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.

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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.

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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.

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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.

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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.

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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. 

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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.

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Be the First: How a Stroke Saved Mary’s Life

Mary Abbas (front right) pictured with her husband, Fred, and four children – (from left to right) Greg, Lori, Sandi and Fred.

She’s the first in Michigan to undergo new procedure to block aneurysm

A stroke saved Mary Abbas’ life.

At least that’s the story the 77-year-old Houghton Lake, Mich., resident says she’s sticking to, after making a full recovery and celebrating Easter with her beloved daughters in Florida.

It was just a regular morning in mid-February, when Mary noticed she was slurring her speech as she called her dogs back into the house.

“I knew I was having a stroke,” she said.

She acted quickly – calling her husband and blurting out, “stroke” and “hospital,” before dialing 9-1-1.

Within minutes, paramedics came to her home and rushed her to Grayling Hospital. A cat scan revealed no bleeding in the brain, but confirmed that Mary was having a stroke.

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Trust Your Intuition: Early Signs of Autism

By Dr. Erin Walton-Doyle, an Internal Medicine and Pediatrics physician with St. Joe’s Medical Group and St. Mary Mercy Livonia

Parents often tell me about a feeling or gut instinct they have about their child. Sometimes it’s a sense their child has an ear infection, other times it’s a premonition their child is in danger.

I tell parents to trust that intuition not only when it comes to a common cold but with concerns about developmental delays. Asking questions or sharing a concern about your child’s behavior is important in order to get a diagnosis and start treatment, if necessary, as soon as possible.

Autism, or autism spectrum disorder (ASD), is a serious developmental disorder that impairs the ability to communicate and interact with others. More than 200,000 cases of autism are diagnosed in the United States each year. While there is no cure, autism can be treated to help reduce symptoms and provide developmental support. The key is early diagnosis and intervention.

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