Category: Health

Before the COVID-19 pandemic, Andrés Cantero tried to see his doctor every three months to discuss his treatment for HIV. He’d visit four times per year, asking questions about his antiretroviral medication, discussing side effects, and confirming he still had an undetectable viral load, meaning he could not transmit the virus to his partner.

But in the two and a half years since the COVID-19 pandemic hit, Cantero, a 32-year-old lawyer in California, says he has only been able to see his doctor in person twice. It’s been difficult to get an appointment, he says, initially because of lockdown restrictions and now because many offices have transitioned to telehealth—an option he finds pales in comparison to the care he received before the pandemic. His routine for treating his HIV has been completely disrupted, he says, and he worries others have had similar experiences, particularly in communities of color like his own Latinx community.

“I think for some people, with the stigma that comes with HIV, you don’t feel comfortable having these conversations with someone you can’t see [in person] and develop this level of trust,” Cantero says. “With communities of color that already feel disenfranchised with the medical community… people are going to feel less enfranchised to engage with the sources that are available.”

A report released by the LGBTQ media advocacy group GLAAD on Oct. 6 and first reported by TIME suggests that Cantero’s situation is not unique. The report—which analyzes peer-reviewed scientific literature along with 26 interviews with both people living with HIV and staff at community-based organizations—found that the COVID-19 pandemic significantly disrupted HIV prevention measures and patient care in the United States. As COVID-19 precautions and lockdowns superseded other public health concerns, services for HIV patients became limited, communities grew hesitant about health-care services, and the rate at which HIV tests—one of the primary tools for fighting the virus’ spread—were administered dramatically declined.

In June, the U.S. Centers for Disease Control and Prevention (CDC) reported that from 2019 to 2020, new HIV diagnoses reported to the agency decreased by 17%. Another study published in the journal the Lancet Regional Health–Americas in March, which examined HIV testing and HIV-positive rates in health care systems in Louisiana, Minnesota, Rhode Island, and Washington, found that from 2019 to 2020, HIV testing numbers decreased by 68% to 97%, and remained 11% to 54% lower than prior rates after some pandemic-era restrictions were lifted. A third study of patients at a Boston community health center published in the Journal of the International Aids Society in 2020 found that initiations of PrEP—an antiretroviral medication that prevents HIV infection—decreased by 72% from January to April of that year.

The GLAAD report warns there is now a “real risk” of an HIV resurgence in the U.S. The authors of the report propose several changes to streamline the fight against HIV as new medical crises, such as monkeypox, emerge. “We just lost two years,” says Sarah Kate Ellis, president and CEO of GLAAD. “We need folks to look up, wake up, and realize that we as a community and a country can walk and chew gum at the same time. We can deal with a major pandemic while not forgetting about our most marginalized folks.”

Lessons learned

The COVID-19 pandemic and the HIV epidemic interact with each other in sometimes deadly ways, exacerbating the problems discussed in GLAAD’s report.

People with HIV are more likely than people without HIV to be immunocompromised, putting them at a greater risk of death and disease from COVID-19. (One study published in Scientific Reports in March 2021, for example, found that being positive for HIV was significantly associated with a high risk of mortality from COVID-19.) As with HIV, COVID-19 has disproportionately affected marginalized communities, and the virus’ negative impact has been exacerbated by systematic racism, stigma, and economic disenfranchisement, limiting access to adequate medical care. One study published February 2021 in the journal AIDS Reviews found that one HIV prevention and treatment clinic in New York City that had been seeing more than 2,000 patients face-to-face in early March 2020 had shrunk down to under 100 per day in May 2020. The clinic transitioned to telehealth, and the results were mixed—as they were with many clinics.

Telehealth made accessing care easier for many patients. One survey of 202 patients with HIV at a clinic in San Francisco, California, published in the journal AIDS Patient Care and STDs in July 2021, found that 80% of respondents said they were equally or more likely to attend a telehealth visit as an in-person appointment. But the transition wasn’t always easy, as patients dealt with technical issues, barriers in digital literacy, and their distrust of speaking about stigmatized issues in a digital setting. One survey published in the journal AIDS Research and Human Retroviruses examining a HIV clinic in Georgia from March to May 2020 found that 40% of the clinic’s patients who had used telemedicine experienced delays getting follow-up appointments, 35% reported difficulty getting their viral load measured, and 21% reported difficulty accessing antiretroviral therapy. “Telemedicine provides us with a variety of options and a variety of providers,” says Shanell McGoy, senior director of public affairs and corporate citizenship at the biopharmaceutical company Gilead Sciences, which provided grant support for GLAAD’s report. “But there’s nothing like that in-person connection that can be established between a provider and a client.”

The report warns that the disruptions in HIV care and prevention over the past two-plus years could be felt for many years to come. In September, the San Francisco Department of Public Health announced that for the first time in nine years, the city saw an increase in the number of HIV diagnoses made from the previous reporting year.

To address these setbacks, GLAAD lays out five lessons to learn from the COVID-19 pandemic as communities prepare for the next health crisis. First, they call for more funding from a variety of sources, particularly in communities that might have limited access to accurate information on the risk and prevention of HIV. They also urge providers to find ways to give consistent care, including having telehealth and in-person options, and to offer a variety of services in one location, rather than directing patients to new locations for different services. And they suggest a streamlining of public-health campaigns using clear, simple language that discuss both the COVID-19 vaccines and HIV prevention. One medical crisis need not eclipse the other, GLAAD argues.

“There’s this level of invisibility that’s surrounded HIV since [its] inception and came back to light during COVID,” says Cantero, the lawyer in California. When reflecting on the past two years, he says “COVID kind of took over,” and made any other concerns related to his health “take the back seat.”

Write to Madeleine Carlisle at [email protected].

After a year of chemotherapy and radiation, doctors told Penelope Wingard in 2014 that her breast cancer was in remission. She’d been praying for this good news. But it also meant she no longer qualified for a program in North Carolina that offers temporary Medicaid coverage to patients undergoing active breast cancer treatment.

Wingard became uninsured. She’d survived the medical toll, but the financial toll was ongoing.

Bills for follow-up appointments, blood tests and scans quickly piled up. Soon, her oncologist said he wouldn’t see her until she paid down the debt.

“My hair hadn’t even grown back from chemo,” Wingard says, “and I couldn’t see my oncologist.”

Medical debt has sunk her credit score so low that she has struggled to qualify for loans, and applying for jobs and apartments has become a harrowing experience.

“It’s like you’re being punished for being sick,” Wingard says.

Earlier this year, when three national credit agencies announced new policies to deal with medical debt, consumer advocates celebrated, thinking it would provide relief for patients like Wingard. But it turns out the changes aren’t enough to help her or many other Black and low-income patients, who are often the ones hit hardest by medical debt.

“They’re just removing the small stuff”

Under the new policies, Equifax, Experian and TransUnion will remove from credit reports any paid debts or individual bills that were less than $500 and had gone to collections, even if unpaid. This doesn’t wipe out what people owe, but the idea is to remove the black mark of collections from their credit so they can more easily reach milestones like qualifying for a car or home loan.

The changes, which go into full effect in 2023, are expected to benefit an estimated 16 million Americans. But a federal report released this summer suggests those may not be the people who need it most.

“Although the credit reporting companies have trumpeted this as a big change, the fact is they’re just removing the small stuff,” says Ryan Sandler, a co-author of the report and senior economist with the Consumer Financial Protection Bureau. “They’re not maybe doing as good of a thing as their press releases would like you to believe.”

Medical debt is highest in Southern states that didn’t expand Medicaid

People burdened most by medical debt tend to be Black or Hispanic, low-income, and in the South. A nationwide KFF poll found 56% of Black adults and 50% of Hispanic adults say they have current debt due to medical or dental bills, compared with 37% of non-Hispanic white adults. And a study published in 2021 found medical debt was highest within low-income communities and in Southern states that had not expanded Medicaid.

But, Sandler says, “the population that is going to have all their collections removed is a little more likely to live in majority-white neighborhoods and high-income neighborhoods.”

Collections under $500 often result from an unpaid copay or coinsurance, Sandler says, and people with insurance are more likely to be richer and white.

Someone like Wingard — a Black woman living in North Carolina — is less likely to benefit from the credit companies’ new policies.

After Wingard’s oncologist cut her off, it took almost six months to find another doctor who would see her while letting bills go unpaid.

North Carolina has not expanded Medicaid, so despite her low income, Wingard, who is 58 and does not have young children, doesn’t qualify for the public insurance program in her state.

She estimates her total medical debt today is over $50,000. It’s not just for cancer care, but also bills for unrelated health problems that developed in the following years.

She has worked as an after-school teacher and tutor, a COVID-19 contact tracer and a driver for a ride-hailing service, but none of those jobs has come with health insurance benefits. Wingard says she tried to buy private insurance on the marketplace several years ago, but her monthly premium would have been more than $200, which she can’t afford.

That left her on the hook for bill after bill after bill. Her credit report shows five pages of notifications from collection agencies representing doctor’s offices, hospitals and labs.

Nearly 20% with medical debt fear they’ll never pay it off

Wingard is resourceful. She has hunted down clinics that work on sliding-scale fees, pharmacy programs that reduce copays and nonprofits that help cover health care costs. But it has not been enough to dig her out of debt.

In February, Wingard needed a specialized mammogram to check for cancer recurrence. Ahead of the appointment, she contacted a local nonprofit that agreed to cover the cost. But a few weeks after the procedure, Wingard received a bill for nearly $1,900. There was some miscommunication between the nonprofit and the hospital, Wingard says. While she tried to resolve the issue, the bill went to collections. It’s more than $500, so it won’t be removed even when the new credit agency policies take full effect next year.

“You fight so hard and you go through so much,” Wingard says. “Still, sometimes you don’t see any kind of relief.”

Nearly 20% of Americans with medical debt don’t think they’ll ever pay it all off, according to the KFF poll. Wingard has resigned herself to living with the ramifications.

“It makes you feel worthless, like you can’t do anything”

Her fridge and stove have both been broken for more than a year. She can’t qualify for a loan to replace them, so instead of making baked chicken from her favorite family recipe, she often settles for a can of soup or fast-food chicken wings instead.

In emergencies — such as when she needed to repair a broken tooth this fall — Wingard borrows from family. But it’s not easy to ask for money, she says. “It makes you feel worthless, like you can’t do anything.”

A study published recently found that medical debt leaves many people unable to pay for basic utilities, increases their housing and food insecurity, and can “contribute to a downward spiral of ill-health and financial precarity.”

How bad credit reports hurt job prospects

For Wingard, it has hurt her ability to get a job. She says two employers told her that poor credit shows up as a red flag on background checks and has led her to be turned down for positions.

Employers sometimes use credit reports as a “proxy on character,” explained Mark Rukavina, a program director with the nonprofit health advocacy group Community Catalyst. If two candidates are equally qualified but one has low credit or several unpaid debts, employers might consider that person less responsible, he says — despite research showing medical debt is not an accurate predictor of someone’s likelihood to pay bills.

Although the new policies from credit companies are unlikely to improve Wingard’s situation, consumer advocates say there are signs that society is starting to think about medical debt differently.

The Biden administration has advised federal lenders to no longer consider medical debt when evaluating loan applications and has asked the Consumer Financial Protection Bureau to investigate whether medical debt should ever appear on credit reports.

A federal law banning certain types of surprise medical bills went into effect this year, and some states have strengthened protections against medical debt by expanding Medicaid or holding nonprofit hospitals accountable for providing financial assistance to low-income patients.

In August, VantageScore, a company that calculates credit scores, said it will stop using medical collections in its formula.

Wingard is ready for swifter and stronger change. And she has an idea for how to get there: a march on Washington to demand relief from medical debt and universal insurance to reduce future bills.

“For a million people to gather up there and say we need better health care, I think that’d be history-making,” she says. “Maybe then they’ll recognize we need help.”

KHN (Kaiser Health News) is an editorially independent, national program of KFF (Kaiser Family Foundation).

Klaus Bartosch has formally resigned as CEO and managing director of Australian digital health group 1st group.

1st Group operates the health services marketplace MyHealth1st.com.au and telehealth platform Visionflex, which it acquired early this year.

In a statement, Bartosch, who helped co-found the company over a decade ago, said that while it has been a difficult decision, his resignation is “the right one for me personally and the right time for the company to move forward under new leadership as it enters its next phase of growth and development.”

“The Board thanks Klaus for his dedication and passion [in] leading 1st Group, which he has done since co-founding the business. He has helped position 1st Group with a great management team, a high-quality customer base and new opportunities for growth. We wish him well with his next ventures,” said 1st Group Chair Stephe Wilks.

Josh Mundey, who was appointed as Chief Revenue Officer in July, will replace him as acting CEO until the company’s board undertakes an international search for the position.

“As a shareholder and someone who is passionate about the business, I remain available to Josh and the team to ensure a smooth and successful transition. We have great customers and I am confident this next chapter for the Company will see it go from strength to strength,” Bartosch commented.

THE LARGER TREND

Bartosch’s resignation came over a year since he was reinstated as CEO of the company in June last year. Two months before that, he was replaced by Louise McElvogue as part of a restructuring. 

It may be time to rethink your approach to heart health.

For decades, the rate of heart disease in the U.S. had been steadily declining.

Heart disease remains the leading cause of death in the U.S., killing about 697,000 people each year. That’s 1 in 5 deaths.

But you can do plenty to protect yourself, said Araya Negash, DO, a board-certified cardiologist with Spectrum Health.

Here are seven things you can do right now to protect your heart:

1. Quit smoking

If you’re a smoker, you’ve probably been told hundreds of times that it’s a leading cause of heart disease and cancer. And yes, that includes vaping.

“Quitting smoking is far and away the most important thing people can do to help lower the risk of a cardiac event,” Dr. Negash said. “It not only helps people live longer but feel better while they’re alive.”

It’s not easy.

A smoker will typically make multiple quit attempts before succeeding. But it’s a winnable battle. About 60% of adults who smoked have since kicked the habit.

If you’ve tried and failed—and most former smokers fail at first—don’t go it alone. Contact the Spectrum Health smoking cessation program.

2. Know your blood pressure

Hypertension is widespread in the U.S., likely affecting 47% of adults. But experts say it’s often undiagnosed. And only 1 in 4 have it under control, according to the Centers for Disease Control and Prevention.

Getting your blood pressure checked regularly is a big component in this fight.

3. Check your cholesterol

Health care providers look at cholesterol levels—a combination of triglycerides, LDL and HDL—to determine the risk of atherosclerosis, a hardening and narrowing of the arteries. This increases your risk of heart disease and stroke.

Healthy adults aged 20 and older should have their cholesterol checked every four to six years.

4. Move more

Exercise and activity improve heart health. But they can also decrease anxiety and lead to better sleep, which reduces stress. Set a goal of at least 150 minutes per week of moderate activity, or 75 minutes of more intense exercise.

5. Manage stress

Simple relaxation breaks can work wonders.

While Dr. Negash doesn’t have a formal meditation practice, he does try to give himself five minutes of quiet, “whether that’s right before I go to bed or during my lunch break. I just sit and take a moment to breathe and try to clear my mind.”

He tries a different strategy on weekends, finding mindfulness in physical activity.

“For a few minutes when I’m walking, I won’t put my headphones in,” he said. “I shake off anything that’s on my mind—work, the family, what’s going on with Michigan State basketball. I just try and clear my mind.”

6. Challenge notions of healthy weight

America is suffering from an obesity crisis, with two-thirds of adults overweight.

Focusing only on the weight scale, however, can contribute to a demoralizing cycle of failed diets. Many experts are increasingly skeptical of using body mass index (based on weight and height) as the only yardstick.

Instead, talk to your health care provider about realistic goals. Losing even a small amount of weight can have powerful health benefits.

7. Reassess your cardiac risk

Talk to your provider about your risk of heart disease, taking into account your current weight, age and fitness level.

If you’re between the ages of 40 and 75, check out this simple health calculator by the American Heart Association.

Finally, look at the big picture.

“All these different things will definitely be good for your heart,” Dr. Negash said. “But they’ll also be good for many other things—your mental health, chronic pain and your gastrointestinal tract.

“Once we start taking care of our bodies and investing in our health by eating right, exercising, sleeping and managing stress to the best of our ability, there are benefits for all our organ systems.”

Corporate mental wellness platform MindFi and Fitbit (now part of Google) have undertaken a pilot study to assess the impact of using a combined fitness wearable device and mental health app on users. 

Their 10-week study engaged around 100 public school teachers in Singapore and evaluated their progress and lifestyle changes, including activity level, sleep and heart rate.

FINDINGS

Based on the survey, six in 10 participants said they are dealing with high levels of emotional exhaustion while over 50% reportedly have moderate to high-stress levels before the opening of a new school term. 

When they started using the combined health tech solutions, 60% of the participants saw a significant boost in their overall well-being and 42% said their physical health improved.  

The study also found that 54% reported better sleep quality and 45% showed an improvement in their resting heart rate.

In terms of mental health, depressive symptoms decreased among 58% of the participants; 57% said they were able to better cope with their workload. 

By the end of the study, 68% of the teachers said they would recommend the integrated MindFi and Fitbit solutions to colleagues.

WHY IT MATTERS

Local counselling service Singapore Counselling Centre conducted a survey last year where they found that among over 1,000 teachers, around 80% said their work has badly impacted their mental health during the pandemic. They cited the long work hours – clocking in more than 45 hours a week – as one reason. Over 60% of the participants also mentioned that their physical health was failing while 33% said they had become sickly.

THE LARGER TREND

In an effort to support the mental well-being of overworked and burned-out teachers, the Ministry of Education, together with the Ministry of Health Office for Healthcare Transformation, launched in late August an online portal that offers tips and strategies to manage their mental health and address workload issues. Called Mindline at Work for MOE, the online resource complements ongoing initiatives such as health screenings and wellness talks to support teachers’ health.

ON THE RECORD

MindFi and Fitbit’s latest study showed that an integrated wearable and mental health app solution could empower users to self-manage their overall health and well-being.

“With the increase in stress and burnout levels in the last two years, these results are further proof of the great role wearable technology and wellness solutions can play in driving positive behaviour change in populations,” said Steve Morley, director of Fitbit Health Solutions International and APAC. 

“The exciting results of our pilot study show that physical and mental health are closely related. Specifically, it shows that the future of mental health is to integrate it into our daily lifestyles via devices such as wearables,” noted MindFi founder and CEO Bjorn Lee. The study, he also mentioned, has emphasised the change that businesses need to make in their HR policies.

In the 100 days since the Supreme Court reversed Roe v. Wade, 66 clinics in the U.S. stopped providing abortion. That’s according to a new analysis published Thursday by the Guttmacher Institute, assessing abortion access in the 15 states that have banned or severely restricted access to abortion.

“Prior to Roe being overturned, these 15 states had 79 clinics that provided abortion care,” says Rachel Jones, a principal research scientist at Guttmacher. “We found that 100 days later, this was down to 13.”

All of the 13 clinics still providing abortions are in Georgia, where abortion is banned at six weeks before many women know they are pregnant.

Dr. Nisha Verma, an OB-GYN who practices in Georgia, said she has had to turn many patients away in recent months.

“I have had teenagers with chronic medical conditions that make their pregnancy very high risk and women with highly desired pregnancies who receive a terrible diagnosis of a fetal anomaly cry when they learn that they can’t receive their abortion in our state and beg me to help them,” she told President Biden and members of the White House Task Force on Reproductive Healthcare Access this week.

“Imagine looking someone in the eye and saying, ‘I have all the skills and the tools to help you, but our state’s politicians have told me I can’t,’ ” she added.

Nearly 22 million – or 29% – of women of reproductive age live in a state where abortion is banned or limited to six weeks gestational age, according to the report.

While 40 of the clinics in these states are still open for other services, the Guttmacher analysis found 26 clinics had completely closed down, which means they might never reopen.

“These clinics don’t have staff anymore, they probably moved their medical supplies to other facilities,” Jones explains. “So it’s not like they could open their doors tomorrow if these bans were lifted.”

The report also notes that the halting of abortion services at these clinics has a ripple effect through the health care system. As patients travel to the states where abortion is still legal for these services, clinics in those states are experiencing larger patient loads and patients face longer wait times.

Having to travel out of state can also complicate care. This has already happened to patients Dr. Sadia Haider treated in Illinois, a state surrounded by states that ban or restrict abortion.

“I recently saw a patient from a Southern state with a very serious obstetric condition, an abnormal placenta, [which] can cause severe hemorrhage and morbidity if not treated appropriately,” she explained during the White House event this week. The patient had already tried to get care in her own state and elsewhere before coming to Illinois.

“We were able to provide the care required for this patient, which was unfortunately more complex than it needed to be because there were several weeks that ensued before the patient sought care and eventually saw us,” Haider said.

Jones and her colleagues at the Guttmacher Institute expect the numbers of clinic closures to grow as more states pass abortion restrictions. “[Our] estimate is that ultimately there’s 26 states that are going to ban abortion, and again, we’ve only got 15 at this point,” she says.

She says the next states to watch – where bans have already been implemented but where abortions are still accessible for now – are Ohio, Indiana and South Carolina.

When turning in for the night, a surprising number of people aren’t in the dark.

That may lead to less restful Zzz’s and, eventually, bigger health troubles.

New research finds that even a single night spent in a too-bright room can impair glucose and cardiovascular regulation. This can raise the risk of developing heart disease, diabetes and metabolic syndrome.

“We talk about light a lot in sleep medicine because it’s what drives wakefulness in the daytime,” said Kelly Waters, MD, a neurologist specializing in sleep medicine at Spectrum Health.

“Bright lights cue your brain to say, ‘It’s daytime–time to be awake,’” she said.

But at night, exposure to the blue-light spectrum—TVs, computer screens and smartphones—can inhibit melatonin release.

“And that interferes with sleep,” she said.

The nervous system

A review of the sympathetic nervous system shows why too much light creates problems.

At its extreme, this system governs our fight-or-flight response. Even when we’re asleep, the nervous system is always paying attention.

That vigilance is why your alarm clock works, Dr. Waters said.

Too much light seems to keep the sympathetic nervous system more active, rather than letting you rest and get the necessary restorative qualities of sleep, Dr. Waters said.

“Even asleep, your brain is capturing data,” she said.

In deeper stages of sleep, however, the parasympathetic nervous system rules our “rest and restore” mode, she said.

There are different stages and types of sleep, all necessary for a good night’s rest. A complete sleep cycle lasts between 90 and 120 minutes. Most people cycle through all stages three to four times a night.

They include rapid eye movement, or REM sleep, which is associated with memory processing and accounts for about 10% to 20% of sleep time. It’s also associated with dreaming.

Non-REM sleep is divided into three stages. The first is drowsy, light sleep. This should account for no more than 5% of sleep time. The next is mid-level non-REM sleep, where we spend between 60% to 80% of our sleeping time. And then there’s the deepest non-REM sleep, which accounts for 10% to 20% of sleep time.

These deeper, non-REM stages make us feel refreshed.

“It’s very restorative. That’s where you get growth hormone release,” Dr. Waters said. “It’s a little like opening up lymphatic channels and recycling used nutrients so that you start your day fresh.”

Tame those electronics

While changing sleep patterns and habits is especially important for those battling insomnia or other sleep problems, everyone can benefit from more restful sleep.

Dr. Waters suggests people start by turning off their TV set or removing it from the bedroom entirely.

A poll from the Sleep Foundation reports that 53% of adults watch TV just before bed, often falling asleep while it’s still on.

That’s problematic, she said. First, a television emits the blue-light spectrum, sending confusing “Hey, it’s daytime!” messages to the brain.

Second, the flickering from scene to scene arouses the sympathetic nervous system.

“Your brain is paying attention, even when you’re asleep,” she said. “It’s disruptive.”

Blackout curtains can help, as they shut out streetlights and early morning sunrises. But be aware that prices and effectiveness can vary widely.

Bright clocks and flashing alarm clocks can also trigger alertness.

Dr. Waters said she’s a fan of alarm clocks that simulate sunrise.

“That starts to give people wakeful cues, just when they need them,” she said. “Morning is when you want to activate the brain and give it wakeful cues.”

Zeeland East High School student Allie Delost has always loved to run.

It started with neighborhood fun runs as a 3-year-old and, by fifth grade, it blossomed into competitive running.

“I really enjoyed it and I was one of the faster kids,” she said. “I could keep up with the boys.”

Later, she found her calling in track and field.

“I love the feeling of the wind in my hair, the crowd yelling,” Allie said. “I love it when the gun goes off. I just love the adrenaline rush that I get from it.”

In January, however, that excitement came to an abrupt halt when she suffered a severe hamstring injury.

It happened in a single stride.

“We were doing winter indoor training, and we were at the end of our sprint set,” Zeeland East High School track coach Lars Draeger said. “She was getting some good top-end speed, popping her knees up, but then she pulled through and went down really hard on the ground.

“Going over to her, I could see an avulsion on the back of her leg and just knew we had to get her to the hospital to get her stabilized.”

Draeger carried Allie to his car and drove her to Spectrum Health Zeeland Community Hospital, where the care team met Allie and her parents.

The diagnosis: a hamstring tear.

It would require extensive physical therapy.

“When it first happened, my initial reaction was, ‘I can’t believe this, I’ve worked really hard,’” Allie said. “I guess I over-strided a little bit. I felt it shift and felt it pop over the other ligament.”

When they returned home, Angie, Allie’s mother, could see her disappointment.

“She couldn’t put any weight on it and she was crying,” Angie said. “It hurt really bad. I think she felt kind of hopeless, as she was so excited and the season was starting.”

“I was super excited to run at Zeeland, not only because it was going to be my first year, but because of the reputation Zeeland has built for girls track and field,” Allie said. “I had a bunch of goals to come in and really help the program and genuinely get to know the girls.”

Pep talk

Not long before Allie’s injury, the Delost family had moved to Zeeland, Michigan, from Metamora, Illinois.

Allie was just getting into the swing of things as a junior at East Zeeland High School.

With this type of injury, she knew she’d have to table her goals for the indoor track season and instead focus on healing in time for outdoor track.

“It was really sad to think my dreams were going to be put aside for an entire track season,” she said. “It’s hard when you love something as much as I love track, to have to stay on the sidelines.”

She soon met with Zeeland Community Hospital physical therapist Eric Hamilton. She had already worked with him a few months prior for some chronic tendonitis in her ankle.

Hamilton quickly helped her put things into perspective.

“He said, ‘If you genuinely want this and if you want to work hard enough for this—if you want it bad enough—you can do this,’” Allie said. “He did a really good job of making me feel like, at the end of the day, I did have control over a lot more things than I thought I did.”

While she wouldn’t be able to run for a few weeks, she could accomplish other things.

“Eric definitely kept me moving,” Allie said. “I stretched every day. There were some funky stretches that stretched different parts of my hamstring that I hadn’t stretched before. It was great.”

Hamilton helped her set goals, too.

“Eventually, the goal was to qualify for state,” Allie said. “Then, after that, the goal was to place at state.”

Hamilton used blood-flow restriction techniques to build muscle, as well massages, dry needling and electrical stimulation. He helped Allie follow exercises that replicated movements she’d use in track.

“We have the equipment to make it feel like she was running track again, which helps with the buy-in,” Hamilton said.

He also used a pain-tolerated exercise approach, allowing Allie to feel some pain while her hamstring healed.

“I think in the end, it showed her you can push through some stuff and it’s not going to make it worse—it’s actually going to make it stronger, because we have to build that muscle back up to handle the stress and load,” Hamilton said.

They started with isometrics, then moved to full range of motion, then weighted movements. They later advanced to more biometrics and speed drills related to track and field movements.

At Spectrum Health outpatient rehabilitation – Zeeland, Allie practiced using runner’s blocks, simulating a race-type atmosphere.

“We can prep them as much as we can for the actual day,” Hamilton said.

Teamwork makes the dream work

Hamilton worked with Draeger and school athletic trainer Katie Putnam to develop a plan to get Allie healthy in time for her outdoor track season as a junior.

They targeted key races toward the end of the school year.

On their calendars, they all circled June 4, 2022.

The date of state finals.

As a team, they followed the plan.

“With Eric’s knowledge and expertise, he’s phenomenal,” Draeger said. “The cooperation we have between Eric and myself, the trainer and her parents, the rehab was very smooth.”

Allie’s mom could see it all come together.

“There was this mutual respect and collaboration amongst the team,” Angie said. “And Eric went above and beyond to ensure there was really great communication so she could have a good outcome.”

Also in Allie’s corner is her father, Matt, her brother, Ben, and the family’s two rescue dogs, Saffy and Liza Jane.

“I like hanging out with my dogs. They’re always reliable,” Allie said. “With my injury, they would lick my hamstring like they could tell something was wrong. They were a big part in helping me stay positive.”

Her faith buoyed her, too.

“We prayed a lot,” she said. “We know there’s a reason for everything and there’s a reason God put this challenge in front of me.

“If I can share my story and help other athletes, there’s always a reason for stuff. And we just believed there was going to be a reason for this—and the outcome was going to be good.”

‘She’s a tough kid’

With aspirations to run track in college, Allie knew that her performances in her junior and senior years would be important. She put full faith in Hamilton’s approaches.

“I tell my patients to trust me and trust the process,” Hamilton said. “She really did that. We were able to get her quickly back.”

Allie met with her trainer every day and followed the regimen.

“She’s a tough kid,” Hamilton said. “I was able to push her probably more than I would be able to push other people.”

Added Draeger: “She’s one of those girls who just wants to work, work, work. She has good leadership skills. Leading by example is one of her strong points. She always wants to be at the front of the pack with whatever drill we’re doing.”

Hamilton also worked to help Allie build confidence in all aspects of healing.

“As much as it’s physical therapy, what people don’t understand a lot of times, the mental side of it is important,” Hamilton said. “Especially nursing something that maybe, in their mind, is something they may reinjure at any moment.”

With sprinters, especially, hamstrings can be delicate.

“We prepped her as much as we could to show her that she could do this and her hamstring can take it, and her body can take it and she was ready to go,” Hamilton said. “That gave her a lot of confidence going into races.

“I told her every Friday, ‘Just go rip it’—to just go for it.”

‘Going to state is amazing’

Rip it, she did.

Competing in the outdoor track season in her junior year, Allie went on to break Zeeland East girls track records in five events: the 60-meter dash, 100-meter dash, 200-meter dash and the 4×100 and 4×200 meter relays.

Hamilton would check her results online after each track meet.

“I was as pumped for her as she was probably,” he said. “It feels good. She trusted all of us and when we told her to go rip it … she did. She killed it.”

She set a personal best of 12.4 seconds in the 100-meter dash at a meet in Jackson and placed eighth in the event at the state meet, earning all-state honors.

Both relay teams she participated in also placed at the state meet.

“Going to state is amazing,” Allie said. “It’s a feeling you can’t even describe.”

Now in her senior year, she has set goals to beat some school records.

She’d like to achieve the 100-meter dash in 12.1 seconds or 12.2 seconds. She hopes to place higher at the state championship meet next year—ideally in the Top 4.

Years ago, she also set a goal to run in college.

And she’s now being recruited to do just that. She’s considering multiple schools and she plans to pursue a career in nursing.

“I want to go somewhere I feel valued as an athlete, on and off the track,” Allie said.

As her senior year kicks off, she’s gained profound new lessons in overcoming adversity.

“Track, for me, relates to a lot of things in life,” she said. “This injury is a good example. No matter what you do in life, there’s always going to be bumps in the road. But it’s how you react to those bumps.”

What is an STI?

Sexually transmitted infections (STIs) are caused by bacteria, viruses or parasites that can be passed from one person to another during sex or intimate contact and most STIs are passed between sexual partners through oral, vaginal or anal sex – especially if you don’t use a condom.

If you are diagnosed with an STI you should avoid having sex with anyone until you have completed treatment. If you do have sex, the infection could be passed to your sexual partner.

General symptoms

If you have signs or symptoms of an STI it is best to go to a sexual health service to be tested in person.

Often people with STIs will get no symptoms at all or the symptoms will take a long time to show, meaning you could be passing infections on to other people without knowing it.

The only way to know you have an infection is to get an STI test.

STI symptoms vary from rashes, to pain when passing urine, discharge from the penis, vagina or anus, and lumps, or sores on the genitals and anus.

Some symptoms may also be internal – for example, pain inside your stomach, testes, pelvic or rectal area.

You can read more on types of STIs and their symptoms and treatment on the Sewwise website here.

What is an STI self-sampling kit?

Many sexual health services in the UK now offer free STI self-sampling kits for people who aren’t showing any symptoms or signs of a sexually transmitted infection (STI) and just want a routine check-up in the comfort and privacy of their own home.

These self-sampling kits can be used to test for the most common STIs, including chlamydia and gonorrhoea, as well as for other STIs such as syphilis and HIV.

The self-sampling kit will arrive in the post in a plain unmarked envelope or letterbox-friendly box and will have everything you need to take the samples, and a freepost return label to send them back.

You take samples yourself and then send them to a laboratory to be tested and get your results back in a few days.

Find out where to order free STI testing kits and find other free online services here.

When should I get tested?

It is a good idea to get tested, especially if you have recently changed partners or think you were exposed to an STI.

You don’t need to have lots of partners to get an infection, as many people with STIs have no symptoms and are unaware they’re passing on an infection to their sexual partner.

Regular testing for HIV and STIs is essential for good sexual health, and everyone should have an STI screen, including an HIV test, annually if having condomless sex with new or casual partners.

If you’re a student going to university for the first time or returning for a new year, it’s a good idea to get tested before you start having sex.

Women and other people with a womb or ovaries aged under 25 years who are sexually active should be screened for chlamydia on change of sexual partner or annually, and gay, bisexual and other men who have sex with men should test for HIV and STIs annually or every 3 months if having condomless sex with new or casual partners.

If you have had sex without using condoms in the last 3 days and think you were exposed to HIV then don’t wait for a postal test – find HIV post exposure prophylaxis (PEP) services here or for out of hours support you can get PrEP from A&E.

What’s included in the STI self-sampling kits?

The contents of self-sampling kits will depend on the answers you give about the types of sex you have.

Kits will include a combination of the following:

• Blood sample – this will be used to test for syphilis and HIV. A lancet (a small needle) is used to prick your finger and you collect drops of blood into a tube.
• Anal, vaginal, and throat swabs – these will be used to test for chlamydia and gonorrhoea. It is a small cotton bud swab that you insert and rub inside the area for a few seconds.
• Urine sample – this will be used to test for chlamydia and gonorrhoea.

Your kit will come with instructions explaining how to best take the samples and some also link to video guides online.

Getting your test results

Self-sampling test kits must be sent back to the lab for analysis. There’s a separate labelled freepost laboratory return envelope or box included within your kit.

Your personal details will not appear on any of the samples or the freepost label, postal test kits are completely confidential.

Your test results will be returned as soon as possible, often by text message – usually within a few days. If you do have an infection, you will be advised of how to get treatment and further support.

How do I get treatment?

If you have an infection, you will get advice about treatment and further support. Usually, you will be advised on what treatment is needed or, when necessary, make an appointment at a local sexual health service for treatment.

If you are diagnosed with an STI, it’s advised that you get treatment as soon as possible to prevent passing it on to your sexual partners or experiencing any long-term effects.

It’s also important to inform recent partners that you have been diagnosed with an STI and that they should get tested.

Typically, treatment will include a course of antibiotics, and may require you to pick up your prescription at a local pharmacy or attend a sexual health service in person.

Taking care of your feet is essential for your overall health and well-being, but it’s something that many people overlook. Your feet are complex structures of 26 bones, 33 joints, and over 100 muscles, ligaments, and tendons, and they work hard to support your body every day. It’s no wonder that they sometimes need a little extra care and attention. That’s where podiatrists come in.

Podiatrists are medical professionals who specialize in diagnosing and treating conditions affecting the foot and ankle.

Here are reasons why you should see a podiatrist

To Treat Foot and Ankle Pain

If you’re experiencing pain in any part of your foot or ankle, it’s worth talking to a podiatrist to get to the bottom of the problem. Podiatric assessment and treatment can help relieve pain and improve function. Common causes of foot and ankle pain include plantar fasciitis (heel pain), Achilles tendonitis (ankle pain), bunions, neuromas (nerve pain), and stress fractures. A podiatrist diagnoses the cause of your pain and recommends a course of treatment to help you find relief.

To Prevent Foot Problems from Getting Worse

If you have a foot problem that’s not causing pain, you might be tempted to ignore it. But even minor issues worsen over time if they’re not treated properly. For example, bunions are deformities that occur when the bones in your big toe joint move out of place. They can be painful, but even if they’re not causing discomfort, they will gradually worsen if they’re not treated. The same goes for hammertoes, heel spurs, and other conditions. Seeing a podiatrist Dallas helps you catch problems early on before they have a chance to worsen.

To Keep Your Feet Healthy as You Age

Your feet go through a lot of wear and tear over the years, leading to problems down the road, such as arthritis or loss of feeling in your feet due to nerve damage. Podiatrists can help you keep your feet healthy as you age by identifying problems early on and developing a treatment plan to prevent further damage. For example, podiatrists can prescribe orthotics (custom-made shoe inserts) to help relieve pain and prevent further damage to your feet.

For Athletes

If you’re an athlete, you put a lot of stress on your feet and ankles. Podiatrists can help you avoid injuries by fitting you for custom-made shoes and orthotics to support your feet. They can also treat injuries such as Achilles tendonitis, stress fractures, and plantar fasciitis.

To Improve Your Overall Quality of Life 

Many people don’t realize their feet’ importance until they start having problems with them. When your feet hurt, it is difficult to walk or even stand for long periods, which significantly impacts your quality of life. Seeing a podiatrist in Dallas regularly helps keep your feet healthy so you can stay active and do the things you love without pain or discomfort holding you back.

To Prevent Infections

While your feet may seem tough enough to withstand anything, they’re quite susceptible to infections, especially if you have diabetes or poor circulation. One common infection is athlete’s foot, caused by a fungus that grows in warm, moist environments (like sweaty shoes). If left untreated, an athlete’s foot leads to more serious problems such as blisters or ulcers. Another common infection is nail fungus, which usually starts as yellow or white spots under the tip of your fingernail or toenail (but it can affect any part of your nail). Nail fungus is difficult to treat on your own, so it’s best to see a podiatrist if you think you may have it.

To Prevent or Treat Diabetes-related Foot Problems

Diabetes can cause nerve damage, which leads to problems with sensation in your feet. This makes it challenging to discern injuries or wounds on your feet. Diabetic foot ulcers are common in people with diabetes and can lead to severe complications if left untreated. A podiatrist helps you care for your feet and avoid potential problems associated with diabetes.

To Prevent or Treat Ingrown Toenails

An ingrown toenail occurs when the edge of the nail grows into the flesh of the toe. This is often painful and even leads to infection if not treated properly. A podiatrist in Dallas prescribes medication or performs a “nail avulsion” procedure to remove the ingrown portion of the nail and allow it to grow back correctly.

To Improve Your Balance and Prevent Falls

As you age, your fall risk increases due to declining muscle mass, vision changes, and medications that cause dizziness or drowsiness. Falls lead to severe injuries, such as hip fractures or head trauma, so it is essential to take measures to prevent falls from occurring in the first place. A podiatrist helps you identify any issues with your feet that may contribute to falls and provide treatments to improve your balance and decrease your fall risk.

For Children’s Foot Health

Parents must take their children to see a podiatrist regularly, even if they aren’t experiencing foot or ankle problems. Children’s feet are still developing, so it’s essential to ensure they are healthy and growing properly. A podiatrist in Dallas can guide children’s foot health and offer advice on choosing the right shoes and socks and when to start wearing orthotics if necessary.

People with Flat Feet

Flat feet (also called “fallen arches”) are a condition in which the arch of the foot collapses, leading to pain and problems with walking or standing. People with flat feet are more susceptible to injuries, so you must see a podiatrist if you think you may have this condition. A podiatrist prescribes arch supports or custom orthotics to help treat flat feet and improve your symptoms.

For Pregnant Women

Pregnancy causes several changes in your feet, including swelling, flat feet, and heel pain. These changes are due to the extra weight you carry and the hormones that relax your ligaments and joints. A podiatrist helps you manage these changes and provide relief from foot pain.

Conclusion

Whether you’re dealing with a foot or ankle injury, struggling with a chronic condition such as diabetes, or want to keep your feet healthy, a podiatrist can help. Podiatrists are trained to diagnose and treat problems with the feet and ankles, so they can help you get back on your feet and improve your quality of life. If you think you may benefit from seeing a podiatrist, make an appointment with one today.