Ask a Lakes Urgent Care Doctor

Preparing early for the oncoming allergy season can significantly reduce your allergy symptoms once the season begins. The best way to prepare is to consult with your primary care physician now and allow her to provide you with guidance for your specific allergy symptoms. Very soon, pollen levels will begin to escalate as our weather warms and the plant life around us comes back to life. It may be advisable to begin preventative allergy medications now. This can help prevent early inflammation and the cascade of allergic reactions you may face before they spiral out of control. If you’re unsure of the source of your allergies, see you doctor right away and get tested. Knowledge of what types of allergens trigger your symptoms can help refine medication treatments and help you reduce exposure. The CDC and our local health department can be excellent sources of information for activity and peaks with particular types of allergies and pollens.

Prevention is always worth a pound of cure! If you are able to determine the specific allergens that trigger your symptoms, this can help you reduce or potentially eliminate exposure to the elements that cause you grief. If tree pollen is your source of misery, it may not be possible to eliminate exposure. That’s where treatment with preventative medications can make a significant difference, especially if you start before your symptoms begin.
In your home, keep windows closed and rely on your home’s heating and cooling system along with good quality air filters and dehumidifiers to reduce symptoms while indoors or sleeping. When coming in from any outdoor activity, showering and changing your clothes can help reduce your exposure to allergens.

Perennial allergies refer to specific allergens that cause an allergic reaction year-round. Common examples include pet hair or dander, food allergies or medication allergies.

In contrast, seasonal allergies typically occur with weather changes that allow for new environmental plant, mold, insect or grass growth. Locally, pollen and mold season can begin as early as February and last through November. Now is the right time to begin discussions with your physician about the preventative measures you can take to keep allergy symptoms from activating your immune system. And this can help you avoid the dreaded return of sneezing, nasal congestion and itchy, watery eyes. Lakes Urgent Care can also be a resource if you do not have a primary care physician. We can help guide your preparation for seasonal allergies or arrange for allergy testing. With appropriate preparation and recognition of triggers to avoid, everyone can enjoy the coming warm, sunny months ahead!

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.

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.

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.

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.

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.

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.

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.

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 family’s 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.

We have known for a long time that high blood pressure is a silent killer, often with no symptoms. New treatment guidelines were announced at the annual meeting of the American Heart Association and American College of Cardiology on November 13, 2017.

The new guidelines may impact up to 50% of our adult population and are based upon extensive research by a panel of scientific health experts. But there is still much work to be done within the medical field to effectively roll out and apply these recommendations in the clinical setting. Proactively treating patients sooner will help reduce the risk of poor outcomes and complications associated with untreated hypertension.

If you do not have a primary care physician, the physicians at Lakes Urgent Care can help with your initial assessment and direct your follow up care with a high-quality primary care provider.

Children, teenagers and young adults should get their blood pressure checked at least once every 5 years. Given the new guidelines, I recommend that this same group get their blood pressure checked at least once annually. As you age, your blood pressure is likely to increase and should be checked more often. If you have any type of underlying chronic illness, more frequent blood pressure checks are mandatory. Your blood pressure fluctuates during the day, so when you start tracking your blood pressure, you should check it at different times of the day, about 5-6 times. If you have already been diagnosed with hypertension and are taking high blood pressure medication, your blood pressure measurements should coincide with your doses. The best time to check it is before you take your medication. Your primary care physician should provide you with education and recommendations for a routine to check your own blood pressure and track those results in a blood pressure diary.

If you smoke, quit. Add some form of regular exercise. Reduce your intake of sodium, alcohol, caffeine, added sugars and refined carbohydrates. Lose some weight. By reducing your body mass index (BMI) by just 5%, you could significantly lower your blood pressure.

Add calcium, magnesium and potassium rich foods, soy, dark chocolate or cocoa and fresh berries to your diet. Many nutritionists recommend whey protein, Co-Q-10, fish oil, Hibiscus, Berberine and aged garlic extract for their beneficial effect on blood-pressure reduction.

Add any type of stress reduction activities in addition to meditation. There is a well-known connection between daily stress associated with work, family or financial difficulties and its negative impact on our blood pressure. Developing effective stress management reduction skills will have a very powerful beneficial impact on your general wellness and mental fitness. Finally, sleep apnea (excessive snoring) has been directly linked to high blood pressure, and other chronic illnesses. Lakes Urgent Care can help you set up a sleep study if you are unable to do so through your primary care physician.

Aside from sunburns, the most common household causes are scalds, contact with hot surfaces, electrical and chemical burns. Burns are further classified into first, second and third degree based upon the depth and tissue involved in the burn injury. A good rule of thumb is if blisters develop, the burn is a second-degree burn. Seek medical attention if the burn is second or third degree, is larger than 3 inches in diameter or involves the face, hands, joint surfaces, or genitals, especially in children and the elderly. Also seek medical attention if the burn looks like it may be infected (swelling, pus or red streaks nearby) or if the source of the burn is from an electrical plug or wire. The best place to get qualified medical attention for burns is at a certified urgent care like Lakes Urgent Care, your primary care physician, or in hospital emergency department.

After removing the source of the burn, immerse the burn in cool water or apply a cool compress for 10-15 minutes. Never apply ointments, butter or grease to a burn as this can lead to infection. Do not apply ice directly to a burn as it can cause additional destruction to the already delicate skin involved. Avoid breaking any blisters if they form. Once cooling has been completed, dry the area involved and cover the burn with a clean cloth, sterile gauze or non-adhesive bandage. Over the counter pain medications such as acetaminophen or ibuprofen are safe to use to help with discomfort. Once the initial burn discomfort has subsided, you can apply 100% pure aloe gel.

Scalding water, hot stoves and unsecured electrical plugs are the most common sources of burns within the home, especially with small children. In the kitchen, never leave a hot stove unattended and make sure to turn pot handles inward so they cannot be pulled down by a child. Never cook over a stove while holding a small child. Place them safely in a high chair nearby. Do not heat baby bottles in microwaves due to uneven heating and risk of oral burns. Set hot water tank thermostats to less than 120F and always check water temps with your wrist or elbow. In the bathroom, secure any hot items such as curling irons, clothes irons and unplug hair dryers to avoid children pulling these items off counter tops resulting in mechanical injury or burn.

Let’s start with back pain. Be mindful if the snow is wet and heavy or light and fluffy. Get a shovel that you push like a plow. Try not to lift the snow, but if you do, bend at the knees and lift in small amounts. If it’s wet and heavy, half the shovel is more than enough. Be sure your muscles are warmed up before you start to shovel. Do some stretching before you head outside. Cold, tight muscles are more likely to cause a sprain or strain. Most importantly, snow shoveling is a perfect storm for a cardiac event. As you shovel, the exertion causes you to breathe harder through your mouth instead of your nose. This brings cold air into your body which may result in spasms in the blood vessels around your heart. Because shoveling is exercise, your heart needs more blood to pump to keep up with demand. And here’s the crux of the problem: The spasming vessels can become so narrowed from the cold that they can’t meet demand, especially if there’s any pre-existing blockage due to coronary artery disease which sets the conditions for a heart attack. Pace yourself, take it slow and easy with the snow shovel and don’t overdo it!

Gloves and dry socks are the best way to beat frost nip and bite. Nip occurs before bite. If you picture your extremities in layers, frost nip happens when the first few layers of tissue are frozen. For frost bite, the entire body part, most commonly fingers and toes, is frozen through and tissue begins to die. If you suspect frost nip or bite, run the extremity under warm water for 20 minutes. Never use hot water or rub the finger or toes to increase circulation. If after 20 minutes there is pain or no feeling at all, it’s time to head to the emergency center or a certified urgent care facility like Lakes Urgent Care. With hypothermia, your body gives plenty of warning to get warmed up before serious problems set in. We see hypothermia in our more vulnerable populations such as the elderly, those who are significantly immunocompromised, those with dementia and those with mental illness. Depending on their mental status, they might not know they’re cold, which can lead to hypothermia.

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 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.

There are 4 basic tests currently approved by the FDA for the detection of the Covid-19 virus:

Rapid antigen test:  detects particles of the Covid-19 virus and is most effective between days 3 and 10 following exposure to the virus. Results are available within 20 minutes.

Rapid PCR test: detects a different particle of the Covid-19 virus and is most sensitive for active disease, typically turning positive within 5 days of exposure and active infection.  Like the gold standard PCR test, this test can remain positive for up to 3 months after active infection. Results are available within 20 minutes of sample run. Testing supplies for this type of test are very limited across the country and therefore we follow strict CDC protocol to determine if this test should be completed.

Full standard PCR test: the “gold standard test” and by far the most sensitive and specific. This test also detects a different particle of the Covid-19 virus and is most sensitive for active disease, typically turning positive within 5 days of exposure and active infection.  This test can remain positive for up to 3 or more months after active infection. Results are available within 24-48 hours of sample run.

Serum antibody test: this is a blood test which detects antibodies in the blood which develop after recovery from an active infection and are created by the immune system.  This test is best used a minimum of 14 days after known or suspected infection. Test results are typically available within 24-48 hours of sample run. Antibody test can also be used to determine if your immune system has properly responded to the Covid-19 vaccine.

The clinical decision about which test should is best utilized depends upon the history of exposure, current symptoms including their time of onset and a physical exam.  While we certainly understand that everyone desires to have an immediate or “rapid result”, a rapid test may not be the best choice to obtain the most accurate diagnosis and actually lead to an incorrect diagnosis.

Lakes Urgent Care follows current CDC guidelines and best practice algorithms.  We make frequent updates to practice guidelines so we can provide the best care possible.  Utilizing this information in conjunction with each specific patient’s history and physical exam, our providers will recommend the best test to be performed for each individual patient. It is important to understand that there is no one size fits all approach when dealing with Covid-19!

This can be a challenging question and there is significant information and clinical decisions to be made, based upon that information to make the best recommendations about testing.

If you previously had a confirmed positive test, the CDC does not support “retesting until negative” and many insurance companies will not cover repeated tests in this circumstance.  The reason for this is that you are likely to continue testing positive for up to 3 or more months.  What is critical, is whether you have symptoms of Covid-19 or possibly some other source of infection.

If you have never tested positive and are concerned that you have been exposed, it is best to quarantine to protect others (even if you have no symptoms) and wait until day 5 after exposure to be tested, while maintaining the quarantine.

If you have never previously tested positive but are now symptomatic, we can certainly test you, although the results may be conflicting.  In this situation maintaining quarantine to protect others is paramount until you have been tested and the result is available.  Also keep in mind, that while Covid-19 is by far the most prevalent current community infection, there are literally hundreds of other viral illnesses which could be responsible for your current symptoms.  Strep throat, pneumonia, upper respiratory infections and to a lesser extent, influenza, are still prevalent at this time and can be the source of your symptoms or illness.

Patients of all ages can be tested at Lakes Urgent Care, but we ask that you kindly make an appointment in advance so we can minimize any wait time for you in addition to minimizing the number of patients in the urgent care at any given time, which helps eliminate exposure risks for everyone. You can easily make an appointment by going to our website and taking a few short minutes to register and find an available convenient time for you or a family member.

“It’s not a good idea at all,” says Dr. Lawrence Dell, one of the Lakes Urgent Care doctors. “While the hydrogen peroxide bubbles, turns foamy white on the wound, it is bleaching the blood away on a cellular level, potentially causing damage and delayed healing,” said Dr. Dell. According to a recent article in USA Today, “While you may think you are thoroughly cleaning your wound, (by using hydrogen peroxide)…you are causing corrosive tissue damage, significantly impairing the healing process, and irreversibly worsen the scarring process. Severe toxicity from skin application could include inflammation and blistering. “The next time you see someone applying hydrogen peroxide to a wound, tell them they are doing much more harm than good.

Instead of hydrogen peroxide, Dr. Dell notes that the proper way to clean a wound is to soak it in sterile water or use running water liberally to clean out the wound. Doctors at the Cleveland Clinic agree: “for fresh wounds, wash out your wound with a large quantity of warm soapy water as soon as possible. It is also OK to get in the shower and let copious warm, soapy water flow through the wound.” Next, Dr. Dell recommends  applying  a topical antibiotic, such as Neosporin (assuming there is no allergy), then apply a compressive bandage.

If you are unsure or the wound will not stop bleeding, then seek medical attention as it is likely that the wound will need surgical glue, suture, or other procedure, along with a possible tetanus vaccine update. We can take care of all this easily and quickly, no appointment needed at either Lakes Urgent Care location in West Bloomfield or Livonia.

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.

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.

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!

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.

In many ways, gravity has some long-term negative effects on our bodies. A great way to overcome that is to include strength training in your weekly exercise routine. This combination is critical across the age spectrum from teens to senior citizens. Any physical activity has a positive influence on your overall health and it’s critical to have a balance between both aerobic and muscular strength training. Regular strength training has a positive influence on your muscles, bones and joints.

For those of you who may not have an active exercise routine, a first goal should be to simply reduce your amount of inactivity. New research supports that even a single episode of exercise has a significant beneficial effect on your brain activity. The greater the intensity of the workout, the more significant the positive impact on neurotransmitters like serotonin, dopamine and epinephrine, which are all naturally produced within our bodies. Scientists refer to these as endogenous opioids or “feel good” substances, which can lead to a true natural high!

Building muscle without the use of weights, also known as body weight training, can be very effective. Regardless of the equipment you use, the key is to place your muscles under tension by using resistance and progressive overload. The classic routine of body weight training includes squats, pull-ups, chin-ups, sit-ups and lunges. There are many interesting ways to expand on these basic principles and I encourage everyone to learn a little bit more about closed kinetic chain exercises (CKCE).  Regardless of which method you ultimately choose, if you stick with a brief weekly routine, the benefits can be immense and help you maintain flexibility, alertness, prevent loss of bone minerals and maintain critical muscle mass.

Yoga can be an excellent way to reduce or eliminate the use of over-the-counter or prescription pain medicine to treat your back pain. A recent study indicates that those who suffered from chronic low back pain and participated in activities such as tai chi, yoga and massage had a significant reduction (greater than 50 %) in the dependence upon medication! Yoga offers more tangible benefits without increasing the risk of worsening the underlying condition or injury. If you never participated in yoga previously, be sure to attend a class with a certified instructor who will properly guide you with the appropriate poses and relaxation techniques so you’ll have a greater chance of success in reducing back pain.

There is plenty of evidence to suggest that “man’s best friend”, the family dog, has several beneficial health effects for human beings including the potential to boost the immune system. It is postulated that dogs can actually act like a probiotic, helping us to develop bacterial colonies, which in turn augments the activity of our immune systems.

In addition to the potential for her improving her immune systems, there are numerous other secondary health benefits to having a four-legged companion. With the commitment to walking her dog on a daily basis, they can help keep you fit and active. This in turn can help her lose weight and also potentially improved her social life because of interactions with other dog owners. Having the companionship and unconditional love of a dog can add significant meaning and purpose for individuals that are now empty nesters and even help prevent the onset of depression. There are many studies that have proven that owning a dog can also help reduce hypertension. Of course there are now many different breeds that are being trained to assist individuals who have physical and mental challenges, better known as service dogs.

What dog owner doesn’t love that energetic, enthusiastic greeting when coming home from a long stressful day, topped off with a wet tongue kiss? Contrary popular believe, the bacterial counts on our pet’s mouth is actually worse than the human mouth. More importantly, the type of bacteria that dogs carry is significantly different than the bacteria that typically reside inside and on our bodies. There are whole host of diseases which are potentially carried by animals, also known as zoonotic diseases. In general, there is a low likelihood of transmission of zoonosis, and an occasional single lick is not likely to cause significant harm. However, the best medical wisdom and recommendation is to avoid those wet sloppy kisses from Fido on your face which carries the greatest area of transmission risk. So in summary, having a family dog has many positive health benefits, just limit or eliminate the number of wet kisses on your face!

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.

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.

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.

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.

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.

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).

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.

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.

The term food poisoning is oftentimes misused and applied to a broad range of gastrointestinal (GI) illnesses. However, generally speaking if food that you have eaten was tainted with a virus, bacteria or parasite, the symptoms often begin within an hour of ingestion. Most often, this type of gastrointestinal illness is self-limited and will spontaneously resolve once your immune system gets to work on the infecting agent. Tolerating and keeping up with the symptoms is usually the challenge.

It can be very challenging to differentiate the cause of stomach upset initially. Generally speaking, food borne illnesses come on very quickly after eating, are very intense for a short period of time and then quickly resolve. More significant viral, bacterial or parasitic GI illnesses often come on gradually and may last for several days. GI infections have many similar symptoms regardless of cause and may include fever, nausea, with vomiting and/or diarrhea. Most mild foodborne illnesses do not have the feature of fever.

Food allergy typically presents with different symptoms including skin rash, tongue or lip swelling, difficulty swallowing and difficulty breathing. Simple food intolerance, such as, lactose intolerance, will have symptoms of gas, bloating and possibly mild isolated diarrhea. If you believe that you are having an allergic reaction to a food, try taking diphenhydramine and contact your primary care physician for follow-up. However, if you are having difficulty breathing or swallowing as a result of a possible food allergy you should seek care in a certified urgent care or emergency center.

The greatest concern associated with foodborne illness is the intensity and length of the symptoms experienced. If there is a significant amount of fluid loss associated with vomiting and diarrhea, this can lead to electrolyte imbalances and dehydration. These more advanced symptoms typically will not occur unless the illness has lasted more than 24 hours and are the initial reason to seek medical attention. The signs of dehydration will include dry mouth, increased thirst and a reduction in urine output. If you begin to feel weak, lightheaded and unable to tolerate oral fluid rehydration to keep pace with fluid losses, it is wise to seek care in a certified urgent care like Lakes Urgent Care, where you can be treated with IV hydration and medications to mitigate the nausea and vomiting. If you begin to experience confusion, intolerable abdominal pain, notice yellowing of your skin or eyes (otherwise known as jaundice) or see any blood in your stool, you should seek care in an emergency center.

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.

It remains unclear as to the exact reason why there is a sudden spike in the number of Hepatitis A cases in Michigan. Unfortunately, local epidemiologists are unable to pinpoint the exact point of origin for this particular outbreak. There are some commonalities associated with those who have been afflicted with the infection. As of last week, there were 398 cases reported in the Tri-County area and, sadly, 15 of those individuals have died.

Hepatitis A is a very contagious viral disease that affects the liver and can lead to liver failure. The virus is generally found within the feces of infected individuals. It is frequently transmitted through contaminated food and water, but can also be sexually transmitted or contracted through injection of illegal drugs. Symptoms commonly begin two weeks to as long as two months after initial exposure and include the usual host of vague symptoms such as nausea and vomiting, abdominal pain, fatigue, loss of appetite and weight loss. The symptoms most classic to advanced cases of Hepatitis (A or B) include yellowing of the skin or eyes (otherwise known as jaundice) or very dark colored urine.

Healthcare workers, food handlers, those who use or inject illegal drugs or participate in casual sexual practices and people who have recently been incarcerated are at the highest risk. The gay community is also disproportionately represented in a higher risk category. Anyone who has not been vaccinated for Hepatitis A is potentially at risk as well.

Getting vaccinated and practicing good personal hygiene and proper sanitation are the best ways to protect yourself and your family. Hepatitis A is a vaccine-preventable disease. Pediatricians now routinely vaccinate children for Hepatitis A along with all the other typical childhood vaccines. However, this practice only began within the last 15 years, many adults have not been vaccinated and there is now a focus on increasing vaccinations with the adult population. The Lakes Urgent Care staff strongly urges that all adults and children be vaccinated against hepatitis A. Contact your primary care physician, pediatrician or local health department to obtain the vaccine, which is a series of 2 injections given 6 months apart. Protection after the 2 vaccines is nearly 100%.  Lakes Urgent Care can also provide the vaccination.

Hives are small areas of swelling that occur on the skin surface in random areas on the body. Other commonly known names for hives include welts or urticaria. The medical term for hives is wheals. Hives typically appear very suddenly and may be pink or red with a raised surface around the edges with associated itching. The vast majority of hives last for a few minutes to a few hours, but in some cases can last for days, despite treatment. Rarely, hives can progress to a more significant allergic reaction that includes swelling of the tongue and throat with difficulty breathing, in which case they are potentially life-threatening.

Allergic reactions are the primary cause of hives. It can be difficult to determine the specific inciting factors, but there are numerous stimuli that can cause them to appear. Food products, plant contact or ingested medications can cause hives. Physiologically, they occur when there is a large histamine release in the body from specialized blood cells called mast cells. The histamines cause fluid to leak around the blood vessels in the area they appear leading to the skin changes that can be easily seen.

The diagnosis of hives is visual. There are no specific diagnostic lab or x-ray tests required for the diagnosis. Since the physiologic cause of hives is due to histamine release, we use antihistamine medications in addition to topical or oral steroids as the mainstay of treatment. Applying a cool compress of the affected area can also be symptomatically helpful. If the hives are associated with tongue, lip or throat swelling and difficulty breathing you should seek medical attention immediately at a certified urgent care or emergency department. The vast majority of times, hives occur independent of these more significant symptoms. If you are able to identify the specific stimulus that may have caused hives, it should be eliminated. If you believe the hives are due to direct skin contact, the affected area should be washed to avoid continued exposure and ongoing symptoms.

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.

It’s beneficial to get your body properly hydrated before you start exercising. Try to consume 17 to 20 ounces of water two to three hours before you start and another eight ounces about a half hour before exercising. If you are engaging in strenuous exercise to the point where you are sweating, drink an extra 12 ounces of water for every thirty minutes of exercise. Some people can’t handle a stomach full of liquid if they are exercising strenuously, and if that’s the case, then adjust these numbers down a bit until you find the consumption level that works for you. Finally, drink another eight ounces within a half hour after you are finished. Again, this can be adjusted up or down based on your age and weight, how strenuously you are exercising and if you are exercising in hot and humid conditions.

The easiest way to know if you are properly hydrated is to look at your urine. If it’s clear or a pale-yellow color, then you are properly hydrated. Dry skin is another sign of dehydration. If your mouth is dry, you aren’t hydrated enough to keep the mucus membranes in your mouth lubricated and your body is likely not producing enough saliva. Bloodshot eyes are another clue. Over consumption of alcohol can cause bloodshot eyes, because alcohol dehydrates you. If your joints are aching, that could be a sign of dehydration. Your cartilage and spinal discs are about 80% water so by staying hydrated, you are keeping your joints lubricated. If you aren’t well-hydrated, you may feel fatigued and lethargic. When your body is dehydrated it “borrows” water from your blood causing you to feel fatigued. If you aren’t drinking enough water, you may also feel constipated or have frequent heartburn or indigestion.

Most of us don’t drink enough water every day and there are plenty of benefits to making sure you are well-hydrated. Eight glasses of water a day is the right amount for some people, but depending on your weight and age, you may need more. The medical research center at the Mayo Clinic devised a formula to help you to come up with your own optimal daily water consumption amount: divide your weight by 2.2. Multiply that number by your age. Finally, divide that sum by 28.3. For example, if you weigh 170 pound and are 50 years old, you should consume 136 ounces of water each day which equals 17 eight ounce cups. This may seem like a lot of water, but remember that coffee, juice, and the water in fruits and vegetables also count towards this amount. Coffee does not cause dehydration, but drinking alcohol will dehydrate your body.

Yes, you should absolutely be concerned! The rate of Meningitis B is on the rise on many college campuses across the country. Students living in a dormitory have one of the highest risk factors for contracting this potentially deadly disease. If your student has other chronic health issues or is known to have immune system disorders, the risk is even higher. Meningitis B typically begins with cold or flu-like symptoms and rapidly progresses to a severe central nervous system and brain infection. Unfortunately, there is a 10% mortality rate in people who contract the disease, in addition to a 25% risk of serious long-term complications. The good news is that this severe illness can be prevented with a series of Meningitis B vaccines.

100% of all meningitis outbreaks on college campuses since 2011 have been from Meningitis B. The preventative vaccine is typically given in a series of 2 or 3 vaccinations over several months. Until recently, this vaccine was considered to be “elective” and not part of routine vaccinations that most children and young adults receive from their primary care physician or pediatrician. The CDC now recommends that all incoming college students receive a series of vaccines as a routine part of the transition from home to the college setting. This potentially deadly disease is completely avoidable by getting vaccinated. If you are unable to obtain the vaccine from your primary care physician, pediatrician or local health department, it is available at Lakes Urgent Care. Please make sure to plan adequately so that your college freshman has had at least 2 Meningitis B vaccine doses.

As your high school graduate looks forward to the college experience, there are some basic health tips you should discuss with her: developing good hygiene habits including frequent hand washing, assuring that all vaccinations that are necessary have been provided including the HPV vaccination, making sure that there is an awareness of local health care on campus or near campus, getting adequate sleep and eating a well-balanced diet. It’s also important to have open conversations about protected sex and a knowledge of how to prevent sexually transmitted diseases. Make sure that your college freshman has a good understanding about sexual abuse and violence that can occur in the college campus setting. Many college orientation programs address this issue, but this is a subject that should be transparently discussed and reinforced with your son or daughter.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 hygiene refers to the quantity and quality of the sleep that you obtain each night. It is important to get an appropriate amount of sleep, making sure it’s not too little or too excessive. Our sleep needs are dynamic and change across different ages and can be impacted by lifestyle and health status. As a general guide, teens need about 8-10 hours a night, young adults and adults need about 7-9 hours, and adults 65+ need about 7-8 hours each night.  Having good sleep hygiene is critical to your overall health and can have a significant positive impact on the reduction of high blood pressure, diabetes and other chronic diseases.

Make sure that your bedroom is completely conducive to sleep. Dark shades, noise reduction and eliminating a bright clock are helpful. Avoid nicotine, alcohol and caffeine a minimum of four hours prior to anticipated bedtime. Try to maintain a regular circadian rhythm and sleep cycle by being consistent with the time that you go to sleep and awaken each day as much as possible. Exercising earlier in the day is better than in the evening. Make sure that you balance your fluid intake to avoid excessive amounts of volume before bedtime which may trigger more trips to the bathroom during the night.

If you do not awaken with pain or soreness, there may be no need to change your sleep position. However, the vast majority of people do sleep on their side which can lead to significant shoulder and neck pain. If you are a side sleeper, make sure that you use a pillow that’s thick enough to support your head and take some of the pressure off your shoulders as well as your neck. In addition, sleeping on your right side can potentially increase problems of heartburn and acid reflux. Those who sleep on their stomach should use a flatter pillow to avoid excessive pressure on the neck and upper back. Sleeping on your back is the best position anatomically speaking, but less than 10% of people actually do so. Sleeping on your back helps to reduce aches, pains and heartburn because it allows the body to rest in a completely neutral position. The downside to sleeping on the back is that it can increase the amount of snoring. Regardless of which position you ultimately sleep in, comfort is the key and if you awaken refreshed and without significant aches or pains, you’re probably in the perfect position!

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.

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.

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.

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.

After reviewing 25 years of scientific research from 1990 to 2015, there are now new guidelines for the diagnosis and management of a mild traumatic brain injury (mTBI), commonly known as a concussion. One of the more important aspects is the recommendation to not perform a complete diagnostic brain imaging by CT scan unless there is a specific set of signs and symptoms present indicating high risk factor that would justify the use of neuroimaging. There are a number of excellent updated validated concussion assessment tools now available to physicians to help guide in the diagnosis and treatment of TBI. The Centers for Disease Control has excellent resources for patients and families who wish to learn more about head injuries and more, at CDC.gov.

New research indicates that a small amount of bed rest is appropriate over the first 48 to 72 hours after a mild traumatic brain injury or concussion. The newest recommendations are to limit bedrest to no more than three days and encourage a gradual return to normal activities, as long as there are no obvious continued symptoms such as headaches, dizziness, nausea, poor balance or visual disturbances. Close monitoring for symptoms during the recovery period is critical.

Current recommendations for return to athletic activity follows a 6-step program, beginning 3 days after the initial injury with a return to normal school routines and light to moderate activity such as fast walking or riding a stationary bike. If there are no symptoms associated with this initial step, then there is a progression to moderate aerobic activity to increase heart rate and head movement, such as jogging, or sports skill related drills. If your student remains symptom-free, there is a stepwise progression to heavy aerobic activity, full unrestricted practice and finally a return to competition. In general, this process takes approximately 2-3 weeks, but should be guided by the managing physician in concert with either the athletic trainer or team coach. It is important to note that if symptoms do reoccur, the process would be restarted and require reevaluation by a physician who is familiar with concussion recovery programs. Most importantly, it is critical to understand that injuries to the brain can take a long time to heal and the treatment and recovery plan should be guided by a health professional knowledgeable of these types of 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!

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.

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.

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.

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.

The pre-participation physical (often referred to as the sports physical or camp physical) is meant to identify a number of potential early warning signs that an athlete may have a more significant underlying health concern. We screen for visual problems, kidney function and diabetes in addition to cardiovascular and pulmonary symptoms. The key components to this process are providing the physician with honest responses to a series of questions meant to screen for potential heart ailments, including chest pain or discomfort with exertion, fainting spells, excessive fatigue or shortness of breath with activity. The second component is the physical exam, which specifically looks at blood pressure, heart rate and assessment for heart murmurs or abnormal breath sounds. If the history or physical exam reveals any potential heart or lung issues, then additional testing is recommended. Additional testing may be required If there are other signs and symptoms suggesting a possible problezm such as diabetes or kidney disease.

If additional testing is indicated, the clearance for participation may be delayed. Typically, additional tests for heart and lung symptoms may include a chest x-ray, EKG and possibly an echocardiogram (ultrasound exam of the heart), which is an excellent way to screen the heart for structural problems, without using any radiation. Starting September 24th, Lakes Urgent Care will offer echocardiograms for any patient where it may be indicated or in the event a parent wants their athlete screened because of a family history of heart problems such as cardiomyopathy (abnormal enlargement of the heart chambers). The echocardiogram may also be recommended if your student has abnormal blood pressure, any warning signs or symptoms or an abnormal EKG.

Under most circumstances, if your son or daughter just recently had a complete annual physical, your primary care physician will be happy to complete the required sports physical paperwork for you. However, if it’s after hours or you haven’t had that annual physical yet (which we always strongly recommend be done with your primary care physician or pediatrician), but need to turn in the paperwork, you can feel confident that Lakes Urgent Care will give your son or daughter a complete sports physical including additional testing if indicated. We always offer to share any evaluation or testing recommended or completed at Lakes Urgent Care with your primary care physician.

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.

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.

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 family’s busy schedule.

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 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.

Tinnitus is best described by “ringing in the ears” or as noise which is not being caused by an external stimulus. Common descriptions of the symptoms include hissing, clicking or whistling sounds when there is no obvious external source for these noises. It can occur in one or both ears and may be constant or intermittent. There are numerous causes for this phenomenon, but more commonly it is due to some acoustical trauma such as listening to music too loud, enduring an explosion in close proximity or direct trauma to the head or ears. Tinnitus can be annoying, distressing and irritating but is generally not life-threatening. The one exception to this rule is if the tinnitus is being caused by a tumor or vascular anomaly within the inner ear or in proximity to the ears within the skull.

While there is no direct link to hearing loss associated with tinnitus, quite often people who are suffering with this condition have an associated partial or near-complete hearing loss. Depending on the cause and specific type of tinnitus, there may be a cure. Unfortunately, many cases of tinnitus are indeed incurable and can often cycle between active and dormant phases without any apparent pattern or stimulus. If you or a loved one is suffering from this type of symptom, it’s best to get evaluated by a specialist such as an ENT surgeon or audiologist to pin down potential treatable causes.

Following an audiological assessment to determine treatable causes, there are number of potential strategies to help diminish or alleviate the symptoms of tinnitus. An audiologist or ENT surgeon can help direct those steps. Sometimes, utilizing a hearing aid properly fitted and adjusted can actually help to reduce the symptoms associated with tinnitus. In addition, many people find that learning appropriate stress management techniques such as mindfulness-based stress reduction can significantly decrease the symptoms or make them more manageable so that they have less of an impact on day-to-day life. if you are having difficulty finding the correct specialist to assess tinnitus, your primary care physician or the physicians at Lakes Urgent Care can provide you with resources to be properly evaluated and potentially treated for this annoying problem.

Plan ahead for delays, changes in weather or other emergencies. Place a small amount of your daily medications in a bottle for your carry-on bag that can take you through a two-day delay. Put your regular medication bottles with your checked baggage. Check the weather, consider that it may change, and bring clothes that allow for layering.

Make 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.

Bring good shoes for hiking and swim shoes for beach and water activities. Pack exercise clothes so that you can maintain your exercise routine in the hotel gym. If visiting somewhere with a high altitude, contact your physician for altitude sickness medication or see us at Lakes Urgent Care. Make sure that everyone is up to date on any needed vaccinations including the influenza vaccine.

Check the local resources in the area where you are traveling to determine any particular health risks. In the Caribbean and Central America, be wary of mosquito-borne illnesses like Zika. In the African continent, Malaria is more prevalent. Prevention of both of these illnesses can be achieved by utilizing insect repellent containing at least 20% DEET. If you are sleeping in an outdoor environment, always use mosquito netting. There is also an increased risk of contracting hepatitis when traveling to these same areas, so if you have not yet been vaccinated for Hepatitis A and B, we strongly recommend doing so. Both of these vaccines are available at Lakes Urgent Care or through your primary care physician or local health department. Pay attention to the local news stations and weather forecasts during your visit, and avoid outdoor activities if severe weather conditions are expected. Additionally, cold and flu-carrying pathogens cover many surfaces such as desks, door handles, and phones. Keep yourself protected by washing your hands with soap and water often or carrying a hand sanitizer with you at all times.

Be prepared before you leave. If traveling out of the country, find out exactly what your health insurance company will cover. Medicare does not cover hospital or medical costs outside of the United States so you will likely require a supplemental insurance plan or have to pay cash and then seek reimbursement. Contact the nearest US Embassy for a list of physicians and medical facilities that they recommended and trust. The US consulate can also be of assistance if you require the transfer of funds or require repatriation. Give strong consideration to purchasing a global medical transport insurance policy, such as MedJet Assist, that can help a sick family member that requires hospitalization.  There are several companies that offer reasonably priced family plans that can provide significant piece of mind if someone becomes ill outside of the country or more than 150 miles from home.

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!

The decision can sometimes be a little daunting, but a good rule of thumb is to trust your instincts. While cost and convenience are top of mind for many healthcare consumers these days, never compromise your health for these reasons alone. If you have had particular symptoms for several days or longer, chances are you could wait to see your primary care physician. Acute injuries, like sprains, strains, eye injuries, burns and cuts are best treated soon. If you are concerned about an acute infection and cannot be seen by your doctor within 24 hours, that would also be a great reason to be seen in a certified urgent care. If you are having a serious potentially life-threatening issue like chest pain, extreme difficulty breathing or any stroke-like symptoms, immediately call 911 or proceed to your closest ER. When your condition is urgent, but less serious, Lakes Urgent Care can save you time and money. Insurance co-pays can be much more expensive at a hospital ER. And you may wait for a long time in a hospital ER for minor health concerns. At Lakes Urgent Care, you’ll be seen quickly by a highly trained physician. And by visiting us, you’ll help keep the ER free to concentrate on more seriously ill patients.

All urgent cares are NOT created equal and in Michigan, urgent care centers are not regulated. Many facilities holding themselves out to the public as an urgent care do not actually qualify under the national guidelines of the Urgent Care Association of America (UCA). Always seek out an urgent care that is certified or accredited by the UCA. Lakes Urgent Care was one of the first certified urgent cares in southeastern Michigan accredited by the UCA. We hold ourselves to a higher standard because our patients deserve the best and most comprehensive care possible at a lower cost than visiting a hospital’s ER.

At Lakes Urgent Care, we provide a very wide array of treatments including on-site lab testing, digital radiology, EKG’s, pulmonary testing and treatments in addition to
IV therapies which most urgent cares do not provide. We like to call it “ER Lite”, where you are seen by physicians with training in emergency medicine who have access to many of the capabilities of the ER without the wait or cost. To learn more about all the great care we provide, visit our website, lakesurgentcare.com, where you will find comprehensive information and resources to help you. We also have a page on our website called “Urgent Care or ER” where you will find an easy to read graphic that we created in conjunction with the Greater Detroit Area Health Council. And stop by our office anytime and pick up a free “Urgent Care or ER” magnet graphic to display in your home, school or office.

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.

Aside from good hand hygiene, adequate sleep, proper diet and regular exercise, vaccinations are the best way to protect our children from potentially devastating and lethal diseases. From early childhood to the teen years, there are 16 vaccines which can help prevent unnecessary illness or hospitalization. Staying current with the right vaccines is even more important if your child has any underlying chronic health conditions which may expose them to a greater risk of contracting these vaccine preventable diseases. Because of the large number of vaccines that are available, it is best that you speak about this very important issue with your child’s pediatrician or primary care physician who can be your best resource and helped guide appropriate vaccination.

In recent years, there has been a significant amount of opinion and even misinformation shared in public about potential complications from receiving vaccines. It’s critically important to understand the true evidence-based science, but for brevity here, I would reassure everyone that vaccines are absolutely safe and have not been proven to cause autism or other genetic anomalies. Most importantly, the best way you can protect your own child from those who are not vaccinated, is give them the appropriate vaccines. Once a child or adult has been vaccinated, their risk of contracting a disease from an unvaccinated individual is essentially eradicated. Vaccines assist our body’s incredible immune system to develop immunities and antibodies that prevent specific infections.

There are highly effective vaccines capable of preventing meningitis, which is a severe and potentially lethal infection of the brain and spinal cord. There is an increased incidence of risk associated with meningitis and college-aged young adults due to a variety of risk factors in this age group. In addition to this vaccine, be aware that several childhood vaccines have the potential to wear off over time and may require a booster vaccine to assure continued immunity. Your primary care physician can be an excellent source of information for the correct vaccinations at each stage of our lives. In addition there are some excellent resources at the Centers for Disease Control website. Lakes Urgent Care also provides many adult vaccines and can be an additional resource for adults to obtain vaccines in a cost effective, friendly environment.

Unauthorized vaping products regularly enter the market, and underage sales too frequently occur in stores and online. Some experts believe vaping is a safer alternative to smoking cigarettes. But much is unknown about the long-term health consequences of vaping. Unlike traditional cigarettes, E-cigarettes don’t contain tobacco, don’t involve combustion and contain fewer ingredients. A 2018 analysis of more than 800 peer-reviewed scientific studies suggests that “e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes.” While vaping exposes users to some toxicants, the vapor has “fewer numbers and lower levels of most toxicants” than cigarette smoke. However, E-cigarettes have not received FDA approval as a medical smoking cessation device.

E-cigarettes are undeniably harmful, exposing users to numerous toxic and carcinogenic substances that may lead to adverse health effects. But they virtually eliminate exposure to carbon monoxide, tar and many of the 7,000 chemicals that contribute to cigarettes’ lethality. In short, e-cigarettes are less harmful than smoking, but they are by no means safe! As of last week, the CDC has reported a total of 29 vaping related deaths across the US, in contrast to nearly half a million cigarette related deaths annually. Vaping products from reputable, regulated manufacturers may indeed be measurably safer than traditional cigarettes, but there is simply not enough experience or research to know the ultimate health impact vaping will have on users. The simple and safe answer is, don’t smoke cigarettes and don’t vape.

It is true that most smokers who try E-cigarettes continue to smoke, but that does not mean that E-cigarettes are an ineffective cessation aid. Most smokers who try FDA-approved nicotine replacement therapies also continue to smoke, but such products are still officially deemed “effective.” The best source of advice and guidance to quit smoking cigarettes or discontinue the use of vaping products will be your primary care physician. There is certainly not a “one fits all” approach but keep trying to quit if you are a smoker or vaper!