Your Practice Transformation Companion

Tuesday, January 7, 2020

2020 Educational Opportunities at PTI!

January 2020

Happy New Year and warm greetings from all of us here at Practice Transformation Institute (PTI). We are a non-profit organization that provides medical, nursing, dietetic, social work and other health care professional continuing education through our customized learning programs. We hope that you will consider letting us be a part of your personal and organizational education goals in 2020.

Continuing Medical Education. We are accredited by the Michigan State Medical Society (MSMS) to provide continuing medical education (CME) for physicians. If you’re interested in attaching CME to your learning event, let us help with our CME Joint Providership Program. We will make sure that your CME event is planned, implemented and evaluated in accordance with the MSMS requirements.

IACET. PTI is an International Association for Continuing Education and Training (IACET) accredited provider and adheres to the highest standards of the training profession. We follow the ANSI/IACET Standard for Continuing Education and Training. IACET CEUs are recognized by a wide range of organizations including professional organizations, regulatory boards, corporations and universities.

Care Coordination and Care Management Training (Self-Management). Care Coordination and Care Management Training is one of PTI’s signature ongoing programs. We have trained hundreds of interprofessionals with a knowledge base and skill set to enable high quality chronic disease care for patients in the ambulatory care setting. The program provides contact hours for nurses, continuing professional education units for dietitians, and continuing education hours for socials workers. IACET CEUs are also available.

National Diabetes Prevention Program. The Centers for Disease Control (CDC) and Prevention established the National Diabetes Prevention Program to help prevent or delay the onset of type 2 diabetes. The program is evidence-based with research showing that lifestyle modifications can cut the risk of type 2 diabetes in half. PTI has master trainers and lifestyle coaches who can bring this program to your organization.  

Learning Collaboratives. A learning collaborative is a learning and innovation community that links a variety of organizations together to rapidly test and implement meaningful, sustainable change within a specific topic area. PTI has been facilitating learning collaboratives for years and is a proven expert.

PATH (Personal Action on Health) Training and Workshops. PATH is Michigan’s name for the Self-Management Resource Center’s (SMRC) self-management programs that were developed and tested at Stanford University to help people learn techniques and strategies for the day-to-day management of chronic and long-term health conditions. PTI can do PATH leader trainings and workshops at your place or ours.

As you can see, PTI can provide a wide range of educational programs for health care professionals that can be customized to fit your organization’s need. Bring an idea to us and we can bring it to fruition. PTI knows the benefits of working collaboratively on interprofessional teams and how they help improve patient outcomes.

Our programs can be delivered at your facility, a facility of choice or at PTI. We want to help you jumpstart your education goals for 2020. Email Harmony at for more information.  We hope to see you in 2020!

Thursday, December 12, 2019

A Healthy Start to Winter: Good Handwashing and a Flu Shot

We have not reached the winter season yet which officially starts on December 21st. I know many people who have already been ill and haven’t adjusted to the temperatures spiraling from the forties down to the teens and back up again. I’m one of them. But the spiraling will soon stop since we are in December. The outside weather will now throw us into a frozen winter wasteland or wonderland (depending on your attitude for this type of thing) and there is nothing we can do about it. With the holidays upon us and the opportunity to see friends and family that we may not have seen for a while, it’s important to stay as healthy as we can to avoid any excess bugs flying around in the air. Most of us know what we need to do, but do we do it? If we get a flu shot and use good handwashing techniques, we have a big head start to stay healthy over the winter months.

Wash your hands with soap and clean water for at least 20 seconds. Clean the back of the hands, all around and between the fingers and even under the nails. Dry your hands off well using a clean towel or hand dryer. The Center for Disease Control says to remember the five steps of “wet, lather, scrub, rinse and dry.” There are 4 principles of hand awareness that are endorsed by the American Medical Association and the American Academy of Family Physicians. These are:

  • Wash your hands when dirty and before eating
  • Don’t cough into your hands
  • Don’t sneeze into your hands (sneezing is like a mini hurricane that blows germs everywhere)
  • Don’t put your fingers into your eyes, nose or mouth

The CDC reports that only 31 percent of men and 65 percent of women wash their hands after being in a public restroom. Gross! We know what you’re doing in there. Please wash your hands afterward, even if you must stand in front of the hand dryer that you don’t like for a couple of minutes. Handwashing prevents many illnesses, including influenza, which brings me to our next topic. 

What is influenza, which is commonly called the flu? The CDC states that it is a “contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs. It can cause mild to severe illness, and at times can lead to death. The best way to prevent flu is by getting a flu vaccine each year.” The flu is spread by tiny droplets when people that already have the flu end up coughing, sneezing or talking and the droplets land in our mouths or noses. It can also be spread by touching an object or surface that has the flu virus on it and then touching our mouth or nose. 

What are some of the differences between the cold and flu? The flu is always worse. With the flu, there may be an abrupt onset with fever, severe aches and pains, chills, chest discomfort, sometimes severe cough, and headache. A cold is much milder with a gradual onset, rare fever, perhaps some aches and pains, sneezing, sometimes coughing, stuffy nose, and sore throat. 

Complications associated with the flu can be life-threatening especially for people at high risk. This includes people over 65 years of age, anyone with a chronic medical condition (like diabetes, heart disease, asthma), children younger than 5 years old, and pregnant women. 

The flu shot is available everywhere and is covered by health insurance. Make sure to get one to help protect yourself, your loved ones, work buddies, and anyone else with whom you come in contact. We are a global community and prevention is always the gold standard.

As we dive into the cold Michigan months, that also contain a few major holidays, PTI wishes you and yours happy holidays and best of health!

Monday, November 11, 2019

Let’s Talk About GERD

What does GERD stand for? Gastroesophageal Reflux Disease. Gastroesophageal refers to the stomach and esophagus. Reflux refers to the backflow of stomach contents into the esophagus.

How common is it? Very common. One out of every five people experience it on a weekly basis. Two out of five people experience it at least once a month. Studies show that one-third of our population has it!

What are the symptoms?
  • Chronic heartburn (a burning sensation in the center of the chest that can be painful, disrupt activities of daily living, and keep you awake at night.)
  • Acid regurgitation (a sour or bitter taste in the mouth from stomach contents backing up into the esophagus.)
  • Frequent belching
  • Chronic sore throat
  • Laryngitis
  • Chronic cough
  • Chest pain or pressure (rule out heart conditions first!)
  • Dysphagia (difficulty swallowing or the feeling of food stuck in the esophagus. This is an alarming symptom that requires medical attention as soon as possible!)

What are the causes?
  • The esophageal sphincter that normally stops backflow of stomach contents into the esophagus is relaxed at inappropriate times or may become weak
  • Other factors:
    •       Distention of the stomach from too large of a meal
    •       Delayed emptying of the stomach
    •       Sliding hiatal hernia
    •       Too much stomach acid in general

What can we do about it? GERD can be a chronic disease with treatment sometimes being long-term.

Treatment includes:
  • Lifestyle change measures (experiment to find out what may be your problem: avoiding spicy foods, large or fatty meals, alcohol, onions, chocolate, caffeine, citrus fruits/juices, tomato products, times you eat, positions you use, being overweight)
  • Over-the-counter medications
    • Antacids
      • Chewable gummy or tablet
      • Liquids
      • Dissolvable tablet in water that you drink
      • Include Tums, Rolaids, Mylanta, Maalox, Alka-Seltzer
  • Low dose H2 (histamine 2) blockers
    • Include Pepcid, Tagamet, Axid, Zantac (Zantac is currently under recall until more details are available)
  • ·Proton pump inhibiters (long-lasting reduction of stomach acid production)
    • More powerful than the ones mentioned above
    • Recommended to be taken daily for fourteen days
    • Long term use can have risks
    • Include Prilosec, Zegerid, Nexium, Prevacid
These medications may only provide temporary symptom relief. Long-term heartburn can become serious as it has the potential to damage the lining of the esophagus. Please consult your physician for any questions related to a GERD diagnosis and appropriate treatment, tests and medications.

Gastroesophageal Reflux Disease Awareness Week is happening this month from November 17-23, 2019. If you feel you possibly have GERD, make this a time to do something about it.

Tuesday, October 15, 2019

Oktoberfest and Chiropractic

Oktoberfest was originally celebrated 200 years ago for the wedding of Bavaria’s Crown Prince Ludwig and his bride, Princess Therese of Saxony-Hildburghausen.  Oktoberfest continues to be celebrated in Germany and around the world with the parties modeled after the original one. These celebrations include lots of beer, dancing, music, games, amusement rides, and traditional foods and clothing. So why am I mentioning Oktoberfest on a PTI blog alongside of chiropractic?

Drinking too much, along with some wild dancing may just throw your back out of whack. After some riotous Oktoberfest celebrations, you may need a chiropractor. Since it is National Chiropractic Health Month, this is the perfect time to talk about chiropractic.

Chiropractors are licensed health care providers who work on the body’s ability to heal itself through spinal manipulation and other forms of treatment. Chiropractic is considered complementary and alternative medicine. Chiropractors are not medical doctors; they cannot prescribe pain pills, nor would they want to. Chiropractic is a whole person, patient-centered approach.

A chiropractor will take a health history, perform tests and an exam, perhaps diagnostic imaging such as x-rays, and develop a management plan for your diagnosis. Spinal manipulation and other manual therapies to the joints and tissues may be done and recommended monthly or at other intervals. A chiropractor may also refer to another appropriate specialist or co-manage with other health care providers.

The musculoskeletal system (muscles, bones, joints) enables our body’s movements and what we can and cannot do. If it’s damaged, then so are we. Injuries or normal aging can be a source of pain, with the most common being low back pain. Improving our musculoskeletal system helps us to become more active and take care of those injuries by keeping us strong and stable.

With the opioid epidemic in the United States, promoting natural healing without the use of narcotic drugs is a welcome choice. Health insurance is paying for chiropractic more and more as insurers are looking to chiropractic as an acceptable form of therapy. 

Yes, the Oktoberfest and chiropractic connection may be a loose one, but I love history and how we can connect it to the present. As you party for Oktoberfest, remember that chiropractic is available if you overdo your musculoskeletal system with those wild, drunken dance moves. Party responsibly.

Tuesday, September 10, 2019

Back to School 2019

Summer is moving into its final weeks and fall is upon us. We can already see changing leaves, cooling temperatures and the beginning of the football season. A big part of this time of year is “back to school” with the non-stop advertising of clothes and school supplies. But once we’ve gotten our children ready for the new school year, it’s time to think about what we could do for our education. Yes, our education. One of the best things about life is that we can keep learning new information and skills to further our careers or because we just want to learn. How can we jumpstart our brain for this fall season? What will be our “back to school?”

Perhaps take a class at your community center, local college or from a wonderful training and education institute like PTI. Here at PTI, we have a great program whether you’re a nurse, dietitian, social worker, medical assistant or any other interprofessional care team member. Our Care Coordination and Care Management Training supports the patient centered medical home by educating health care professionals on the specifics of care management. This training is a blend of two onsite training days and multiple on-demand courses that cover the following topics:
  • Introduction to Care Management Principles
  • Chronic Care Model, Self-Management Background and Goals
  • Motivational Interviewing to Enhance Self-Management Support
  • Goal Setting, Problem Solving, Decision Making
  • Communication and Team Building
  • Health Coaching/Counseling with Self-Management Support
  • Flinders Self-Management Model
  • Care Coordination and Transitions Management
  • Integrating a Care Management Team into a Practice
  • Evidence-Based Guidelines Across the Life Span
  • Health Literacy, Cultural Competency, End of Life Care
  • PCMH and PCMH-N
  • Case Studies and Discussion

PTI’s Care Coordination and Care Management Training is approved by four different entities for continuing education:

Nurses. This continuing nursing education activity was approved by the Montana Nurses Association, an accredited approver with distinction by the American Nurses Credentialing Center’s Commission on Accreditation. Contact hours awarded are 12.5.

Dietitians. PTI is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR). CDR Credentialed Practitioners will receive12.5 Continuing Professional Education Units (CPEUs) for completion of this program.

Social Workers. This course is approved by the Michigan Social Work Continuing Education Collaborative for 12.5 CE Hours. The Collaborative is the approving body of the Michigan Board of Social Work.

IACET. Does your professional organization accept IACET Continuing Education Units (CEUs)? IACET CEUs are recognized by a wide range of organizations, including professional associations, regulatory boards, corporations and universities. Check with your organization to see if they qualify for you. PTI is authorized by IACET to offer 1.25 CEUs for this program.

There is still time to register for the September 25 and 26, 2019 program at If you have any questions, please contact Yang at 248.475.4839 or email her at If you’re unable to attend the September program, we will be announcing a program slated for December 4 and 5, 2019 soon. Make this “back to school” time of year the best for yourself and your family.

Thursday, August 1, 2019

Immunizations Are for Everyone

August is National Immunization Awareness Month. With the importance of this month comes also comes the responsibility of getting yourself and your children vaccinated.
Why get vaccinated? Here are some important reasons:
  • Vaccines can save lives. Vaccine-preventable diseases can cause long-term illness, hospitalization and even death.
  • Reduce the chance of spreading disease. Many of these vaccine-preventable diseases are contagious. Getting the vaccination can reduce the risk that you’ll get sick and spread the disease. For young children or others who may not be able to get certain vaccinations due to their age, health or other factors, you are helping to protect them by getting your vaccinations.
  • People with chronic conditions are more vulnerable to complications. Adults who smoke, have weakened immune systems or have a chronic health condition (such as asthma, heart disease, lung disease, diabetes are more vulnerable to complications including long-term illness, hospitalization and death.
  • Being non-vaccinated can make you sick and it costs money. Medical visits and treatment cost money. Work is missed, co-pays and lots of out-of-pocket expenses can add up. Children may have to stay home from school and day care, and you may have to find alternative child care arrangements. Getting vaccinations can avoid unnecessary expenses to your household.
  • Vaccinations protect your health when you travel. International travel may expose us to illnesses that aren’t circulating in the United States. Check the CDC website before you travel to other countries.

During this National Immunization Awareness Month, I would be remiss not mentioning the measles outbreaks that have occurred in many parts of the United States. This is not something to take lightly. The number of cases continue to jump each year due to people being unvaccinated and the prevalence of international travel.

Measles used to be common when I was a kid. I had it. The only thing I remember is being moved to my parent’s bedroom to isolate me to protect my younger sister with whom I shared a room. I had a high fever and light hurt my eyes so bad that my mother had to keep the shade down in the room. I was lucky not to have any lasting effects and, thankfully, my sister didn’t catch them from me.

For many years we had widespread immunity in the United States, but due to reduced vaccination rates, the incidence of measles has increased significantly. Measles is highly contagious virus in the nose and throat of an infected person that can cause many complications. If you haven’t received the vaccination, you’re more likely to get the disease. The Centers for Disease Control and Prevention (CDC) recommend that children and adults receive the measles vaccine to prevent measles.

The CDC has recommended vaccination schedules for all age groups. Get up to date on your immunizations now and tell your family and friends. Please. We all thank you.

Monday, July 1, 2019

Youth Sports and Physical Activity

Most of the time this blog promotes physical activity for adults as one of the main ways to ward off a chronic disease such as type 2 diabetes. But since National Youth Sports Week of July 15-21 is nearing, it is also important to discuss how sports and physical activity can help our youth.

Statistics say that 70% of young people drop out of organized sports by age 13 for many reasons:

  • Not having fun
  • Ineffective coaches
  • Overbearing parents
  • Can’t afford to play

Unfortunately, organized sports in schools do cost quite a bit of money to participate, which many families can’t afford. Some schools are also reducing or eliminating sports programs. Many sports are now done as extracurricular activities with parents signing up their kids for the sport they choose and can afford through community sports and activity classes.

We already know how important physical activity is for all ages. It’s especially important for our youth as health consequences related to obesity is a definite predictor of chronic disease and is starting younger all the time. It’s important to instill a love for sports and activity early to carry our youth over into the adult years.

If you want your kids to stay active, not only to have fun, but to help with their health, there are also things you can do:

  • Make fitness a part of their (and your) day. Walk, run, bike or swim together. Be an active role model!
  • Have your kids help with household chores both inside and outside the house. Seriously, it is still physical activity. (I remind myself of that every time I clean the house or cut the grass. It makes me feel good AND I can claim the activity minutes.)
  • Organize active play at home such as dodge ball, jump rope, frisbee, badminton and volleyball. 
  • Try ice skating or skiing in the winter or swimming at the community pool in the summer. Mix it up according to the season. So many other activities such as martial arts or bowling can be done year-round.
  • Help them find a sport they enjoy and provide the equipment needed. Drive them to the sport and be an active parent on the sidelines.
  • Reward, encourage and praise your kids’ physical activity. 

Physical activity is proven to help a child’s growth and development and boost their thinking skills. We can all do our part as a parent or grandparent to instill the importance of being active into their lives. Exercise can make you happy, along with all the other wonderful things it does for our health.

Wednesday, June 5, 2019

June is National Migraine and Headache Month

Headaches. We all get them, but unfortunately some people experience them more often or worse than others. Some have headaches that are easily dealt with by using over-the-counter medications. Natural treatments such as avoiding alcohol, using essential oils, taking specific vitamins, going to sleep and using cool compresses can be used for certain headaches. Some people have headaches that require medical evaluation with ongoing treatment. Other headaches can be a true medical emergency. Whatever type of headache you have, it is important to recognize that many different types exist and treatment can vary for each one.

There are over twenty different kinds of headaches. It’s hard to believe that so many exist. Some that you may or may not have heard of include:

  • Allergy headaches
  • Aneurysm
  • Arthritis headaches
  • Caffeine withdrawal headaches
  • Chronic daily headaches
  • Cluster headaches
  • Depression and headaches
  • Eyestrain headaches
  • Exertional headaches
  • Fever headaches
  • Hangover headaches
  • Hunger headaches
  • Hypertension headaches
  • Menstrual headaches
  • Migraine with aura
  • Migraine without aura
  • Post-traumatic headaches
  • Sinus headaches
  • Tension headaches

With so many different kind of headaches, knowing what kind you have is extremely important. Symptoms, precipitating factors, treatment and prevention are located here for each headache listed and many others: It’s important to have medical evaluation if you are concerned about any symptoms you are having. Seek medical attention as soon as possible for the following:
  • Severe headaches that come on quickly
  • Headaches that include vomiting, confusion, shortness of breath, slurred speech, dizziness, weakness, vision loss
  • Headaches that won’t go away
  • Headaches that interfere with your activities of daily living
  • Headaches symptoms that change
  • If over-the-counter medication isn’t helping or you are taking it more than two days a week 
Education is of the upmost importance for headache sufferers. The National Headache Foundation wants to raise awareness through education and by supporting research. For more information about headaches visit to find resources, tools, publications and the latest studies.

Thursday, May 9, 2019

Gimme Some ZZZs

Sleep is something we all need. It’s important to our health and quality of life and it just feels good to lay down to rest. But quite a few people have trouble sleeping. Some just occasionally, some all the time. Whether it’s tossing and turning, mattress uncomfortable, pillow uncomfortable, too hot, too cold, pets taking up too much room, partner taking up too much room, sinus problems, eating too late, drinking too much, worried about something. How many things can we come up with that disrupt our sleep? Unfortunately, it looks like quite a few.

What can we do to maximize our amount of sleep every night? Let’s discuss!
  • Seriously, aim for 8 hours of sleep every night. It’s true what has always been said. Most people get the most benefit out of 8 hours. Plan for that 8 hours, just like you plan a vacation, plan a work meeting or plan a hair appointment. Think of it as a sleep appointment with yourself to help with your health and quality of life. Create a bedtime routine that works for you, just like you may do for your kids.
  • Don’t hit the snooze, even though you want to. Besides making yourself late, you get no extra benefit from those few extra minutes. It’s proven. This is a bad habit for some people who can’t seem to stop hitting that snooze. If you must hit it, only hit it once. Focus and make changes to get up when you’re supposed to.
  • Watch the eating and drinking. Don’t eat, drink alcohol or have anything with caffeine 2-3 hours before going to bed. All three can disrupt your sleep.
  • Avoid that workout at least 2 hours before bed. Exercise is important for us to get our bodies ready to rest, but try to complete your workout at least 2 hours before bed. Some people are energized after working out and you sure don’t want that at midnight when your alarm says to get up at 6 AM for work. Your body needs to be ready to relax in order to sleep.
  • Check that mattress. What is the age and condition of your mattress? Mattresses break down. The single most important item for a good night’s sleep is your mattress. Maybe you need a new one to maximize sleep.
    • Size matters. Make sure you’re getting a mattress that meets your size needs. The size of your room, how much you move around at night and how many people and pets sleep in your bed are all important. A king is certainly the best choice for couples who want maximum sleeping space, but measure your room to make sure you have the room.
    • Type matters. Do your homework. Do you want a latex, airbed, innerspring, waterbed, pillowtop, hybrid, foam, gel, adjustable or memory foam? I had no idea there were so many options.
  • Do you need a new pillow? Just like mattresses, make sure your pillow isn’t 20 years old or your sister’s hand-me-down. Check out the many different kinds on the market and take a leap for a new one. Some of the best ones don’t cost that much.
  • Nap if you can during the day. Maybe it’s the brief time you are waiting in the car to pick up your daughter from dance class after school or a few minutes Saturday or Sunday afternoon. A short nap can do wonders and don’t you forget it. A quick 10-30 minutes can help you gain extra energy to continue the day and not disrupt your sleep at night.
  • No electronics in the bedroom. People tend not to listen to this one. It’s hard to unplug for a lot of people, but to maximize sleep, no television, laptop or smartphone in the bedroom. Please. It’s for your own good. The electronic lighting stimulates the brain, so no sleep for you.
  • Leave your worries outside the bedroom door. Put those worries in a box outside your door, close it, and don’t open it until you absolutely must. Never bring work inside your bedroom or think about work during the night if you wake up. We all need to figure out how to do that.
  • Make your bedroom an oasis of comfort. If it isn’t an oasis, make it one. Get a new comforter, paint the room, put up pictures you love of sandy beaches with palm trees. Your bedroom needs to be a relaxing place and be quiet, cool, and cozy. A place you want to be 8 hours a night to catch those ZZZs, along with some good dreams.
Maybe one of these solutions will work for you. If so, here’s hoping you will soon wake up refreshed and ready to tackle the day, instead of being groggy, foggy and crabby. Your family and coworkers will thank you.

Monday, April 1, 2019

Type 2 Diabetes Anyone? No, Thanks

Type 2 diabetes and prediabetes continue to be an overwhelming threat to the health of the United States. Think about a big bad looming over you ready to pounce, but doing it in a secretive way. A way where you don’t see it coming because it takes place over months or years. You may not notice what’s happening to you because there may be no symptoms at all. Then one day your health care provider tells you at an office visit that you have type 2 diabetes or prediabetes. Yikes! I certainly don’t like hearing that.

But what are type 2 diabetes and prediabetes?

  • In type 2 diabetes, your cells no longer respond normally to insulin and become insulin resistant. You may be able to manage your type 2 diabetes with healthy eating and being active or you may need medication such as insulin or oral diabetes medication to help control your blood sugar and avoid complications. 
  • Prediabetes is identified when a blood sugar level higher than normal, but not high enough to be diagnosed with type 2 diabetes. You can prevent or reverse prediabetes. Eighty-six million adults in the United States have prediabetes with nine out of ten people not knowing they have it. Prediabetes can be stopped before it progresses into type 2 diabetes, but it takes a concentrated effort of changes in day-to-day living. 

The risk for prediabetes and diabetes is higher if the person is:

  • Overweight or obese
  • Has a family history of diabetes
  • Age 45 or older
  • Not physically active
  • Had gestational diabetes
  • Is African-American, American Indian, Hispanic, Asian-American or Pacific Islander

The Centers for Disease Control (CDC) and Prevention established the National Diabetes Prevention Program (DPP) to help prevent or delay the onset of type 2 diabetes. The program is evidenced-based with research showing the lifestyle modifications can cut the risk of type 2 diabetes in half. This lifestyle change program consists of:

  • A year-long commitment of participants to eat healthier, include physical activity into their daily lives, incorporate problem-solving strategies to maintain positive lifestyle changes
  • A small group setting with others making the same achievable changes
  • Sixteen sessions during the first 6 months to provide core learning, eight to ten sessions during the last 6 months to reinforce and build on content
  • A lifestyle coach trained by an approved organization

The word is getting out about this program and pushing healthier lifestyles. Medicare and various insurance companies around the United States are paying for the DPP program. Insurance companies may have deductions in health premiums, discounts on gym memberships or reimbursements for being active. Some Medicare Advantage plans pay for Silver Sneakers, a program that encourages older adults to participate in physical activates such as land or water fitness classes.

What will it take for you to eat better and be active on this “Defeat Diabetes” month of April? Do you want not just to be present, but an energetic participant in family activities in the future? Whether it’s to see your kids grow up, relish the wonder of a grandchild or be up for travel, we can all find reasons to take better care of ourselves.

Unfortunately, it is cheaper to eat unhealthy rather than healthy. It’s easier to sit on the couch than go outside and be active. This is where that “concentrated effort” of making changes to our lives comes into play. You can do it, but it takes determination on your part. As I look outside at the blue sky and sun shining on this beautiful spring day, it makes me want to take a walk and breathe in the fresh air. And you know what? I’m going to do it. Right now.

Friday, March 1, 2019

Spring Clean Your Health!

Believe it or not, winter is almost over and spring will officially begin on Wednesday, March 20.  It can’t come soon enough for me and everyone else I know. We Michiganders persevered for yet another tough winter of cold, ice and snow and the end is now in sight. Let’s cross our fingers and hope we won’t have too many more harsh winter days and nights as we await the beginning of a new season.

As we look towards spring, many people see this time of year as one of renewal. The plants, flowers and trees start to bloom. The sun is starting to feel a bit warmer. We can be outside more and breathe in the fresh air. The days are getting longer and, thanks to Daylight Savings Time, we’ll get an additional hour of daylight starting March 10. Even writing about spring takes me out of the winter blahs. 

Some of us also see this as a good time to change something in our lives. A change of season can be a cue to re-evaluate. Perhaps we resolve to take better care of ourselves by eating better and getting outside for physical activity. Maybe we want to get our yearly physical and health screenings completed so we know where we stand.

National Health Observances for March cover quite a few items to keep us healthy:

  • March is National Nutrition Month and emphasizes the importance of making better food choices and developing sound eating and physical activity habits. is the Academy of Nutrition and Dietetics website that has many great articles to help you make these informed choices with food, health and fitness information. Healthy eating and increasing physical activity are also the two prime things a person can do to prevent type 2 diabetes!
  • March is Colorectal Cancer Awareness Month with the message that colorectal cancer is preventable, treatable and beatable. Current guidelines recommend screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy or colonoscopy in adults beginning at age 50. Colonoscopy continues to be the gold standard. 
  • March is Save Your Vision Month which reminds us to get a yearly eye exam from an optometrist. The American Optometric Association recommends eye exams every two years for adults 18-60 and yearly for people 61 and older. 
  • March is National Kidney Month with the goal of helping us understand how important our kidneys are to our health. High blood pressure and diabetes are the leading risk factors of kidney disease. Learn more about how you can preserve your kidney health at

Evidenced-based Clinical Practice Guidelines such as the ones provided by the Michigan Quality Improvement Consortium (MQIC) are a good place for a deep dive. The aim of the Adult Preventive Services below are to recommend to the health care provider and adult patient appropriate recommendations and screenings to consider for their age group. Let your provider know any concerns or complaints you have about your health and be honest. 

There is always more we can do for our health. Sometimes it can be overwhelming where to start. For some people, biting off a little piece at a time is the way to go. Focus on what is important to you. Reading some of these links could be helpful. Bring up screenings to your health care provider if they don’t bring them up to you. With spring on the way, take some time to focus on health and consider making a change or get a needed physical or health screening. Spring clean your health! Ready, set, go!

Monday, February 4, 2019

What is Macular Degeneration?

You may have heard the term used before, but are unsure what it means. Perhaps an older relative mentioned that they had it or were afraid of getting it. With February being Macular Degeneration Awareness Month, it is good time to learn about a subject in which most of us are not familiar.

Age-related macular degeneration (AMD) is the leading cause of blindness among older Americans, even more than cataracts and glaucoma combined. It is a problem with the retina when a part of the retina – called the macula – is damaged or deteriorates in the central portion. In the early stages, there won’t be any vision problems. Sometimes vision will become blurry or wavy. But once the disease progresses, a person with AMD loses their central vision. This means you can’t see details in the center of your vision area whether you are looking at something close or far. You don’t have any problem with your peripheral or side vision; it will still be normal. If you were looking at a traditional clock, you might see the numbers on the clock, but not the hands in the center. Whatever you are looking at, you won’t see what is in the very center of your vision; that part will be a grey or a black area of non-vision or what some people call “blind spots.” AMD is diagnosed as either “wet” or “dry” with most people having the dry form; the wet form leads to greater vision loss.

Some of the symptoms can develop slowly over time and include:
  • Visual distortions, such as straight lines seeming to be bent
  • Reduced central vision in one or both eyes
  • The need for a brighter light when reading or doing close work
  • Increased difficulty adapting to low light levels, such as when entering a dimly lit restaurant or movie theater
  • Increased blurriness of printed words
  • Decreased intensity or brightness of colors
  • Difficulty recognizing faces

The causes of AMD can be due to a variety of things. Most often, the risk increases with age. Other risk factors include:
  • Heredity (people with a family history are at a higher risk)
  • High blood pressure (studies have shown it is associated with the development of AMD)
  • Smoking (reduces the amount of oxygen that goes to your eyes and doubles your risk)
  • Being a Caucasian female (followed by Chinese and Hispanic/Latino females)
  • Side effects of certain anti-psychotic and anti-malarial drugs
  • Obesity and inactivity (high levels of dietary fat may be a risk factor)
Treatment varies depending on the type of AMD. There is currently no cure. A healthy diet with a focus on antioxidants and omega-3 fatty acids, along with vitamin and mineral supplements have been shown to help in some studies. Wearing sunglasses when outside to protect your eyes against the sun’s harmful ultraviolent rays is also recommended. There are drugs and a combination of drugs/laser treatments for the wet AMD that has shown good results to delay or prevent worsening AMD, but unfortunately it can still reoccur down the road. It is important to note that new treatments are making AMD more manageable on a day-to-day basis, but there is limited funding for research on this disease.

The first line of defense is seeing your eye care professional on a regular basis and getting a comprehensive, dilated eye exam. Sometimes AMD can be detected before symptoms start. An early diagnosis may delay vision loss.

Tuesday, January 1, 2019

Go Red in January!

January 2019 is here! Let’s ring in the new year! Perhaps you’ve received some nice gifts or had extra time off from work over the holidays. Maybe you even managed to go somewhere warm. That’s great! Now it’s time to get back to business. Let’s start the new year off right by doing something good, something noble for other people. Let’s ring in 2019 by holding out our arms and giving blood.

Blood is usually in short supply in the winter months, especially in the month of January. Weather has had some severe turns the last couple of months in many areas of the United States and blood drives have been cancelled. People are exhausted from the holidays and are getting back to work and school. Some may have New Year’s resolutions to eat better, exercise and focus on their health. All these things create a reduction in blood donor turnout causing a blood shortage around our country.

Maybe you have some questions on blood donation, for example, who can be a donor or the different types of blood donations. Most people do have questions, especially if they’ve never given blood before.

Donors must meet certain requirements regarding age, weight and last donation date. A donor must be in good health and feeling well at the time of the donation. Other criteria that may affect donor eligibility can be:
  • Certain medical conditions
  • Medical treatments
  • Medications/vaccinations
  • Exposure to certain illnesses
  • Lifestyle and life events
  • Sexually transmitted diseases
  • Travel outside the United States

There are different types of blood donations:
  • Whole Blood – The most flexible of donations. Whole blood is what flows through your blood vessels and can be donated every 56 days.
  • Power Red Donation – A special machine allows you to safely donate 2 units of red blood cells. Can be done 2-3 times a year.
  • Platelet Donation – Uses a machine that collects only platelets and returns the rest of your blood to you. Can be done every 7 days, up to 24 times a year.
  • AB Elite Plasma Donation – A plasma only donation with type AB blood donors being the best candidates. Uses a high-tech machine that removes the plasma from your blood and returns your red blood cells and platelets back to you. Can be done every 28 days, up to 13 times a year.

Who can you help by donating blood?
  •      Cancer patients
  •      Trauma patients
  •      Sickle cell patients
  •      Burn patients
  •      Chronic disease patients

January is National Blood Donor Month to encourage people to give blood or pledge to give blood in the new year. So why give blood? It feels good to give. You’ve helped someone in need. It’s a wonderful thing to do for another human being. It can help save a life or make a life better. It’s fun. Okay, maybe not fun, but it’s not that bad. Once you make that first donation you’ll see the process is easy. Whatever reason you can come up with for giving blood is a good one. Let’s make giving blood a New Year’s resolution by going red in January.

Saturday, December 1, 2018

Seasonal Flu Vaccination: Put It On Your List and Check It Twice

Winter is here! With an earlier than expected winter season upon us in Michigan, it’s important to keep preventive health care at the top of your list. This list starts with thinking about the seasonal flu. Millions of people get the flu each year. It can be mild or severe and can even kill you.

Flu is listed as an immunization that should be received annually on preventive care lists for children, adolescents and adults. Children younger than 5 years old, adults over 65, pregnant women, chronic disease patients, people who are immunocompromised, nursing home residents and long-term care facilities are especially vulnerable.

The flu is linked to between 3000 and 49,000 deaths and 200,000 hospitalization each year in the United States. Pretty scary statistics. The flu vaccine was created to try and stop this epidemic.

There are 3 types of flu with Influenza A being the one constantly changing from year to year and being the worse. Different strains of the flu mutate over time and that’s why there is a different vaccination every year so your body can develop immunity to the most recent strain of the virus.

It can sometimes be hard to distinguish between the cold and the flu because they share many of the same symptoms. See the chart below to compare.

But one thing is certain and that is the flu can be a lot worse than having a simple cold. It comes on fast and furious and can cause serious health problems.

Like a cold, the flu is spread by tiny droplets when people sneeze, talk or cough. It is also spread by touching a surface or object with the flu virus on it and then touching your mouth, nose or eyes.

Complications of the flu can include:
·        Bacterial pneumonia
·        Sinus infections
·        Worsening of chronic medical conditions (congestive heart failure, heart disease, diabetes)

The key to preventing seasonal flu is to get an annual flu shot each year. Getting the flu vaccine has been shown to reduce flu-related illnesses and helps reduce the risk of serious complications that can result in hospitalization or even death. Work on using preventive care in your everyday life such as staying away from people who are sick, covering mouths and noses when sneezing or coughing, and the mainstay of preventive action - frequent handwashing to help stop or slow the spread of germs.

Take action now to prevent the flu by getting your immunization. Don’t wait any longer. It’s time. Get your annual flu shot at your local pharmacy, your health care provider’s office or health department. With December 2-8 being National Influenza Vaccination Week, put it on your list and check it twice.

PTI wishes you and your family a healthy, happy and flu-free holiday season.


Tuesday, November 6, 2018

National Hospice and Palliative Care Month

By Carla Irvin, RN, BSN
I recently had a death in my family. My dear mother-in-law, Marilyn, had dementia and lived in an assisted living facility for the last four years. Marilyn was in a wheelchair and required 24-hour care from the staff. She had been placed on hospice once she was found to be in multiple organ failure due to numerous medical problems and, thus, was considered terminal.
But what does hospice care do if she was already getting 24-hour care in a facility? My mother-in-law’s assisted living facility had a contract with a southeastern Michigan hospice. The hospice had nurses who came to visit, did physical assessments, made recommendations, and answered questions from both the staff and the family on how to best meet Marilyn’s, the family’s, and the staff’s needs at this difficult time. There was a chaplain who was available to our family and the facility staff for support as the end grew near. The chaplain and one of the hospice nurses were even there with the family when Marilyn passed. In the days afterward, we received calls and a letter offering services of a bereavement coordinator and referrals to support groups if needed. They told us that we’ll continue to receive informational mailings on grief and loss, and they’ll be available to us for questions or support for a year.
November is National Hospice and Palliative Care Month where awareness is raised about caring for people who have an advanced or life-limiting illness. Providing quality, compassionate end-of-life care is what a hospice does. Every single day. What an amazing group of people with a noble goal. Hospices give that care to people not only in their homes, but in long-term care facilities, nursing homes, hospitals and free-standing hospice facilities. They are committed to enhancing the quality of life. Services are available to people of any race, religion, age or illness with a team oriented approach. The cost is covered by private insurance, Medicare or Medicaid (in most states) for people who meet certain criteria. Care can be available after hours if needed, 24 hours a day, 7 days a week.
Hospices and palliative care programs provide:
·         Regular visits and consultations for medical care
·         Pain management
·         Symptom control
·         Psychosocial support
·         Spiritual and emotional support to patients and their families
·         Education
The statistics say that every year in the United States more than 1.6 million people receive care from a hospice. Hospice care is a tough job. I’m thankful there are people out there who want to be in that line of work.
For further information, check out the website for the National Hospice and Palliative Care Organization. Their mission is to lead and mobilize social change for improved care at the end of life. Their vision is a world where individuals and families facing serious illness, death, and grief will experience the best that humankind can offer.