Health Articles


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Whether you are a seasoned athlete or a weekend workout warrior, it is important to stretch before and after a workout. The benefits of stretching go far beyond flexibility. When done properly, stretching can:

  • Enhance physical fitness
  • Enhance ability to learn and perform skilled movements
  • Increase mental and physical relaxation
  • Enhance development of body awareness
  • Reduce risk of injury to joints, muscles and tendons
  • Reduce muscular soreness
  • Increase suppleness due to stimulation of the production of chemicals which lubricate connective tissues
  • Reduce severity of painful menstruation in females.

Unfortunately, even those who stretch do not always stretch properly and hence do not reap some or all of these benefits. Some of the most common mistakes made while stretching are:

  • Improper warm-up
  • Inadequate rest between workouts
  • Overstretching
  • Performing the wrong exercises
  • Performing exercises in the wrong (or sub-optimal sequence)

There are several elements to a good stretch. Ideally, a particular stretch should work only the muscles you are trying to stretch. In general, the fewer muscles you try to stretch at once, the better. By isolating the muscle you are stretching, you experience resistance from fewer muscle groups, which gives you greater control over the stretch and allows you to more easily change its intensity.

Another important aspect of stretching is leverage. Having leverage during a stretch means having sufficient control over how intense the stretch becomes, and how fast. If you have good leverage, you have greater control.

Remember not to stretch too far beyond the point of comfort. If you begin to feel pain during a stretch, chances are you are overdoing it.

Stretch often. Stay flexible.


A Better Night's Sleep

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  Sleep Patient - Greg Budweg 

“I’ve got a lot more zip now,” says restaurant owner Greg Budweg. 


For Greg Budweg, the quest for great sleep began with a picture in a magazine. While waiting to see his doctor a few years ago, the Hubbell man flipped to a photo of a woman sleeping soundly.

Greg ripped out the picture and showed it to Dr. Joseph DellaValla.

“I want to sleep like this, doc,” he said. Greg spent his nights tossing and turning. “I’d wake up more tired than I was when I went to bed,” he said.

Greg worked with Dr. DellaValla and the team at the Portage Health Sleep Disorders Center to achieve his goal of healthy sleep.

An overnight sleep study confirmed that Greg was one of the 40 million Americans who have a sleep disorder. Obstructive sleep apnea (OSA), which causes temporary stoppages in breathing, was robbing Greg of the rest he needed, sapping his energy and jeopardizing his health.

OSA and other sleep disorders, including snoring and insomnia, can contribute not only to sleepless nights, but also pose serious risks to physical and mental health, said Dr. DellaValla. He is one of just three physicians in the Upper Peninsula who has earned board certification in Sleep Medicine.

In the short term, people with OSA frequently are sleepy during the day, Dr. DellaValla said. This makes for poor quality of life, and has been shown to dramatically increase the risk for car crashes. In the long term, OSA has been associated with an increase in high blood pressure, diabetes, depression, stroke, heart attack and sudden death.

Greg began using a CPAP machine, a device that regulates his breathing while he sleeps. The change in the quality of his sleep – and in his life -- has been gradual, but profound. Sleeping well has boosted Greg’s energy level at home and at work at Jim’s Pizza, the restaurant he owns in Hancock.

“Getting enough sleep makes a big difference,” he said.

In 2006, Greg was one of the Sleep Disorders Center’s first patients. In 2008, the growing center moved into a brand-new location in Hancock. The state-of-the-art facility offers amenities that you won’t find at any other sleep lab in the western Upper Peninsula, including private rooms furnished with Sleep Number adjustable beds and plasma televisions.

Greg said that he would encourage anyone who has trouble sleeping to get checked out at the Sleep Disorders Center.

“Slowly but surely,” he said, “you’re going to feel a lot better.”

Sleep: Small changes can have big benefits

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We all know that getting enough sleep improves our overall health. More specifically, research has shown that healthy sleep staves off serious health problems like obesity, diabetes, heart disease and stroke. Getting the right amount of good quality sleep also improves our quality of life, resulting in improved mood, energy level and alertness.

In the last year or so, new research has reinforced the relationship between sleep and good health. Several groups have recently published their results regarding how obstructive sleep apnea (OSA), a common disorder where recurrent pauses in breathing interrupt our sleep, impacts our long-term health prospects. One group analyzed all available data on the proposed connection between OSA and automobile accidents. They confirmed that drivers with untreated OSA are roughly three times more likely to cause an accident compared with drivers without the disorder.

Keeping their eyes on the big picture, three independent groups published data on OSA and risk of death from any cause. Taken together, the three groups followed more than 8,000 patients. Severe obstructive sleep apnea was found to be an independent risk factor for death in all three studies.

Insomnia also gets a lot of attention from medical researchers. Over the past several years, research has connected inadequate sleep to both weight gain and the development of diabetes. New research now suggests that insomniacs who get too few hours of sleep each night have an increased risk of developing high blood pressure, a major cause of heart disease and stroke.

Car crashes, high blood pressure, death? Scary stuff! The good news is getting a good night's sleep doesn't have to be impossible. We can make some important changes on our own. One less cup of coffee or one less television program can make a big difference. Keeping a regular sleep schedule, even on weekends and holidays, can also help. Tobacco, whether smoked or chewed, can keep us awake and should be avoided before bed. If you can't fix things on your own, your doctor can help. Your doctor might tweak your sleep habits, recommend a medication or ask you to see a sleep doctor.

When it comes to obstructive sleep apnea, patients usually need an overnight sleep test (called a polysomnograph) to figure out if they have it. Signs you're at risk include loud snoring, feeling tired or sleepy despite a normal night's sleep and being told you stop breathing while you sleep.

Recent research has only reinforced the relationship between sleep and wellness. Sleep well and stay healthy!

Men's health: keeping that motor running

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Most men realize the importance of proper maintenance to keep their homes and automobiles running smoothly. Unfortunately, when it comes to their health, men often overlook simple and effective strategies that could potentially save their lives.

Heart disease, cancer and stroke have become the leading causes ofillness and death in adults of both genders, but heart disease and stroke affect men at an earlier age than women. Health maintenance strategies for men also focus on prevention and screening for prostate and testicular cancer.

Many health problems men experience can be prevented by developing healthier lifestyles. A good diet and regular physical activity have been proven to reduce the risk of high blood pressure, diabetes, heart attack, stroke, colon cancer, depression and memory loss. Walking 30 minutes daily five times a week is a simple and effective start to living longer and healthier.

Use of tobacco products greatly increases the risk of stroke, heart attack, and emphysema. Men who use tobacco have much higher rates of various cancers including lung, mouth, throat, stomach, and bladder. Prostate cancer rates may be higher in smokers, also.

Alcohol abuse increases the risk of accidental trauma and contributes to health problems includingliver disease, cancer of the esophagus and stomach, and damage to the nervous system. Regular consumption of more than two alcoholic drinks daily may indicate problem drinking.

Unfortunately, some medical problems are unpreventable, so screenings are an important part of health maintenance. Just as women perform regular monthly breast self-exams, men should examine their testicles monthly between age 15 and 35 and advise their physician if they notice anything out of the ordinary or causes them concern. Men who have a father or brother with prostate cancer are at increased risk and should consider having their prostate examined by a doctor and having blood drawn for a PSA (prostate specific antigen) test beginning around age 45 to 50. Colon cancer screening should begin at age 50 and include a rectal examination and colonoscopy every ten years until age 75 for most men.

Screening for high blood pressure, diabetes, and high cholesterol should begin in middle age. Earlier screening for diabetes and hypertension is recommended for men in their thirties if they have risk factors of obesity or a family history.

Helping your kidneys do their job

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Everyone knows that kidneys are important organs we can’t live without, but most of us don’t know everything our kidneys do for us. Besides making urine, kidneys play a vital role in fighting anemia, maintaining blood pressure, and healthy bone maintenance.

Those bean-shaped, fist-sized organs are located near the middle of the back, just below the rib cage, on both sides of the spine. They are made up of millions of nephrons; tiny filtering units that can clean 200 quarts of blood and produce about two quarts of urine per day.

Within the nephrons are the glomeruli (tiny blood vessels) that are intertwined with tubules (tiny urine-collecting tubes). These very tiny structures are where the complicated filtering actually takes place. The glomeruli must keep normal proteins and cells in the blood, but allow the wastes and extra fluids to pass into the tubules and enter the urinary system.

The wastes are the results of normal cell function and the food and medications we consume. If the glomeruli are unable to remove all of the wastes, they build up in our blood and damage our bodies.

Do you know how well your kidneys are functioning? Most people do not. Kidney disease is a silent disease, causing no noticeable symptoms until it is quite advanced.
Fortunately, there are ways of detecting kidney disease that should be performed routinely, especially for people with conditions such as diabetes, that put them at higher risk for its development.

Kidney Function Tests

eGFR is the acronym for estimated glomerular filtration rate. It is a calculation of how well those little glomeruli are able to filter the blood. In the laboratory, a person's blood is tested for creatinine levels. Creatinine is a waste product created by normal breakdown of muscle cells. A patient’s age, sex and race are taken into consideration when calculating the eGFR. This number estimates how well the glomeruli are clearing wastes from the body.

Chronic Kidney Disease

eGFR is our best indicator of how well the kidneys are working. An eGFR of 90 or higher is considered normal. If the eGFR stays below 60 for three months or longer, a person is considered to have chronic kidney disease (CKD).

eGFR 30-59: This stage of CKD is considered moderate. At this stage, hormones and minerals are thrown out of balance, causing anemia and weak bones.

eGFR 15-29: This is considered severe, and serious consideration must be given to treating the complications of CKD. A patient's doctor may refer a patient to a nephrologist (kidney specialist) who can discuss treatment options.

eGFR < 15: At this point, the kidneys can no longer filter well enough to maintain life. Dialysis or a kidney transplant must be done.

Dialysis consists of being hooked up to a machine that cleans the blood for about four hours a day, three days a week for the rest of a person's life. If a patient travels for work or pleasure, the schedule must be maintained. The patient must arrange ahead of time to travel somewhere where there is a dialysis center.

Prevention — Our Best Medicine 

Hypertension: Hypertension (high blood pressure) damages the blood vessels in the kidneys. Keeping blood pressure under control helps to preserve kidney function. A patient with hypertension may be prescribed medication to lower the blood pressure and help protect the kidneys.

Keep blood glucose under tight control: Research has shown that keeping average glucose levels below 150mg/dL (A1C less than 7 percent) can result in a 50 percent decrease in the development and progression of CKD.

Points To Remember

  • Get regular screenings
  • Control blood pressure
  • Control blood glucose
  • Know your numbers

Chronic Kidney Disease (CKD) is stealthy. It provides us with no obvious warning signs. It takes us by surprise. Diabetes is the leading cause of CKD, accounting for about 44 percent of kidney failure in the United States.

How to choose a home health agency

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Home health care services range from high tech pharmacy services, skilled professional and paraprofessional services, and home services delivered to your home. Generally, home health care is ordered and initiated by a physician when a loved one is no longer able to care for themselves due to adverse changes in their health.

Services provided by home health agencies can be divided according to their specialty area:

High-tech pharmacy services include:

  • Infusion Therapy
  • Ventilator management
  • Diagnostic Services (lab/x-ray)

Skilled professional home health agency services include:

  • Nursing provided by a registered nurse (RN) or a nurse practitioner.
  • Licensed practical nurse (LPN)
  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Medical Social Work

Paraprofessional services include:

  • Home Health Aides
  • Personal Care Assistants
  • Physical Therapy Assistants
  • Certified Occupational Therapy Assistants (COTA)

Home services include:

  • Homemaker and housekeeping services
  • Live-in services
  • Hourly or shift coverage
  • Home companions

According to Tammy Carroll, director of Portage Health Home Care and Home Services, there are several things to consider when choosing a home health agency for you or your loved one.

  1. Is the home health agency Medicare-certified?
    Medicare establishes minimum requirements for home health agencies to provide care to those withMedicare benefits. Many health insurers require Medicare certification for an agency to provide care to their members. Departments of public health review home health agencies regularly to insure adherence to these requirements.
  2. Does the home health agency use its own employees or do they rely on contract staff? Home health agencies employ full-time and part-time professional staff. Home health agencies often cannot find adequate nursing, rehabilitation, or home health aide staff to meet all of their patients' needs. Many agencies contract with other providers or staffing agencies.
    You should choose a home health agency that can provide the majority of your care with its own staff. Inconsistent staffing can be disruptive for patients. If contract staff is used, ask what role the agency has in hiring and supervising contract employees.
  3. What are the home health agency’s hiring standards for professional and paraprofessional staff? Each home health agency establishes hiring standards according to the type of services the employee provides. Some of these requirements include:
    • Verification of professional licensure for clinical staff, minimum educational requirements and prior home health experience
    • Verification of paraprofessional staff's certification by an approved board, and annual competency skills assessment testing
    • Criminal Offense Record Inquiries checks
    • Annual in-servicing and continuing education for all employees
  4. What is the home health agency’s process for scheduling visits? Home health agencies take into account overall agency needs as well as the needs of the individual patients when scheduling visits. Circumstances such as holidays, illnesses and weekends force agencies to prioritize staffing. Often, staff members arrange to visit at a certain time, but emergencies come up that delay or postpone a visit. It's important that patients and families remain open to the possibility of changes in visit schedules. It is equally important that patients notify the agency if they are not going to be home for a scheduled visit.
  5. What payment sources do home health agencies accept? Home health agencies accept payment for services from a variety of sources. If the agency isMedicare-certified, skilled home health services will be covered according to Medicare rules. MostMedicare-certified home health agencies also accept payment from Medicaid or state-sponsored health insurance. Individual insurers and managed care plans contract with selected agencies that meet their requirements and cover home health services according to their benefits.
  6. How does the home health agency coordinate care with my physicians and other health care providers?
    Communication is key to achieving your healthcare goals. Agency nurses and therapists should monitor your care and regularly report progress or changes to your physician. Agencies should immediately contact your physician if there is a sudden change in your health and if there is a need to change any treatments. At a minimum, the agency must verify the doctor's orders every 60 days.
  7. Does the home health agency make nurses available for emergencies?
    During regular office hours, an agency may be able to provide an urgent home visit to assist with non-life threatening emergencies. When offices are closed, agencies still generally make a nurse available for urgent situations. The nurse may not be available to make a visit, but will answer calls and advise patients and families over the phone. Some agencies employ an answering service to inform the nurse on call.
  8. How do I voice my concerns with the agency?
    Home health agencies strive to provide high-quality care. However, you may encounter problems during the course of your relationship with the agency. If a patient or family member feels that the care received was inadequate, they should inform the agency. Many agencies request that patients complete a satisfaction survey once services have ended.
    You should play an active role in selecting the agency that will be providing care to you or your loved one. Educating yourself about the requirements and services offered by agencies is the best way to make the most informed decisions. Knowing which agencies meet your individual needs enhances the likelihood of a successful recovery.
    Locally, Portage Health Home Care and Home Services provide expert home health care. When your family or loved one needs care at home, call (906) 483-1160 or (800) 573-5001 (toll free) for reliable, caring service.

For the safest summer ride, strap on your helmet

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Boy with Bike HelmetSummer days in the Keweenaw are made for cruising on your bicycle. Some folks love to zip along on a sleek racer, while others prefer to pedal a sturdy mountain bike. Once in a while, you’ll even catch a pair of riders sharing an old-fashioned tandem bicycle built for two. No matter which type of bicycle you ride, there is one accessory that’s a must for every bicyclist: A helmet.

Wearing a helmet is the most important — and simplest — safety measure you can take to protect yourself against serious injury while riding your bicycle.

Here are some tips to make sure your helmet fits properly:

  • The helmet should be level on your head.
  • When you look up, the front rim of the helmet should be barely visible to your eye.
  • The Y of the side straps should meet just below your ear.
  • The chin straps should be snug against your chin, so that when you open your mouth very wide, the helmet pulls down a little bit.
  • Move the helmet from side to side and front to back. You should feel the skin around your eyebrows move slightly with the helmet. If it doesn’t, the fit pads are probably too thin in the front or the back, or the helmet may be too large.
  • If the helmet has a rear stabilizer, make it snug under the bulge on the rear of your head.
  • Put your palm on the front of the helmet and push up and back. If it moves more than an inch forward, more fitting is required.
  • Shake your head around. If the helmet dislodges, work on the strap adjustments.
  • Make sure your helmet is comfortable! Try on several different helmets so that you can choose the one that fits you best.

Once you’ve got your helmet strapped on, keep an eye out for the Portage Health Helmet Incentive Team. We’re cruising the Keweenaw this summer, keeping an eye out for kids who are wearing their helmets properly while biking, rollerblading and skateboarding.

Happy riding!

Concussion: More than a bump on the head

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A concussion is an injury to the brain caused by a blow to the head. A concussion may cause you to become temporarily confused or disoriented, have memory loss (amnesia), or become unconscious. Concussions are the most common head injuries in sports.


If you have had a concussion, you may have any of the following symptoms: 

  • Headache
  • Confusion
  • Memory loss (amnesia)
  • Loss of consciousness
  • Sleepiness
  • Nausea or vomiting
  • Trouble concentrating
  • Dizziness
  • Weakness
  • Seizures
  • Loss of balance

These symptoms, called post-concussive syndrome, can last for several days or weeks after the injury.

How is a concussion diagnosed?

Your healthcare provider will examine you and find out what happened. Your evaluation includes a neurologic examination, testing your strength, balance, reflexes, and memory. Additional tests may be ordered such as an X-ray called a computed tomography (CT) scan, a magnetic resource image (MRI) to make sure there is no damage to your brain, or specialized brain function tests and possibly spinal X-rays.

What treatments are available for concussions?

The treatment for a concussion is rest. Headache may be treated with a pain reliever. Nausea may be treated with a medication. If you have a concussion, you need to be watched by a friend of relative for 8 to 12 hours. Your provider may want you to be awakened and checked every 2 to 4 hours. If you experience any of the following, you should proceed to the emergency room.


In collision and contact sports, it is important to wear appropriate headgear and mouth pieces that are fitted properly. In sports such as football, it is important to use proper blocking and tackling techniques and not to use your head for initial contact. In sports such as bicycling or rollerblading, it is important to wear a helmet.

Prior to returning to your activities, you should seek approval from your medical provider. Concussions can be severe. Receiving a second blow to the head before the first injury is fully healed can be fatal, even if the second injury seems minor.


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