The best way to treat diseases is to prevent them in the first place. (Courtesy Spectrum Health Beat)
By Robert Preidt, HealthDay
Be sure to put vaccinations on your children’s back-to-school lists, whether they’re just starting school or heading off to college, experts say.
By protecting infants, children and teens from serious diseases, vaccinations also protect families, schools and communities.
“The best way to treat diseases is to prevent them in the first place, and the diseases on the vaccine schedule are all preventable for the vast majority of our population,” said David Kimberlin, vice chair of pediatrics at the University of Alabama at Birmingham.
“The scientific evidence and public health statistics are comprehensive and compelling—properly scheduled and dosed vaccines are safe and effective, and they’re the reason we don’t see diseases like measles or whooping cough running rampant across our country,” Kimberlin said in a university news release.
Kimberlin is the American Academy of Pediatrics’ liaison to the U.S. Centers for Disease Control and Prevention’s advisory committee on immunization practices.
Immunization requirements vary by state. All have a minimum requirement for dosing each school year to attend public schools. Many require an updated immunization certificate before a child enters any public school or child care center.
Here’s what else you should know:
All 50 states and the District of Columbia require vaccinations for diphtheria, tetanus and pertussis, polio, measles and rubella.
49 states and D.C. also require mumps vaccination.
48 states and D.C. require varicella (chickenpox) vaccination. (Montana and Pennsylvania do not).
45 states and D.C. require hepatitis B vaccination to enter kindergarten. (Alabama, Maine, Montana, North Dakota and South Dakota do not).
Some states require Hib (Haemophilus Influenzae Type b); PCV (pneumococcal); flu and hepatitits A vaccines to enter kindergarten.
Insurance covers school vaccinations. If you don’t have insurance, your state health department can direct you to services that offer low-cost and/or free immunizations, said Dr. Rachael Lee, an assistant professor in the university’s division of infectious diseases.
Vaccinations are available at doctor offices, pharmacies, health centers and local health departments.
College students require specific vaccinations and should check with their school to learn which ones they need, university experts said.
Life-threatening infections such as meningococcal disease are more common among college-age people, but can be prevented through full vaccination, the experts said.
The dilemma is all too familiar: It’s Monday morning, you walk into your office and see that someone has left a big box of donuts in the break room. Then, your co-worker tells you there will be cake later for yet another birthday celebration.
One thing’s for sure. You’re not alone.
A new federal government survey found that about one-quarter of Americans “acquire” nearly 1,300 calories at work every week. Even worse, the survey only included foods people didn’t bring to work themselves, and food they didn’t purchase from outside vendors.
“The majority of the calories people got at work, people didn’t pay for—70 percent of the calories were free,” said study co-author Stephen Onufrak, an epidemiologist at the U.S. Centers for Disease Control and Prevention.
The food and beverages that were most commonly obtained at work, he said, were:
Coffee
Sugar-sweetened soft drinks
Sandwiches
Tea
Cookies
Brownies
French fries
Pizza
Salad
Water
Diet soft drinks
When the researchers looked at the foods by calories, pizza was the leading source of calories obtained at work, followed by sandwiches and regular soft drinks.
Onufrak said the foods obtained at work might have been lunch—some workplaces did have onsite cafeterias and foods purchased at an employee cafeteria were included in the survey.
The study included more than 5,200 people from a nationally representative group that completed a U.S. Department of Agriculture survey in 2012 and 2013. The volunteers answered questions about the foods they obtained at work over a seven-day period. They only reported food they acquired at work, and they didn’t say whether or not they ate the foods.
Onufrak said the survey didn’t ask about what people ate at home, so it’s hard to know for sure if they continued eating foods that were high in refined sugar, salt and empty calories once they left the office. But he said that based on other research he’s done, “a lot of the eating patterns we saw tend to be consistent.”
The findings show that employers have an opportunity to improve their workers’ health, he said.
“If you look at data on worksite wellness programs, they’re effective at getting people to have healthier behaviors, reducing health care costs and reducing absenteeism. I think encouraging a healthy diet is an essential part of a worksite wellness program,” Onufrak explained.
Nutritionist Samantha Heller noted that offering healthy fare could provide a benefit to employers, because employees who eat well “will feel better, will have more energy and can focus better.”
Heller, who’s with NYU Langone Medical Center in New York City, added, “When we feed our bodies well, our bodies and brains respond. It’s a win-win for the company and the employees.”
But what if your workplace doesn’t offer healthy options? The best option may be to bring your own lunch, Heller suggested. That way, you’re in charge of what foods are available to you, and it saves you money.
If you don’t bring your own lunch, she said, you should do some scouting to see what healthy food choices are available around your workplace. And it’s a good idea to do this when you aren’t hungry.
And what about all those free sweets at work?
“People bring a lot of treats to work. People like to feed each other to show affection. But it’s OK to say no to the birthday cake or the brownies. It’s always going to be somebody’s birthday or another celebration. Decide ahead of time that you’re going to say no to treats at work,” Heller advised.
Onufrak is scheduled to present the findings at the American Society for Nutrition annual meeting in Boston. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.
For help developing better eating habits, visit Spectrum Health Nutrition Counseling or schedule a personalized appointment by calling 616.391.1875.
Children who accidentally swallow button batteries should immediately be given honey to reduce their risk of serious injury and death, according to a new study done with pigs.
“Button batteries are ingested by children more than 2,500 times a year in the United States, with more than a 12-fold increase in fatal outcomes in the last decade compared to the prior decade,” study co-principal investigator Dr. Ian Jacobs said in a Children’s Hospital of Philadelphia news release.
“Since serious damage can occur within two hours of ingesting a battery, the interval between ingestion and removal is a critical time to act in order to reduce esophageal injury,” he noted.
Jacobs is a pediatric otolaryngologist and director of the hospital’s Center for Pediatric Airway Disorders.
When a swallowed button battery reacts with saliva and tissue of the esophagus, it creates a solution that dissolves tissue and can cause severe damage to the esophagus, airway, vocal cords and major blood vessels, the researchers explained.
The longer it takes for the battery to be removed, the higher the risk of serious injury.
The researchers used live pigs to test if a variety of liquids—including honey, juices, sodas and sports drinks—could provide a protective barrier between a swallowed battery and tissue until the battery is removed. They found that honey and a medication called sucralfate were the most effective.
The study was published online in the journal The Laryngoscope, and the findings are being incorporated into the latest National Capital Poison Center Guidelines for management of patients who’ve swallowed button batteries.
“Our recommendation would be for parents and caregivers to give honey at regular intervals before a child is able to reach a hospital, while clinicians in a hospital setting can use sucralfate before removing the battery,” Jacobs said.
But the researchers said these substances should not be used in children who may have sepsis or perforation of the esophagus, severe allergy to honey or sucralfate, or in children younger than 1 year old due to a small risk of botulism.
“While future studies could help establish the ideal volume and frequency for each treatment, we believe that these findings serve as a reasonable benchmark for clinical recommendations,” Jacobs said. “Safely ingesting any amount of these liquids prior to battery removal is better than doing nothing.”
The study’s other principal investigator, Dr. Kris Jatana, a pediatric otolaryngologist at Nationwide Children’s Hospital in Columbus, Ohio, said the shiny metallic batteries should be stored where toddlers can’t get to them.
“Parents and caregivers should check all electronic products in the home and make certain that the battery is enclosed in a compartment that requires a tool to open and periodically check to ensure it stays secure over time,” Jatana said in the news release.
Other uses for honey
Honey is an artisanal food that can be used as a sugar substitute.
Keep coin lithium battery-controlled devices out of sight and reach of children.
Remote controls, singing greeting cards, digital scales, watches, hearing aids, thermometers, children’s toys, calculators, key fobs, tea light candles, flashing holiday jewelry and decorations all contain button batteries.
The Spectrum Health Helen DeVos Children’s Hospital injury prevention team has compiled information and tips to help you with home safety to limit these dangers.
If your child ingests a button battery, call your poison center at 1.800.222.1222 and visit your local emergency room.
The answer could be yes if you use the towel for many purposes, have a large family and are not a vegetarian, according to a new study of germs lurking on towels.
Forty-nine percent of the kitchen towels collected for the study were laden with bacteria, and the bacterial count increased with the number of family members and kids, researchers from the Indian Ocean island/nation of Mauritius reported.
“Cross-contamination is happening in the kitchen, and those bacteria could reach our food and cause food poisoning,” said lead researcher Susheela Biranjia-Hurdoyal. She is a senior lecturer in the department of health at the University of Mauritius.
Specifically, the researchers found that towels used for a variety of tasks—such as wiping utensils, drying hands, holding hot utensils or cleaning surfaces—had more bacteria than towels used for one task. In addition, damp towels had more bacteria than dry ones, the investigators found.
Of the 49 samples that were infested with bacteria, 37 percent had Escherichia coli (E. coli), 37 percent had Enterococcus, and 14 percent were infected with Staphylococcus aureus (S. aureus).
For the study, Biranjia-Hurdoyal and her colleagues sampled 100 kitchen towels that had been used for one month. They classified the types of bacteria on the towels and also how much bacteria was present.
Higher rates of S. aureus were found among low-income families and those with children, the findings showed. The risk for E. coli was higher in damp towels than dry ones, from towels used for several jobs rather than single-use ones, and from those used in non-vegetarian households.
Both E. coli and S. aureus were found at higher rates in families with non-vegetarian diets.
E. coli is a normal bacteria found in the intestine and is released in large numbers in human feces. S. aureus is a bacteria found in the respiratory tract.
The researchers’ advice? “Avoid humid and multi-usage towels,” Biranjia-Hurdoyal suggested.
Kevin Sauer is an associate professor of dietetics at Kansas State University College of Human Ecology in Manhattan, Kansas. He said, “The key advice is to remain attentive to food safety when preparing food in the home, which includes proper hand-washing, avoiding cross-contamination, and cooking and storing foods at the right temperatures.”
In a food-handling study he did in 2015, Sauer found that cloth towels were the most contaminated.
“However, even when provided with disposable single-use paper towels, participants were still observed using these in a way that led to additional contamination of contact surfaces,” he noted.
Sauer advised that people should avoid using towels in place of hand-washing, because they can easily become contaminated with harmful germs from raw meat and poultry juices.
“Furthermore, reusing contaminated towels to wipe hands or other surfaces can easily lead to cross-contamination, and therefore should not be reused throughout meal preparation, since they too can contribute to contamination of hands, surfaces or other food products,” Sauer said.
Findings from the study were scheduled for presentation at the American Society for Microbiology meeting, in Atlanta. The findings should be considered preliminary because they have not yet been published in a peer-reviewed medical journal.
According to Jessica Corwin, MPH, RDN, community nutrition educator for Spectrum Health Healthier Communities, and Kristi Veltkamp, an outpatient dietitian at Spectrum Health Blodgett Hospital, we should all follow these key tips to avoid cross-contamination:
Always wash your hands with soap and water before preparing or handling food.
Keep raw meat, poultry and seafood securely wrapped to prevent any juices from contaminating prepared dishes and raw foods.
Take time to rinse fresh fruits and vegetables under running water. Scrub any firm-skinned produce with a vegetable brush.
Avoid re-using towels, platters or utensils that were used with raw meats.
Corwin urges people to follow food safety precautions, even if they ignored them in the past and didn’t feel any ill effects.
Not everyone responds to infections the same way. Those most at risk of serious complications include small children, pregnant women, the elderly and those with compromised immune systems.
Service dogs may help reduce levels of the stress hormone cortisol in military veterans who have post-traumatic stress disorder, a new study finds.
For the study, researchers compared a group of veterans with PTSD who had a service dog to a group of veterans on the waitlist to receive one.
“Our previous research suggests that the presence of a service dog reduced clinical PTSD symptoms and improved quality of life,” said study co-leader Maggie O’Haire. She is an assistant professor of human-animal interaction at Purdue University’s College of Veterinary Medicine, in West Lafayette, Ind.
“In this study, we wanted to determine if those beneficial effects also included changes in the physiology of stress,” O’Haire said in a university news release.
The researchers focused on cortisol, a biomarker involved in the stress response system, and one that is detected through saliva.
According to study co-leader Kerri Rodriguez, “military veterans with a service dog in the home produced more cortisol in the mornings than those on the wait list.”
Rodriguez explained that “this pattern is closer to the cortisol profile expected in healthy adults without PTSD.”
In addition, “having a service dog was also associated with less anger, less anxiety and better sleep,” she noted. Rodriguez is a human-animal interaction graduate student.
The findings are the first of their kind and offer insight into how service dogs may provide mental health benefits to veterans with PTSD, according to the study authors.
The researchers are now conducting a large-scale, long-term U.S. National Institutes of Health clinical trial comparing veterans with service dogs to those without.
The report was published in the journal Psychoneuroendocrinology.
Benefits of owning a dog:
Fight heart disease. Owning a dog has a positive impact on blood pressure, which is one of the main factors in heart attack and stroke, according to Thomas Boyden, MD, MS, Spectrum Health program director of preventive cardiology. The American Heart Association reports a link between pet ownership and lower cholesterol and triglyceride levels. Studies also show you’ll be more likely to survive a heart attack if you have a dog.
Relieve stress. “Being around pets, and dogs in particular, actually changes your body at a hormonal level,” Jared Skillings, PhD, ABPP, Spectrum Health chief of psychology said. Of course, it’s not a cure-all. “Getting a dog won’t cure depression or clinical anxiety, but it certainly can help.”
Reduce loneliness. Dogs provide unconditional love. They’re caring, excited to see you and glad to be by your side. Need to talk? “Dogs are good listeners and they’re not going to argue with you,” Dr. Skillings said.
Improve sociability. There’s also the added benefit of the camaraderie among dog owners. “Having a dog can connect people to other pet owners, which can reduce isolation, too,” Dr. Skillings said.
Inspire exercise. A study published in the journal BMC Public Health said the average dog owner walks 22 minutes more per day than those who don’t own a dog. Daily walks have lots of added benefits, from controlling chronic conditions to burning weight and improving moods.
Add purpose. Having a dog or any other pet can give you a reason to get going in the morning. Size doesn’t matter. In fact, cats, horses and birds can all have a similar effect. Even tiny pets—hamsters, mice, fish, insects—can imbue you with a sense of purpose. In one study, elderly people were asked to care for a cage of five crickets. After eight weeks, the people who had the crickets in their homes were less depressed and had better cognitive function than those in the control group.
Leah Davidson, 9, rolled down the hall in her hospital bed to visit Charlie in the playroom. Her mom and staff pushed her bed up to the door and Charlie walked up to the side of her bed to get some love from Leah.
She is being treated for osteogenesis imperfecta, a group of inherited disorders characterized by fragile bones that break easily. She smiled from ear to ear as she touched his nose, whispering, “Hi, Charlie.”
Photo by Taylor Ballek, Spectrum Health Beat
Charlie’s owner, Ronica Froese, especially enjoys Charlie’s visits to the hospital. They started their therapy visits in 2015 when Charlie was just a year old.
“I said if my horse can do this, this is what I want to do with my life,” Froese said. “And it turns out (Charlie) was made for the job.”
Froese handed out cards with Charlie’s hoof print on them, as well as small plush horses with Band-Aids on their legs that read, “Get well.”
Several children enjoyed their visit with the handsome miniature horse, who sports sneakers and a great attitude.
Froese’s favorite part is seeing the children’s big smiles.
“It’s good for everybody’s heart,” Froese said.
The Child Life team at Helen DeVos Children’s Hospital is always looking for community visitors to bring activities and events to the hospital for patients. If you are interested in having your group host an event, more information is available online.
Your little one’s first day back to school isn’t that far off. Now is the time to think about new strategies for a productive school year. (Courtesy Spectrum Health Beat)
By Sue Gunnink, Spectrum Health Beat
It’s always difficult transitioning from the laid-back summer schedule to the hectic schedule of the school year.
It usually takes a good month or so to get back into the groove, at least to where you feel confident everyone in your household is back on track.
And once you’ve gotten into the groove again, don’t you wish you could keep it going all year long? Wouldn’t it be great to keep everything running smoothly ’til next June?
It just so happens that a few handy tips can keep your family functioning like a well-oiled machine, at least when it comes to nutrition and meal preparation.
We all know that one of the best tools in the toolbox is the lunchbox.
Here’s how to keep your meals on track all year long:
Pack ahead
Pack lunches the night before to avoid the rush in the morning. This gives you more time to plan meals, which increases the chances you’ll select nutritious foods. Have your kids get involved in the lunch packing, too. They’re more likely to eat the food in their lunch when they’re involved in the process.
Be a portion pro
To simplify lunch preparation, cut your fruit into individual portions for the week. For example: If you have three kids and want them to have fruit each day of the week, you can cut 15 containers of fruit on Sunday night.
Get stocked and ready
For after-school snacks, consider stocking healthier items that are easy to grab, such as trail mix, unbuttered popcorn, or peanut butter on sliced apples or pears.
Coordinate schedules
Plan dinners in advance. On Sunday night, take a moment to survey your family’s schedule for the coming the week, identifying nights that involve sports practice, school activities, special events and so forth. Plan the meals accordingly. Consider having one night where your child is responsible for coming up with a meal.
Prep and freeze
Consider preparing and freezing meals well in advance. Once every few months, you can make a large batch of a particular food item, such as lasagna, then divide it into dinner portions. These can be frozen and labeled for easy use later on.
Are you interested in learning more about balanced nutrition? Schedule a personalized appointment with a Spectrum Health registered dietitian or call 616.391.1875 to register for a group class series.
In a tech-centric world, it’s tough on the brain to focus on any one thing as it’s bombarded with data. (Courtesy Spectrum Health Beat)
By Don Shell, Spectrum Health Beat
It was another typically busy day.
In between testing patients, Michael Lawrence, PhD, ABPP-CN, a clinical neuropsychologist with Spectrum Health Medical Group, found himself answering instant messages and emails, grabbing a quick lunch, calling AT&T about his cell phone bill, racing to Blodgett Hospital for a meeting, and reading an article a certain Health Beat reporter had sent him for an interview.
If that sounds all-too familiar to you, you’re not alone. But if you think you’re multitasking, what you’re really doing is kidding yourself, Dr. Lawrence said.
“We all have to do it to some extent,” he said. “But we know multitasking is a misnomer. We have to be aware that you’re not doing two things at work, you’re switching back and forth. If we have three or four or five things, our performance suffers.
“The problem is, we don’t know how to deal with technology. We’re bombarded by things.”
Our cell phone addictions are doing more than stifling our real-world social lives: they’re stifling our creativity, too, Dr. Lawrence said.
“We used to think that different parts of the brain were responsible for controlling different abilities, but what we’ve learned with recent advances in neuroscience is that actually your brain is networked together,” he said. “The Default Mode Network, the DMN, actually encompasses the prefrontal cortex and the limbic system. That’s the part of the brain that turns on when you’re at a resting state. And studies have shown that creativity is increased when you do nothing at all first.
There’s an app for that
New app helps track your cell phone addiction.
Are you addicted to your cell phone? If you’re like a growing number of Americans, the answer is probably yes – and it’s likely worse than you thought.
Enter the new app called Moment, which can track just how often you check your messages, emails, Facebook or anything else.
You can even set daily limits on yourself and force yourself off your device when you’re over your limit.
“It’s the last thing you look at before you go to bed, and the first thing you wake up to,” Dr. Lawrence said. “That’s why this Moment app is so interesting. I don’t think people realize how addicted they are to their phones.”
“When you’re doing too much at once, this area of the brain is burning too much energy, and your capacity to do any one thing suffers.”
This flies in the face of the common belief that things such as music can help increase focus and productivity, Dr. Lawrence said, but that doesn’t mean people can’t juggle tasks at all.
“I think you can do two things at once, but the problem is, you don’t do any one thing as well,” he explained. “The research says the quieter the environment, the more sterile, the better you do. People say they focus better with music, but your brain has to turn on to process music, and if it’s expending energy to process music, that’s energy it’s not using on whatever else you’re doing.”
The multitasking myth isn’t age-specific, either.
“They talk about kids with video games, but I think adults are even worse,” he said. “I went to a meeting the other day and everyone was on their cell phone. They say technology is making everybody ADD. It makes our lives better in some way, but at what cost? There has to be some moderation.”
Dr. Lawrence said he has a simple way to fight the anxiety of overstimulation.
“We all have that feeling, when we’re being pulled in a million different directions,” he said. “When I do it, I realize it and get anxious. What’s the first thing I do? I turn off everything–my cell phone and email–and create a checklist of the things I need to do. That helps me focus and prioritize what I need to do.”
The bottom line, says Dr. Lawrence, “We have to learn to adapt, because technology isn’t going away.”
Take precautions before and after entering the pool to stay healthy. (Courtesy Spectrum Health Beat)
By Susan Hollman Krieger, Spectrum Health Beat
You know that sign at the entryway of your local pool that asks you to shower before entering the water? Do it.
And then make sure to shower again after you are done swimming for the day. You may be saving yourself and other swimmers a miserable summertime bout of diarrhea.
According to the CDC, although both E. coli and norovirus are eliminated by chlorine and other chemicals used in pools, cryptosporidium survives for up to 10 days. People who have or who recently had diarrhea can carry the parasite into the pool, exposing other swimmers. They, in turn, develop diarrhea a few days later.
So is the answer to stay out of swimming pools and head for one of Michigan’s beautiful lakes?
Not necessarily, said George Fogg, MD, PhD, an infectious disease specialist with Spectrum Health Helen DeVos Children’s Hospital.
“This parasite has always been around in our pools. It only receives attention when there is an outbreak of cases in a water park or in a community, for example, when cryptosporidium got into the Milwaukee municipal water supply,” Dr. Fogg explained. “The two most common parasites that can cause diarrhea are giardia and cryptosporidium and they have been around for a long time. We are seeing more incidences lately because we are doing a better job of detecting and reporting the cause of these intestinal disorders.”
Dr. Fogg said that swimmers developing diarrhea after being in a pool is still “very uncommon. You have a greater risk of getting norovirus on a cruise ship than getting cryptosporidium in a swimming pool—it is very rare.”
He recommends that swimmers who do experience diarrhea inform their health provider, although they will likely see the condition “self-correct” within a few days.
While there isn’t currently a chemical that is both safe to use in a pool and that would kill the parasite, Dr. Fogg said that taking normal precautions will help swimmers stay healthy.
Avoid ingesting any pool water. “That is how it gets into your system.”
Shower before and after swimming. “Soap can remove the spores from your skin and prevent you from inadvertently ingesting them through touch.”
Stay out of the pool if you have a compromised immune system. “That is who we really worry about—people who have other health conditions who are particularly vulnerable to parasites.”
All in all, Dr. Fogg said not to let unnecessary worry about what’s in the water curtail your traditional summer activities.
By Sue Thoms, Spectrum Health Beat, photos by Chris Clark
Cuddling her favorite stuffed dog as she tucked down into a hospital bed, Acacia Walter-Rooks dreamed of life with a healthy kidney.
“I’m excited to eat more foods and go to school and see my friends,” she said.
At the top of the list for this 14-year-old: French fries and macaroni and cheese.
The busy life of a teenage athlete seemed within reach—if her body accepted the donated kidney, and if disease did not attack the new organ.
Two big ifs.
Acacia had already surmounted one big hurdle: She had a living kidney donor who was a good match.
The next day, she would undergo surgery at Spectrum Health Butterworth Hospital to receive a kidney from Beth Hill, a 46-year-old mother of four young children.
And Hill was not the only one who offered.
Photo by Chris Clark, Spectrum Health Beat
Acacia’s parents, Brie Walter-Rooks and Ryan Rooks, marveled as dozens of friends, neighbors and co-workers volunteered as donors when they learned a rare disease destroyed Acacia’s kidneys. Some potential donors didn’t even know the family well.
Transplant coordinators halted the application list at 30, just so they could process the offers on hand.
The generosity buoyed the family at a difficult time.
“My hope is that Acacia will always remember how loved and cared for she was by her community, and people’s desire to love and care for her so her life can be full and whole,” Ryan said.
For Hill, a friend from church, being chosen as the best match was an honor.
“I feel very blessed to be able to do that,” she said.
‘Always in motion’
Before kidney disease struck, Acacia exuded good health. She played soccer, made the cut on a select volleyball team, and did gymnastics for fun. She and friends from East Grand Rapids Middle School rode bikes, hung out in Gaslight Village and went to movies.
It became clear we needed to take the next big step.
Brie Walter-Rooks Acacia’s mom
“She was just a really active kid,” Brie said. “Always in motion.”
Brie and Ryan adopted Acacia when she was 3 weeks old. They also have a 15-year-old daughter, Mica. The two girls, just a year apart in age, “are totally different and extremely close,” Brie said.
Acacia showed the first signs of kidney disease in July 2013, at age 11. She had puffy eyes, swollen ankles and a bloated stomach. Her face and neck swelled.
They learned she had a rare kidney disease called focal segmental glomerulosclerosis, which scars and damages the kidney’s filtering units.
Genetic testing showed Acacia has a genetic mutation in the APOL1 gene that is sometimes found in people of African descent. The mutation boosts protection from African sleeping sickness, but also carries a sevenfold risk of kidney disease.
Acacia had an exceptionally aggressive form of the disease, one that can rapidly lead to end-stage kidney failure. Doctors said she would likely need a transplant in two to six months.
But she went 30 months before she reached that point. Even with kidneys functioning at 30 percent, Acacia played sports full-speed and hiked in the mountains on family backpacking trips.
In January, however, her kidney function dropped below 20 percent, and her blood pressure rose. Her doctor said she should stop playing sports.
“It became clear we needed to take the next big step,” Brie said.
On Feb. 11, a surgeon removed Acacia’s failing kidneys.
Photo by Chris Clark, Spectrum Health Beat
She began receiving dialysis three times a week. The treatments did the blood-cleaning work of her kidneys, but they left her nauseated and tired. She had to stay home from school.
As Acacia underwent final tests before the transplant, her parents also faced the possibility that the new kidney would not be the fix they sought. Thirty percent of those with focal segmental glomerulosclerosis get the disease back within minutes to hours after transplant.
Before the operation, Brie said she and Ryan were concerned, but they chose not to dwell on possible downsides.
“You realize there is a higher probability that she will be healthy,” Ryan said. “And you go with that.”
‘Called to do this’
Hill remembers the day at Genesis Methodist Church when Brie talked about her daughter’s kidney disease and how she would need a transplant one day.
“It was heart-wrenching,” she said.
Over the next few weeks, Hill thought several times about donating a kidney. She thought about what she would want for her four young children if they were sick. She ultimately decided she could, and should, offer to help.
“I felt called to do this,” she said. “I believe in following those urges.”
Talking with her oldest daughter, 6-year-old Emersyn, Hill explained that she had two kidneys but only needed one.
“We have to help where we can,” she told her.
And Emersyn said, “It’s like having two chances.”
At first, Hill wanted to keep a low profile about her decision to donate. She eventually agreed to discuss it publicly to raise awareness about those waiting for kidney transplants.
“So many people are suffering,” she said.
All those who volunteered to give a kidney to Acacia “are just regular people,” she said. “We all have our own lives and jobs and things that need to be taken care of. Other regular people can help, too.”
Transplant day
The morning of the transplant, the festive crowd gathered in the pre-op area. Acacia curled up under a blue fleece blanket, clutching her stuffed dog, while Mom and Dad talked, smiled and hugged her.
I’m very glad I did it. A little bit of pain is worth it.
Beth Hill Kidney donor
Julia Steinke, MD, Acacia’s pediatric nephrologist, appeared at Acacia’s bedside.
“This is the best day ever,” Dr. Steinke said.
Nearby, Beth Hill lay in another bed, while her spouse, Lisa, held her hand. Their pastor, the Rev. DeAnn Dobbs, moved from bed to bed, leading them all in prayer.
Hill went to the operating room first. As her bed rolled by, she and Acacia raised their hands to each other―a long-distance high five.
Photo by Chris Clark, Spectrum Health Beat
In side-by-side operating rooms, one team worked to detach Hill’s left kidney while another team prepared Acacia for the transplant. Surgeon Stanley Sherman, MD, carried the kidney from one room to the other in a basin filled with a slushy saline mixture.
Acacia’s parents sat in a waiting room, hoping for updates.
Clinical transplant coordinator Eric Beuker soon entered with good news: The kidney was in place and already working.
“We have liquid gold,” he said.
In the hours and days following transplant, the news got even better. Acacia’s new kidney continued to function well, and her kidney disease did not reappear.
“From a well-being standpoint, she is really doing better than expected,” Dr. Steinke said.
Acacia will need medication for the rest of her life to prevent rejection of the new organ. But she will no longer have restrictions on her diet. And she will be able to spike volleyballs over the net again.
Two days after transplant, Acacia took her first walk. With baby steps, she covered 80 feet down the hall at Helen DeVos Children’s Hospital. She sunk back into the recliner in her room, and her parents and therapists applauded.
Acacia, exhausted, had a request: French fries and an Oreo-vanilla milkshake.
Live-saving
In Hill’s room at Butterworth Hospital, her four kids clustered around her. Kathryn, 2, sat on her lap, and Brendan, 3, asked when she would come home.
Caught off guard by the pain on the second night post-transplant, she’d pulled through with adjustments in medication.
“I’m very glad I did it,” she said. “A little bit of pain is worth it.”
Donors go through extensive medical evaluations to make sure patients will function well with one kidney, Dr. Steinke said. Surgery is done laparoscopically, so recovery is quicker than it was in the past. Still, it can take four to six weeks for a donor to recover, as the body adjusts to a 50 percent drop in kidney function.
A living donor benefits more than just the recipient. Thirteen children are waiting for kidney transplants at Helen DeVos Children’s Hospital. When a living donor volunteers, it means the line shortens for those waiting for a kidney from a deceased donor.
Photo by Chris Clark, Spectrum Health Beat
Dr. Steinke marvels at the commitment of donors like Hill. While some know the recipient well, others volunteer to give to a stranger.
“That is just an amazing, selfless act that I always am so humbled by,” she said.
For kids like Acacia, a functioning kidney means a chance at a full life and a healthy childhood and teen years.
“It’s a life-saving procedure,” Dr. Steinke said. “She will be able to follow whatever dream she wants.”
If you are considering becoming a living kidney donor, call the Helen DeVos Children’s Hospital pediatric kidney transplant team at 616.391.2802.
Runners are among the high-intensity athletes who should be especially cognizant of their exposure to heat on summer days. (Courtesy Spectrum Health Beat)
By Jolene Bennett, Spectrum Health Beat
Early last summer, incoming Kent State University freshman Tyler Heintz, 19, fell severely ill during an early-morning football practice.
His breathing grew labored and he began to slip in and out of consciousness. An ambulance rushed him to a hospital, but he later died.
The cause: exertional heat stroke.
This dangerous condition can strike an athlete of any stature, even those who have reached the pinnacle of their sport. In August 2001, 6-foot-4, 335-pound offensive tackle Korey Stringer, of the Minnesota Vikings, died shortly after collapsing during drills on a hot, humid day.
The Centers for Disease Control and Prevention identifies groups most at risk of heat stroke, including the very young, the very old, the chronically ill, people who work outdoors and people in low-income households.
It is not uncommon for an athlete to sweat 1 to 2 liters per hour on a hot day. A large football player can lose up to 15 pounds of water in a single practice session.
The problem is most athletes drink far less than they sweat, simply because they underestimate the extent of their sweat loss.
Limitations
With summer underway, athletes young and old are more often found outdoors. It’s an essential time to impress the importance of proper hydration and rest.
Summer training camps for runners, soccer players and football players are proving grounds for excellence, but they can be ground zero for heat stroke trouble.
When athletes—especially runners and football players—participate in vigorous exercise in the warm months, dehydration can turn fatal.
Almost all heat-related deaths occur from May to September, according to the CDC, which also identifies exertional heatstroke as a leading cause of preventable, non-traumatic exertional sudden death for young athletes in the U.S.
Two-a-days, those notoriously difficult practices common to football, can often lead to trouble. Last year, the NCAA Division I Council banned two-a-days in preseason practices.
A 2016 study in the Journal of Athletic Training found that exertional heat exhaustion occurs at an increased rate in the first 14 days of practice, and especially in the first seven days.
About a decade ago, the National Athletic Trainers’ Association issued guidelines for preseason heat acclimatization. The guidelines establish a 14-day plan that helps athletes acclimatize to the heat. It zeroes in on the first three to five days of summer practice as the most important for progressive acclimatization.
On Day 1, for example, athletes shouldn’t participate in more than one practice and they should wear limited gear, as well as limiting the level of exertion and physical contact. For full-contact sports, “100 percent live contact drills should begin no earlier than Day 6.”
Coaches and training staff must carefully consider their approaches to summer practices, scrutinizing duration, intensity, time and place.
On especially hot days, for instance, the practice may need to be limited in length or simply rescheduled to a cooler part of the day.
Keeping watch
Athletes and parents need to be aware of the signs and symptoms of dehydration and heat stroke.
Keep in mind that thirst is not always the best indicator of dehydration. By the time a person senses thirst, the body may have already lost more than 1 percent of its total water. Athletes, coaches and parents should emphasize the importance of proper hydration before, during and after sporting activities—and then keep watch for any signs of trouble.
Not urinating, or very dark yellow or amber-colored urine
Dry, shriveled skin
Irritability or confusion
Dizziness or lightheadedness
Rapid heartbeat
Rapid breathing
Sunken eyes
Listlessness
Shock (not enough blood flow through the body)
Unconsciousness or delirium
When dehydration goes untreated, the body can no longer maintain homeostasis, which leads to heat stroke. This can cause impaired cardiovascular function and neurological failure.
An athlete experiencing heat stroke may become agitated, confused or unable to maintain balance.
The signs of heat stroke:
High body temperature
Hot, red, dry, or damp skin
Fast, strong pulse
Headache
Dizziness
Nausea
Confusion
Losing consciousness
Heat stroke, also referred to as heatstroke or sun stroke, is a true medical emergency that is often fatal if not properly and promptly treated. Call 911 or go to the emergency room if heat illness is causing vomiting, seizures, or unconsciousness. Locate an urgent care facility near you.
To celebrate her 11th birthday, Lily Brouwer and her family planned a mini-vacation at a beachfront cabin in Grand Haven, Michigan.
She had been battling an upset stomach and intermittent abdominal pain, but determined to have fun, the birthday girl insisted on going.
Frigid Lake Michigan waves rolled in when they arrived that dreary Sunday. They still remember the date: Dec. 30, 2012.
A more chilling fear would sweep over the family.
After loading up with Motrin and going sledding, Lily’s condition worsened. She thought she was seeing blood in her frequent diarrhea.
“I tried to tuck her into bed and prayed for her, but she was up 15 minutes later,” said Michelle Brouwer, Lily’s mom.
Lily’s dad, David, said they knew something wasn’t right, that this was no ordinary stomach virus.
Michelle drove Lily to Spectrum Health Helen DeVos Children’s Hospital in Grand Rapids.
When the clock rolled to midnight on New Year’s Eve, ushering in Lily’s birthday, they were in the emergency room.
“She was lying on my lap, writhing in pain,” Michelle said. “She was in complete misery.”
Doctors told Michelle they were going to observe Lily for six hours. If she could keep fluids down, they could release her.
Instead, they admitted her. She remained there for 21 days.
Tainted food
Michelle’s parents dropped off a birthday gift to Lily at the hospital and then tended to Lily’s siblings—Madeline, Jorja and Liza—so Michelle and David could watch over their daughter.
Photo by Chris Clark, Spectrum Health Beat
For four days, Lily went to the bathroom every 15 minutes. Bloody diarrhea. She vomited frequently. She took morphine every two hours for pain. A steady stream of IV fluids dripped into her young veins.
With doctors trying to pinpoint a cause, anyone who visited the room had to don gowns and gloves.
That Thursday afternoon, a pediatric nephrologist delivered the soul-shaking news: Lily had hemolytic uremic syndrome. The doctor said Lily could lose her kidneys. And her life.
Lily fell into acute kidney failure. She was rushed to the intensive care unit and put on a huge dialysis machine.
According to Alejandro Quiroga, MD, section chief of pediatric nephrology at Helen DeVos Children’s Hospital, something Lily ate caused this life-threatening condition.
“(Hemolytic uremic syndrome) is a condition where there is a toxin produced by a bacteria in your gut that causes your red blood cells to be destroyed and form small clots in your blood vessels, creating multiple organ damage, but particularly to the kidney,” Dr. Quiroga said.
Lily either ingested undercooked or poorly handled food, Dr. Quiroga said.
“We don’t know from where,” he said. “The health department was notified and they performed an investigation without any yield.”
David and Michelle prayed. And they cried. But they had faith. In God, and in the doctors who cared for their precious daughter.
“There were countless times I feared the loss of Lily’s life and how that would forever change the course of our family,” David said. “But we continued to pray, believe, and put our faith in the amazing team of doctors and nurses responsible for her care.”
Incomprehensible horror
Lily remained in the ICU until Sunday afternoon. While there, she began suffering from hallucinations.
“They had to rush her down for a CT scan,” Michelle said. “It can attack your brain. Every organ can be affected. She saw pretty much every specialist there is. Her heart rhythm was off. She developed pancreatitis. She had a pleural effusion.”
How could this be? Their precious daughter, who had just celebrated her birthday, appeared to be nearing her death day.
Photo by Chris Clark, Spectrum Health Beat
“We had thousands of people from around the world praying for Lily,” Michelle said.
As if life couldn’t get any more terrifying, another dagger struck.
“We got a text from grandma that our baby, Liza, who was 5 at the time, was having vomiting and bloody diarrhea,” Michelle said.
David and Michelle swallowed hard as they reread the text message in disbelief.
“I was horrified,” David said. “After watching Lily for 10 days and knowing what she was going through, it was incomprehensible to think that Liza was going to have to go through that pain as well.”
Michelle returned home to check on Liza.
“I got a call from my husband,” she said. “He didn’t know what to say other than, ‘You need to get down here to the hospital right away.’ The way he said it, I didn’t know if Lily was still going to be there when I got there.”
Lily had difficulty breathing. She was upside down in bed, gasping for air.
The grandparents took Liza to the Helen DeVos Children’s Hospital emergency department.
“They were going to transfer Liza to the seventh floor to be right next to Lily,” Michelle said. “But at the same time, Lily was getting worse and they had to transfer her back up to ICU.”
‘I’m afraid I’m going to see Jesus’
Lily told David she couldn’t breathe.
“She said, ‘Daddy, I can’t breathe, I’m afraid I’m going to see Jesus,’” Michelle said. “She told him, ‘I don’t want to see Jesus today.’”
They intubated Lily. She remained on a ventilator for four days.
Meanwhile, the nightmare continued. Liza’s numbers trended in the wrong direction. She also tested positive for hemolytic uremic syndrome, and transferred to the intensive care unit.
“This could be lethal in some cases and Lily and Liza were critically ill and at risk of death or permanent organ damage,” Dr. Quiroga said.
Slowly, the medicine—and the prayers—began to work.
“We tried an off-label medication on them that in our experience and other centers’ case reports have shown improvement in severe cases like them,” Dr. Quiroga said.
A community responds
Michelle and David’s emotions crawled from the valley of death to the mountaintop of hope.
Photo by Chris Clark, Spectrum Health Beat
Lily came home from the hospital on Jan. 18. Liza followed three days later.
Hundreds of people lined the Brouwers’ street, clapping and cheering.
“Lily is a miracle that she’s here and that her kidneys started to turn back on,” Michelle said. “Our God is a big God and he did a miracle. Lily and Liza are amazing. They’re miracles. They’re perfectly healed.”
The girls went home on a special diet and required outpatient dialysis.
Now, they’re both off medication and only need to do urine checks once a year with their pediatrician.
“They are doing great now,” Dr. Quiroga said. “They have normal lives and the prognosis is excellent.”
Michelle said no one would even know the girls were sick if it weren’t for the testimony the family has to share.
The illness may be gone, but the lessons remain for the Brouwers and all who know them.
“This story affected so many people,” David said. “Lily and Liza became symbols in our community for hope, faith and healing. We were shown so much support, love and care. During that time and ever since, we have tried to do the same for others going through horrible times as well. We witnessed a profound miracle and everyone near and far realized it, too.”
Just back from a run with her husband, Laura Metro faced a parent’s worst nightmare: Her 6-year-old daughter, Maison, ran to her screaming, “I think Clay died! I think Clay died!”
Metro’s 3-year-old son, who was swimming with family friends, was found at the bottom of the pool with his towel. One friend started CPR—or the closest thing he knew based on what he’d seen on TV—on Clay’s blue, lifeless body.
Paramedics arrived and got Clay’s heart beating again. He was taken by helicopter to the hospital and spent two days in a coma before making what Metro calls “nothing short of a miraculous recovery.”
“The doctors said, ‘We don’t know why he’s alive,’ ” Metro said. “The only thing—the only thing—we can attribute it to is the bystander CPR. … He didn’t see the inside of a hospital for an hour and a half [after almost drowning]. That was really what did it.”
Drowning is the third-leading cause of unintentional injury death worldwide, accounting for 7 percent of all injury-related deaths, according to the World Health Organization. The agency estimates there are 360,000 annual drowning deaths worldwide.
The Metros’ good fortune is anecdotal evidence of the findings from a study, published in the June 2017 edition of the journal Resuscitation, which found that chances for neurological recovery from a near-drowning increase when the victim receives CPR from a bystander.
“We would advocate for parents knowing CPR, and particularly if they have a pool, they should become familiar and get trained in mouth-to-mouth rescue breathing,” said Dr. Michael Sayre, a professor of emergency medicine at the University of Washington in Seattle. “Whereas hands-only CPR is typically focused on someone who is not in the water and collapses suddenly for other reasons, people underwater die because of lack of oxygen.”
After Clay’s recovery, Metro founded a nonprofit called CPR Party, using the model of at-home shopping parties to encourage people to teach and learn CPR. The lessons aren’t equal to official CPR certification, Metro said, but “they will know what to do and hopefully, we create a bridge to certification. We just give them that basic knowledge to empower them.”
About one in five people who die from drowning are 14 years old or younger, according to the U.S. Centers for Disease Control and Prevention. And for every child who dies from drowning, another five receive emergency department care for nonfatal injuries, often including brain damage. The numbers are particularly discouraging, experts say, because in many cases, drowning is preventable.
“The biggest thing we try to get through to people is you need to maintain constant, active supervision when people are in the water,” said Adam Katchmarchi, executive director of the National Drowning Prevention Alliance. “Regardless of age and swimming ability, you should never swim alone. You should always swim around someone who’s keeping that vigilant watch over the water, whether that be a parent in a backyard pool or whether you’re swimming in a lifeguarded area.”
Courtesy Spectrum Health Beat
On its website, the NDPA stresses what it calls “layers of protection,” including swimmer training, facility safety and parental responsibilities designed to prevent drowning. Drowning can happen quickly and silently, without warning, Katchmarchi said.
“We’re used to the Baywatch drowning, where people see on TV that someone’s going to be waving their arms and screaming for help,” he said.
“An actual drowning victim, when they’re in that 20- to 60-second fight for survival, they’re unable to call for help because all of their energy is being used to keep their head above water. A lot of times they’re bobbing up and down, going under and re-emerging and trying to get air, so it’s really difficult for them to call out for help,” Katchmarchi said.
“It’s really easy to say, ‘Oh, I’m watching my kids,’ but you’re scrolling through Facebook or your Twitter feed. … Even if you’re distracted for just a short period of time, it can happen really quickly and really silently.”
She ordered remedies off the internet. She used over-the-counter medications that worked for friends. She visited multiple doctors in Northern Michigan near her Onaway home not far from the Mackinac Bridge.
But nothing could stop the hot flashes, night sweats, sleeplessness, weight gain and lack of energy she suffered during menopause.
“I started menopause three-and-a-half years ago,” Peterman said.
Life hasn’t been the same since.
She averaged 25 hot flashes or night sweats a day. Scalding. Miserable.
“All my friends in menopause said, ‘Try estrogen,’” Peterman said. “When I went on estrogen, the hot flashes disappeared.”
But another issue surfaced: migraine headaches.
She tried cutting the estrogen patch in half for a lower dosage. Migraines continued. She tried a quarter of a patch. Same result.
Peterman, who has worked for over three decades as a school superintendent’s administrative assistant, said the condition messed with her daily life.
“I saw a neurologist,” she said. “He checked for a brain tumor because I had visual migraines, with auras and pressure. They call it vascular migraines. They affect your vision and ability to drive.”
The neurologist ran multiple scans before finally discovering the culprit.
“He asked, ‘Are you by chance on an estrogen patch?’” Peterman said. “I took it off and threw it away. That was no longer an option for me.”
But what was? She needed to find someone who understood her symptoms and could assist.
“I tried cutting all caffeine out and exercising more,” she said. “I have no energy and just don’t feel good. No matter what you do or where you go, you are uncomfortable. I’ve never had anything like this and was so frustrated.”
She increased her exercise. Decreased her calories. Weight loss remained elusive.
“I wear a Fitbit to keep track of my steps, but it also keeps track of how many times you are up in the night and I averaged eight times a night. It gets to the point where I am just exhausted. I just pray my daughters don’t go through this.”
Frustrating. Tiring. But always warm.
“Some days I just hate the way I feel because I’m so sick of burning up and being sweaty,” she said.
Staying cool
In the winter, she keeps her bedroom thermostat at 50 degrees because of night sweats. Her husband piles on the blankets to keep warm.
“My husband (Tom) can look at me and tell,” Peterman said. “You can’t even disguise them. I use cool washcloths on my neck, dress in layers and drink a lot of ice water. I have bought a cooling mattress, cooling mattress pad and cooling pillows. If it said ‘cool,’ I bought it.”
She has spent more than $1,000 in search of a solution. But nothing worked. She knew it. Her husband knew it.
“When a hot flash starts, I go out on the porch in the winter and you can see the steam come off my body,” she said.
Perhaps not only physical steam, but emotional and spiritual steam.
With hope evaporating, and options dwindling, frustration built.
Peterman’s daughter, who lives near Grand Rapids and works at Spectrum Health was aware of unique services in Women’s Health and recommended the Midlife, Menopause and Sexual Health practice.
Peterman made an appointment with Natasha Peoples, NP-C, NCMP, a Spectrum Health Medical Group advanced practice provider who is specialty trained and nationally certified in caring for patients with menopause concerns.
“My daughter said you need to see a menopause specialist, your symptoms are extreme and beyond normal,” Peterman said. “My glasses were steaming up my hot flashes were so bad.”
Peterman had her first appointment with Peoples in late December.
Peoples took her off the medication another doctor had prescribed and put her on a new medication that other menopausal women found helpful.
Peterman said her hot flashes have dropped to about half of what she used to have, and she has also lost some weight.
For the first time in a long time, she feels hope.
“I keep a gratitude journal,” Peterman said. “I’ve always been a very positive person, happy and busy. It’s not that I’m depressed. I just don’t have the energy I used to have.”
Her seven grandchildren, with whom she spends as much time as possible, spur her on.
“I want to have energy to keep up with the seven grandchildren without struggling,” she said.
She credits Peoples for leading her on the first steps to improvement. Finally she felt “heard.” After three and a half years of chasing remedies, she’s experiencing her first symptom relief under People’s care.
“She’s a very sweet, compassionate person who is also very knowledgeable,” Peterman said. “Since she is a menopause specialist, this is what she does all day long and she sees every situation. She has already helped me and I’m hopeful she will continue to help me improve so I can get back the quality of life I had before.”
Complicated journeys
Menopause is different for every woman, according to Peoples, but Peterman’s journey has been particularly challenging.
“Diane’s symptoms are somewhat complicated due to the fact that she has hormone-mediated migraines, so hormone therapy is not an option for her,” Peoples said. “It’s not uncommon to experience the most severe and disruptive symptoms in the years just before or after the final menstrual period, as is the case for Diane.”
Making lifestyle changes and switching medications helped Peterman.
“Learning her triggers and patterns for hot flashes has been helpful,” Peoples said. “Being aware of how her daily habits can make a difference is a motivating factor. Her hot flashes have improved.”
Peoples said menopause transition symptoms—hot flashes, night sweats, difficulty sleeping, mood changes, vaginal dryness, decreased libido and irregular bleeding—are like an out-of-control roller coaster ride, “one that we hope to help them navigate.”
While some menopausal symptoms are genetic—think, “How was menopause for my mother?”—other symptoms can be related to lifestyle, according to Peoples.
“They are more severe for women who drink caffeine or don’t drink enough water, for those who don’t exercise and those who smoke,” Peoples said. “Weight gain and poor sleep can both be caused by menopause but also contribute to worsening symptoms.”
For women suffering from severe symptoms, it’s important for them to realize they are not alone.
“We all do it differently, but we all do it,” Peoples said. “Talk to your peers, talk to your provider and come and talk with us. We hope to help empower women to make the transition in a way that maximizes health and minimizes distress and discomfort.”
Take a hard look at your daily habits.
“Drink water, keep a good sleep schedule, exercise regularly, make healthy diet choices—watch out for sugar—and practice meditation or mindfulness,” Peoples said. “All of these choices will make a difference.”
Kimberlin is the American Academy of Pediatrics’ liaison to the U.S. Centers for Disease Control and Prevention’s advisory committee on immunization practices.
