My City Wellness Fall 2021

Fall 2021

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114 Surgeon Profile:

LOCAL CONNECTION 104 My City Wellness Awards 2021 Winners 106 7 Questions with Chris Candela President & CEO, McLaren Flint 108 Genesee Health System Helping the Community to a Healthy Future

Ashley Richardson, DO, FACOS

116 McLaren Fenton

Meeting the Needs of the Community

HEALTHCARE SPOTLIGHT 118 Advance Care Planning

It’s Time to Start the Conversation

140 Healthcare Community News

Contents Volume 7 Issue 1

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TREATMENT HIGHLIGHTS 120 Ascension Genesys Offers New Lung Valve Treatment 122 Chemo Patients can Escape from Reality at Genesys Hurley Cancer Institute 136 Got Dry Eyes? 138 What the Heck is Onychomycosis?

THE HEALTHY WORKPLACE 124 Back-to-Work Woes Avoid Office Health Hazards 128 Carpal Tunnel Syndrome Common & Treatable 132 Avoiding Back Pain

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My City Magazine is happy to acknowledge the top vote recipients in our recognition of excellence in local health care.

AFTER HOURS CLINIC McLaren Urgent Care

NURSE Tammy RaCosta, RN, NTSB-ICU Hurley Medical Center ORTHODONTIST

ASSISTED LIVING FACILITY Abbey Park, Grand Blanc CHIROPRACTOR Khaled S. El-Ganainy, DC Renaissance Chiropractic, PC DENTIST Alex L. Givens, DDS DENTAL HYGIENIST Destiny Bristol, RDH EMERGENCY FACILITY Hurley Medical Center EMERGENCY MEDICAL SERVICE

Nicole Wax, DDS, MS OPHTHALMOLOGIST Jeffrey S. Rohr, DO PEDIATRICIAN Habib Akrawi, MD PERSONAL TRAINER Francesca O’Brien Orangetheory Fitness, Grand Blanc SPECIALISTS: Manjit Grewal, MD, FACP, FASN - Nephrology Nkechi N. Onwuzurike, MD - Oncology Frank V. Tilli, MD - Cardiology SURGEON Gul R. Sachwani-Daswani, DO, FACOS

MedStar Ambulance FAMILY PHYSICIAN Abeer Fayyad, MD HOSPITAL Hurley Medical Center

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My Wellness

7 Questions with...

When you were a kid, what did you want to be when you grew up? A: I’ve always had a calling to public service to some degree. Growing up, I wanted to be a police officer. Ultimately, I ended up in health care where I can continue to fulfill my dream of service to the community. Q: What was your very first job? A: I was a busboy at a Greek restaurant. Q: What’s one work-related thing you want to accomplish in the next year? A: I want to continue McLaren’s com mitment to constant improvements in the quality of care we provide to our patients and the community, and patient and teammember safety. Q: What do you do to keep fit? A: I work out six days a week using weights 4-5 and doing cardio 1-2. Q: What is one of your pet peeves? A: Procrastination! I want positive changes to happen quickly, which leads me to constantly push myself and my team to keep momentum. Q: What is your definition of success? A: Success means being able to do something you love that contrib utes to the betterment of others. Q: What’s your most prized possession and why? A: My family is the pride and joy of my life. They are an integral support system and every day, I acknowledge that I’m blessed to have each of them. Š Q:

Chris Candela PRESIDENT AND CEO MCLAREN FLINT

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Wellness

Genesee Health System HELPING THE COMMUNITY TO A HEALTHY FUTURE BY PETER HINTERMAN PHOTOGRAPHY BY AUTUMN RUMMEL-SCHULTZ

In 1963, in response to a growing acceptance and understanding of those struggling with mental health, then President Kennedy signed into law the Community Mental Health Act, greatly changing the delivery of mental health services in cities throughout the United States. Getting away from an institution style of service delivery, the act pushed for mental illness to be treated as community based, behavioral healthcare. This led to the establishment of comprehensive community mental health centers throughout the country, including Genesee County. “Genesee Health System was established as a result of the Community Mental Health Act,” explains GHS CEO, Danis Russell. “We are the community’s mental health center and service provider for individuals struggling with mental illness, severe intellectual and developmental

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GHS SENIOR STAFF BACK (L-R): KATIE BAXTER, SR. DIR. CLINCIAL SERVICES; JEAN TROOP, EXEC. DIR. GENESEE COMM. HEALTH CENTER; DEXTER CLARKE, DIR. OF FAITH BASED & COMMUNITY ENGAGEMENT INITIATIVES; GLEN CHIPMAN, CFO; RENEE KESWICK, DIR. OF COMMUNICATION & P.R.; KARRY STEELE, SR. DIR. BUSINESS OPERATIONS; JENNIFER MCCARTY, SR. DIR. CLINICAL PERFORMANCE & INNOVATION. FRONT (L-R): SHAWN EDWARDS, SR. DIR. ENGAGEMENT, DIVERSITY & INCLUSION; DR. ANTHONY ELLIS, CMO; DANIS RUSSELL, CEO; SHEILA MASON, DIR. OF HUMAN RESOURCES.

disabilities, emotionally struggling children and those battling with substance abuse.” GHS offers community based behavioral healthcare and is funded by Medicaid, Medicare, state and federal programs, private insurance and self-pay. “We care for any individual regardless of ability to pay,” adds Russell. Located at 420 W. 5th Ave. in Downtown Flint, GHS provides care for all of Genesee County. The nearly 500-member staff includes psychiatric professionals, nurse practitioners, social workers, counselors, case managers and support staff. In addition to mental health support, GHS offers primary care services. “We are quite unique in that respect,” says Russell. “The majority of community mental health centers in cities throughout the U.S. do not offer primary care. We understand that physical and mental health

are interconnected. We are concerned with the physical and mental health of everybody.” Last year, GHS provided mental health support for approximately 12,000 individuals and primary care for another 5,000. “Really, since the water crisis, we have seen a tremendous uptick in need, especially in children,” states Russell. “Even today, that number continues to grow.” In response to increasing demand, GHS, in collaboration with Children’s Health Fund, launched a mobile mental health clinic in 2017 (in the form of an equipped RV) to bring service to those in need who are without transportation.This new mobile mental health unit joined a medical mobile unit that GHS’ Genesee Community Health Center began in 2016 with a grant from Blue Cross Blue Shield. The mobile health clinics are made available at schools, community events, neighborhood centers and

other places where residents gather. Today, the mobile clinics have aided the fight with COVID-19 by offering mental health assistance, testing and vaccinations, in addition to continuing their other functions. The programs at GHS also include virtual urgent care and mental health services, psychiatric and physical health screenings, professional training, consultations and crisis intervention (the GHS Crisis Hotline is available 24/7/365 at 810.257.3740). Perhaps nothing illustrates the wide range of GHS services better than their Baby Court program. With this specialized court docket, parents and their children are offered individualized support and mental health service to help strengthen and stabilize the family. In the program, parents receive child training, coaching, education, mental health counseling and substance abuse treatment. t

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We understand that physical and mental health are interconnected. We are concernedwith the overall health of everybody. " Danis Russell, CEO

C hildren receive mental health consequences of maltreatment. Early intervention and support can make a big difference in the life of a child and their emotional and social health is of utmost concern in the program. Recently, and due to the growth of children’s services since the advent of the water crisis, GHS began the construction of a new building located on S. Saginaw St., between 9th and 10th Streets. “Currently, we provide services at a number of different facilities throughout Flint and Genesee County,” says Russell. “We really need more space and we really need to consolidate.” GHS has been providing children’s services they need to overcome the negative

services from a number of buildings for years – a burden to families with children needing multiple forms of therapy. GHS board member, William Winiarski of Rowe Professional Service Company, offered the idea of a single building to house all children’s services. The C.S. Mott Foundation took interest and before Russell could blink, plans were in the works for a brand-new facility that will house all children’s program areas including the Neurological Center for Excellence, Children’s Autism Center, Outreach, and Child and Family Services. The building is funded through new market tax credits and private and public funding, including a $5.5 million grant from the C.S. Mott Foundation and a $200,000 grant fromThe Community

Foundation of Greater Flint through the Flint Kids Fund. “It’s extremely exciting and surprising,” says Russell. “It will be a great thing for children.” Genesee Health System is there for any person, adult or child struggling with physical or mental health issues. They are ready and willing to go above and beyond for anyone in this community. “Anyone can just walk in. You don’t need an appointment or referral,” says Russell. “We have been in the area for over 50 years and still, a lot of people don’t know about us. GHS is here to help.” If you or anyone you know are in need of help, don’t hesitate to call the free GHS crisis hotline and virtual behavioral health urgent care at 810.257.3740. Š

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ADVERTORIAL

Top 5 Tips for Achieving FINANCIAL WELLNESS

Financial Wellness is not just a cool buzzword. Improving your financial health can benefit your mental health and stress lev el. Here are some tips to help you achieve Financial Wellness. 1. Track, track, track. You can’t improve what you don’t measure. Just like if you are trying to lose weight, it’s important to keep track of the numbers. If you aren’t already, start tracking your income and expenses to see where you are. A variety of mobile apps are de signed to help you do this from the convenience of your smartphone. 2. Pay down debt. This is always a good goal to start with; but make it SMART. A generic goal like, “I want to pay off my debt” is not very motivating or specific, and therefore unlikely to be achieved. Try this instead: determine how much extra money per month you can put toward your debts, and then set up a payment schedule. You may have heard of the “debt snowball” method. It is just as it sounds – you start paying down your debts by putting a little bit toward each one. Once you have the smallest debt paid off, you take the amount you were paying to that debt and put it toward the next smallest loan and so forth, until you are rolling a big snowball down the hill full of all the minimum payments you were mak ing on smaller amounts of debt.

3. Start (or build up) an emergency fund.

A statistic published in the Federal Reserve’s, “2018 Survey of Household Economics and Decision Making” stated that at least 40% of Americans would struggle to come up with the cash needed to pay for a $400 emer gency. To prepare for such an event, I recommend creating an emergency savings account, with a goal of saving enough to cover 3 - 6 months of your expenses. It will provide a cushion for extenuating circumstances, such as a job loss or medical emergency. 4. Save for retirement. Even if you are currently saving, consider increasing your contribu tion. You may now be able to con tribute up to $19,500 to a 401(k), 403(b), and most 457 plans. If you will be age 50 by the end of 2021, you may also be able to contribute another $6,500 in “catch-up” contri butions. If you don’t have a retire ment plan or are already “maxing it out” and want to do more, you now may be able to contribute up to $6,000 in an IRA or Roth IRA ($7,000 if you are over age 50). 5. Consider hiring a professional to help you. Professionals may have tons of education, skill and resources for helping you save time and money. Consider hiring a CPA to do your taxes, as they may find additional deductions. In this role, I’ve helped clients with investment account

tax diversification and maximizing retirement contributions. Also, think about hiring a financial advisor to help you think through and achieve your future financial goals and avoid potential blind spots along the way. A study by The Vanguard Group indicates that professional advisors can add about 3% return to a client’s portfolio. One of the main things a financial advisor can do is to help “save you from yourself ” and avoid big mistakes that can devastate your finances. Some examples include helping you avoid 401(k) loans, determining the best place to take withdrawals in retirement (especial ly in down markets) and maximiz ing your Social Security payments. Advisors can also provide sound ad vice during periods of transition and navigating through major life events – such as divorce, inheriting money, and planning for retirement. Pro fessional advisors can also provide accountability and create a financial plan or “road map” to help you work toward your goal. Remember, a goal without a plan is just a wish. Š Jill R. Carr, CPA, CFP ® Financial Advisor Stephens Wealth Management Group

Investment advisory services are offered through Stephens Wealth Management Group, an investment adviser registered with the Securities and Exchange Commission. SWMG is neither a law firm nor a certified public accounting firm and no portion of this article should be construed as legal or accounting advice. Past performance may not be indicative of future results. This information has been obtained from sources considered to be reliable, but we do not guarantee that the foregoing material is accurate or complete. Stephens Wealth Management Group, 5206 Gateway Centre, Suite 300 Flint, MI 48507 Ph: 810.732.7411.

My Wellness

ASHLEY RICHARDSON, DO, FACOS Family Ties Bring Breast Surgeon Back Home BY CINDY FICORELLI Š PHOTOS COURTESY OF MCLAREN KARMANOS CANCER INSTITUTE

Born and raised in Byron, MI, breast surgeon Ashley Richardson, DO, FACOS, is back home practicing medicine and raising two children with her husband in the community that brings her so much passion. “It always was my dream to live and work in the place I’m proud

to call my home,” states Dr. Richardson. After graduation from Byron High School, Dr. Richardson complet ed her undergraduate degree in human biol ogy at Michigan State University, where she continued her education and obtained her medical degree. She wanted to re turn home, so she applied

for the General Surgery Residency Program at Ascension Genesys. Fol lowing her residency, she completed a breast surgi cal oncology fellowship at McLaren/Karmanos Cancer Institute in Flint, and proudly announced she was the first gradu ate of the program. When presented with “such a tremen dous opportunity” to join comprehensive breast care surgeons Eric Brown, MD, FACS and Linsey Gold, DO, FA COS, FACS, she happily accepted. “They have been such great mentors and partners – they have an amazing reputation among their colleagues and patients,” she says. “Joining their practice al lowed me to stay in this community and serve people who live here.” Dr. Richardson’s work is “exclusively breast,” she notes. She treats pa tients with benign breast disease, helps high-risk patients manage their condition, and she specializes in axillary node dissection, sentinel

node biopsy, lumpecto my/breast conservation, mastectomies, oncoplas tic surgery and simul taneous reconstruction with plastic surgery. Dr. Richardson spends the majority of her time see ing patients in her Flint office and performing surgeries at the Genesee County hospitals. “When treating my patients, I see the whole person,” Dr. Richardson says when talking about her philosophy of care. “For example, I may care for a 37-year-old wife and mother of two kids who works at a small busi ness in downtown Flint, or treat an 82-year-old widow who has mobility

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In July, Dr. Richardson was the catcher at a Pink Night breast cancer fundraiser at Comeri ca Park, when Karmanos and McLaren Health Care partnered with the Tigers for First Pitch Fri day. Her patient, Tina Craciun of Grand Blanc was the pitcher.

issues and worries about transportation to and from her appointments. Through our visits, I’ve met many of her family members and gotten to know them, too.” Dr. Richardson says some of her patients express their fears about what is going to happen to them. “I walk them through the entire can cer process, step by step, answer all of their ques tions and the questions their family members have, and spend as much time with them as they need to feel a little less anxious and much more confident,” she shares. “Just as each patient has her own personal story,

so does the cancer she is living with. I fit the treatment to each indi vidual patient. Cancer is a social and emotional disease and we need to treat all aspects of it, far beyond the physical illness,” she believes. When she is not in her office or the operat ing room, Dr. Richard son is home with her husband of nine years, Scott, a Flint native and a teacher in Mount Morris Consolidated Schools. “I love being a surgeon, mom and wife, and being able to do it all in my hometown commu nity!” she enthuses. Dr. Richardson is accepting patients.

To schedule an appoint ment, call 833.949.1108. The Flint office is located at 3500 Calkins Rd., Suite B. She also will see patients at Karmanos Cancer Institute at Mc Laren in Clarkston.

Dr. Richardson, along with her colleagues, Dr. Brown and Dr. Gold, co-host “The Breast of Everything,” a podcast offering breast health information, support and encouragement. Š

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McLAREN FENTON Meeting the Needs of the Community COMPILED BY CHERYL DENNISON Š PHOTOS COURTESY OF MCLAREN

also approximately 12,000 square feet and can accommodate mul tiple providers each day with 24 exam rooms, a procedure room, a spacious waiting room and access to the lab and imaging services. Q: When was the ER completed ? A: The ER was completed in February 2020 and opened that March. The Fenton area has been on McLaren’s radar for expansion for several years. In 2017, a new

Good things are hap pening in Fenton and the surrounding communi ties that will help its citizens stay healthy and have easy access to state-of-the-art emergency services and additional testing such as 3D mammography, MRI and more. My City Magazine reached out to McLaren Fenton to find out the latest updates and any additional plans for the facility’s future. Q: Tell us about the renovations that were completed at McLaren Fenton. A: The building’s entire 24,000 square-foot interior was reno vated. The ER is approximately 12,000 square feet and includes 17 exam rooms, three trauma bays, and observation and iso lation rooms. To support the

ER, space was designated for a full-service lab, as well as a suite for comprehensive imaging ser vices. The primary care clinic is

Three trauma bays allow ample space for speedy care.

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The full service lab allows McLaren Fenton to offer the fastest and best care

Single exam rooms feature state-of-the-art technology.

president and CEO (Chad Grant) was appointed at McLaren Flint and his experience with McLaren’s free standing ER at McLaren Clarkston pushed the project to the forefront and its timeline was accelerated. Q: Tell us about Telestroke. A: Each ER across the McLaren system throughout Michigan has telemedicine technology in their emergency department, ensuring that patients have access to rapid decision-making for treatment during the critical period following the onset of stroke symptoms. As part of the McLaren Stroke Net work, interventional neurologists utilize a telemedicine “robot” to provide consultative services within minutes of notification by onsite emergency and in-house physicians. TeleStroke allows the interven tional neurologist to beam into the patient’s bedside from a remote lo cation and assess the patient, review CT scan images and discuss best options for the patient with onsite physicians and the patient’s family. This technology assures that clinical therapies such as clot removal and clot-busting drugs can be applied quickly and effectively, resulting in a better outcome for the patient. With the TeleStroke

network, stroke patients benefit from speedier diagnoses, faster care and a better chance of recov ery. We’re proud to offer this high level of neurolog ic intervention. Q: What addi tional services are

Imaging suite and 3D mammography machine

available at McLaren Fenton? A: Providers available at the site include family and internal medicine, nurse practitioners, OB/ GYN, midwifery, otolaryngolo gists (ear, nose and throat) and of course, the ER physicians. Services include a full-service outpatient lab, MRI (new last month), 3D mammography, CT, ultrasound, X-ray and bone density scans. board-certified emergency physi cians along with emergency room nurses and support personnel. Our primary care physicians include both MDs and DOs, and there are three nurse practi tioners, several medical assistants and office support personnel. The Q: Tell us about your staff. A: The ER is staffed by

lab and imaging suites also have specially trained personnel. Q: Is there any other information you would like to supply that may be helpful for our readers? A: This past spring, the imaging services at McLaren Flint earned American College of Radiology (ACR) accreditation. The cen ter offers online appointment scheduling for ER patients with non-life-threatening conditions and for screening mammograms. Imaging services also offer Satur day appointments. There are addi tional plans to add more specialists and services. McLaren Fenton would like to thank the residents of Fenton and surrounding com munities for entrusting us with their health care over the years. Š

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Now is the Time to Start the

Conversation fate for an early death.’ Look at COVID. No one anticipated it. One day you are healthy, and a couple of days later, you could be on a ventilator. Or what Ask yourself … • What does “quality of life” or “living well” mean to you? • If you were having a good day, what would happen on that day? • If you have an unexpected

If you became seriously ill or injured and could not speak for yourself, who would make decisions for you regarding your medical care?

Now is the time to start the conversation.

An Advance Directive allows you to express your wishes for end-of-life care so you are not leaving those decisions to some one else – a family member or a physician, for example, who may not know what your wishes are. “Advance Care Planning is far more than completing a written document,” reports Tommie Franklin, RN, Advance Care Planning Facilitator at Genesys Hurley Cancer Institute (GHCI) in Flint. “It is a process of plan ning end-of-life care, clarifying the medical treatment you want to receive if you cannot voice your preferences on your own, and talking with loved ones about your wishes,” she explains. Franklin works with indi viduals, couples and families to make sure their wishes about medical care are written in their own words, and she walks them through the step-by-step process of completing the documentation. She also helps individuals review the process of choosing their health care advocate – the person who will speak for themwhen they cannot speak for themselves.

about a car accident? If you are the parent of a 25-year-old who was in a motorcycle accident, what would you do? We don’t want to think or talk about these tragedies, but wouldn’t you want your wishes to be known?” In fact, as a result of COVID, there are now two versions of an Advance Directive that individ uals can complete. The first is simpler – it is choosing a health care advocate – someone you trust – to make decisions for you. The second is the full Advance Directive that documents your specific end-of-life wishes. For example, what lifesaving treat ments do you want? Do you want CPR performed? Do you want to be placed on a ventilator? “It is so important to have your wishes in writing or choose an advocate who will speak on your behalf,” she urges. “Don’t leave these important decisions up to someone who doesn’t know what you want. It also helps your family make decisions, because they are following your wishes.”

health emergency and doctors believe there is little chance to recover, what are your wishes? • Who do you want to be in volved in your care? Set up your plan while you are healthy, Franklin advises, and take the burden off your loved ones. She finds that those who complete an Advance Di rective reduce the anxiety and stress for their family, and it can lead to a smoother transi tion into end-of-life care. “By completing a plan, you are not giving up your right to make your own decisions,” she clarifies. “You still make your own health care deci sions until you no longer can verbalize them yourself.” That is the point when an Advance Directive goes into effect. “Some of the statements I have heard are, ‘I’m too young to need an Advance Directive,’ or ‘if I complete an Advance Directive now, I am sealing my

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Tommie Franklin, RN helps complete an Advance Directive document at GHCI.

“Don’t leave these important decisions up to someone who doesn’t know what you want.” Tommie Franklin, RN both, and they cannot speak on behalf of each other. Franklin will work with you to help you complete your Ad vance Directive documents and ensure they are legal. The service is free of charge and available to anyone in the community. Genesys Hurley Cancer Institute presents free month ly Advance Care Planning presentations for any Genesee

County resident. Upcoming presentations are Tuesday, October 19 at 1pm; Tuesday, November 16 at 1:30pm and Tuesday, December 14 at 1pm, at Genesys Hurley Cancer In stitute, 302 Kensington Avenue in Flint. If you are unable to at tend a presentation, call Tom mie Franklin at 810.908.5972 and she will arrange an ap pointment with you. To sign up for a presentation, call Franklin at 810.908.5972, or register online at ghci.org. You can find additional information on Advance Care Planning by con tacting the Greater Flint Health Coalition - Your Health Your Choice at YHYC@flint.org. Š Think about it. Talk about it. Share your wishes. Document your wishes.

Here are a few steps Franklin recommends for those pursu ing an Advance Care Plan: • Choose an advocate – some one you trust completely to follow your wishes. • Complete an Advance Direc tive, a legal document speci fying your wishes. Once com pleted, the Advance Directive becomes a Durable Power of Attorney for Healthcare. • Make many copies. Give one to your physician, one to your advocate, one to your advance care planning facilitator, take one with you when you travel and keep one in a safe place at home. • If a husband and wife choose each other as their advocate, designate a sec ond primary advocate in the event something happens to

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Ascension Gene Offers New Lun Valve Treatment Giving emphysema a COPD patients hope f better quality of life A scension Genesys Hos pital is offering a new treat Photos Courtesy of Pulmonx Made by Pulmonx (based in Redwood City, CA and Neuchâ tel, Switzerland) the Zephyr® endo

ment option for patients with severe emphysema, which is a form of chron ic obstructive pulmonary disorder (COPD). A new type of endo bronchial valve, smaller than a pencil eraser, can be implanted without surgery or incisions to damaged areas of the lung, helping people who have advanced COPD to breathe easier and enjoy a better quality of life.

bronchial valve is the only such device to receive approval from the FDA for treatment of patients with homogenous distribu tion of the lung disease, making it the only min imally-invasive option to help control symp toms once medications are no longer effective. According to the American Lung Asso ciation, more than 16.4 million people have been diagnosed with COPD, with 3.5 million of those individuals having emphysema, which is caused when lung tissue becomes hyperinflated and damaged usually because of cigarette smoking or inhaled toxic chemicals/substances.

The Zephyr Valve treatment procedure implants tiny valves into a targeted section of the diseased lung where air has become trapped, causing shortness of breath. The one-way valve allows the trapped air to es cape, resulting in easier breathing. W

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According to the American Lung Association, more than 16.4 million people have been diagnosed with COPD, with 3.5 million of those individuals having emphysema.

While there’s no cure, it can be treated and managed through med ications, oxygen therapy and pulmonary rehabil itation. Even with these treatments, more than one million emphysema patients suffer symptoms of hyperinflation – where air becomes trapped in damaged areas of the lung and puts pressure on healthier parts of the lungs. This can cause extreme shortness of breath and make activities like walk ing or eating difficult. With limited treatment options, the only other alternatives include inva sive procedures like lung volume reduction surgery or transplantation. “Medical care for em physema often involves bronchodilators, and if the patient gets worse, we use oxygen therapy,” said M. Ghiath Bayasi, MD,

a physician board certi fied in pulmonary, critical care and sleep medicine. “Traditional surgery may remove damaged areas of the lung, but these procedures have frequent complications, especially for people with emphysema who often have heart disease and increased complications, putting them at greater risk and longer recovery time. In contrast, I can now perform a new endobronchial valve procedure using a bron choscopy which requires no incisions or cutting,” explains Dr. Bayasi. During the proce dure, three to five tiny valves are inserted in the

diseased area of the lung. The valves prevent air from getting into the bad part of the lungs but allow trapped air to escape. The healthy part of the lungs are able to expand more fully, relieving pressure on the diaphragm and mak ing breathing easier. “This new treatment can increase quality of life for years,” said Dr. Bayasi. “It’s a great advancement that is providing signif icant benefits including improvements in lung function and quality of life out to at least 24 months, and improve ments in exercise capacity out to at least 18 months.” Clio resident Krystal McCotter was among

Dr. Bayasi’s initial pa tients to receive the new endobronchial valve. “Before the procedure, I could hardly breathe. Now I’m back to where I was years ago. I feel 100 percent better,” McCot ter said. “I have a garden outside, and I’m so glad I can do gardening again. It’s nice to be outside.” Individuals who may be eligible for this procedure must have a diagnosis of severe COPD with emphyse ma and hyperinflation, breathlessness despite taking medications and a relatively high degree of airway obstruction. For more information, talk with your physician. Š

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they enjoyed the experience, 98 percent reported it was relaxing, and 64 percent said it reduced their anxiety and boredom. “Our virtual reality head sets are a way for patients to transport themselves to a place of happiness, peacefulness and relaxation,” finds Sue Root, GHCI Quality of Life Direc tor, who was instrumental in obtaining the funds needed to offer this service to patients. “Patients are worried and anxious about their chemother apy. ‘What is going to happen? Will I be in pain? Will the treatments work? How long do I need to stay connected to an IV line?’ During their therapy, the minutes seem to drag on and on, and so can their added stress,” Root notes. Studies show that the immersive experience of virtual reality alters the perception of time, making the treatment sessions seem shorter. “If we can provide a positive, relaxing distraction, an escape from their life of cancer, patients will feel much better and more comfortable about their treat ments and leave the clinic feeling much happier,” she finds. “We are helping remove them from the re ality of their treatment and taking them to a place of peacefulness. “You can tell someone how to meditate and imagine they are in a place of calmness, but during a chemotherapy session, that is almost impossible with all of the surrounding distractions,”

BAIVECTOR / STOCK.ADOBE.COM

,I you were given a choice between spending a few hours in a cancer treat ment clinic or on a sunny beach, you’d choose the beach, right? Thanks to virtual reality head sets, patients at Genesys Hurley Cancer Institute (GHCI) are benefiting from technology that allows them to take a mini-va cation while receiving treatment. Now in use at GHCI, VR headsets help cancer patients “travel” to a favorite peace ful destination during their

chemotherapy treatments, helping relieve anxiety, appre hension, depression and pain, and reducing side effects such as fatigue. After their virtual reality experience, patients re portedly feel more energized. Research shows and patients have confirmed that the use of virtual reality headsets is improving their in-clinic expe rience. A pilot study on the VR program documents overwhelm ingly positive comments from patients. All participants said

ALEXANDER OZEROV / STOCK.ADOBE.COM

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GHCI Quality of Life Director, Sue Root (left), helps a patient navigate the VR headset.

Root finds. “Through our virtual reality headsets, patients can see the visuals and hear the sounds of comfort, making it so much easier to find that place of peace.” The individual VR headsets are hands-free and simple to use. Patients can choose from 36 different experiences – life on a beach in Cape Cod, Irish land scapes, swimming with aquatic life or listening to and watching the gentle, soothing sounds of ocean waves. They also can tune into general educational informa tion about their cancer, treat ments, side effects and what to expect as a cancer patient – infor mation they received from their

patients how the headsets work and guides them through the process of finding programs they want to watch. Programs run from five to ten minutes in length. Virtual reality is feasible to use as a distraction intervention during chemo treatments and is well-accepted by patients.The headsets are available to any patient undergoing chemother apy but are not recommended for patients who have issues with diz ziness, vertigo or motion sickness. Genesys Hurley Cancer Institute provides the newest treat ments and technology in a warm, welcoming, home-like setting. For more information, visit ghci.org. Š

“We are helping remove patients from the reality of their treat ment and taking them to a place of peacefulness.” Sue Root, GHCI Quality of Life Director physician offered visually and in easier-to-understand terms that they can listen to as often as they want. The GHCI staff shows

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Don’t be afraid to take five minutes and just “zone out” and clear your mind.

18th floor? Well, suck it up, Bucko! After a few days of that climb, you’ll be the fittest per son in the bullpen (or at least the sweatiest). 3. Take your breaks and do it outdoors. We get workday breaks for a reason. Take them and get some fresh air while you’re at it. There is nothing wrong with taking 15 minutes to relax and ease your mind. Side Note: This includes taking earned vacations. Everyone needs time away from work to recharge and perhaps partake of a poolside piña colada. Create an ergonomical ly correct workspace. Adjust your monitor position, find the right chair, computer mouse and keyboard. Your back should be sup ported while seated, your wrists parallel to the desk surface, and make sure to stand up at intervals. Don’t be a Slouchy Sam when you can be an Upright Ike! 5. Pack a healthy lunch and hydrate. I know – boring, right? This is where most of us need some serious willpower. All of those fast-food calories (or pizza or Chinese, etc.) plus a sedentary 4. Use the right tools.

and headaches. At its worst, eye strain can cause dizziness, fatigue and nausea. To mitigate this ailment, you should be seated approximately an arms-length away from the monitor. If you cannot do this and still read the screen, increasing the font-size of what you are reading or working on or adjusting the screen brightness can help. Don’t forget to take a break from the screen every now and then (this also goes for mobile phones). Viruses/Bacteria Guess what? The threat of sickness is never going to simply “go away.” Viruses and bacterial infections are here to stay for the long term and must be dealt with quickly and efficient ly. Offices, like school

classrooms, are havens for sickness transmission. Constant close quarters and tight meeting rooms add to increased infec tion and common objects hold increasing amounts of bacteria. The dirtiest items in the office are those we use the most and clean the least. I am, of course, speaking of the phone, keyboard, mouse and CPU. When was the last time they were disinfected? A month ago? A year? Make it a habit to disinfect at least monthly and never eat at your desk – find a clean common area instead. Look, jobs are de manding. We often spend the majority of our daily lives surrounded by four office walls, machinery, cubicle walls, meetings, etc. Time off is hard to come by; but we need

to stay healthy in order to make the most of our free time. Good work place habits can ensure good times after work. Simple Tips for a +HDOWKLHU 2ɝ FH /LIH 1. Eat breakfast. Seri ously, do it. Don’t sur vive on just coffee or that much waited-for Starbucks latte. Eating something for break fast can increase con centration and jump start your metabolism, providing more energy throughout the day (I mean, you CAN make toast, right?). 2. Use the stairs. We all need a little more ex ercise in the office, and since the destination is the same, why not get it when you can. What? You work on the

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workday equals a future health problem. We must resist! If you must, pick one day a week to treat yourself at lunch and make sure to double your movement that day. Get rid of the open boxes of snacks and sugary drinks. If you need to sip during the day, sip water. Keep a refillable container at your desk. Dehydra tion will certainly add to a tiring day. media. Nothing is more distracting or can disrupt your train of thought more than staring at your phone or browsing social media, and that doesn’t begin to consider its effect on your men tal health. Too much negativity can make for a depressing day and change your outlook on even the simplest of tasks. Avoid it, if pos sible, or at least limit access with a “phone time” schedule. 6. Put the mobile phone away and limit social

7. Practice mindfulness. Speaking of mental health, take some time to work on yours. Don’t be afraid to take five minutes and just “zone out” and clear your mind. Close your eyes and concentrate on breathing out the stress. In with the good air, out with the bad. In with the good, out with the bad … 8. Believe that all your coworkers are your allies. (Yes, even the back-stabby ones.) For many, this will be the hardest thing to do because we all have that “one” coworker. Maybe they sit kitty-corner from you, staring at three computers, design ing whatever all day and when you are minding your business and think ing about what a nice day you are having … bang! Drama. Yes, even those people are your allies. Think positively. Maybe they just need a friend and being with friends is a good way to mitigate stress. Š

REFERENCES Avon. (2021). Top ten health tips for office workers. Avonchiro practicclinic.com. Retrieved from avonchiropracticclinic.com/blog/ top-ten-health-tips-for-office-workers Daum, K. (2021). 25 ways you can make your life happier in the office. Inc.com. Retrieved from inc.com/kevin-daum/25-ways-you can-make-your-life-healthier-in-the-office.html Pacific Prime. (2021). 10 biggest health problems from working in an office. Pacificprime.com. Retrieved from pacificprime.com/ blog/10-biggest-health-problems-working-office.html WebMD. (2021). 10 tips to improve your health at work. WebMD. com. Retrieved from webmd.com/women/features/10-tips-to-im prove-your-health-at-work

Wellness

CARPAL TUNNEL SYNDROME Avoidance and Treatment BY PETER HINTERMAN Since the 1930s, the general population of the United States has been plagued by Carpal Tunnel Syndrome (CTS) with over 8 million new cases documented each year. A common occupational hazard, it causes employers to pay over $7.4 billion in Worker’s Compensation and can create major up heaval in life with only 23% of people being able to return to their previous jobs. With the majority of Americans either heading back to the office or spending most of their time at their home-office computer, CTS remains a possibility for many. So, what is CTS? How can we avoid it? And, if afflicted, what are the treatment options?

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The Carpal Tunnel

women are three times more likely to develop CTS than men. The main symptom of CTS is numbness and/or tingling in the fingers, which later becomes pain. Sufferers often claim that their digits feel swollen even though no physical swelling is evident. Symp toms often first appear at night and can cause the afflicted to wake from sleep. During the day, symp toms can take the form of grip weakness, trouble handling small objects, or increased difficulty writing or typing. As the syndrome worsens, there can be difficulty holding onto objects and perform ing simple tasks such as buttoning a shirt or turning a steering wheel. Treatment After diagnosis, there are a few options for treatment of CTS, depending on its severity. In hopes of relieving the issues causing undue pressure upon the median nerve, non-surgical options are typically tried first. They are: • Splinting – wearing a wrist splint at night or during the day helps keep the wrist straight and the carpal tunnel open. The goal is to reduce pressure on the median nerve by giving it as much room as possible, especially during sleep. • Changing Daily Routine – Iden tifying and altering daily tasks that can worsen CTS symptoms can help relieve pain and pres sure in the long run. Something as simple as taking a break from the task, when possible, can go a long way toward recovery. • Over-the-Counter & Prescription Drugs – In certain circumstances, common anti-inflammatories

such as aspirin or ibuprofen may provide short-term relief of the symptoms but, as the condition worsens, they are not enough and stronger corti costeroids such as prednisone are prescribed. For persons experiencing mild symptoms, lidocaine is injected directly into the wrist to relieve pres sure on the median nerve. • Yoga – Improving flexibility and muscle fitness has been shown to relieve pain and in crease grip strength. Yoga, in particular, has shown positive results in people suffering from mild CTS. If the condition continues to worsen, surgery may be a person’s only relief. CTS surgery is the second most common surgery in the U.S. with over 230,000 procedures performed annually. Generally, surgery involves severing the carpal liga ment around the wrist to relieve pressure on the median nerve. There are two types of CTS surgery: • Open Release – A two-inch incision is made in the wrist to sever the carpal ligament and enlarge the carpal tunnel. • Endoscopic – The surgeon makes one or two incisions about a half-inch each, inserts a camera attached to a tube to observe the carpal tunnel via monitor, and then severs the carpal ligament with a small instrument inserted through the tube. This proce dure offers faster recovery and lesspost-operational discom fort, but has a higher risk of complications and possible need for further surgery. t

Surrounded by tendons, ligaments and bones, this narrow passageway leads from the wrist to the hand. The carpal bones make up the bottom and sides of the tunnel, while the carpal ligament covers the top (palm-side). The tunnel allows passage of the me dian nerve and nine tendons that travel from muscles in the forearm to bones in the hand allowing us to move our fingers and thumbs. The median nerve provides feeling to the palm side of the thumb and index, middle and part of the ring fingers (not the little finger). CTS begins when the me dian nerve becomes pressed or squeezed at the wrist due to thick ening from the lining of irritated tendons or other swelling, which causes frequent numbness or tin gling in the fingers and thumbs. Grasping objects or performing manual tasks is difficult and, if left untreated, the muscles at the base of the thumb will waste away, further inhibiting dexterity and strength. People with severe CTS often cannot determine between hot and cold by touch and can suffer burns without feeling it. Cause and Symptoms No single, underlying cause for CTS is known; rather, a com bination of factors is usually the culprit. Wrist trauma or injury, an overactive pituitary gland, an underactive thyroid, rheumatoid arthritis, diabetes, or a cyst or tumor located in the tunnel can play a role in CTS development. The most common cause remains the repeated use of vibrating hand tools, assembly line work and often, repetitive movements. Gender also plays a large role as

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Those undergoing surgery may experience infection, stiff ness or pain at the incision site and a decrease in grip strength, which improves over time. While healing, work activity will have to be modified and some may need to change jobs after recovery. Recurrence of the con dition following surgery is rare. Avoidance Although common, CTS can be avoided by making sim ple changes to how we work and play. Here are eight easy ways to keep CTS at bay. 1. Try a softer touch. When working on certain tasks, we often use a little more “oomph” than needed. Maybe we pound the keyboard when typing, use a little extra torque when turning a screw, or go too hard for too long. Remember: You are a caveman no longer. We have evolved. Go easy. 2. Take a break. Everyone needs to take some time to relax once in a while. If possible, take a ten-minute break every hour to stretch and rest your hands. Take a few deep breaths. Then, get back to it. 3. Stretch often. Does Stretch Armstrong get CTS? The answer is NO. He’s as loose as a long-neck goose and you should be, too. While stretch ing, do not neglect your wrists.

A common occupational hazard, CTS causes employers to pay over $7.4 billion inWorker’s Compensation. 6. Maintain good posture.

The internet offers a bevy of simple stretches to keep them supple – give them a try. 4. Stay neutral. Avoid bending your wrists. Make sure your workspace is set up in such a way that your wrists remain even with your desktop, or at least in line with your hands as much as possible if working on a shop floor. 5. Switch it up. If your daily rou tine or job allows it, mix up your tasks to avoid repetitive motion for long periods.

Straighten your body, straighten your wrists.

7. Stay warm. Colder tempera tures can cause greater pain and stiffness. Keeping your hands warm or wearing fingerless gloves can help relieve pressure. 8. Visit an occupational therapist. If all else fails, get professional help. An occupational therapist can help you alter your day to-day plan to avoid CTS and other work-related maladies. Š

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REFERENCES Cleveland Clinic. (2021). Carpal tunnel syndrome. Cleveland clinic.org. Retrieved from my.clevelandclinic.org/health/diseas es/4005-carpal-tunnel-syndrome Harvard Medical School. (2014). Can you avoid carpal tunnel syndrome? Harvard.edu. Retrieved from health.harvard.edu/pain/ can-you-avoid-carpal-tunnel-syndrome National Institute of Neurological Disorders and Stroke. (2021). Carpal tunnel syndrome fact sheet. NIH.gov. Retrieved from ninds.

nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal Tunnel-Syndrome-Fact-Sheet Orthopedic Center of Arlington. (2021). 11 astounding carpal tunnel statistics. Orthoarlington.com. Retrieved from orthoarlington. com/contents/patient-info/conditions-procedures/11-astound ing-carpal-tunnel-statistics Wheeler, T. (2021). 9 things you can do to prevent carpal tunnel syndrome. WebMD.Com. Retrieved from webmd.com/pain-man agement/carpal-tunnel/how-can-i-prevent-carpal-tunnel-syndrome

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AVOIDING BACK PAIN BY LISA L. GUYOT, MD

Back pain is the second most common reason that

people go to see their doctor; second only to cold or flu symp toms. Those who have experi enced back pain know that it can be debilitating and life-altering. Thankfully, statistics show us that 70-80% of back pain sufferers can get better without surgery within 8-10 weeks. Avoiding an occur rence of back pain would be ideal and will be the topic of this article. I often tell patients that preven tion is the best treatment for avoid ing back pain. I often use the exam ple of changing the oil in your car;

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