Giving Thanks at the Table

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By Kristina Ward, MAS-MFT, LMFT | NOAH Marriage & Family Therapist

Family life is usually busy: with mornings consisting of getting kids moving and out the door, sometimes even fed, and afternoons that include sports, homework, and general catch up. Family meal times have frequently become an occasional activity, just for the days of the month that aren’t horribly hectic and on the run. Between work, children, social media, and other activities, family meal time is often a chore to be avoided. But, the benefits of a regular family meal time is measurable. Studies have shown that regular family meal time together improves the overall outcome of relationships.

In couples with no children, be they pre, post, or no children, regular meals together reduce the levels of conflict within the relationship. Couples are more frequently able to resolve, come to a compromise, or even agree to disagree. The couple increases the level of friendship and companionship during the time spent together. In families with young children, the meal time together has the same protective factor in the couple relationship and improves the overall relationships at the meal allowing for increased conversation and interaction. As parents model communication and interaction, these young children improve in the ability to listen and respond.  Additionally, the conversation at family meals leads to developmental changes in the children. Regular conversation, including and around, young children helps to develop the child’s vocabulary. In families with older children, family meal time is a time to learn the family culture and develop a sense of “who I am” as part of the family system. 

Family meal time has protective factors on the mental health of the family members as well. Allowing children to express his or her thoughts in an opportunity for self-esteem to improve, improve school-related activities, and for the child-parent bond to increase, which in turn decreases the risk of early sex in pre-teen and teenage relationships. Another protective factor observed in regular family meals is the reduction in patterned disordered eating (which can lead to eating disorders), reduce the risk of substance abuse, and an improvement in health. Additionally, multiple studies from Europe to Japan to the US have shown regular family meals decreases depression in all age groups. 

Family meals do not need to be every day or every dinner. Family meals can be breakfast together on Saturday mornings, Friday night pizza, or Sunday brunch. Scheduling the regular meal times and the family expectation that everyone will be there is the important factor. If the kids have late start on Wednesday mornings, schedule breakfast to be at 6:30am before parents have to leave for work. No time to cook, have cold cereal! Make meal times a social event. Couples can make the meal together, eat, and clean up together. Parents can take turns teaching the children how to cook and prepare meals. The goal is to increase the moments of regular togetherness.

Tell me and I forget, teach me and I may remember, involve me and I learn.

Benjamin Franklin

Sharon M. Fruh, Jayne A. Fulkerson, Madhuri S. Mulekar, Lee Ann J. Kendrick, and Clista Clanton. (2011). The Surprising Benefits of the Family Meal. The Journal for Nurse Practitioners. January 2011, 7 (1) 12-22.

Megan E. Harrison, Mark L. Norris, Nicole Obeid, Maeghan Fu, Hannah Weinstangel, and Margaret Sampson. (2015). Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. Canadian Family Physician. February 2015, 61 (2) e96-e106.

Stay Healthy and Happy This Holiday Season

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By Stanley Aladi, BA and Mimi Hauber, BS | Behavioral Health Technician Leads

The holidays are supposed to be fun and joyful, right? Right! However, with the holiday season comes stress and, in some cases, even depression. Being realistic, planning ahead, and seeking support can help.

Be Realistic

Shopping, wrapping. baking, decorating, and even attending holiday parties and events can leave you feeling overwhelmed during the holiday season. Remember, you don’t have to do it all. Pick a few things that are most important to you and your family. If you always decorate inside and outside, just choose one and alternate year after year. Families change and grow and so do traditions. Select a few to keep and incorporate new traditions, especially ones that aren’t a ton of work.

Sticking to a budget is also important during the holidays. Prior to shopping for gifts and groceries, decide what your budget is and don’t go over it. Money does not buy happiness.

Set realistic expectations for relationships too. Just because it’s the holiday season doesn’t mean everyone suddenly gets along. Setting aside your differences is important. Accept your friends and family as they are even though you may not agree with some of their thoughts and behaviors.

Plan Ahead

Planning ahead can also be helpful in alleviating holiday stress. Set aside certain days to shop, wrap, bake, decorate, and connect with family and friends. Breaking up everything you have to do into manageable blocks of time will help reduce the anxiety that comes with last-minute scrambling. 

Learn to say “no”. You’ll be appreciated a lot less if you are feeling resentful and overwhelmed because you put too much on your plate. If you feel you must help, add time for those projects into your agenda when planning ahead. Be sure to manage expectations by understanding what’s being asked of you and don’t take on additional tasks that weren’t on your original agenda.

Take Time for You

Self-care is important, especially during the holidays. Find something to help clear your mind such as breathing exercises, going for a walk, listening to music, or going for a drive. Spending 15-minutes alone with no distractions can help restore your “inner calm”.

Sometimes just having someone to talk to can ease the burden of a stressful situation. Call a trusted friend or family member and talk about anything! Get your mind off of what’s stressing you out or hit the topic head-on, you’ll know what works for you by how you feel after the conversation. Additionally, there are social media channels, support groups, and even online events that can provide a support system to help ease the tension.

While many people experience stress during the holiday season because there’s just too much to do, sometimes people feel anxious and depressed because they don’t have a packed agenda for the holidays. If you or someone you know feels isolated or lonely, reach out to your community. Get involved in social events through work, school, or even the church you attend. Dedicating some time to volunteering is another great way to fill your schedule and lift your spirit.

It’s important to know when symptoms are becoming unmanageable and you need to seek help. If you’re feeling sad, anxious, irritable, hopeless, or unable to sleep or do your daily tasks, it might be time to reach out to a professional. Mental health providers have tools to help you feel better by talking through and processing your feelings. There is nothing wrong with asking for help! Make sure that you are prioritizing your mental health because we all need time to recharge.

Learn more about NOAH’s counselors and how you can request an appointment here.

ACA Open Enrollment is Here!

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Having health insurance is one of the best ways to take care of yourself and your family. Whether it’s through an employer, the Health Insurance Marketplace, or a public program like AHCCCS, there are options available to fit your lifestyle. Knowing the best plan for you and your family is important and NOAH is here to help during Open Enrollment.

With open enrollment you can enroll in a health insurance plan through the Health Insurance Marketplace anytime from Nov. 1 to Jan. 15. NOAH Community Resource Specialists can provide you with information about several different options and can help you complete paperwork to see what you qualify for.

The Health Insurance Marketplace

Often referred to as the Affordable Care Act (ACA) Marketplace or Obamacare, the Health Insurance Marketplace helps more Americans have access to health insurance. If you aren’t covered under an employee plan or don’t qualify for Medicaid/AHCCCS, you can get insurance through the Marketplace. In Arizona, there are several different providers to pick from, and different plans to fit your healthcare needs and finances. NOAH’s Certified Application Counselors are available to help you understand your options and help with your enrollment in a Health Insurance Marketplace plan.

For health insurance coverage through the Marketplace, the enrollment deadline is January 15, 2023.

Other Health Insurance Options

  • Arizona Health Care Cost Containment System (AHCCCS) – AHCCCS is Arizona’s Medicaid program. There are free and low-cost plans available for individuals and families. To qualify, you need to meet income requirements and be an Arizona resident. AHCCCS is open for enrollment year-round but does need to be renewed annually.
  • KidsCare – If parents are covered under an employer insurance, but kids are not, the KidsCare program can help! KidsCare, often referred to as CHIP (Children’s Health Insurance Program) is offered through AHCCCS and is available for Arizona children under age 19 who meet the income requirement. Like AHCCCS, this health insurance is also open for enrollment year-round. If your family already qualifies for AHCCCS, you don’t need to worry about the separate KidsCare coverage for your children.

If you’ve recently received a letter reminding of your recertification date for AHCCCS or KidsCare, or have had changes to work, income or other health coverage, NOAH Community Resources Specialists can help with your AHCCCS eligibility and enrollment.

Enrolling in an ACA Plan During Open Enrollment

Health insurance can be complicated. Whether you are enrolling in the Health Insurance Marketplace for the first time, are renewing your AHCCCS plan, or have changes to your policy, it is nice to have support along the way. NOAH has trained, certified team members here to help you with 2023 ACA/Obamacare/Health Insurance Marketplace Open Enrollment. To schedule an appointment call 480-882-4545, or fill out the form here and select “Community Resources – Eligibility” under Type of Appointment. 

Is Your Child Feeling Sick? When is a Cold Not a Cold?

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By Dr. Patricia Avila | Pediatrician

It’s that time of year again! The cooler weather is among us, nights are getting longer, and families are even busier than usual as the holidays approach. It’s also the time of year when children start coming down with symptoms of colds or other respiratory illnesses. While most of these symptoms will turn out to be simple colds and resolve on their own, there are some related illnesses that can be more serious.

The Common Cold: Also Known as an Upper Respiratory Infection

The common cold is caused by several different viruses and is the most common of all the respiratory illnesses. On average, children under the age of two will have three to five colds per year. Children who are in daycare or school-aged children are likely to get sick even more often, because they are exposed to lots of other children on a daily basis. Fortunately, most of these illnesses are just colds and will go away on their own. 

Symptoms of the Common Cold

  • Low fever (101-102 degrees F).
  • Runny nose, nasal congestion, and/or sneezing
  • Sore throat
  • Cough
  • Lack of appetite
  • Fussiness

Symptoms can last up o 14 days but most children feel better within 7-10 days.

When to Worry with the Common Cold

While the majority of children will not need to be see a medical provider for the common cold, you should seek immediate assistance if your child:

  • Is an infant under 3 months old
  • Has trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath
  • Nails or lips turn blue
  • Symptoms last longer than 10-14 days
  • Is dehydrated or not drinking or urinating well
  • Is too sleepy or very fussy and not consolable
  • Has ear pain
  • Has any other symptoms or continues to get worse

Treatment for the Common Cold

  • Antibiotics do not treat the common cold since it is caused by a virus
  • Increased fluids
  • Use of pain/fever medication such as acetaminophen or ibuprofen
  • Nasal saline with suctioning for congestion
  • Honey for cough in a child OLDER than 1 year (NEVER give honey to a child under the age of 1)
  • Use of a humidifier may provide relief

The Flu: Also Called Influenza

The flu is also caused by respiratory viruses called influenza and can present very similar symptoms to the common cold.  However, children with the flu feel much worse and are sicker than with the flu than the common cold.  The flu can have very serious complications including need for hospitalization and sometimes death.   

Symptoms of the Flu

  • Rapid onset of high fever (above 101 degrees F)
  • Chills
  • Headache or other body aches
  • Runny nose, nasal congestion
  • Chest pain and cough
  • Sore throat
  • Poor appetite
  • Feeling tired and weak

Most children will get better after two weeks. Fevers from the flu can last up to seven days. 

When to Worry with the Flu

Flu symptoms can lead to serious complications that require immediate medical treatment. You should seek assistance if your child:

  • Has trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath
  • Nails or lips turn blue
  • Is dehydrated or not drinking or urinating well
  • Is too sleepy or very fussy and not consolable
  • Has ear pain
  • Has any other symptoms or continues to get worse

Young children, infants, and children with high-risk medical conditions who are having flu symptoms should see their pediatrician as soon as possible. High-risk medical conditions may include:

  • Heart defects
  • Chronic lung issues
  • Asthma
  • Weakened immune system
  • Diabetes
  • Cancer

Treatment for the Flu

  • Increased fluids
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given honey to children under the age of 1)
  • Use of humidifier may provide relief

Outside of supportive care, there is an antiviral medication called Tamiflu which may be prescribed if the flu is diagnosed within the first 1-2 days of onset.

Bronchiolitis

Bronchiolitis is another respiratory illness that is common during the winter months.  There are several viruses that can cause this illness, but RSV, also known as Respiratory Syncytial Virus, is the most common.  RSV is an infection that will affect almost all children under the age of 2 at least once. It usually starts as a cold and within 3-5 days of the onset of the illness is followed by lower respiratory symptoms. For some children the illness can be severe, especially in younger infants, preemies, and those with heart or lung defects.   

Symptoms of Bronchiolitis

  • Cold symptoms with fever, runny nose, nasal congestion, and cough
  • Fussiness
  • Poor appetite
  • Wheezing
  • Difficulty breathing

When to Worry with Bronchiolitis

Bronchiolitis symptoms can lead to serious complications that require immediate medical treatment. You should seek assistance if your child:

  • Has trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath
  • Nails or lips turn blue
  • Is dehydrated or not drinking or urinating well.
  • Child is too sleepy or very fussy and not consolable
  • Has ear pain
  • Has any other symptoms or continues to get worse

Treatment for Bronchiolitis

  • Increased fluids
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given honey to children under the age of 1)
  • Use of humidifier may provide relief

For infants who are high risk there is an injection that is given monthly during the winter months called Synagis that can decrease the risk of severe RSV infection. 

Croup

Croup is another respiratory illness that is common during the fall and winter months and is usually seen in infants and children under 5. Croup is caused by several different viruses including the flu virus and some cold viruses.  The illness is characterized by swelling of the upper airways including the voice box (larynx) and the windpipe (trachea). Symptoms from croup are usually worse at the beginning of the illness. 

Symptoms of Croup

  • Fever which can be low grade or high
  • Cold symptoms with runny nose and nasal congestion
  • Hoarseness of voice
  • “Barky” or “seal like” cough
  • Noisy breathing called stridor, a high-pitched, turbulent sound when a child inhales or exhales

When to Worry with Croup

The swelling of the airway can sometimes be severe and need immediate medical attention. You should seek assistance if your child:

  • Has trouble breathing – struggles to catch their breath
  • Has noisy breathing that is getting louder and child/infant appears to struggle to breathe
  • Cannot talk because of difficulty breathing
  • Nails or lips turn blue
  • Is drooling and not able to swallow saliva
  • Is dehydrated or not drinking or not urinating well
  • Is too sleepy or very fussy and not consolable

Treatment for Croup

Steroids can decrease the swelling and can be given by mouth, injection, or in a breathing treatment. If given early steroids can help decrease the need for hospitalization and improve breathing.  For severe cases, a breathing treatment with epinephrine may be administered, but this requires careful observation in the emergency department or hospital setting.

Use of cold moist air can help improve mild symptoms as well and can be used at home with a cool mist humidifier.

Tips to Keep Your Child Healthy and Well

  • For all respiratory infections, the best form of prevention is to avoid exposing infants or young children to large crowds or people who are sick.
  • Breastfeeding infants as long as possible (at least 6-12 months) is also an important way to help prevent and fight infections because breastmilk provides antibodies. 
  • Practicing and teaching children good hand hygiene is key.
  • Use soap and water and scrub for at least 20 seconds (sing the ABCs, Baby Shark, or another fun tune).  Another option is the use of an alcohol-based hand sanitizer if hands are not visibly soiled. 
  • Teach children to cover their coughs and sneezes properly by using a tissue or coughing in their arm rather their hands. 
  • Keep children home from daycare or school when they are sick to avoid spreading the illness. 
  • Eating a healthy balanced diet high in fruits and vegetables can help boost the immune system and decrease the chances of getting sick.   

If you have questions about these or other common childhood illnesses, talk to your NOAH provider. If at any time you’re not sure what to do, you can also call our Nurse Triage for immediate advice.