Ice vs. Heat: Which Is Better for Pain?

This article was originally published on Sharecare.

Jonathon Faber, DO, is a sports medicine specialist with Saint Joseph Mercy Health System in Livonia, Michigan,

Whether chronic or acute, aches, pains and injuries can put a damper on everyday activities. Along with rest and elevation, we’ve been told that heat and ice can speed recovery, but which is best for your particular ailment? Jonathon Faber, DO, a sports medicine specialist with Saint Joseph Mercy Health System in Livonia, Michigan, explains when you should apply ice or administer heat, and when it’s time to see your doctor.

When to opt for ice
Acute pain is sudden, brought on by a specific incident. Broken bones, sprains, strains, burns, cuts and surgery can all cause acute discomfort. As soon as the cause of pain is remedied, the uncomfortable sensation should subside. But what to do in the meantime?

As a general rule, acute injuries should be treated with an icepack or a bag of your favorite frozen veggies. “Typically, when you have an acute injury, like an ankle sprain, it’s very appropriate to apply ice for the first 48 to 72 hours,” recommends Faber.

When used promptly, ice helps reduce swelling. Swelling is caused by the rush of fluid and white blood cells to an injury, which works to promote healing and help prevent you from using the affected area. “[However,] a lot of times, swelling can be excessive enough, especially in places like the ankle and knee, that it prevents further healing,” says Faber. So, reducing swelling quickly can help speed recovery.

For some injuries, ice isn’t enough. Rest, compression and elevation are also necessary. “The acronym RICE stands for rest, ice, compression and elevation,” says Faber. “These methods reduce swelling and inflammation at the site of an injury.”

When to reach for heat
Not all types of discomfort should be treated with an ice pack. Chronic or long-lasting pain, which can persist for more than 12 weeks, is often better soothed with a heating pad. This type of discomfort may be caused by an injury or illness like arthritis or fibromyalgia, but in some cases, has no known cause. Frequently, the goal in treating chronic pain is minimizing discomfort as much as possible, to enhance your quality of life.

Here’s why heat helps: while ice reduces inflammation in areas with a buildup of fluid, heat is better suited for pain not caused by swelling, like arthritic joint pain. “Heat tends to be more appropriate for joint pain in people who suffer from osteoarthritis, because it increases blood flow to affected areas,” says Faber. There are exceptions: some with arthritic joint pain may benefit from applying ice to numb the sensation of pain, as well.

Heat also helps ease discomfort linked to achy joints and stiff muscles. By improving blood flow and circulation, it relieves pain and stiffness caused by conditions like tendinosis, chronic stiffness of tendons attached to the joints.

Sometimes, pain from injuries older than six weeks can also be alleviated with heat. “After a few weeks, icing sprains and strains doesn’t tend to be as beneficial,” says Faber. “At that point, it’s personal preference, and you should do what feels better.”

See your doctor
Some injuries shouldn’t be treated at home. See your doctor if:

  • An injury significantly affects your range of motion, rendering you unable to complete everyday tasks like bathing, cooking or dressing.
  • You injure certain parts of your body. “With any lower extremity injury, the hip, knee or ankle, that leaves you unable to bear weight, you should see your doctor,” says Faber.
  • You have a minor injury, and swelling doesn’t improve after a few days of at-home treatment.

Ignoring an injury or compensating for the pain by putting more pressure on other parts of the body can lead to permanent dysfunction, making treatment difficult. In that case, your injury may be less of a job for heat or ice and more of a job for your healthcare provider.

Looking for a doctor or ready to make a switch?
Visit stjoeshealth.org to find a doctor near you, or call 1-800-231-2211, and we can guide you through the process.

I Found the One!

When it’s the right one — you just know it. We just clicked. I felt so comfortable. It’s like we had known each other for years. I’d been searching for so long. I’ve even written about my struggle to find the one. Truthfully, I had almost given up looking… And then it happened.

I found my new primary care doctor.

It was hard for me as a health reporter to admit I didn’t have a doctor for so long. My last doctor had chosen to go concierge, meaning he was now charging close to $3,000 a year in return for more personalized care. But at this point in life, I’m healthy (knock on wood) and just need a doctor for my yearly physical. But how do you choose the right one? Admittedly, I’m picky.

Dr. Leslie Caren with a pediatric patient and his mother at the new St. Joseph Mercy Waterford Medical Complex. Dr. Caren treats adult and pediatric patients at Waterford Adult and Pediatric Medicine.

And then she just walked in. The moment we started talking I knew. I just knew.

I had gone to see the new St. Joe’s Waterford Medical Complex located at 59 and Pontiac Lake Road. The new medical facility features a lab, imaging services and an Urgent Care (opening July 1, 2019) along with the Waterford Adult and Pediatric Medicine practice. That’s where I met Dr. Leslie Caren, an internal medicine and pediatric specialist. She was so easy to talk to. Her calm demeanor, obvious concern and compassion made her an easy choice. Plus, she’s a St. Joe’s doc which was a high priority for me. She was so approachable and clearly interested in my wellbeing and, lucky for me, she had an appointment available for a physical. I grabbed it and never looked back.

On the day of my appointment, I wasn’t left waiting in a waiting room. She came in and took a thorough and complete history. It’s uncomfortable talking to a stranger about your most personal issues. But in this case, I instantly felt like I was talking to a friend. She just got me. She listened without interrupting and gave me thorough answers to any questions I had. It’s one of the main reasons I wanted a primary care physician — the better a doctor knows you, the more likely you are to get an accurate diagnosis.

But there are three other reasons I really wanted to have a primary care physician (and so should you):

Lila’s Health Report:
In order to stay healthy, you need to stay active and engaged. In addition to exercise, good nutrition and sleep, you also need a good dose of adventure. So each month I’ll share ways to boost the excitement and passion in your life with adventurous ways to create more wellness in your body, mind and your spirit.

A primary care doctor keeps you healthier as you age. Studies show, people who have a good relationship with a doctor don’t just get better care, they’re healthier! It’s like any relationship: The better you communicate and connect, the better the outcome. I have no doubt my new primary care doc will make sure I get all the tests and treatments I need to keep me healthy.

Someone has your back. Gone are any worries of who I would call if suddenly I need a prescription, or a specialist or quick medical advice. We talked so openly about so many topics from weight, to alcohol, to sex, stress and aging. I felt listened to, which is important. And I felt like someone truly had a plan to ensure I stay healthy for as long as possible. My new doctor arranged for all my lab work, followed through on the results and explained any concerns. I have 24-hour access to my health information and any lab results on the St. Joe’s portal. When I sent her an email through the portal, she responded!

Health is a team sport. It’s not just the primary care doctor that impressed me, it’s the whole office. After all, I’ll be dealing with all of them to book appointments, get my labs done or deal with insurance issues. The right primary care doctor needs the right support team.

Looking for a doctor or ready to make a switch?
Visit stjoeshealth.org to find a doctor near you, or call 1-800-231-2211, and we can guide you through the process.

Be Resilient: Keep Pedaling Forward

After overcoming HPV-related squamous cell carcinoma, Matthew looks forward to embracing an active lifestyle again.

Matthew Robinson was unsuspecting and shocked when he learned that the months of headaches he had been experiencing were likely due to cancer, and not just long work hours.

The 58-year-old triathlete was diagnosed in July 2017 with squamous cell carcinoma, after a PET scan showed a tumor at the base of his tongue.

Even more surprising, Matthew said, was learning that his cancer was probably caused by human papillomavirus, or HPV.

While tobacco and alcohol are two of the most common risk factors of cancers in the back of the throat, the Centers for Disease Control and Prevention (CDC) says recent studies show that about 60% to 70% of cancers of the oropharynx may be linked to HPV.

Continue reading “Be Resilient: Keep Pedaling Forward”

8 Tips for Going Back to School with ADHD

This article was originally published on Sharecare.

Closing the book on summer break and heading back to school can be a struggle for any child. But back-to-school time can be particularly stressful for kids with attention deficit hyperactivity disorder (ADHD), says Charan Cheema, DO, a family medicine specialist at Saint Joseph Mercy Health System in Saline, Michigan.

Why is it so important to start on the right foot? Doing so can mean the difference between a year filled with good grades and social success versus a year of anguish, poor school performance, and behavioral problems. Here are eight ways parents of kids with ADHD can help ensure a smooth and successful transition to school—and help them stay on track all year long.

Set up a calendar
At the start of school, your child may be making resolutions that this is the year they’ll get—and stay—organized. Several well-thought-out calendars can help them get there.

Look for one organizer that is large enough for them to write down all their assignments, plus a second one where they can log after-school programs and events, along with social activities like parties or playdates, advises Cheema.

Kids who are old enough to have their own smartphones or tablets may also benefit from a digital calendar, since these offer reminders and pop-up notifications. Have your child share their digital calendar with you to keep you in the loop.

Create an ‘out-the-door’ checklist
You probably know that a clear, rigid morning routine is crucial to helping your kid with ADHD make it to the bus on time. And it goes without saying that a morning spent searching for lost socks, homework, and lunch boxes can make anyone crabby.

That’s why it’s a good idea to have a checklist your child can use to itemize tasks like making their bed, getting dressed, eating breakfast, brushing their teeth, and gathering their homework and lunch box before they head out the door, says Cheema.

Make sure you have backups at the ready, like hats, mittens, or pairs of shoes. These have a tendency to mysteriously disappear in households, so having extras will help guarantee you and your kid keep moving forward.

Touch base with your teacher
If your child has ADHD, you may already have an IEP (individualized education program), a written plan of goals and accommodations that help ensure a student makes progress. But there are other strategies you can employ to help make sure your child’s doing okay.

A communication binder that goes between school and home will allow you and your child’s teacher to share notes about daily behavior and progress, explains Cheema. This sort of regular contact also helps make sure the teacher is following through on needed accommodations, like giving your child breaks or extra time to complete their work.

Teachers can also seat your child in a part of the classroom where they’re least likely to get distracted, like up in front. If your child is older (say, middle or high school), consider asking if they can record lectures on their smartphone. This way, they can re-listen at their own pace and review any missed information at home.

Create a set homework routine
Kids with ADHD thrive on consistency, so it often helps to start and finish homework at the same time and place every evening, advises Cheema. Choose a part of your home that’s relatively distraction-free, and ideally somewhere where you can easily keep an eye on your child.

Allow frequent breaks, and imbue those breaks with a reward. For example, after finishing their spelling worksheet, let your child have a five-minute break to grab a snack and run around for a few moments. Make sure you offer positive reinforcement. Anytime they notch a success—even something small like sitting down at the table voluntarily to do their homework—praise them and explain exactly what they did well. Ignore negative behaviors, like whining.

You can also reward kids once homework is completely done by letting them play on their tablet or going outside. If they have a lot of trouble concentrating, you might try using a white noise machine or the sounds available from a relaxation program like Sharecare Windows (available on the Sharecare app for iOS and Android). Sounds like rainfall, waves, and soothing music may help maintain attention. Of course, if these add stress or distraction, it’s best to set them aside.

Carve out time for exercise
Physical activity is important for all kids but may be especially valuable for those with ADHD. Some studies suggest that regular exercise can improve attention, behavior, and motor control in young people with ADHD. The research isn’t yet definitive, but getting exercise is pretty low-risk, so it may be worth a try to work movement into your child’s afternoon routine.

Just remember that structured team sports can be challenging for some kids with ADHD, since they may have trouble following multi-step directions and/or coordination, points out Cheema. Other options include running, swimming, marital arts, or even just going on a family walk.

Help them stay focused
It can be hard for a child with ADHD to figure out which assignments take priority. You can make it easier for them by ensuring they have an assignment notebook to help organize their work.

Another good idea: color code everything. Colored folders can help your child organize work for different subjects like reading, math and writing, while highlighters will help them rank assignments by priority level. For example, use red to indicate a task due the next day, yellow for one due later in the week, and green for longer-term projects.

Clutter can also get in the way of staying organized, so it’s a good idea to do a clean sweep of backpacks, desks, and workspaces on a regular basis.

Set up some play dates
Establishing and maintaining friendships can be tough for kids with ADHD, since they often struggle with social skills. If your child has trouble making and keeping friends, setting up some structured play dates—where you can prep in advance for what’s expected—can help ease anxiety. Try to organize some outings with another child in class as early in the year as possible, and ideally before the first day of school.

“It can be easier those first few days if there’s a familiar face there with them,” says Cheema.

Ease back into medication
Some kids with ADHD take a “drug holiday” over the summer, especially if they’re experiencing side effects such as weight loss from decreased appetite due to stimulant meds. While most of these drugs have an immediate effect, it’s a good idea to start kids back on their regular dosage about a week before school resumes, says Cheema. This way, they have a chance to get used to the medication before the first day of class.

After that, you can follow your kids closely and speak to your physician about tweaking dosage as needed. Some kids may also need a “booster” dose after the school day to help them get through homework and after-school activities—and set them up for a successful next day.

Looking for a doctor? Visit stjoeshealth.org to find a doctor near you, or call 1-800-231-2211, and we can guide you through the process.

Wanted: A Primary Care Doctor

by Lila Lazarus

Adventurous, fun-loving, healthy, 50-something woman seeks intelligent, compassionate, patient, trustworthy and attentive primary care physician for a long-term relationship.

Hard to admit, but I don’t have a doctor. Last year, my general practitioner went “concierge,” meaning his services now cost an extra $3,000 a year— a retainer fee paid by some patients to avoid crowded waiting rooms and get more personalized service.

While that may appeal to me someday, for now, the extra price tag seems exorbitant for someone I see maybe twice a year. So now I’m in search of. And I’m not alone. One out of eight people are looking for a new doctor, either because their doctor retired or changed plans or because of the quality of care from the doctor or staff.

Continue reading “Wanted: A Primary Care Doctor”

The Infectious Return of Measles – A Previously ‘Eliminated Disease’ in the U.S.

by Anu Malani, MD, Medical Director, Infection Prevention and Control Services, St. Joseph Mercy Ann Arbor, Livingston and Chelsea

When I was a third-year medical student, measles was declared eliminated from the United States in 2000.

There has been a resurgence of measles, and there is significant concern that the disease can become widespread again. As of May 3, 2019, the U.S. has seen 764 cases of measles this year in 23 states, including 43 cases in Michigan. It’s only the beginning of May, and surveillance data shows that cases are well over 50% higher than numbers recorded last year. There will be many more cases of contracted measles in the upcoming months. There are several ongoing outbreaks across the U.S., including Michigan, New York, Washington, New Jersey, and California. The main reasons for the measles reemergence include more international travel – several countries have ongoing measles outbreaks – and low vaccination rates in several communities. Globally, the World Health Organization reports that measles cases in the first quarter of 2019 nearly quadrupled compared with what was reported at this time last year. 

Watch Dr. Malani and St. Joe’s Health Reporter Lila Lazarus discuss the measles outbreak on Facebook Live.

Continue reading “The Infectious Return of Measles – A Previously ‘Eliminated Disease’ in the U.S.”

Be Resolute: Crossing the Finish Line Twice

Facing cancer again, marie is determined to cross the finish line with her oncology nurse navigator, for a second Time

Marie Candiotti has her eyes set on Orlando 2020. Her mission – to run the Disney Princess Half Marathon in full princess costume.

She’s also fighting cancer for the second time around.

“She is the embodiment of courage,” described Marie’s husband, Lou. Self-dubbed Captain of Team Candiotti, Lou has watched his wife face cancer fearlessly since receiving the first diagnosis in 2017.

It was stage 3 ovarian cancer, Marie and Lou were told on Feb. 15, 2017. Marie had been having trouble emptying her bladder, and went to the ER after she couldn’t complete a set of jumping jacks. A lifelong fitness instructor, she otherwise looked and felt healthy. She was working for St. Joe’s ShapeDown program at the time.

This diagnosis was shocking and disorienting.

Continue reading “Be Resolute: Crossing the Finish Line Twice”

St. Joe’s Ann Arbor Gynecologic Oncology Team Receives Grant to Fund Pilot Project for Ovarian Cancer Patients

Rebecca Liu, MD, Nicole Brashear, NP, and the gynecologic oncology team at St. Joseph Mercy Ann Arbor received the 2019 Geri Fournier Ovarian Cancer Research Award from the Michigan Ovarian Cancer Alliance (MIOCA). The $50,000 grant will fund their pilot project for ovarian cancer patients.

MIOCA announced the research grant on May 8, World Ovarian Cancer Day. Since it started giving grants in 2014, MIOCA has awarded over a half-million dollars to researchers in Michigan who are finding new ways to improve the early detection and treatment of ovarian cancer.

St. Joe’s project, titled, “EASE: Education, Alliance, Solace and Empowerment for Ovarian Cancer Patients” was designed by Dr. Liu and her team, and is a comprehensive curriculum to complement the care and management of ovarian cancer patients.

Continue reading “St. Joe’s Ann Arbor Gynecologic Oncology Team Receives Grant to Fund Pilot Project for Ovarian Cancer Patients”

Yes, I did that.

St. Joe’s Health Reporter Lila Lazarus broadcast her routine colonoscopy on Facebook Live to raise awareness about the importance of screening and prevention.

“You did what!?”

That’s the usual reaction when people hear I had my colonoscopy on Facebook Live.

Why on Earth would you do that?” is usually the follow-up question.

In case you don’t know what a colonoscopy is – it’s when a trained specialist, in this case, St. Joe’s colorectal surgeon Dr. Amanda McClure, takes a probe with a tiny HD camera and goes six feet in through the patient’s rectum and colon. She examines the lining of the colon – which is where colon cancer starts – and searches for pre-cancerous polyps.

Only this colonoscopy was a little more…public. My colonoscopy was broadcast live on social media. Thousands have now seen the inside of my colon and rectum on Facebook. They watched as Dr. McClure narrated a journey through my large intestine looking for growths on the lining— precancerous polyps. 

Continue reading “Yes, I did that.”

What May Be Wreaking Havoc on Your Body Clock

by Emily Willingham

This article was originally published on Sharecare.

If you find yourself nodding off at 10 p.m. despite your best efforts to stay awake, or routinely opening your eyes at 7 a.m.—even on mornings when you could sleep in—you have your circadian rhythm to thank. This self-sustaining 24-hour internal body clock responds to daylight and darkness to tell us when it’s time to be sleepy and when we should be fully awake. Fending off these messages is tough. Your rhythm is based on a roughly 24-hour day, and once it’s there, it can be hard to shift.

Circadian rhythms are determined mainly by genetics, but they’re also influenced by external factors, such as exercise, meal times, sleep deprivation and exposure to artificial light, particularly the glow emitted by smartphones, tablets and computer screens. Your environment or lifestyle can derail your internal clockwork, which, in addition to sleep, helps regulate your metabolism, blood pressure, body temperature, and hormone levels.

Continue reading “What May Be Wreaking Havoc on Your Body Clock”