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

From asthma to flu shots, sports injuries to seasonal health topics, Dr. Sandy Vieder, Medical Director and co-owner of Lakes Urgent Care, answers questions asked by his patients every month.



Most-Recently Answered Questions

Cold-Weather Health Issues

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.

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Cold-Weather Health Issues

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.

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"I needed to take my two boys in to be seen today and we just moved to the neighborhood so I googled the nearest urgent care and boy am I so glad I did because this is the BEST urgent care that I have ever been to!! They were super fast and got us seen right away. The nurse made my sons laugh and feel comfortable the whole time. The doctor was very thorough and really connected with my boys which calmed their nerves. They even gave my sons a prize for coming in! Thank you for being so kind and thorough in this fast paced world!! You guys are awesome!"

Deshon - Google review

Lakes Urgent Care
5
2020-07-20T11:13:48-04:00

Deshon - Google review

"I needed to take my two boys in to be seen today and we just moved to the neighborhood so I googled the nearest urgent care and boy am I so glad I did because this is the BEST urgent care that I have ever been to!! They were super fast and got us seen right away. The nurse made my sons laugh and feel comfortable the whole time. The doctor was very thorough and really connected with my boys which calmed their nerves. They even gave my sons a prize for coming in! Thank you for being so kind and thorough in this fast paced world!! You guys are awesome!"
"My minor daughter, my elderly mom and myself went here this morning @ 10am and from the intake worker to the nursing staff and Doctors we have never been treated so kindly at any other ER. Very friendly, compassionate staff. They even let all three of us go into one exam room and treat all of us as a family unit! We all three highly recommended Lakes Urgent Care!"

Kimberly - Facebook review

Lakes Urgent Care
5
2020-07-20T10:36:23-04:00

Kimberly - Facebook review

"My minor daughter, my elderly mom and myself went here this morning @ 10am and from the intake worker to the nursing staff and Doctors we have never been treated so kindly at any other ER. Very friendly, compassionate staff. They even let all three of us go into one exam room and treat all of us as a family unit! We all three highly recommended Lakes Urgent Care!"
"They were incredibly fast to get us back and taken care of and super professional when I had questions. I can’t say enough good things! Thank you Lakes Urgent Care in Livonia for being so professional, quick and clean!! It’s worth the drive if you’re in Southeast Michigan. Definitely our urgent care of choice!!"


Whitney - Facebook review

Lakes Urgent Care
5
2020-07-20T10:43:28-04:00

Whitney - Facebook review

"They were incredibly fast to get us back and taken care of and super professional when I had questions. I can’t say enough good things! Thank you Lakes Urgent Care in Livonia for being so professional, quick and clean!! It’s worth the drive if you’re in Southeast Michigan. Definitely our urgent care of choice!!"
"This place was awesome! Phone etiquette was amazing and they accommodated me last minute. Once I was there the environment was clean, staff was really nice informative and even with everything going on with this pandemic they were very attentive and professional. Super helpful and even though I went just for testing the doctor made sure to stop in and answer any questions I had. I’d recommend this place for any urgent needs!"

Andrea - Google review

Lakes Urgent Care
5
2020-07-20T10:46:23-04:00

Andrea - Google review

"This place was awesome! Phone etiquette was amazing and they accommodated me last minute. Once I was there the environment was clean, staff was really nice informative and even with everything going on with this pandemic they were very attentive and professional. Super helpful and even though I went just for testing the doctor made sure to stop in and answer any questions I had. I’d recommend this place for any urgent needs!"
"I woke up Sunday with severe vertigo. After calling my PCP I decided I couldn't wait and went to Lakes Urgent Care Livonia. They got me in quickly, did a thorough exam and sent in a prescription to my pharmacy. The doctor explained everything to me in a manner I could understand. I have complete confidence in the doctor. Also, I felt safe (coronavirus) and everyone was pleasant and helpful. Additionally, the doctor made a follow up phone call to check on me! I'm happy to say the medicine prescribed is working great!"

Cindy - Google review

Lakes Urgent Care
5
2020-07-20T11:33:19-04:00

Cindy - Google review

"I woke up Sunday with severe vertigo. After calling my PCP I decided I couldn't wait and went to Lakes Urgent Care Livonia. They got me in quickly, did a thorough exam and sent in a prescription to my pharmacy. The doctor explained everything to me in a manner I could understand. I have complete confidence in the doctor. Also, I felt safe (coronavirus) and everyone was pleasant and helpful. Additionally, the doctor made a follow up phone call to check on me! I'm happy to say the medicine prescribed is working great!"
"Needed care for my 93 yr old Father in Law during Covid pandemic. We were not infected but he needed a simple procedure. Their complete screening process before entering Clinic dispersed any worries we had. Everything went great. Huge effort to ensure everybody's health and safety. Well done."

Aaron - Facebook review

Lakes Urgent Care
5
2020-07-20T10:44:59-04:00

Aaron - Facebook review

"Needed care for my 93 yr old Father in Law during Covid pandemic. We were not infected but he needed a simple procedure. Their complete screening process before entering Clinic dispersed any worries we had. Everything went great. Huge effort to ensure everybody's health and safety. Well done."
"Super clean, they take your temperature before you walk in. I saw the staff clean everything after every patient. The staff and doctor were so great today! Thank you for servicing our community! Highly recommended!"

Stephanie - Facebook review

Lakes Urgent Care
5
2020-07-20T10:41:37-04:00

Stephanie - Facebook review

"Super clean, they take your temperature before you walk in. I saw the staff clean everything after every patient. The staff and doctor were so great today! Thank you for servicing our community! Highly recommended!"
5
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Lakes Urgent Care