Vegetable Paella

Paella is traditionally made with sausage, chicken and seafood. We’ve taken this recipe meatless, and swapped white rice, for brown rice, giving this recipe more fiber.

This recipe packs a nutritional punch, giving you the following daily values:

  • 200% Vitamin C
  • 70% Vitamin A
  • 72% Manganese
  • 8% Calcium

Serve With: Pears packed in Natural Juice

Ingredients:

1 cup low sodium vegetable broth
1 bay leaf
2 cups onions, diced
1 red bell pepper, cut into strips
¼ cup pimiento-stuffed Spanish olives
4 cups button mushrooms, sliced
1 Tbsp. minced fresh garlic
1 cup dry medium grain brown rice
1 cup dry white wine
2 cups tomatoes, diced
1 cup canned artichoke hearts, halved
2 tsp. paprika
1 cup frozen peas, thawed
1 cup canned chickpeas, drained and rinsed
4oz. green beans
1 lemon wedged

Preparation:

  1. Simmer broth with bay leaf in a saucepan over low heat for 10 minutes.
  2. Sauté onion, bell pepper and olives in 1 tsp. extra virgin olive oil, until onions begin to brown, about 5 minutes. Add mushrooms and garlic and cook for an additional 2 minutes. Stir in rice and cook for another minute.
  3. Slowly add the wine, cook until the wine is nearly evaporated. Add broth, tomatoes, artichokes, and paprika. Bring to a boil, reduce heat and simmer until the rice is tender about 40 minutes.
  4. Stir in the chickpeas, peas, and green beans, cook for 2-3 minutes to heat through. Garnish with lemon wedges. 

ä   Servings:                   4

Š    Time to Prepare       20 minutes

Š    Time to Cook:           60 minutes

Nutrition per Serving:

Calories 321; Fat 3.5 g (sat 0.5 g); Protein 13 g; Cholesterol 0 mg; Sodium 127mg; Fiber 15 g; Carbohydrate 57 g

What You Should Know about Prediabetes

If your blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes, then you have a serious medical condition known as prediabetes.

According to the Centers for Disease Control and Prevention, health data through 2018 indicates that 88 million American adults — approximately 1 in 3 — have prediabetes, so you are not alone. Left unchecked, prediabetes can lead to type 2 diabetes, which has serious implications for your health, and specifically your eyes, kidneys, nerves, and heart.

Here is the good news: For most people, getting type 2 diabetes isn’t inevitable and neither is prediabetes.

Are their symptoms of prediabetes?

Since there are no symptoms of prediabetes, how can you tell if you have it?

Weight is one important factor. For most people, there is a direct correlation between weight and healthy or unhealthy blood sugars.

Fat is important too. There are different types of fat, and fat around the belly tends to be correlated with insulin resistance. Pay attention if you have weight gain in the abdomen, or your shape is “more like an apple than a pear.”

The results of your lipid panel at your annual checkup provide more clues. They can help to determine if you have begun to have insulin resistance, which is present in both prediabetes and diabetes.

Five 5 Factors of Insulin Resistance

If you get an annual physical, your primary care provider (PCP) will likely order a lipid panel blood test that measures different kinds of blood fats, including HDL (high-density lipoprotein, aka “good fat,”), LDL (low-density lipoprotein, aka “bad fat,”), total cholesterol, and triglycerides. Some of these lipids along with other factors can indicate that a person has insulin resistance.

If you have any three of the following insulin resistance markers, you may have Insulin Resistance Syndrome, which increases your risk of type 2 diabetes.

  • High triglycerides
  • Low HDL (aka, “good cholesterol”)
  • Difficulty controlling blood pressure
  • Difficulty controlling blood sugars, based upon an abnormal fasting blood sugar or HgB A1c
  • Having a waist circumference of more than 35 inches in females or 40 inches in males

Can medications cause increased blood sugar levels?

Yes, certain medications can affect blood sugar levels. It is important to have a discussion with your PCP to check for these side effects and to consider your options.

How to Avoid Prediabetes

The good news is that prediabetes is reversible. Statin medications can help raise your HDL, but they are no substitute for following a healthy diet and exercising. The best way to avoid prediabetes is to practice the following:

  • Eat healthy foods in appropriate quantities.
  • Make exercise part of your daily routine.
  • Maintain a healthy weight.
  • Limit your intake of alcohol.
  • Control your blood pressure and cholesterol.
  • Don’t smoke.
  • Get an annual checkup to keep an eye on your lipid profile.

The Bottom Line

Even if other family members have prediabetes, following these important steps will go a long way toward giving you a healthier life that doesn’t involve issues with controlling your blood sugar.  

Learn more about the St. Joe’s Diabetes Education program and Diabetes Prevention Program.

Livonia Medical Center Now Offering Outpatient Surgery

The St. Joe’sIHA Livonia Medical Center, which opened in May of this year on the campus of Schoolcraft College, was conceived, designed and constructed to deliver patient-centered care and convenience.  The facility was built around the belief that the needs and expectations of the patient are paramount.

The 124,000-square-foot health-care facility brings together multi-disciplinary specialists to offer local residents the full continuum of care, including primary care; obstetrics and gynecology; women’s specialty imaging; pediatrics; physical therapy; urology and more.  It also offers onsite lab services, diagnostic imaging, a retail pharmacy, and the Joe’s Java Coffee Shop.  For members of the Schoolcraft community and local residents, the Livonia Medical Center also offers a convenient urgent care center.

This month Saint Joseph Mercy Health System and IHA announced the opening of their newest addition, an ambulatory (or outpatient) surgical center that promises to bring high-quality, coordinated surgical care to patients.

“The new surgical center is extremely convenient and improves the patient experience by providing pre and post-operative services all in one location,” says IHA Associate Division Head of Orthopedics Mark Pinto, MD, MBA.  “From the initial primary care visit, to a specialist visit, to blood work and imaging, our patients have everything they need should they require surgery.”

The concept behind the new ambulatory surgical center is that the procedures offered do not require an overnight hospital stay.  Procedures available include hip and knee replacement, ACL reconstruction and repair, rotator-cuff repairs, tonsillectomies, hernia repairs, gallbladder removals, and more.

“Healthcare in general is moving away from the in-patient setting and more towards out-patient care because of the convenience and benefits it offers patients,” Dr. Pinto says.  “It’s the case with all surgeries that our patients will be observed following their procedure for a few hours before being safely discharged home.  We find that patients are much more comfortable and recover much faster in their own homes, with the support of their own families, rather than trying to sleep and recover in a hospital bed.”  

“Increasingly, we are doing more complex procedures on an outpatient basis, where our patients can safely return home in a shorter amount of time,” said Dave Spivey, president of St. Mary Mercy Livonia, a member hospital of Saint Joseph’s Health System.

The new ambulatory center includes four operating rooms with the potential to add a fifth if there is demand.

“There are times patients are told they need surgery and then have to wait months for an appointment, but that won’t be the case here,” says Dr. Pinto.  “We have the facilities and resources where we can do quite a bit of volume.”

There are also 18 pre and post-operative bays.  “This is a kind of dedicated home base for the patient,” Dr. Pinto says. “It’s where they will begin and end and it makes the whole experience much more relaxing and comfortable for everyone.”

Dr. Pinto says the ambulatory surgical center is part of the Livonia Medical Center’s overall goal to improve the patient experience.

“There was a lot of time and effort put into creating a convenient and comfortable patient experience,” he said.  “We send the patient home only when we are satisfied that they are doing well.  There is no loss in the quality of care.  Home is where patients really want to be and where we want them to be.”

The Road to Recovery Begins at St. Joe’s

Joseph Parker of Howell is on the move.  He’s often on the road for his businesses or involved with the community, but he always makes time for his family – especially his grandchildren. Joseph then started noticing pain in his right knee when performing everyday tasks. However, he pushed through to kept up his normally busy schedule.

Joseph knew something was wrong when he could no longer sit  on the floor to play with his grandchildren without pain. He also had to forego some of his favorite hobbies, such as riding his motorcycle because the pain was unbearable.

Joseph’s primary care doctor suggested he make an appointment with Orthopedic Surgeon, Dr. G. Victor Gibson. “I’m not a big doctor guy,” said Joseph.  Taking this step was a turning point.  He knew he needed a doctor that would be down to earth and prepare him every step of the process.

Dr. Gibson determined Joseph’s right knee was bone-on-bone. Joseph and Dr. Gibson worked together as a team to create a plan. Initially, they tried cortisone shots, but the pain persisted. Joseph’s injured knee was also starting to affect his hip and ankle.

The next step in their plan was surgery. Dr. Gibson provided Joseph with information about the surgery to prepare for before and after. “Dr. Gibson was upbeat, friendly and willing to answer any questions my wife and I had,” said Joseph.

In October 2019, Dr. Gibson performed a partial knee replacement on Joseph at St. Joe’s Livingston. By surgery day, Joseph had no worries and felt prepared for surgery. “The staff and the education for my surgery were great,” said Joseph.

Joseph learned about the pain relief methods for his surgery. Upon discussions with his doctor and nurses, he was prescribed a lower dose of opioids and an ice machine at home. “The ice machine really worked,” said Joseph. His nurse helped him to set up the ice machine rental and it was delivered to his home and set up after surgery. The ice machine was so effective, Joseph was able to manage his pain and didn’t need to take the opioids prescribed.

A few months later, Joseph was walking without pain. He was even able to get back to playing and wrestling with his grandchildren.

Unfortunately, Joseph slipped and fell in December 2019 injuring his recovering knee. Dr. Gibson had to perform another surgery to fix the damage. Although a different circumstance, Joseph was still pleased with his quality of care.

“Surgery is just one piece of this journey,” said Joseph.  It is important to understand the recovery process and steps to take when you get home from the hospital.

Now, Joseph is walking with comfort again. He looks forward to getting stronger and being able to get his motorcycle back on the road.

“I should have done it sooner; go see your doctor if you feel pain – don’t wait too long,” said Joseph.

FDA Grants Full Approval of COVID-19 Vaccine

On Monday, the U.S. Food and Drug Administration (FDA) approved the Pfizer-BioNTech COVID-19 vaccine. The approval replaces the emergency use authorization (EUA) granted by the agency on December 11, 2020 for use of the vaccine in individuals 16 years of age and older.

“The public is counting on safe and effective vaccines and we are thankful to the researchers and medical community that worked diligently to investigate, study, and inform the public throughout the vaccine trials,” said Rob Casalou, president and CEO of Trinity Health Michigan. Permanent approval means the vaccine passed numerous, required safety checks including study of all reported side effects and any adverse reactions. Several months of safety data showed the vaccine is safe and effective. This announcement should ease concerns from people who’ve been hesitant to receive the vaccine while still under emergency use authorization.” 

The U.S. has recorded over 37.7 million cases of COVID-19 and 628,000 deaths. More than 170.8 million Americans, or 51.5-percent of the population, have been fully vaccinated, according to the CDC.

“We are pleased to see the FDA’s approval as we continue to fight against the recent COVID-19 variants, knowing that we still have more work to do,” said Rosalie Tocco-Bradley, PhD, MD, Chief Clinical Officer, Trinity Health Michigan. We encourage all colleagues, patients, residents and people in the communities we serve to get vaccinated. Vaccination is an important step to end the COVID-19 pandemic.”

The U.S. Department of Health and Human Services recommends those who received the Moderna or Pfizer vaccine should receive a booster shot eight months after their first round of vaccination starting the week of Sept. 20, but they do not recommend crossing over which type of vaccine you receive. Therefore, if you received a Moderna vaccine, you should not get a booster shot of the Pfizer vaccine and vice versa. The Center for Disease Control and Prevention (CDC) and FDA will provide additional information in the coming days.

The Pfizer vaccine continues to be available under EUA for individuals 12 through 15 years of age, and for a third dose in certain immunocompromised individuals. The FDA is also reviewing Moderna’s application for permanent approval of its vaccine. Johnson and Johnson earned EUA for its vaccine later than Pfizer and Moderna, and has not applied for permanent approval from the FDA.

COVID-19 Delta Variant Cases Increasing in Michigan

With the Delta variant causing COVID-19 cases to rise in the United States, health care professionals are continuing to urge Americans to get their COVID-19 vaccine. Currently, more than 99-percent of all deaths from COVID-19 infections are in unvaccinated persons.

The vaccine does exactly what it should, which is minimize the symptoms, prevent you from getting hospitalized, prevent you from getting sick, and prevent you from dying. Initial data is showing that mRNA vaccines are still protective against the Delta variant, so getting your COVID-19 vaccine can help prevent infection and severe illness. The COVID-19 vaccine reduces the risk for hospitalization and death by over 95-percent.

Think of a vaccine as a way for your immune system to practice for a virus. Vaccines give the body a preview of one or more key features of a virus before you get the actual virus. Due to the vaccine, the immune system develops a ‘memory’ of how to react and stop the virus once you are exposed to it. The immune system can quickly recognize the actual coronaviruses and interfere with its ability to multiply.

A variant is a strain of the SARS-CoV-2 virus. There are currently 11 variants of the SARS-CoV-2 virus that the World Health Organization (WHO) is monitoring. When a virus is widely circulating in a population and causing many infections, the likelihood of the virus mutating increases. The more opportunities a virus has to spread, the more it copies – and the more opportunities it has to undergo changes. Most viral mutations have little to no impact on the virus’s ability to cause infections and disease. However, depending on where the changes are located in the virus’s genetic material, they may affect a virus’s properties, such as transmission (for example, it may spread more or less easily) or severity (it may cause more or less severe disease).

The Delta variant is more transmissible and has one-thousand times more viral load than other variants, meaning it is more infectious and causes harsher sickness. The time between exposure and developing symptoms is also much quicker with the Delta variant.

While getting the COVID-19 vaccine doesn’t guarantee immunity against the variant, it can lessen affects. Those fully vaccinated with the Pfizer vaccine have 88-percent protection against symptomatic COVID-19 and 95-percent protection against hospitalization and death. Initial reports show Moderna is equally as protective against the Delta variant. The Johnson & Johnson vaccine appears 66-percent protective against the Delta variant.

The Michigan Department of Health and Human Services (MDHHS) now confirms that 90-percent of new cases in Michigan are the Delta variant.

The Centers for Disease Control and Prevention (CDC) has reinstated mask mandates and is continuing to urge vaccinations even as some studies show vaccinated individuals can spread COVID-19.  

Health care professionals are already seeing numbers rise week by week, and that’s why hot spots in the south – where there are lower vaccination rates – are seeing more COVID-19 infections, hospital admittances, and death.

Braised Sweet Corn

Yield 4-6 servings

Ingredients:

6 ears of corn, shucked

1/8 tsp. kosher salt

1 Tbsp. extra virgin olive oil

2 medium Fresno chilies

1 shallot minced

2oz. feta cheese crumbled

Juice of 1 lime

¼ cup chopped cilantro leaves

Preparation:

  1. Using a knife, cut the corn kernels off of the cob and place into a medium bowl, set aside. Using the back of the knife, scrape the cobs to extract the milk from the cob, place into a small bowl and set aside. Cut the cobs into 2” pieces.
  2. In a 1 gallon saucepan, over high heat, combine the cob pieces with cold water to cover, season with the salt. Bring mixture to a boil, reduce heat to a simmer, and cook for 20-30 minutes. Strain and discard the cobs, reserve ½ cup of the stock and put the remaining aside for another use.
  3. In a medium saute pan over medium heat, warm the olive oil, until hot but not smoking. Stir in the chilies and shallot add cook until golden brown, about 3 minutes. Add the corn kernels, stock and corn milk, add half of the feta and cook until the liquid has reduced by half. Stir in the lime juice, remove from the pan and garnish with the cilantro and remaining feta.

The Do’s and Don’ts of Diabetic Foot Care

Proper foot care is important all year round, especially for diabetic patients. But during the warmer months when most people wear sandals, diabetic patients may be even more aware of their feet and their condition. That’s why summer is a great time to review self-care.

If you have diabetes, your feet are prime candidates for several diabetes-related problems because of two complications that often show up in the feet. The first complication is poor circulation, which is the result of blood vessels that have been damaged by diabetes. The second complication is neuropathy, which results from damaged nerves. 

Circulation Issues

Poor circulation can lead to undesirable outcomes, such as difficulty healing a wound and inability to fight infection. As many diabetic patients know, a tiny cut can turn into a big problem without proper medical treatment.

The potential signs of poor circulation are cramping in the legs or feet, cuts or other injuries that take longer to heal, and changes in color in the toes or feet. Because poor circulation and poor healing can turn the tiniest problem into something serious, you will want to address these types of problems with a medical professional right away.

Neuropathy Issues

Neuropathy, or nerve damage, causes loss of feeling in your feet. It takes away your ability to feel pain or discomfort, which means you may not be able to detect an irritation or injury to your foot. That’s obviously dangerous if you have poor circulation, because an unnoticed — and untreated — foot injury in individuals with diabetes often results in poor healing.

Patients living with diabetes need to do all they can to maintain foot health and prevent problems. One way to do this is through proper self-care. The following lists offer ways that patients can be proactive when it comes to caring for their feet.


Self-Care Do’s

  • Check blood glucose regularly.
  • Check your feet daily. Inspect for any cuts, blisters, redness, new swelling, or nail problems. 
  • Dry your feet well between toes after bathing.
  • Keep your feet warm and dry. Consider wearing socks to bed.
  • Wear properly fitting shoes and socks.
  • Shake out your shoes before wearing them to avoid accidental injury due to something in your shoes that you did not feel.
  • Moisturize your feet — but NOT between your toes — because this could promote a fungal infection.
  • Get periodic exams with your foot doctor. It is recommended that patients have their feet examined by a doctor every 3 to 6 months. 

Self-Care Don’ts

  • Ignore any new pain, swelling, or area of irritation.
  • Ignore a sore on your foot.  
  • Use over-the-counter medicated corn pads. The chemicals in these can be harsh on good skin, and neuropathy makes it challenging to notice if a problem is arising. 
  • Walk around barefoot.
  • Go without socks when wearing shoes.
  • Soak feet in HOT water or walk on HOT sand or other HOT surfaces (asphalt). You may experience burns. 
  • Expose your feet to COLD weather for extended periods of time.
  • Smoke, because smoking negatively affects circulation. 

Paying close attention to the health of your feet year-round will help improve your well-being.

Need help managing your diabetes? St. Joe’s is proud to offer comprehensive diabetes management and prevention programs. Learn more here.

Protecting Kids From COVID-19 During School

With the new school year fast approaching, considerations of how to safeguard children from COVID-19 in the classroom are an increasingly frequent topic of discussion.  On July 9, the CDC provided updated guidance that stresses the importance of effective precautions such as masking, physical distancing and excellent hand hygiene. It is also important for parents to consider the benefits of ensuring eligible students (ages 12 and over) are fully vaccinated to slow the spread of the Delta variant.

“The vaccines that are available are some of the most carefully evaluated and highly effective in our history. They are more than 99% effective in preventing COVID-19 fatalities and are highly effective for the Delta variant,” said Anurag Malani, MD, Medical Director of Hospital Epidemiology, Antimicrobial Stewardship, and Special Pathogen Response for Saint Joseph Mercy Health System. 

Dr. Malani stresses serious vaccine side-affects are extremely rare and communities that embrace vaccination and COVID-19 precautions have seen much lower infection rates throughout the past few months.  In addition to being a leading authority on infection prevention during the COVID-19 pandemic, Dr. Malani is also a concerned father.  “I have an eligible child who is fully vaccinated in preparation of the school year. As a health care professional and more importantly, as a dad, I understand that people have questions and worries. I would strongly urge parents to review the facts, discuss the benefits and concerns with your pediatrician or primary care physician before making a decision. I am anxiously awaiting authorization for my younger child to receive the vaccine.” 

As new cases of the Delta variant continue to climb, the importance of keeping kids safe using a layered approach of precautions remains central to resuming classes. Please see these key CDC Back to School Safety Takeaways…

  • Students benefit from in-person learning, and safely returning to in-person instruction in the fall 2021 is a priority.
  • Vaccination is the leading public health prevention strategy to end the COVID-19 pandemic. Promoting vaccination can help schools safely return to in-person learning as well as extracurricular activities and sports.
  • Due to the circulating and highly contagious Delta variant, CDC recommends universal indoor masking by all students (age 2 and older), staff, teachers, and visitors to K-12 schools, regardless of vaccination status.
  • In addition to universal indoor masking, CDC recommends schools maintain at least 3 feet of physical distance between students within classrooms to reduce transmission risk. When it is not possible to maintain a physical distance of at least 3 feet, such as when schools cannot fully re-open while maintaining these distances, it is especially important to layer multiple other prevention strategies, such as screening testing.
  • Screening testing, ventilation, handwashing and respiratory etiquette, staying home when sick and getting tested, contact tracing in combination with quarantine and isolation, and cleaning and disinfection are also important layers of prevention to keep schools safe.
  • Students, teachers, and staff should stay home when they have signs of any infectious illness and be referred to their healthcare provider for testing and care.
  • Many schools serve children under the age of 12 who are not eligible for vaccination at this time. Therefore, this guidance emphasizes implementing layered prevention strategies (e.g., using multiple prevention strategies together consistently) to protect students, teachers, staff, visitors, and other members of their households and support in-person learning.
  • Localities should monitor community transmission, vaccination coverage, screening testing, and occurrence of outbreaks to guide decisions on the level of layered prevention strategies (e.g., physical distancing, screening testing).

To learn more, please see: Guidance for COVID-19 Prevention in K-12 Schools

Living with Type 2 Diabetes?

Five Tips for Staying Comfortable and Healthy During Warmer Weather

According to the CDC National Diabetes Statistic Report 2020, in 2018 (most recent statistics), an estimated 7.3 million U.S. adults aged 18 years or older (2.8 percent) had undiagnosed diabetes and 88 million adults (34.5 percent) had pre-diabetes. It was also estimated that 26.8 million U.S. adults (10.2%) had diagnosed diabetes. Of those 26.6 million, 90-95 percent had the most common type of diabetes: type 2 diabetes.

In type 2 diabetes, the body becomes resistant to insulin that is produced by the pancreas. The pancreas compensates for this resistance by producing even more insulin. Eventually the pancreas creates as much insulin as it can, but the resistance increases. Insulin resistance leads to high blood sugars.

Once a patient has high blood sugars that are untreated, those blood sugars damage blood vessels, particularly the small vessels that supply glands and tissues. The organs most affected are eyes, kidneys, nerves and heart.

While there can be a genetic component to type 2 diabetes, there is a correlation with weight gain and specifically abdominal fat. Trying to stay lean will help most people avoid issues with blood sugar control. Losing weight can help improve the health of a person with diabetes.

If you are living with type 2 diabetes, there are simple steps you can take to stay comfortable and healthy during the warm summer months.

Stay Hydrated

When a person’s blood sugars are high, body fluids can shift. In the warmer weather, diabetic patients can become even more dehydrated than others, so it is essential to remain hydrated with water. Water is the best choice — not sports drinks, pop, juices, coffee, or tea. Be sure to drink about eight glasses of water during the course of each day.

Continue to Exercise

With type 2 diabetes in particular, we encourage people to stay physically active. Whether you walk or participate in another sport, be sure you have well fitting, comfortable, supportive shoes. We do not recommend going barefoot or wearing sandals. It is best to wear shoes that offer support, protection and coverage.

Eat More Locally Grown Fresh Fruits and Vegetables

Processed foods tend to be higher in simple sugars and carbs that could raise your blood sugars even more. Unprocessed foods are better because your body has to work harder to metabolize their sugars. Following an average healthful diet, such as the Mediterranean diet, is a good place to start. Depending on your diabetes, you may want to be mindful of eating fruits and vegetables with a higher glycemic index. As an example, bananas, carrots, and corn are foods with a higher glycemic index that can be absorbed more quickly than other vegetables and fruits.

Get a Good Night’s Sleep

With the longer hours of daylight, it is still important to pay attention to your sleep environment so that it promotes quality sleep. Find a cool, dark and quiet place to sleep. Sleep apnea can occur among patients with type 2 diabetes. If you have sleep apnea, consult a sleep specialist to help promote better sleep.

Protect Injectable Medications

If you use injectable medication for your diabetes, it is important to remember that the medication needs to remain at room temperature, which is about 70 degrees Fahrenheit. During warmer months, keeping your injectable medication in your car or outdoors could reduce its effectiveness by allowing it to reach a higher temperature.


If you are living with diabetes or caring for a person with it, it is good to remember that diabetes is a chronic medical condition: There will be good days and bad days. Be gentle with yourself if you falter. No one is perfect. Tomorrow is another day, so pick yourself up, and do your best to follow guidelines that can improve your health.

Learn more about St. Joe’s diabetes education and diabetes prevention programs.