warmth started the blooming and pollination process much earlier than normal.  If you are miserable and feeling the effects and symptoms of seasonal allergies, you’re not alone. Tree pollen, mostly from Cottonwood, Maple and Juniper trees are causing the most grief right now.

Category: Allergies

Exposure to different allergens or bacteria can help your immune system develop antibodies and other useful proteins that can aid in fighting infections in the future. There is also evidence to suggest that having pets in the home may help children develop antibodies slowly over time. There is certainly nothing wrong with children playing in the dirt outside, but this should always be followed by good sanitary habits including washing hands and exposed areas with soap and water. Cleaning up after play also helps prevent any significant infections from developing initially with contact.

An ounce of prevention is worth a pound of cure! Staying in front of allergy symptoms by utilizing your treatment program before symptoms begin is much more effective. It’s also very helpful to take note of specific triggers that may initiate allergy symptoms. If there are certain seasonal milestones that always seem to give you trouble, such as spring-flowering trees or cottonwood season, it’s always best to take your medication and initiate your prevention program before those triggers come into full bloom.

Category: Allergies

Pillows accumulate many asthma- and allergy-provoking items such as bacteria, pollen, mold, and dust mites. In general, most experts in this field recommend replacing pillows every 3-5 years at most. It can also be helpful to cover your pillows with allergy-proof protective coverings. And don’t forget to wash your pillowcases at least once a week to keep them free of these allergy-provoking elements.

Category: Allergies

It’s always best to consult with your primary care physician for direction in creating the best treatment approach to seasonal allergies. Zyrtec is certainly an excellent antihistamine that generally does not cause sedation. Your doctor can tell you if you may also benefit from adding additional elements to your treatment program such as a nasal steroid spray, which is also now being offered as an over-the-counter choice.

Category: Allergies

It can be difficult to determine whether your symptoms are due to a common cold or allergies. However, the most distinct difference is that allergy symptoms generally only cause nasal congestion, runny nose and sneezing, without the other typical symptoms of the common cold such as fever, headache, muscle aches and sore throat. Allergy symptoms may also cause sinus congestion that manifests itself as pressure behind the cheekbones and mild to moderate pressure or headache in your forehead just above the eyebrows.

Category: Allergies

Asthma

Cold air causes bronchospasm or constriction of the bronchial tubes and places a higher work demand on the heart. For kids and adults with asthma, being prepared for that physiologic effect is key. Use an inhaler or give a breathing treatment with a nebulizer before going outdoors. Wearing a ski mask or scarf over the mouth and nose can help to warm the air to some extent. Limit time exposure in cold air to 20 or 30-minute periods. Take frequent breaks indoors to limit exposure. If your child begins to have difficulty breathing and does not respond to prescribed medication at home, seek medical attention at a certified urgent care center or emergency department.

Part I (Asthma and Urgent Care)

  • Lisa: Hi everyone! It’s Lisa with LivingWithAsthma.net, and we’re back with another one of our Asthma House Calls, where we get to sit down and talk with some of the very best doctors who treat children with asthma.Today we’re here with Dr. Sandy Vieder of Lakes Urgent Care and Michigan State University. Dr. Vieder is Chairman and medical director of the Emergency Trauma Center at Botsford Hospital in Farmington Hills and also a clinical professor of medicine at Michigan State University. Dr. Vieder is board certified in emergency medicine.

    Hi, Dr. Vieder! We are so glad you could be with us.

    Dr. Vieder: Thank you for having me.

    Lisa: Now just to start for those parents who have never taken their child to an urgent care center before can you tell us what an urgent care center is and how it is different from a traditional emergency room?

    Dr. Vieder: So an urgent care center really is kind of a hybrid between your pediatrician’s office and the emergency department. It’s important that you try and look for urgent cares that are certified urgent cares because not all urgent cares are certified.

    That certification comes from the Urgent Care Association of America and the big difference there is that these are centers that are really geared towards taking care of a very wide variety of illnesses and injuries. They pretty much operate like an emergency department without the ambulances and without the hospital beds.

    So while we certainly don’t want to take somebody who is really critical to an urgent care, like somebody with chest pain or perhaps has a bone sticking through their skin or something along those lines, pretty much all of the other run of the mill daily things like asthma attacks, upper-respiratory infections, cuts that need stitches, that sort of thing can certainly be taken care of in a qualified urgent care.

    Listen to Part 1 of the interview.

Part II (Why Urgent Care?)

  • Lisa: What are the advantages of going to an urgent care over an emergency room?Dr. Vieder: The biggest advantage really is that if you are going to a certified urgent care center, you are likely going to be cared for by an emergency physician who happens to be working in that urgent care center, similar to what ours is.

    All of our physicians have emergency medicine training so you get the emergency physician without all of the other sort of unwanted issues like long wait times, crowded waiting rooms, but the biggest thing is that the cost is considerably less for anybody to go to an urgent care compared to an emergency department. Your copay is going to be significantly lower and the charges for those people who don’t have insurance is going to be significantly less. So that is probably the number one reason to consider going to an urgent care.

    The other things that it certainly affords is that it’s generally a more comfortable environment, a little bit of a friendlier environment than an emergency department is because of some of the chaotic things that do go on in emergency departments across the country, and also the amount of time that you take. Most urgent cares will see you and treat you within a 60-minute period so that’s start to finish. Whereas it may take you 30 minutes or more just to get into an emergency department to be seen by a physician depending upon what department you go to. Some are excellent and really do get people in and out very, very quickly.

    Listen to Part 2 of the interview.

Part III (When It’s Time for the Emergency Room)

  • Lisa: Now it sounds to me like for a lot of situations, the urgent care can be the go-to for parents when an asthma attack occurs, but are there times when a parent should just head for the ER?Dr. Vieder: Yeah, you know there are some real basic rules I like to share with parents in particular when we’re talking about kids with asthma and that is that if your child is at all unresponsive or seems to be really sleepy, or what we sometimes call lethargic, and they are having trouble breathing and you think it is from their asthma, this is clearly a time when you want to head to the emergency department and not likely an urgent care.

    However, if you’re seeing that your child is having some problems and you’re comfortable with the sort of stages of asthma that they go through and you’re catching it early on, it’s very appropriate to be able to go to an urgent care at that point. They can typically give some steroids to initiate the treatment, breathing treatments to give and often times that can be enough to kind of turn the situation around and you can avoid going to the emergency department.

    But the last rule of thumb is always trust your instincts. Parents who have kids with asthma or other chronic conditions generally have a really good sense as to when their kids are doing well or when they’re in trouble and that’s always the best thing to follow. Follow your intuition. Nobody knows your child like you do. So don’t ever not pay attention to that. That’s a very important element.

    Listen to Part 3 of the interview.

Part IV (Taking Your Child to Urgent Care)

  • Lisa: Dr. Vieder, can you take us through if an asthma attack is occurring in a child, are there things that parents can do to make sure that their child gets the best care possible at an urgent care center?Dr. Vieder: Well there’s basic things that whether you go to an urgent care center or an emergency department are generally going to happen with an acute asthma attack. Because we are really honing down our treatments to one specific area, that being asthma, you’re always going to see breathing treatments that are given.

    You’re likely going to see some form of a steroid being provided whether that is an oral medication which is just as good as an injection, it doesn’t have to be one or the other. They’re both just as efficacious as the other. And the time of onset for steroids that are given is typically 4 to as much as 6 hours after the initial dose, so you’re not going to see a benefit immediately.

    The other thing is that if you have a child who is having a really severe asthma attack, we will sometimes give adrenaline or epinephrine and that too can be given in both of those settings. So those are the things that you’re generally going to be looking for.

    I personally try to avoid doing chest x-rays on kids with asthma because over the course of their lifetime they generally have so many x-rays and more often than not those x-rays are normal. If we know that the issue is asthma and it has been triggered by an upper-respiratory infection or a runny nose or a cold or perhaps an allergen that might be in their environment then there is really no need to do a chest x-ray. And so trying to avoid unnecessary x-rays is important as well.

    Listen to Part 4 of the interview.

Part V (Reducing Emergency Room Stress)

  • Lisa: Are there any things that parents can do to make those late-night trips to the urgent care or the ER less stressful for the child and maybe the parent too?Dr. Vieder: Well, initially the difference between the urgent care and the ER is certainly pretty dramatic in terms of that stress-inducing environment. So certainly going to an urgent care is going to be a little bit less stressful than going to the emergency department.

    But most importantly, I think just being supportive with the child, getting to know your local facilities, maybe even making a trip into that facility when the child feels well, can be a really great way to introduce them so that if and when that time comes where there is an asthma attack that you are not able to effectively treat at home, and now you’re heading to your local facility whether it be an emergency department or an urgent care, that can be really beneficial because now the child kind of knows where they’re going.

    I frequently say to the residents that I teach that stress is the function of what you don’t know. So if you don’t know where you’re going and you’re not aware of your surroundings, that is going to be way more stressful than if you are familiar with your surroundings.

    So sometimes taking a child to a local facility when they’re feeling well, maybe those facilities will give them a little prize or gift or toy, spend a few moments showing them around and making them feel comfortable so that if that moment comes, it’s a little bit less stressful for them.

    Listen to Part 5 of the interview.

Part VI (Managing Asthma Every Day)

  • Lisa: Kind of on that note, are there everyday things that parents can do to manage their child’s asthma and avoid going to an urgent care center?Dr. Vieder: Absolutely, the most important thing is making sure you follow the directions of your primary care physician. Whoever is managing your child’s asthma is likely going to provide you with a roadmap of things that you should do on a regular basis and things that you can do when you start to notice specific symptoms.

    There are some physical symptoms that we can look for in children with asthma and it is not hard to learn but it is certainly something that hopefully your pediatrician or primary care physician will spend some time teaching parents about to look for. And I’ll give you just a couple of examples.

    For instance, nasal flaring and that’s when the nostrils kind of move in and out. It’s something that is pretty easy to see and if you see that happening with your child, what that should tell you is that you know what they’re working a little bit harder than they normally do when they’re feeling well so that’s just going to be a little bit of a red flag. Perhaps they are starting to get into trouble and we need to give an extra treatment or get out the inhaler or the nebulizer at home and make sure that we do what we need to do because again, early intervention as these things progress really make a big difference.

    The other thing is making sure that you address certain environmental issues that trigger the asthma or asthma attack in your child. So you’ll need to learn whether or not if you have pets, are those potential problems? Some kids with asthma do perfectly fine with dogs and cats. Some do not because they have a combination of reactive airway disease and asthma, and environmental allergies and when you add that all together that can be kind of a 1, 2, 3 punch that really puts them over the edge.

    Any one of those elements independently might be just fine and they can tolerate it but when you have that additive effect it can certainly impact their airway and create a worse situation so that’s the other thing you want to kind of look like, is what seems to trigger specific events.

    Perhaps keeping a log is another great idea so that when you notice that your child has a particular problem is there some commonality between the events. Is it something that they ate? Perhaps it is a new food allergy that triggers it as well.

    These are all possibilities. It doesn’t mean that they happen in every child, but certainly something to keep in mind and that can help parents sort of prevent those events from getting worse and having to go to an urgent care or an ER.

    Listen to Part 6 of the interview.

Part VII (Why to Quit Smoking)

  • Lisa: On the flip side, are there things that you see that parents don’t realize can land their child in the urgent care or ER?Dr. Vieder: Probably the number one thing I see is unfortunately where parents are smokers or there are smokers in the home and that creates an environment that is certainly going to get kids into trouble. Generally speaking, most parents who have got kids who have asthma and those kids have been evaluated are pretty much with the program. It’s pretty rare.

    Parents are really great. Once they learn about the disease and once their child has been living with it for some period of time, they generally figure things out and they are generally pretty good about intervening early and trying to prevent bigger problems.

    And once they do end up in the emergency department or urgent care, those are the parents that I find more often than not are really well educated and they’ve done all of the things they can do at home and now it is time for some professional help.

    But going back to the smokers the other issue is that a lot of times I’ll hear parents say, well I don’t smoke in the house which is certainly better than smoking in the house, but even the smoke, the smell of smoke on their clothing or on their skin, can be an irritant that is enough to trigger an asthma attack in some kids who are really sensitive. So that is probably the number 1 thing that we see, particularly in my line of work where people and kids do get into trouble with asthma and that is that exposure to smoking.

    Listen to Part 7 of the interview.

Part VIII (Talking to Your Child About Asthma)

  • Lisa: Do you have any advice for parents for talking to their child about asthma?Dr. Vieder: Absolutely. Unfortunately, there is going to be some percentage of kids who have asthma and move on to be adults who have asthma. And it’s not going to get any better. But it’s certainly manageable. So empowering your children to learn about the disease and empowering your kids to lead as normal a life as possible is really really critical.

    By way of example and this is not directly related to asthma, but I’ve got a son who has got a congenital heart problem and has to take blood thinners because he has an artificial heart valve and we’ve always been supportive of him being involved in certain sports.

    Now I won’t allow him to play contact sports, but we do allow him to participate and play sports to the best of his ability. And so he hasn’t grown up feeling like a cardiac oddity if you will, or a child who can’t be like all of his friends and buddies.

    So making sure that your kids are involved in other activities to their tolerance is really important and being supportive of that. Because again, kids with asthma can do really well in athletic activities. That might require a little extra TLC just before participating. For instance, some kids might require a puff or two of an inhaler before they begin playing in a sport and once they do that, they do absolutely fine.

    So I would be cautious about having kids sort of put into the bubble and not allowed to participate and do the things that their peer group does. To as much as their tolerance, they should be allowed to do that.

    Listen to Part 8 of the interview.

Part IX (Final Advice)

  • Lisa: Is there any other advice you would give parents of children with asthma today?Dr. Vieder: The biggest thing is that if asthma is new to you and your child, take the time to educate yourself because it is such a treatable disease and it is a disease that you can live with and lead a totally normal healthy life. That’s probably the most critical message I would give. And make sure that you become familiar with your local facility, so that when you get into trouble you know where to go and you are a little bit more comfortable.

    And like I previously mentioned, introducing the child to those facilities is something that many facilities would be happy to do. We certainly are at our urgent care and our emergency department. We would welcome that opportunity so that the child is less scared and less apprehensive when they do need to come in when things have not been successfully turned around at home.

    Lisa: Thanks so much for being with us today Dr. Vieder. If people today want to keep up with you what is the best way to do that.

    Dr. Vieder: Well they can certainly look at our website which is www.lakesurgentcare.com and we do have a Facebook page. We post all kinds of informative articles and we try to send out posts at least twice a week so there is always health related links there. But certainly for those who live in our area, we are happy to take care of any of their needs and again I appreciate the opportunity to speak with you today.

    Listen to Part 9 of the interview.

Category: Asthma

Back to School

Regardless of whether he plays sports or not, your son should have a complete physical exam once a year with his pediatrician or primary care physician. The sport or camp physical should never be used as a substitute for this more thorough annual evaluation. The focus of each of these types of physicals is very different.

The sports physical is really an adjunct to the annual complete physical, with more specific questions about your son’s physical ability to play sports safely. Most health insurance plans to don’t cover services for this type of evaluation, but you can get this completed at a certified urgent care at a very reasonable cost. Simply download and bring your school’s athletic exam form to either your primary care physician or a certified urgent care facility. Lakes Urgent Care takes care of sports physicals easily and quickly if you need us after hours to accommodate your families busy schedule.

The State of Michigan now requires vaccination history be provided, so make sure all recommended immunizations are up to date. If your son is in high school, now would also be a good time to discuss getting the meningitis and HPV vaccines. Your pediatrician or primary care provider can provide you with counseling and administer the vaccines as well.

Have his hearing and vision checked. Often times, visual changes can be subtle, but can contribute to correct a potential learning challenge. Your pediatrician, primary care provider or local certified urgent care are an excellent resource to determine if there is an underlying vision or hearing problem.

Update his emergency medical records and contact information at school. If your son has any chronic medical issues like asthma, diabetes or seizure disorder, make sure there is a well-reviewed action plan, should there be an issue. Also update any allergy history.

Stay away from those jumbo backpacks! Backpack should not be more than 20% of your son’s total weight. Anything heavier can lead to issues with back pain, strain or even distort good posture.

Help him manage and relieve stress! The new school year always brings exciting new experiences, but can also be very stressful with new challenges. Getting plenty of sleep, eating a well-balanced diet providing good nutrition, and maintaining an active exercise routine can help make the new school year more successful.

Category: Back to School

Cold-Weather Health Issues

Aside from the impact on your skin, dry air also contributes to those jarring static shocks that practically propels you across the room every time you touch your pet or grab a conductive object! Aside from the traditional central HVAC humidifier or room sized/table top humidifier, there are several other simple, low-cost actions to reach the target 35-45% humidity level in your home:

Use a traditional tea pot to boil water and quickly add humidity to your kitchens adjacent living space. Houseplants can help in adding humidity to your home. Plants continuously release moisture from their leaves and stems as vapor. This process is called transpiration and if you keep your plants watered, they will help regulate humidity levels inside your home. Place a metal or ceramic bowl on top of your floor register or a radiant heating unit. Depending on the current humidity levels in your home (and how much your heat is blasting) the water will evaporate into the air.

Finally, vent your clothes dryer inside instead of outside your home with a simple conversion kit. The moisture from drying your clothes will stay in the house and reduce heating costs by releasing the warm air into your home.

In winter, the humidity drops and dry air sucks moisture out of your skin. With less humidity, the moisture in your skin evaporates more quickly. When it’s cold outside, a long hot bath or shower may seem really appealing. However, within 15 minutes, that hot water starts degrading the lipid (fatty & oil) layer, and the removal of these natural fats dry your skin.

Try to treat dry hands at the very first sign of symptom. Large cracks or fissures can be difficult to treat if you wait too long. Apply a hand cream or treatment at least twice daily—but you really should be applying it after every hand wash or the moment they begin to feel dry again. If you’re prone to dry, cracked hands, try to avoid hand sanitizers, which are high in alcohol. Use gentle cleansing soaps that are lipid-free and are more moisturizing than traditional antibacterial soaps. If you develop cracks on your skin or fingers, apply bacitracin or hydrocortisone 1% ointment to the open area twice daily for up to two weeks, then wrap with a Band-Aid.

Perhaps the number one preventative thing that we can all do is get vaccinated for seasonal influenza. Good hand hygiene is imperative as another preventative measure against the spread of illness. Teach children to cover their cough or sneeze and to wash their hands after they touch their noses or sneeze.

Try to promote a healthy winter diet. Many of us complain about putting on the calories during the winter months but eating food items rich in Vitamin C like citrus fruits, tomatoes, melons and leafy greens are a great way to maintain a healthy immune system while limiting calorie intake. Also, keep well hydrated as this will help to reduce the susceptibility to a cold or the flu. Lastly, shake off winter laziness and avoid seasonal depression by encouraging regular exercise during the winter. Activities such as ice skating, snowboarding, skiing and tobogganing are all fun and healthy!

Protect your child’s head from injury, especially during any type of winter sports where there is a significant amount of motion and potential for falling. Remember that hard packed snow and ice can be just as damaging as a fall on concrete.

A sledding hill should not be too steep, with a slope of less than 30 degrees that ends with a flat runoff. Often, sledding hills are not far from highways or roads so it’s important to keep a safe distance from motor vehicles. Any sledding area should be clear of obstructions like trees or fences. Kids can prevent injury by wearing a helmet and sledding feet first or sitting up, instead of lying down head-first. Dressing in layers is also important. If your child begins to sweat, remove layers as needed, so they stay dry. Wet clothes can lead to hypothermia or frostbite.

Stay up-to-date on vaccinations and limit your baby’s exposure to potential infections.
Good hand hygiene is imperative. Before letting anyone touch your child, ask them to wash their hands first.

You should not use a blanket in your child’s crib. If you’re concerned that she may be cold, dress her in a warm baby sleeper and investigate any potential cold drafts that may be in the room, particularly from windows that may leak. Your home has a lower relative humidity during the winter months and running the heat contributes to further dryness. If your baby develops eczema, consult with your pediatrician or primary care physician to determine the best course of action.

Climate projections across the Midwest point to warmer winters, earlier springs and warmer summers. This fosters conditions suitable for higher precipitation, which leads to a greater risk of vector-borne diseases. Examples include mosquito-borne diseases such as West Nile virus and tick-carried diseases such as Lyme disease.

Heat waves featuring high temperatures, high humidity and stagnant air masses could become more common and may lead to increased levels of heat-related illness.

Predicted increased precipitation and flooding from such events can also lead to runoff from sewage and septic systems potentially increasing the risk of water-borne diseases and, in some cases, harmful algal blooms in our most precious Great Lakes.

The winter months in our region can certainly bring many challenges. As our days get shorter with less sunlight and our weather gets progressively colder, there is a natural tendency for us to become less active and more dormant. In an effort to remain healthy, it is important to try and maintain a nutritious diet. If you are able to keep to a regular exercise program, balanced diet and also get adequate sleep, you will have created the foundation for preventing wintertime illness. The key to success with exercise is to create a program that is both convenient and consistent. However, there are also some strategies to help reduce exposure to illness, both in the home and workplace. Frequent hand washing is the best way to prevent the spread of illness. Keep an adequate supply of hand sanitizer available in backpacks, cars and briefcases, in addition to other common sites in your workplace and home. Don’t forget to adequately clean common surfaces such as doorknobs, computer keyboards and mice that are shared, along with refrigerator handles, the community coffee pot and other similar frequently touched community surfaces. In elevators, try using a glove, sleeve or a finger knuckle to depress buttons. Make sure to have your heating system checked for proper operation and change your air filters. When firing up either central or room-based humidifiers, make sure they have been cleaned from summer storage. This will avoid disseminating mold into the air that may have accumulated in the ultrasonic nebulizers inside these units.

Cold weather puts an extra strain on the heart. If you have heart disease or high blood pressure, your baseline status is already compromised. Your body is working hard just to stay warm, so take frequent breaks and don’t overdo it. In addition, warm up your muscles by stretching and walking; shovel small loads of snow at a time and work slowly. Bend your knees and avoid twisting your body, keep your back straight, and let your arms bear the load. Most importantly, never ignore back or chest pain!

Cold air causes bronchospasm or constriction of the bronchial tubes and places a higher work demand on the heart. For kids and adults with asthma, being prepared for that physiologic effect is key. Use an inhaler or give a breathing treatment with a nebulizer before going outdoors. Wearing a ski mask or scarf over the mouth and nose can help to warm the air to some extent. Limit time exposure in cold air to 20 or 30-minute periods. Take frequent breaks indoors to limit exposure. If your child begins to have difficulty breathing and does not respond to prescribed medication at home, seek medical attention at a certified urgent care center or emergency department.

As a general rule, it is safe to exercise outdoors in freezing temps as long as you pay attention to the signs and symptoms of specific cold-weather dangers. The three primary concerns are frostbite, hypothermia, and heart attack. Wind chill and time exposure are critical factors to consider when you are attempting to exercise outdoors. Learn the symptoms of impending trouble to avoid danger. Numbness or tingling of the hands, feet, ears, or nose signal early frostbite. Shivering, slurred speech, loss of coordination, and unusual fatigue signal hypothermia. Breathing cold air can trigger lung bronchospasm and coronary vasospasm in addition to placing an additional load on the heart. If you experience any chest pain, stop immediately and seek medical attention.

Enterovirus D68

Antibiotics are not effective against any type of virus including Enterovirus D68. There is no vaccine for this virus. The best defense is good hygiene and supporting your immune system by eating a balanced diet and getting adequate sleep. If you become concerned that your child may have this severe respiratory illness, you should seek medical evaluation with your primary care physician or a certified urgent care. The staff at Lakes Urgent Care is capable of evaluating and initiating treatment for this virus as well as submitting the required testing to the state immunology lab if indicated.

Category: Enterovirus D68

Enterovirus D68 most commonly causes advanced respiratory symptoms such as persistent cough, wheezing and progressive shortness of breath. Initially, symptoms from this virus may emerge in a typical fashion with fever, rash, nausea, vomiting or diarrhea. However, the most significant aspect of this virus is the advanced respiratory illness that it causes in children. It can also have a greater impact on children with underlying respiratory issues like asthma or if they are immunocompromised due to congenital heart disease or other chronic ailments that may impact their immune system.

Category: Enterovirus D68

As with any type of communicable disease, good hand washing is the most important thing you and your family can do to prevent contraction and spreading. The virus is capable of surviving on solid surfaces for several hours. Maintaining a regular cleaning program for community surfaces such as desks, doorknobs and other commonly handled items with a disinfecting solution or wipe, should be adequate to kill the virus on these surfaces. Keep hand sanitizer in many easy to reach places and use it!

Category: Enterovirus D68

This is a rare strain of a common virus, which for unknown reasons has become very active now. The virus is related to the common cold. It is not a new strain of virus and has caused significant respiratory illness specifically with children. There have been no reports of illness in adults related to the D68 Enterovirus.

Category: Enterovirus D68

Flu Season

If your father enjoys visiting with his children or grandchildren, let him know that he is putting his family at risk by not getting vaccinated. That might be adequate motivation!

I would also tell him that by not getting immunized he also puts others at risk. If he won’t choose to do it for himself perhaps he could do it for the benefit of others.

Category: Flu Season

Earlier this year, the American Academy of Pediatrics and the Centers for Disease Control issued statements discouraging use of the nasal vaccine in children. Unfortunately, the nasal vaccine has proven to be not as effective as the injectable vaccine.

All children age six months and older should receive the flu vaccine beginning any time in October. This should provide immunity for the entire 2016-17 influenza season. Always consult with your pediatrician or primary care physician if you have any concerns about the vaccine. You may also obtain the vaccine at a certified urgent care center.

Category: Flu Season

Flu vaccines are offered in many places including doctor’s offices, urgent care clinics, health departments or some pharmacies. The pricing varies from place to place, usually ranging from $20 – $30. At Lakes Urgent Care, you can get your flu vaccine for $22.00 and you do not need to have an appointment. Most insurance plans today cover for vaccines, so the only time you would have to pay for the vaccine at Lakes Urgent Care is if you do not have insurance or your insurance plan does not offer this benefit. All retail locations which offer the vaccine, generally do not participate with any insurance plans, so it will be an out of pocket expense, even if you have coverage. Just come in anytime during open hours from 9:00 am – 10:00 pm to get your vaccine. Lakes Urgent Care offers both the regular dose vaccine and high dose vaccine for the same price.

Category: Flu Season

Flu seasons are extremely unpredictable, but peak flu activity is usually between January and February each year.  Epidemics of flu occur each year, but the location and severity of the cases varies from year to year. Also, the actual type of flu strain can change from year to year, but the CDC helps to predict what strains will be most likely and this information is used in formulating the vaccine for each season.

Category: Flu Season

Current medical recommendations indicate that it’s best to get your flu shot sometime after October 1st.  In particular, patients over the age of 65 may be negatively impacted by getting the flu vaccine too early in the season. The vaccine stimulates our immune systems to create antibodies to fight against influenza. However, those antibodies may have a limited period of effectiveness.  If the vaccine is provided too early in the season, it may lose some of this effectiveness if we experience a late flu season. The flu season typically begins around November or December, with peak activity in January and February. Should there be a slight delay in that pattern, it is possible that the vaccine’s effectiveness may not be as good as it could have been if provided too early in the season, say in August or September.

There seems to be a great deal of “medical marketing” going on by stores like CVS and Walgreens who provide discount coupons or offer to make charitable donations in order to gain your business early in the flu season.  It is always best to seek advice from your primary care physician, pediatrician or at a qualified urgent care center, as there may be some specifics differences in your own personal health status indicating the need for a different vaccination schedule.

Category: Flu Season

There are 3 different types of flu vaccine available today. There are 2 different types of injectable vaccine and also a nasal spray vaccine. Most healthy individuals between the ages of 2 years and 49 years may opt for the nasal spray if they prefer not to receive an injection. The nasal spray version is not recommended for individuals who have chronic health issues.

There is also a “high-dose or high- powered” injectable version available which is recommended for adults over the age of 65. This vaccine is comprised of 3 types of flu strains in the formulation (known as trivalent).

Category: Flu Season

The flu shot is indicated for infants older than 6 months and all adults.  Any healthy adult who wants to decrease their risk of contracting the flu should get the vaccine. The flu shot is particularly important for anyone who has chronic health problems such as asthma, COPD, diabetes, heart conditions or if you have a weakened immune system. Women who are pregnant or plan to become pregnant should also get the flu vaccine.

Category: Flu Season

While each flu season is highly unpredictable as to the time of onset or how severe it may be, the best recommendation is that you should get vaccinated against influenza as soon as possible, beginning in September. In some years the flu season can last all the way until late April or even early May. Influenza vaccine is recommended for all individuals aged 6 months and older. There is also a different vaccine recommended for individuals who are older than 65. For children under the age of six months who are not eligible for vaccination, it is best to discuss treatment options and prevention with your pediatrician. However, assuring that all members of the family and close relatives get vaccinated is a great first step in prevention. The flu vaccine is generally covered by most insurance plans although it’s always best to check with your specific plan to see what your coverage may be. The influenza vaccine is currently available from most primary care providers. We have an ample supply available at Lakes Urgent Care right now.

Category: Flu Season

Foodborne Illness

As in most instances of illness, everybody responds differently. Some individuals will have very mild symptoms, while others may go on to have more significant complications associated with Escherichia coli or other foodborne illness. If your symptoms are mild and have been time-limited, just keeping up with the fluid demand by drinking plenty of water or sport drinks containing electrolytes should be adequate to keep hydrated. Vomiting greater than 24 hours is a key indicator that you should seek medical treatment. If diarrhea becomes bloody, this too would be a reason to seek medical advice.

With more severe cases of food poisoning, it is best to seek medical treatment at a certified urgent care that is capable of providing you with IV fluids and medication to stop the vomiting cycle.

Unfortunately, there is no vaccine available to protect us from Escherichia coli-based illness. When eating in a restaurant, there may be online sources that provide readings or grades for restaurants, based upon such factors as cleanliness and prior history of foodborne health problems. Many large cities are now adopting a grading system, which in the case of New York City has proved helpful, significantly reducing the number of food-related illnesses there in the last year.

Making wise food choices can also help prevent problems. Make sure all beef and poultry products are cooked to a temperature of 160° or higher (most menus in restaurants today require this notification). Also, don’t be afraid to ask restaurant staff if they thoroughly wash raw produce or if kitchen assistants typically wear vinyl or latex gloves while preparing foods.

Escherichia coli is a bacteria which normally lives in our intestines harmlessly, but there are several different strains of it, some of which can cause severe abdominal cramps, excessive or bloody diarrhea, as well as vomiting. Typical exposure to Escherichia coli is from contaminated water or food, especially raw vegetables or ground beef that is undercooked. When multiple cases occur it is typically from exposure to a common food source, such as in a restaurant. There are numerous possibilities as to the exact source within a restaurant, but they could include accidentally contaminated food from restaurant staff, undercooked beef and poultry, or contaminated work surfaces from raw or poorly-washed foods.

Hot-Weather Health Issues

The elderly, people with significant underlying chronic diseases, including heart and lung disease, weakened immune systems, mental health disorders and dementia are most effected by extreme heat. People who work outdoors or in extreme heat conditions – outdoors or indoors are also at risk.

You can be more or less vulnerable to health risks from extreme heat based on these factors:

Sensitivity – the degree to which you are affected by a stressor such as higher temperatures

Exposure – the physical contact between you and higher temperatures

Adaptive capacity – your ability to adjust to or avoid potential hazards

Heat is the number one weather-related killer, and as carbon pollution continues destroying earth’s atmosphere, global temperatures will keep climbing, bringing us hotter summers and more dangerous heat.

The ability to sweat is one of the primary mechanisms your body uses to cools you down.

When humidity levels rise, sweat does not evaporate as efficiently, which keeps your body from releasing heat as fast as it may need, and this leads to overheating.

Always drink plenty of fluids when you are sweating. Excessive sweating can accelerate dehydration and worsen the situation in high heat environments.

Staying well-hydrated is the number one action we can all take to limit the effects of extreme heat. When the temperatures and heat index begins to reach 100 degrees or more, it is especially important to drink water and other drinks that contain electrolytes (salts and minerals in the body that are found in body fluids) – avoid sodas and alcoholic beverages! Contrary to popular belief, it is perfectly fine to hydrate with coffee or tea.

Limit exposure time to extreme temperatures; hydrate often; wear light colored, loose fitting and sweat absorbing clothing. Avoid the outdoors during extreme heat and stay out of the direct sun. If you must work outside, slow down and take frequent breaks. Avoid strenuous exercise during the hottest part of the day. Finally, consider postponing outdoor games and activities.

MRSA

MRSA is a very treatable bacterial infection, but the key is seeking medical attention early before symptoms worsen and the infection progresses. Boils or abscesses must be evaluated by a health care professional for incisions and drainage. The primary treatment is medications and antibiotic therapy that is not resistant to MRSA. Sometimes intravenous (IV) antibiotics are necessary if the infection does not respond to oral antibiotics. The recovery process varies and depends upon how quickly treatment is sought, the severity of the infection and response to treatment.

Category: MRSA

MRSA symptoms in children and adults are the same, although can vary based upon the initial skin infection or its severity. In general, seek medical attention when you see skin containing pus or fluid, such as an abscess, blister or boil. Also look for areas where the skin may be red and swollen, and feels hot and tender to the touch. This could be cellulitis, a common potentially serious bacterial skin infection. The rash of cellulitis may also begin with red bumps that begin to spread.

Category: MRSA

The basics of good hygiene apply to best protect yourself and your family from MRSA and other bacterial related infections. Frequently wash your hands with soap and water or an alcohol-based hand sanitizer for at least 30 seconds. Avoid sharing toiletries like razors and towels. For those involved in athletics, avoid sharing sports equipment, and always wear shower shoes in the locker room. Avoid touching others who have visible skin cuts or abrasions. If you have cuts or abrasions, cover them to protect yourself and others. MRSA is most commonly contracted from contaminated items and surfaces in crowded living conditions, like dorms, barracks and athletic settings, where skin to skin contact can occur.

Category: MRSA

MRSA (Methicillin-resistant Staphylococcus aureus) is a type of bacterial infection which commonly affects the skin causing boils, abscesses and other skin infections. If MRSA goes unrecognized or untreated it can extend to deeper tissue and even enter the bloodstream. It can also result in bacterial infections like pneumonia, meningitis and other life threatening illnesses very rapidly. The most significant concern regarding MRSA is its resistance to commonly used antibiotics, which can make the MRSA infection more aggressive and difficult to treat.

Category: MRSA

Outdoor Summer Safety

For your health and safety, it is critical to clean your grill grates before you start cooking. The concern with wire brush cleaning tools is that the wire bristles can snap off, land in the grates and ultimately find their way into your food. There are hundreds of emergency department visits annually related to ingested wire bristles.

The good news is that there are many safer and just as effective alternatives to a wire brush. Consider using a grill cleaning stone or brick, a bristle free metal brush made of metal coil or even a nylon bristle brush. These are all safer alternatives. If you do want to stick with a wire brush, make sure that it is in good condition and always wipe down the grates or grill surface with a wet paper towel after using the wire brush.

There is nothing better than the aroma and taste of summer grilling! Unfortunately, there is now ample research indicating that cooking meats at high temperature with flames that cause excessive charring increases the presence of HCA’s and PHA’s which are the chemicals known to increase the risk of cancer. As with so many other things in our lives, moderation is the key.

Marinating meats for at least 30 minutes prior to grilling provides a protective mechanism that prevents these chemicals from developing. Cut back on grill time, reduce the heat being used and avoid direct flame to the foods being cooked. Before cooking, clean your grill thoroughly to remove carcinogenic residue that builds up over time. Processed meats such as hot dogs and sausages also have an increased risk associated with these potential carcinogens.

Consider swapping grilled meats for grilled vegetables and fruits, which do not carry the same risk. This will allow you to enjoy that Bar-B-Q charred taste because the previously mentioned chemicals develop only in muscle proteins.

With any type of head injury, if there has been a loss of consciousness or there is evidence that your athlete has confusion, nausea/ vomiting, visual disturbances or has a headache that will not resolve with a simple dose of Tylenol or Advil, they should be seen by a physician experienced with concussion evaluations. Depending upon the outcome of that evaluation, advanced imaging like a CT scan of the brain may be required.

With extremity injuries, a good role of thumb is if they cannot reliably bear weight on a lower extremity or use their upper extremity for simple tasks like opening a door or carrying a book, it is best to have a physician evaluate that injury and take diagnostic x-rays to rule out the possibility of a fracture.  Keep in mind that even though somebody may be able to move a joint, there may still be an underlying fracture and the only reliable method to determine this is with an x-ray and a physician evaluation.

Wearing a properly-fitted helmet, which has been approved with the ATSM label, is an excellent start. In addition to a proper fit on the head itself, make sure your kids understand that it’s critical to also wear the chin strap, so the helmet stays on their head! Beyond that, consider additional safety devices like properly-fitted wrist guards, elbow pads and kneepads. We frequently see severe elbow fractures as a result of skateboard falls, which can quickly ruin a child’s summer.

Exposure to different allergens or bacteria can help your immune system develop antibodies and other useful proteins that can aid in fighting infections in the future. There is also evidence to suggest that having pets in the home may help children develop antibodies slowly over time. There is certainly nothing wrong with children playing in the dirt outside, but this should always be followed by good sanitary habits including washing hands and exposed areas with soap and water. Cleaning up after play also helps prevent any significant infections from developing initially with contact.

The vast majority of insect bites do not require medical attention. It is common to have some localized redness and swelling immediately after a bite. However, if the bite site begins to appear infected, redness, swelling, severe pain or any fluid draining from the area, you should seek medical attention, as the infection may require antibiotic treatment. If the bug bite causes the individual any facial swelling, shortness of breath or trouble breathing, seek medical attention immediately.

There are simple measures you can take to help reduce your risk of exposure to bug bites. Wear long sleeves and long pants when planning evening outdoor activities. In addition, apply a good quality insect repellent that contains at least 10 percent DEET, and use preventive environmental products such as citronella candles and yard torches. Mosquitoes frequently breed in standing water and puddles so, be vigilant and don’t let water accumulate around your home.

To ensure that you get the maximum protection from your sunscreen product, apply sunscreen prior to going out in the sun. You generally need approximately 1 ounce (the equivalent of a shot glass) applied to the overexposed areas. Then follow the recommended reapplication guidelines mentioned previously above. Another important fact to know is that no sunscreen is truly waterproof. Some products are more resistant to coming off when exposed to water or sweat, but the best defense to ensure that your sunscreen does not come off your skin when exposed to the sun is frequent reapplication, particularly after swimming, to avoid any risk of unintended exposure.

As the old rhyme goes, “leaves of 3—let them be!” Poison ivy is a three-leafed very distinct appearing plant that generally grows in the midst of other shrubbery. It rarely grows independently.
The rash caused by poison ivy is from an oily resin found in the leaves, stem and roots. When this oil touches your skin, it often causes a very itchy and blistering rash. If you believe you have come in contact with this plant, immediately wash the area with soap and water. There are products available that are effective at specifically removing poison ivy oil. You can find them online or at camping/outdoor stores.

If you develop a rash, it can generally be safely treated at home with a topical hydrocortisone cream and an antihistamine like diphenhydramine for the itching. An oatmeal bath can also be very beneficial to help treat severe itching. If the rash is gets infected (generally from scratching the lesions), then you should seek medical care with your primary care physician or a certified urgent care center.

Most lawn equipment today comes with excellent safety features built-in. However, there is no substitute for reading the owners’ manual (yes gentlemen, you should do this!) and fully understanding how the equipment works. While lawn tools can be very effective in helping create a wonderful appearance in the yard, they can also be extremely dangerous. There’s no replacement for common sense along with these safety recommendations:

  1. Always wear closed toe shoes and work gloves to protect your hands and feet.
  2. If a device stops working properly and you believe that there may be something jamming a rotating blade or other moving part, always shut the device off and refer to the manual for troubleshooting. Do not risk injury by substituting your fingers for tools.
  3. Be aware that cutting devices can frequently launch unexpected materials, striking the operator, other people or pets and causing severe injury.

While choosing the best sunscreen is important, perhaps even more crucial is using it correctly — something a lot of us don’t do.

Sunscreen is best applied before going outdoors and before planned activity. Once outdoors, it is best to reapply sunscreen again following swimming or participating in an activity where you may sweat. Although some sunscreen products claim they remain effective after swimming, it is always best to reapply sunscreen after drying off. The FDA defines water-resistant sunscreen as meaning that the SPF level stays effective after 40 minutes in the water. Sunscreens are in no way waterproof, so you’ll need to reapply them regularly after you take a dip.

Don’t forget that wearing a hat and sun glasses with UV-A and UV-B type filtering and some type of clothing is always recommended which is more effective than just sunscreen alone. Enjoy the beautiful Michigan summers safely!

It is critical to choose a sunscreen with broad-spectrum or multi-spectrum protection for both UVA and UVB. Sunscreen products are rated by their “sun protection factor” (SPF). This rates how well the sunscreen protects against one type of cancer causing UV ray, ultraviolet B (UVB.) UVA rays do not cause the skin to burn, but do increase the risk of skin cancer and are largely responsible for the wrinkles associated with prolonged sun exposure.

For the vast majority of people, SPF 15 is fine. People who have very fair skin, a family history of skin cancer, or other conditions like Lupus that increase sensitivity to sunlight should consider SPF 30 or higher.

Keep in mind that the higher the SPF, the smaller the increased benefit: contrary to what you might think, SPF 30 isn’t twice as strong as SPF 15. While SPF 15 filters out 93% of UVB, SPF 30 filters out 97%. Generally, the cost of sunscreen products increases with the higher SPF rating.

The sensitive skin of babies and children is easily irritated by chemicals found in adult sunscreens, so avoid sunscreens with para-aminobenzoic acid (PABA),sulisobenzone, oxybenzone or dioxybenzone. Children’s sunscreens use ingredients less likely to irritate the skin, like titanium dioxide and zinc oxide.

Playground Safety

With any type of head injury, if there has been a loss of consciousness or there is evidence that your athlete has confusion, nausea/ vomiting, visual disturbances or has a headache that will not resolve with a simple dose of Tylenol or Advil, they should be seen by a physician experienced with concussion evaluations. Depending upon the outcome of that evaluation, advanced imaging like a CT scan of the brain may be required.

With extremity injuries, a good role of thumb is if they cannot reliably bear weight on a lower extremity or use their upper extremity for simple tasks like opening a door or carrying a book, it is best to have a physician evaluate that injury and take diagnostic x-rays to rule out the possibility of a fracture.  Keep in mind that even though somebody may be able to move a joint, there may still be an underlying fracture and the only reliable method to determine this is with an x-ray and a physician evaluation.

Winter is not only hard on our bodies, but also takes a toll on playground equipment. As children begin to move outdoors, check playground equipment for things like worn or rusted bolts, cracked plastic parts or exposed splinters of wood. Make sure that any moving parts have been properly lubricated. It is critical to install some sort of padding or landing zone beneath swings, slides or monkey bars. Ideally, shredded rubber is best, but woodchips, mulch or pea gravel can also serve as adequate padding for falls occurring beneath or around the equipment. Experts generally recommend a depth of at least six to nine inches of these substances in areas where children are likely to fall or hit the ground.

If your child falls and has an obvious deformity to a limb, is unconscious or complains of severe head or neck pain, do not move them. Call 911 for help. It’s very common for kids to fall on their outstretched hand trying to protect themselves, causing a fracture involving the elbow. This type of injury requires a trip to the operating room for treatment. Most other injuries, ranging from a sprain to a moderate to severe cut, can be safely treated in a certified urgent care, saving you time and money.

Adult supervision is always advised so that you can keep an eye out for potential hazards and be the referee if play gets a little out of hand. Make sure that your child is using age-appropriate equipment. Preschoolers (ages 2 – 5) and school-age children (ages 5 – 12) are developmentally different and should use equipment (hopefully in separate areas) designed for their age group to help ensure a good (and a safe) experience.

The majority of playground injuries are related to children falling to the ground from slides, swings, monkey bars and other equipment. Wood fiber or mulch, pea gravel, sand, poured-in-place rubber, rubber mats or rubber tiles are safer playground surfaces, while concrete, asphalt, black top, and packed dirt or rocks are much more hazardous.

Make sure the equipment, including home play structures, are anchored safely in the ground. You can also do a quick check to see if all equipment pieces are in good working order, S-hooks are entirely closed, bolts are not protruding, and there are no exposed footings. Equipment should be free of rust, splinters, and missing parts.

Strings on clothing, long necklaces, or ropes used for play can cause accidental strangulation if caught on equipment. Ropes used as part of playground equipment should be secured on both ends.

Check for hot surfaces on all playground equipment before your child starts to play on it. If shade structures do not protect the equipment from the sun, the surface can become extremely hot and can even cause burns on the skin. And never let your child go barefoot or wear open toe shoes.

Encourage the use of UVA and UVB protective clothing and sunglasses, suggest playing in shaded areas, and, of course, always use sunscreen. A heat index at or above 90˚F may pose a health risk. Always keep your child well hydrated.

Pneumonia

One reason that it takes so long for people to recover from pneumonia is because of all of the byproducts and debris that is left behind in the lung tissue. While antibiotics help kill the bacteria, your body’s internal weaponry must then work to clear your lungs. This often leads to prolonged and severe coughing and shortness of breath with any significant exertion.

In addition to the energy used in the process of chronic coughing, lingering symptoms of fatigue and weakness can also be pronounced. There’s no surefire way to predict how long it takes for anybody to recover from pneumonia, but those individuals who are not an optimal health at the onset of illness will take longer to recover.

During recovery, it’s important to stay in contact with your primary care physician, who can help you deal with any other potential complications. A local qualified and certified urgent care like Lakes Urgent Care, is another resource if your primary care physician is not available.

Category: Pneumonia

The CDC recommends pneumococcal vaccination for all babies and children younger than two years of age, as well as all adults 65 years or older. They also recommend that everyone between the ages of two and 64 who are at increased risk for pneumococcal disease due to underlying chronic medical conditions should also be vaccinated.

There are two pneumonia vaccines currently available on the market. The vaccine sometimes referred to as Prevnar 13 is appropriate for all ages. The vaccine otherwise known as Pneumovax 23 is generally recommended for adults age 65 or older, or those who are at increased risk of contracting pneumonia.

The CDC website, your primary care physician or pediatrician will be an excellent resource of information to decide if you should be vaccinated. The vaccines for adults are available at Lakes Urgent Care if your primary care physician does not stock it.

Category: Pneumonia

Pneumonia can range from either mild to life-threatening. Pneumonia is an infection that inflames the air sacs in either one or both lungs. Once this occurs, those sacks may fill with fluid or pus, causing symptoms of cough in addition to fever, chills and difficulty in breathing.

While pneumonia is not contagious, the germs that cause pneumonia can spread from person-to-person. When these bacteria enter the lungs, they can overpower the immune system, which is very delicate. The most serious cases tend to occur with older adults, children and those with chronic diseases like emphysema, asthma and heart disease.

Most commonly, pneumonia is a secondary complication of a milder respiratory infection like bronchitis or especially with those who are afflicted with the flu.

Category: Pneumonia

Safety for Seniors

Get some exercise! Stay active to maintain good balance and muscle tone to reduce the likelihood of falling.

Be aware that certain medications may cause dizziness or drowsiness. Whenever sitting or lying for a prolonged period of time, allow time to equilibrate your blood pressure by changing position slowly and with support.

Check your vision and eyeglass prescription every year and make sure that glasses have the correct prescription. Reduced or blurry vision is a major contributing factor to falls in the home.

And be sure to eliminate the trip and fall hazards as outlined above!

Millions of adults age 65 and older fall each year. These falls can lead to severe injuries including hip fractures and head trauma. Underlying health conditions, such as the need to take blood thinning medication, can lead to other serious problems.

While winter certainly creates more treacherous conditions outside, there are plenty of potential dangers within the home that are present year round. Here are some ideas to help keep everyone’s home safer:

  • Remove any tripping hazards such as items on the fl oor including books, papers, clothing and shoes.
  • Remove small throw rugs. Make sure that any remaining area rugs fi rmly grip the fl oor to avoid sliding.
  • Keep commonly used items on lower shelves of cabinets. Avoid using a step stool.
  • Use nonslip mats or other type of friction tape in bathtub and shower fl oors.
  • Be cautious of wet fl ooring during rainy or snowy days.
  • Improve lighting in the home. As we age, our vision requires a higher level of bright light to see well.
  • Make sure handrails are available and properly maintained near any steps or staircases.
  • Add additional lighting along steps and staircases.
  • If a family member should fall, do not move them from that location unless they are able to move themselves.

Seasonal Affective Disorder

Typically, the symptoms of Seasonal Affective Disorder will respond to light therapy, a balanced diet and increased exercise. Most importantly, make sure to maximize the amount of natural light exposure you get each day.  Some people they may find benefit by trying light therapy. There are a variety of different light boxes that can be purchased relatively inexpensively to provide light therapy daily. Other strategies include limiting the amount of alcohol intake and increasing the level of daily exercise while your body transitions to the new time period. While you still may notice the symptoms that you’re having, they usually are not as debilitating as other types of depression, anxiety disorder or bipolar disorder. Most importantly, if you are feeling the impact of the seasonal change you are not alone and there is help available!

If you feel depressed, fatigued, and irritable shortly after this time change and you’ve noticed that this has occurred in previous years, you most likely have seasonal affective disorder (SAD). However, if your symptoms become severe enough that they significantly impact your typical daily routine or activities and you don’t feel like you can’t get out of a “rut”, that would be a great time to see your primary care physician to get evaluated for other types of depression that may require a different course of therapy.

While many people see daylight savings times as an opportunity to save an hour of sleep on that special Saturday night each fall, it can also bring on a variety of health-related issues for many people. For those of us living in the northern latitudes, it means significantly shorter days and much less light exposure. The reduction in light exposure and shorter days can affect the regulation of our normal sleep – wake cycle, in addition to bringing about changes in our own circadian rhythms. This can affect the production of several hormones in our body such as serotonin and melatonin. And less of these hormones can significantly impact our daily productivity as well as our normal sleep cycle. The ultimate result of these hormonal imbalances include sleep disorders, depression, fatigue and also seasonal affective of disorder.

Sleep

If you’ve already made an effort to address all the things you can do on your own and continued to have insomnia, that would be a good indicator to seek medical attention.

Start by seeing your primary care physician. They can often help you work through some additional factors that may be contributing to your insomnia before recommending or prescribing any type of medication to improve your ability to fall asleep or staying asleep. In some instances, they may even recommend that you undergo a sleep study along with consultation with the physician who specializes in sleep disorders.

Category: Sleep

Unfortunately, for children adults alike, we are part of a modern society and generation of chronically sleep deprived individuals. Recent studies indicate that as many as 87% of high school students do not get the recommended 8-10 hours of daily sleep. Routine over-programming, high expectations for academic and athletic performance, along with the technological and social pressures consume a disproportionate number of hours daily. The deficit this creates has a negative impact on quality sleep time for all of us.

Failing to get an adequate amount of quality sleep on a regular basis can lead to a long list of significant health problems, including issues with learning and behavior, mental health issues such as memory loss and depression, a higher risk of obesity and behaviors that are likely to foster dependence on medication or recreational drugs. Scientific studies have also shown that there is significant worsening of hypertension, diabetes and emotional disorders with ongoing sleep deprivation.

Category: Sleep

There is significant scientific evidence suggesting how not only the amount of sleep we get each day but the quality of that sleep is critical to our overall health. So you are wise to get your kids back on track after a summer of deprogramming and fun. Perhaps the best recommendation is to begin “powering down” our brains at least one hour

Perhaps the best recommendation is to begin “powering down” our brains at least one hour before scheduled bedtime. This means turning off all the electronics around us including TVs, laptops and Smart phones. Bright light is one of the primary triggers that your brain uses to help regulate your sleep/wake cycle. Limiting that exposure prior to bedtime is critical. Setting a specific time or even an alarm signaling when it is time to go to bed can begin to get you back on track. Try and do this before the school year starts to adjust to this new circadian rhythm.

Other simple things that you can do include limiting caffeine intake many hours prior to bedtime, assuring that the bedroom is quiet and dark, and for those of you would like to share the bed with your favorite pet, reconsider having your dog or cat find her own perfect place to sleep outside of the bedroom.

Category: Sleep

Slip & Fall Accidents

Falls account for over 8 million hospital emergency room visits each year, representing the leading cause of visits. If you have fallen, wait a moment and do a “self-assessment” rather than quickly getting up. Most bumps and bruises do not require medical attention. However, if pain from a fall persists beyond a few hours or you are unable to bear weight or move an upper extremity without pain, be sure to get evaluated by a physician. If the fall should cause a broken bone with skin disruption, get emergency care immediately. Most other sprains, strains or fractures can be safely treated by your primary care physician or at a certified urgent care. A certified urgent care can complete x-rays and initiate fracture care and casting, avoiding a visit to the emergency department.

Take small careful steps instead of large ones. When getting out of a vehicle, step, don’t jump. When possible, use handrails, handles – anything that will help keep your balance. Don’t carry large loads while walking on snow or ice. If you are carrying a load on an icy walk and feel yourself falling, toss your load to break the fall with your arms. While walking, retain stability by keeping your hands out of pockets.

Kids are always in a rush. It’s no surprise that running or walking quickly without proper footwear on a wet or slippery surface can cause a fall. Kids and adults should be sure to use caution upon exiting a vehicle. If need be, hold onto the vehicle for added support. When on a slippery surface, bend slightly forward and shorten your stride or shuffle your feet for better stability.

Slip and fall accidents are inevitable during winter months. Wearing footwear with grooved rubber soles will provide additional traction when conditions are slippery or icy. It is important to avoid rushing when you need to clear snow from your walkway or driveway. Make sure you have the correct type of tools for the job. A snow blower, wide shovel, plus salt or melting crystals help make a slippery surface safer to maneuver.

Sports Injuries

A concussion is a type of closed head injury, which is often referred to as a traumatic brain injury or TBI. The symptoms of concussion include headache, dizziness, sleep disturbances, visual changes, difficulty with balance, fatigue and memory problems. TBI encompasses many more brain injuries aside from concussion. Some examples would be, epidural or subdural hematomas, traumatic brain hemorrhage or skull fractures.

Fortunately, the vast majority of TBI cases in relation to high school athletes is on the milder side and most often is related to concussion. Take time to learn about all the potential risks associated with the sports activities that you or your family members participate in and learn about the specific ways you can mitigate risks and help avoid a traumatic brain injury.
Good luck on the field and play it safe!

Category: Sports Injuries

There are some new training methods that are being investigated now which have shown great promise in reducing the risk of head injury in the game of football. The training program is called “Heads Up Football.” The data associated with schools that have deployed and implemented this system have shown a drop in the rates of concussions among players who have received the “heads up” training and coaching techniques.

In addition to this type of training, it is also very important that any player who may be at risk for repeated head contact must be wearing properly fitted headgear. And keep in mind that there is no latitude for improperly fitted helmets. Many soccer organizations are now even beginning to promote some form of headgear for soccer players.

Category: Sports Injuries

Approximately 300,000 adolescents suffer concussions or mild traumatic brain injuries each year while participating in high school sports. And high school girls do have a significantly higher concussion rate than boys according to a recent 2017 orthopedic medical study.

The study hypothesizes that girls may be at greater risk of concussion while playing soccer due to “heading” the ball, not having appropriate protective gear and perhaps a greater emphasis on contact during the game. Coach and parental awareness are key components to addressing any injuries that have occurred and preventing further progression of those injuries to something more serious.

Category: Sports Injuries

With any type of head injury, if there has been a loss of consciousness or there is evidence that your athlete has confusion, nausea/ vomiting, visual disturbances or has a headache that will not resolve with a simple dose of Tylenol or Advil, they should be seen by a physician experienced with concussion evaluations. Depending upon the outcome of that evaluation, advanced imaging like a CT scan of the brain may be required.

With extremity injuries, a good role of thumb is if they cannot reliably bear weight on a lower extremity or use their upper extremity for simple tasks like opening a door or carrying a book, it is best to have a physician evaluate that injury and take diagnostic x-rays to rule out the possibility of a fracture.  Keep in mind that even though somebody may be able to move a joint, there may still be an underlying fracture and the only reliable method to determine this is with an x-ray and a physician evaluation.

Adequate stretching and conditioning prior to competitive play is the most important thing for parents and student athletes to keep in mind! These are good practices regardless of the level of competition and can often play a significant role in preventing more serious injuries once the whistle blows.

Category: Sports Injuries

We see and treat a large number of injuries like joint sprains and fractures, in addition to closed head injuries and mild concussions at Lakes Urgent Care. As the rates of participation increase across all pediatric populations, the total number of injuries we see is increasing as well. In general, it seems that the level of competition has become more intense. Many parents and students recognize the opportunities for scholarship dollars if they can elevate their skills to that “next level” for collegiate play. As a result, kids no longer play for a season, but frequently play year-round and that really increases the risk of injury.

Each sport brings its own particular types of injuries.  Specific to soccer, we most commonly see lower extremity problems like foot, ankle and knee injuries. They can range from minor sprains and strains of soft tissue and muscle to more serious fractures or ligamentous ruptures requiring surgical repair.

Category: Sports Injuries

Sports Physicals

As a condition to participation in many extra-curricular activities, most sport or camping organizations are required by law to maintain on file a current history and physical exam form with physician approval to safely participate. Obtaining the pre-participation physical at your pediatrician or primary care physicians office is very appropriate. Many offices will even complete the form without an exam, if the annual full exam was recently done if you drop the form off for completion. However, for after-hours convenience, a qualified and certified urgent care can quickly perform a sports physical at a very reasonable cost. At Lakes Urgent Care we complete a more comprehensive sports physical and will complete the required form at the time of the visit if no concerns are uncovered at the evaluation for a fixed cost.

As our way of giving back to the community for our 13 years of service, we now offer FREE sports physicals all day, every Thursday at Lakes Urgent Care in West Bloomfield and Livonia. You’ll find all the details on our Free Sports Physicals page.

The pre-participation physical is NOT a substitute for your child’s annual complete physical with his or her pediatrician or primary care physician. The focus of this annual visit is much different and should never be ignored or avoided in your child’s best interest. Vaccination status, psychosocial history exploration, in addition to a much deeper history and physical exam are critical in maintaining excellent health in our children and keeping them safe.

As our way of giving back to the community for our 13 years of service, we now offer FREE sports physicals all day, every Thursday at Lakes Urgent Care in West Bloomfield and Livonia. You’ll find all the details on our Free Sports Physicals page.

A sports, camp, or pre-participation physical is an abbreviated physical exam which essentially looks for any health issues that may preclude a young athlete from safely participating in the sport or activity of interest. When done properly, the history portion is completed by the parent and then reviewed with the health care provider to determine potential risks.

Family history is an important component to a sports physical.

The physical portion of the exam focuses on the patient’s vision, heart, lung and musculoskeletal system. If the doctor finds any sign of a potential problem, he or she should require a more in depth evaluation or testing with the patient’s regular pediatrician or primary care physician. At Lakes Urgent Care we also routinely complete vision testing along with urine testing as a part of the pre-participation physical.  If there appears to be no reasons for exclusion, the appropriate forms are completed for submission.

As our way of giving back to the community for our 13 years of service, we now offer FREE sports physicals all day, every Thursday at Lakes Urgent Care in West Bloomfield and Livonia. You’ll find all the details on our Free Sports Physicals page.

Regardless of whether he plays sports or not, your son should have a complete physical exam once a year with his pediatrician or primary care physician. The sport or camp physical should never be used as a substitute for this more thorough annual evaluation. The focus of each of these types of physicals is very different.

The sports physical is really an adjunct to the annual complete physical, with more specific questions about your son’s physical ability to play sports safely. Most health insurance plans to don’t cover services for this type of evaluation, but you can get this completed at a certified urgent care at a very reasonable cost. Simply download and bring your school’s athletic exam form to either your primary care physician or a certified urgent care facility. Lakes Urgent Care takes care of sports physicals easily and quickly if you need us after hours to accommodate your families busy schedule.

Strains vs. Breaks

We always suggest you check with your primary care physician to help navigate and obtain the most appropriate care for any health condition. Some primary care offices are comfortable taking care of minor fractures, some are not. A certified urgent care facility can competently take care of fractures, providing initial x-rays, diagnosis, and casting. At Lakes Urgent Care, we provide all of these services and also work closely with several orthopedic specialists to provide excellent continuity of care for more complex fractures.

If you have injured a joint and are not experiencing severe pain or marked limitation of motion, you may consider applying the basics of “RICE” (Rest, Ice, Compression, Elevation) for a period of 24-48 hours. If pain remains persistent beyond a few days or prevents you from near normal mobility in a joint, especially the ankle or foot with weight bearing, it is best to have the injury evaluated by your primary care physician or a certified urgent care.

A painful extremity can be very misleading! Generally, without obtaining an x-ray of the area, it will not be possible to ascertain if the pain is due to a strain or fracture (break). The old advice of “if I can move it, it’s not broken,” generally is false. Quite often we discover a fracture even though someone can move a painful finger, wrist, foot or ankle.

Ticks and Lyme Disease

Ticks are skillful at attaching themselves to skin. When they do, it is difficult to remove them. Use fine tweezers to grasp the tick as close to the skin surface as possible and pull at a perpendicular angle to the skin surface until they let go. Removal should be attempted as quickly as possible to decrease the length of exposure.  Avoid “breaking” the tick so that no small pieces are left in the skin which could cause a localized infection. In rare instances where a tick bite does lead to an infection, initial signs and symptoms include itching, burning and redness in a circular fashion around the tick bite. Sometimes that rash can proceed to what is called a bull’s-eye lesion with concentric red circles around the bite area. If the disease is going to progress, you’ll start to have flu-like symptoms including muscle aches, fatigue, headache and fever. If you begin to experience any of these symptoms following a possible tick bite, get evaluated by your primary care physician or go to a certified urgent care like Lakes Urgent Care to initiate prompt diagnosis and treatment.

Most ticks don’t carry diseases and most tick bites don’t cause serious health problems.

But several diseases are attributed to bacteria transmitted by tick bites including Lyme Disease and Rocky Mountain Spotted Fever. Ticks can act as a transmitter of disease for both humans and many domesticated animals. When ticks latch onto their host to obtain a blood meal, they transmit these potentially infectious bacteria through their saliva. If you have a dog that likes to run in the woods, he will be at higher risk for having a tick join him. Your veterinarian can recommend either a monthly flea and tick preventative chew tablet or topical medication to reduce the risk of your dog becoming infected with ticks or bringing them into your home.

Tick infestations and activity in the lower Peninsula of Michigan has been increasing over the past few years and there are some specific things you can do to stay safe. When on a hike, walk in the center of the trail. Wear light colored clothing to make ticks easy to spot. Apply an insect repellent containing at least 20% DEET. Consider wearing clothing treated with permethrin when hiking or working in wooded areas. Also consider placing your clothes in a dryer on high heat for at least 60 minutes upon returning from potential exposure areas to kill the ticks. In our region, the greatest time of risk is from April through September.

Travel-related Health Issues

Modern day aviation gets a bad rap when it comes to illnesses associated with commercial flight. The truth is, the air in airplane cabins is actually filtered very well every 3 to 5 minutes with HEPA filters. The primary reason you may get ill is because you are flying in close quarters with a crowd of people, and several of them likely have an infection like the common cold or flu. Germs spread through the air before it gets circulated, resulting in exposure. In reality, the nozzles blowing air above your seat may actually mitigate the effects of germs from those around you who may be coughing or sneezing.

Breaking away from your typical routine of exercise and fitness can certainly be interrupted by a great vacation. Keep in mind that schedule changes, alcohol consumption and dietary changes contribute to falling off your typical routine.

However, if you get a little bit creative you can find some ways to burn off those extra calories and maintain aerobic fitness. Take stairs instead of elevators, do simple things like push-ups, pull-ups and sit-ups to help keep your muscles toned. Take your extra leisure time to go on a long walk or find a new and exciting place to go for a run. You’ll definitely feel better about yourself and your overall fitness when you return home and get back to the daily grind!

There are a multitude of reasons why some people contract an illness while vacationing.

A change in routine, the interruption of normal sleep and dietary patterns, along with dehydration all can contribute to common symptoms like migraine headaches, weakness, muscle cramps and fatigue. Travel itself is stressful given all of the ongoing security concerns.

Start by making sure everyone stays adequately hydrated and drinks plenty of fluids each day, especially when traveling to warmer climates. Bring along plenty of hand sanitizer to reduce your exposure to contaminated surfaces. Also bring a travel package of sanitary wipes and clean commonly touched surfaces in your hotel room, like the TV remote. Finally, do your best to maintain regular sleep and exercise habits.

Urgent Care or Emergency Room?

We always suggest you check with your primary care physician to help navigate and obtain the most appropriate care for any health condition. Some primary care offices are comfortable taking care of minor fractures, some are not. A certified urgent care facility can competently take care of fractures, providing initial x-rays, diagnosis, and casting. At Lakes Urgent Care, we provide all of these services and also work closely with several orthopedic specialists to provide excellent continuity of care for more complex fractures.

Falls account for over 8 million hospital emergency room visits each year, representing the leading cause of visits. If you have fallen, wait a moment and do a “self-assessment” rather than quickly getting up. Most bumps and bruises do not require medical attention. However, if pain from a fall persists beyond a few hours or you are unable to bear weight or move an upper extremity without pain, be sure to get evaluated by a physician. If the fall should cause a broken bone with skin disruption, get emergency care immediately. Most other sprains, strains or fractures can be safely treated by your primary care physician or at a certified urgent care. A certified urgent care can complete x-rays and initiate fracture care and casting, avoiding a visit to the emergency department.

 

"Best urgent care ever they have never failed me great friendly staff and I have health issues so I'm always their and they go out of their way for me."

Ray

Lakes Urgent Care
5.0
2016-12-21T11:11:37+00:00

Ray

"Best urgent care ever they have never failed me great friendly staff and I have health issues so I'm always their and they go out of their way for me."
"The doctors were prompt, had great bedside manner, and were accurate with their diagnosis and treatment. We also appreciated their follow up care and genuine care."

Annette

Lakes Urgent Care
5.0
2016-12-21T11:13:45+00:00

Annette

"The doctors were prompt, had great bedside manner, and were accurate with their diagnosis and treatment. We also appreciated their follow up care and genuine care."
"With a child, urgent care facilities are such a peace of mind—and until I found Lakes, I never knew where to go."

Anthony

Lakes Urgent Care
5.0
2016-12-19T12:52:20+00:00

Anthony

"With a child, urgent care facilities are such a peace of mind—and until I found Lakes, I never knew where to go."
"I've only had great experiences here. For an urgent care facility, they are quick and efficient. The staff is very friendly and wait times are minimal."

Amanda

Lakes Urgent Care
5.0
2016-12-19T12:54:48+00:00

Amanda

"I've only had great experiences here. For an urgent care facility, they are quick and efficient. The staff is very friendly and wait times are minimal."
"The doctor was AMAZING!! I got in quick, he was the most thorough, and no nonsense doctor I've ever been to! He listened to me, gave me the correct prescriptions"

Gail

Lakes Urgent Care
5.0
2016-12-21T11:07:36+00:00

Gail

"The doctor was AMAZING!! I got in quick, he was the most thorough, and no nonsense doctor I've ever been to! He listened to me, gave me the correct prescriptions"
"The Doctor did everything she could do for me and i was able to walk out (i was wheeled in) and to top it off I got a follow up call from Nicole today."

Jessica

Lakes Urgent Care
5.0
2016-12-21T11:12:30+00:00

Jessica

"The Doctor did everything she could do for me and i was able to walk out (i was wheeled in) and to top it off I got a follow up call from Nicole today."
"The staff was very friendly, respectful, and knowledgeable. I will definitely return for any health issues that will challenge me."

Erika

Lakes Urgent Care
5.0
2016-12-21T11:13:15+00:00

Erika

"The staff was very friendly, respectful, and knowledgeable. I will definitely return for any health issues that will challenge me."
5.0
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