Summertime Family Fun by Dr. Patty Avila, Pediatrician

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“There are lots of ways to keep your children busy during the summertime that do not involve use of media and many of these do not require you to go anywhere or spend a lot of money.”

Dr. Patty Avila, Pediatrician

Creativity

  • String beads together to make jewelry.
  • Create leis with wildflowers.
  • Collect rocks and paint them to use as paperweights or pet rocks or leave on a hiking trial for people to find.
  • Use recyclable items to make crafts.
  • Paint canvas sneakers with fabric paint pens or acrylic paint.
  • Decorate a wall or walkway with chalk.
  • Play with playdough or clay.
  • Make your own instruments and record music.
  • Put on a play.

Keep your children physically active

  • Plan a dance party.
  • Build an obstacle course in your backyard and have a competition to see who gets through it the fastest.
  • Take a family bike ride together.
  • Play a sport together.

Make memories together

  • Create a scrapbook or Time Capsule.
  • Create a summer mural by using a long piece of craft paper that can include drawings/paintings/pictures of your summer activities.
  • Have a night where the kids get to plan and cook a meal for the family.
  • Plan family game nights.

Explore Nature

  • Go bird watching and take pictures. There are websites and free apps that help you identify birds in your area like https://merlin.allaboutbirds.org/.
  • Go on a nature walk/hike and take a bag to find “nature” and bring it home.
  • Hunt for bugs.
  • Plant an herb garden/butterfly garden.
  • Find a local farm that allows for you to pick your own berries, veggies, or flowers.

Asthma Awareness in Children by Dr. Patricia Avila, Pediatrician

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“Asthma in children is one of the most common long term (chronic) diseases. It is estimated to affect 1 in every 10 children in the US. If your child has Asthma one of the most important things you must do is to learn as much as you can about Asthma. Being educated about your child’s Asthma will help you work together with your child’s doctor to control their Asthma and have the absolute best outcome.”

Dr. Patty Avila, Pediatrician

What is Asthma?

  1. It is a disease of the lungs that causes the airways or tubes that bring air into the lungs to become swollen and inflamed. The muscles around the airways become tight and it makes it hard to breathe. This leads to episodes of coughing, wheezing, feeling breathless, chest pain/chest tightness, and feeling more tired than usual.
  2. It is more common in children with a parent or sibling or close relative with Asthma, Allergies, and/or Eczema. Children with Asthma often develop Allergies or Eczema as well. These are sometimes present before they develop Asthma.
  3. There is no cure for Asthma. There are medications and things you as a parent/caregiver can do to help control it. Know what the signs/symptoms of Asthma are, how to avoid triggers, and follow your doctor’s treatment plan. This is especially important to prevent and decrease the damage to your child’s lungs. It will also help avoid your child needing emergency medical treatment.

What causes an Asthma Attack?

  • An Asthma attack happens when your child is exposed to “triggers” things that cause your child’s Asthma to get worse.
  • An Asthma attack also happens when a child does not take their medications as prescribed.

Common triggers include:

  • Allergens – including outdoor allergens like pollen, animal dander, dust mites, mold, and cockroaches.
  • Infections – including the common cold, the flu, sinus infections, and cases of pneumonia.
  • Irritants – including cigarette smoke or other smoke, pollution, strong odors like perfumes or scented candles, and cleaning products.
  • Changes in weather – cold and dry, very humid, or extremely hot weather.
  • Exercise.
  • Stress and strong emotions.

How can you help control your child’s Asthma and how is it treated? Avoid triggers. It may not be possible to completely avoid all possible triggers, but there are some changes you can make that will help.

  • Allergens. Have your child take their allergy medications during allergy season. Keep windows and doors shut during allergy season. Avoid outdoor activities when pollen counts are high.
  • Dust mites. Use mattresses and pillow covers. Vacuum and dust regularly. Wash bedding once a week. Limit and wash stuffed animals.
  • Furry pets. Keep pets out of your child’s bedroom. Wash pets more often.
  • Use HEPA filters.
  • Fix any water leaks that could lead to mold.
  • Infections. Make sure your child and family receive their yearly Flu vaccine. Having Asthma increases your child’s risk for severe Flu illness that can trigger an Asthma attack.
  • Use good hand hygiene.
  • Irritants. Do NOT allow anyone to smoke in your home or car. Avoid public places where smoking is allowed. Avoid the use of perfumes, scented candles, incense, paints, and cleaning supplies that can irritate your child’s lungs. Check your local forecast for air quality and keep your child indoors when the pollution is bad.
  • Weather. Avoid outdoor activities in extreme weather conditions.
  • Exercise. If your child’s Asthma is triggered by exercise have your child take his/her Albuterol 15-30 minutes prior to activity to prevent these symptoms. Encourage your child to exercise and participate in sports. Know what medications help control his/her Asthma so that they can continue to be active.
  • Medications. Includes inhaled medications in the form of MDIs also known as inhalers or “pumps” and nebulizers that are given by a machine. Rescue or quick relief medications like Albuterol help during an Asthma attack. They help open the airways or tubes that bring air to the lungs. Long-term controller medications like inhaled corticosteroids help improve the inflammation of the lungs. When these medications are used daily your child is less likely to have an Asthma attack.

Develop an Asthma Action Plan.

This plan is made with the help of your child’s doctor. It will help you and your child know what medications to use and when. It will also help you and your child know what to do in the case of an emergency. Share this plan with the school as well. It is important because your child spends a good amount of time there and the school will know exactly how to help your child.

By becoming knowledgeable about your child’s Asthma, avoiding triggers, and following a good Asthma Action Plan you are taking important steps in keeping your child healthy. Have your child see his/her doctor at least 2 times per year to ensure their Asthma is under control. Do not forget to make sure your child and family receive a yearly Flu vaccine. Your child should be able to enjoy everyday activities and participate in sports without any problems breathing if their Asthma is under control.

Improving Self Esteem by Zach Clay, LMFT

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Let’s face it, we are our own best critics. Most everybody has some sort of area in their life in which they doubt themselves. If you’re saying “no I don’t” or “I’m perfect,” then you can stop reading here. LOL. The rest of us have some measure of self-worth. Self-affirmations are a great way to trick your brain into truly recognizing those things that make you unique.
Positive self-affirmations are a way to strengthen aspects of ourselves that have constantly been playing on constant negative beliefs which are seemingly on a loop in our heads, typically from an early age. Short, positive messages can combat these long-held beliefs. These new, positive messages can be rewritten to rewrite your new life story.

Here are just a few simple positive self-affirmation techniques for you to try at home:

  • Write index cards or post-it notes you can put in an area that you frequently look at (ex. a mirror, refrigerator, or on your car dashboard).
  • Write a daily journal to be more aware in those positive aspects and personality traits which can boost your self-esteem (see ‘Self-Esteem Journal’ handout below for a printable copy you can use).
  • For those who enjoy a poetic method to increase awareness of your ‘good-stuff,’ you can fill in the blanks on the printable “I Am” poem below and put it where you can see it or better yet, take a cell picture to look at daily from anywhere you are.
  •  Sing these self-affirming messages to one of your favorite songs.
  • Say these positive messages out loud, in your head silently or record them on your phone to play back later.
  • Identify some common personality traits which most of us aspire to achieving.

These short, positive statements benefit:

  • Physical health.
  • Improve success and wealth.
  • Challenge self-defeating behaviors.
  • Aid and heal emotional pain or trauma.

Try them! What do you have to lose?

Self-Esteem Journal
I am … (Poem)

At NOAH, we offer behavioral health consulting and traditional outpatient counseling programs and services where these highly skilled and trained behavioral health staff work alongside our #medical and dental teams to assess, diagnose and effectively treat the core-symptoms of our patients.

Phone Apps to Use for Mental Health by Katelyn Millinor, LPC

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In recent months, there’s been quite a few mental health apps available to smart phone users. These, most often free apps, offer a wealth of resources at your fingertips. Our behavioral health expert, Katelyn Millinor, LPC, recommends the following apps for you to try out at home.

Anxiety/Depression

  • Happify – help reduce stress, overcome negative thoughts.
  • What’s Up – utilizes cognitive behavioral therapy and acceptance commitment therapy to cope with anxiety, stress, and depression.
  • Sanvello – teaches cognitive behavioral therapy through journeys that combine videos, audio exercises, mood and health tracking.
  • Mood Kit – utilizes cognitive behavioral therapy for mood improving activities.
  • Worry Kit – short (under 2 minute) activities designed for those in between moments in life where you need to reset your brain.
  •  MoodFit – create/track daily goals, understand relationship between mood and lifestyle factors, gratitude journal, mindfulness.
  • Mind Shift – designed for teens and young adults with anxiety that focuses on riding out intense emotions and facing challenging situations.
  • IMoodJournal – record everything from mood symptoms, sleep, medications, and energy.
  • Panic Relief – better manage and move through panic attacks.
  • Breathe2Relax – teaches breathing techniques to manage stress.

Meditation

  • Calm – guided meditations, sleep stories, breathing programs, and relaxing music.
  • Headspace – meditation and mindfulness.

Other

  • Quit That! – help users beat habits or addictions (drinking, smoking, drugs).
  • eMoods – designed for people with bipolar disorder to track symptoms.
  • notOK – suicide prevention app that users can add trusted contacts and let them know they are not okay.
  • PTSD Coach – education, assessing, and offering easy to understand tips to manage common symptoms.

Ten Basic Rules for Emotional Health

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In light of May being deemed Mental Health Awareness Month in the U.S., here are some keys to creating and maintaining emotional wellness.

  1. Take care of yourself. Take time to relax, exercise, eat well, spend time with people you enjoy and activities which you find pleasurable.
  2. Choose to find the positives in life experiences instead of focusing on the negatives. Most clouds have a silver lining and offer opportunities for personal understanding and growth. When you accept that things are sometimes difficult, and just do what you need to do, then it doesn’t seem so hard.
  3. Let go of the past. If you can’t change it, and you have no control over it, then let it go. Don’t waste your energy on things that cannot benefit you. Forgive yourself and others.
  4. Be respectful and responsible.
  5. Acknowledge and take credit for your successes and accomplishments.
  6. Take the time to develop one or two close relationships in which you can be honest about your feelings.
  7. Talk positively about yourself and about others.
  8. Remove yourself from hurtful or damaging situations. Temporarily walk away from a situation that is getting out of control.
  9. Accept that life is about choices and is always bringing change to you. Accept that change also requires personal adjustment.
  10. Have a plan for the future. Develop long range goals for yourself, but work on them one day at a time—or even one minute at a time.

We know these things aren’t always as easy as they seem. We are here for you on your journey to wellness!

Bouncing Back to a Better You by Dr. Alethea Turner, Associate Director – HonorHealth Family Medicine Residency Program

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Many of us deal with stress on a daily basis. Some causes may include pressures at work, unhealthy relationships, medical issues, financial problems and even past traumas. All of it can lead to bad habits, poor health and a general sense of unhappiness.

Resilience is our ability to bounce back and regain control. We might not always be able to change our circumstances, but we can change how we handle stress.

6 Tips for Coping with Stress

  • Relationships – Think about the relationships in your life. Which ones bring you joy? Take time to connect with those who add positivity to your life. Schedule a weekly date night, monthly dinner with your friends, or even call a relative you love.
  • Nutrition – Emotional eating is real! We often use food to celebrate our wins and to drown our sorrows. Yet, unhealthy eating can make us feel tired and bad about ourselves. Try to cut out sugary drinks, pack only healthy snacks, or cut down on portion sizes. If you are eating out choose items that are healthiest on the menu rather than those packed with calories.
  • Mental Health – Stress can lead to feelings of anxiety and depression, like worrying all of the time or feeling hopeless. Talk to your doctor and consider meeting with a counselor. It might change your life.
  • Exercise – We all know that exercise is good for our health, but did you know that it is also a powerful tool for managing anxiety and depression? Turn on some music and dance in your room, or go for a walk over your lunch break. Getting your body moving can help you in more ways than one.
  • Sleep – Good sleep habits are essential for recovering from a stressful day and for keeping your mind and body healthy. Create a bedtime routine that includes sleeping in a cool, dark and quite room. Try to sleep around the same time every night and avoid looking at a screens (TV, cell phone, tablets…) at least 30-60 min before bed. Aim for at least 7 hours of quality sleep each night.
  • Mindfulness – Mindfulness is another way you can achieve calmness and control over your feelings. It is about being completely aware of your thoughts and emotions, being focused on a single moment or action, and accepting yourself. You can practice mindfulness in many ways including writing in a journal, taking a minute to focus on deep breathing, meditating (there are apps for that), or even listening carefully to someone you are talking to.

Tip the scales in your favor! Introducing even ONE of these practices into your daily life will help balance out stress and negativity, and can help you build resilience and a greater sense of well-being.

6 Anxiety and Panic Coping Skills

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By Katelyn Millinor, LPC | Behavioral Health Quality Manager

For many, coping with change is hard enough, let alone the emotions many may face such as fear and anxiety due to changes in daily routines. Added stress from job loss and inability to cover expenses, illness, and or loss of a loved, one may cause anxiety and panic. Learn 6 tips to help you cope with these emotions and check out some of our highly recommended apps that may help decrease your anxiety.

Breathing slowly and deeply. Anxiety can cause you to breathe very quickly, which makes both the mental and physical symptoms of a panic attack or generalized anxiety even worse. When you start to feel panicky, be sure to take slow, deep breaths to soothe your mind and body. Be sure to breathe using “belly breathing” also known as diaphragmatic breathing.

Stop and think. When your thoughts start spinning out of control, tell yourself to stop. Organize your thoughts and decide what you need to do to get yourself calm again. This is a way to interrupt thoughts and refocus.

Think positively. Push negative thoughts out of your mind, and remind yourself that you are in control. Think about times when you’ve been able to manage situations successfully and reduce anxiety. Stay in the present moment.

Take a break. If you need to leave a situation, do so or tell someone you need to leave. Don’t be afraid to ask for help. Allowing yourself to become more upset will not help if what you really need is to take a walk and blow off some steam. Allow yourself to have space as needed.

Relax your muscles. Anxiety causes your entire body to tense up, so make a conscious effort to relax each muscle from your toes all the way up to your neck and face. This will alleviate tension.

Get physical. Exercise can combat stress and anxiety. It can also improve your overall health and immune system. Even a brisk walk can help.

Tips to remember:

  • Deep breaths.
  • Self-care.
  • Adequate sleep.
  • Exercise.
  • Talk to yourself.
  • Acknowledge your feeling.
  • Mindfulness.
  • Lavender hot baths.
  • Cut back on caffeine/nicotine/alcohol.
  • Stay present.
  • Good nutrition.
  • Muscle relaxation.
  • Slow down.
  • Picture your ‘safe place.’
  • HALT (hungry, angry, lonely, tired).
  • Close your eyes

Apps to help with anxiety:

  1. Calm
  2. Worry Kit
  3. Breathe2Relax
  4. Panic Relief
  5. MoodFit
  6. Headspace
  7. What’s Up
  8. Happify

Pandemic School Meal Replacement

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The Arizona Department of Economic Security (DES) will provide Arizona P-EBT Pandemic School Meal Replacement Benefits to households
with children who are eligible for free or reduced-price school meals.

Read more

Adverse Childhood Experiences and Child’s Brain Development by Dr. Patricia Avila, Pediatrician

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Did you know that suffering a potentially traumatic event during childhood also known as ACE or Adverse Childhood Experience can have long lasting negative effects on a child’s health, brain development, and life potential? 

Adverse Childhood Experiences can include experiencing violence, abuse, neglect, witnessing violence in the home, loosing a family member, mental health issues in a parent, substance/alcohol abuse by a parent, or instability from divorce or having a parent become incarcerated. 

These events lead to what is called toxic stress. Research shows that this toxic stress negatively changes a child’s brain and body by affecting the child’s brain development, hormonal system and immune system. These changes can persist for years and can lead to long term behavioral, mental, physical health problems.

The toxic stress from ACEs on brain development can impact a child’s potential to: 

  • Develop normally – leading to delays in development.
  • Focus and learn – leading to learning disabilities, dropping out of school, lack of future job opportunities.
  • Make decisions – leading to increase risk taking behaviors such as involvement in drugs and unprotected sex, unwanted or teen pregnancy.
  • Develop mental illness – leading to increase depression, anxiety, and rates of suicide.
  • Form healthy, stable relationships – leading to continuing this cycle of toxic stress in their children and families.

Research also shows that toxic stress from Adverse Childhood Experiences negatively affects a child’s body and can lead to chronic health problems like: 

  1. Obesity.
  2. Cancer.
  3. Heart disease.
  4. Autoimmune problems.
  5. Asthma and chronic lung disease.
  6. Headaches.
  7. Early death from general poor health.

The more of these events a child has suffered, the higher the risk of developing these long-term problems.

The GOOD NEWS is that we can do something about this! Research also shows that we can PREVENT and UNDO the harm done and the future harm on a child’s brain and body. There are some simple things that parents/caregivers can do at home to help regulate a child’s stress response and change the negative impacts of the stress hormones to keep them healthy and on track with brain development.

These include providing our children with: 

1. Supportive and nurturing relationships.
a. Tell them and show them how loved, special, and important they are.
b. Spend quality time doing activities that they enjoy. Simple activities like making art, dancing, cooking, playing games, reading, and singing together are excellent choices.
c. Keep connections outside the home with friends and family members.
2. Regular physical activity. Recommendation for 1 hour of physical activity which does not have to be all at the same time. These can include sports, dance parties, hula hooping contests, hiking, playing tag, chasing the family dog, or anything you can think of to get your child physically active.
3. Healthy meals.
a. Avoid high sugar foods/drinks. Avoid high fat foods or foods/snacks high in carbohydrates.
b. Include fruits and vegetables with every meal. 5-9 servings of fruits/veggies per day are recommended. Fruits and veggies provide nutrients that no other foods can provide.
c. Include foods rich in healthy Omega 3 fatty acids such as fish, nuts, avocados, flax seeds.
4. Restful sleep.
a. Keep a routine with a regular bedtime.
b. Make sure the bedroom is quiet, calm and free of distractions.
c. Avoid all electronics including cell phone, tablet, computer, and TV 1-2 hours prior to bedtime.
5. Getting mental health care for yourself as parent/caregiver and for your child.
6. Practicing mindfulness.
a. This can include meditation, breathing exercises, and prayer.
b. Talk with your child about how they are feeling physically and emotionally.
c. Practice talking about, writing down, or drawing what you are grateful for each day with your child.

All of these will build connections in their brains to help them succeed in school, behave in ways you would expect and become happier, healthier, and more successful.
When parents and caregivers manage stress in positive ways as well, your brain also changes in ways to make you happier and healthier.

Learn ways to manage your stress as a parent/caregiver:

  1. Know what is stressing you out. When you know what exactly it is, you can better deal with it.
  2. Ask yourself “can I do something about this?” If the answer is no, then let it go and focus on something else. If the answer is yes, break it down to small steps so that it is not overwhelming.
  3. Have faith. Think of other times you have overcome challenges. It has been proven that people who attend church, pray or practice other forms of spirituality have less stress.
  4. Relax. Use breathing exercises, meditation, listen to music, or take a nap.
  5. Form healthy habits for yourself by getting good sleep, exercising, and eating well.
  6. Take time for yourself like reading a book, picking up a hobby, or spending time with friends.
  7. Make connections with others. Have a support network that includes friends and family. Don’t be afraid to ask for help.
  8. You are never alone. Your child’s Pediatrician or Family Doctor can also be a great resource and support person for you. They can help give you ideas, resources, and help connect you with others who can help.

Additional resources:
Crisis Text Line Text HOME to 741-741 to connect with a Crisis Counselor. It is Free and is available 24/7.
National Domestic Violence Hotline 1-800-799-SAFE (7233) or text LOVEIS to 22522. Available 24/7.
Childhelp National Child Abuse Hotline 1-800-4-A-CHILD, 1-800-422-4453 or chat/text at www.childhelphotline.org. Available 24/7.

Amazing Brain Series of booklets to help parents/caregivers:
http://preventchildabuse.org/wp-content/uploads/2016/02/ABSapps.pdf
preventchildabuse.org/wp-content/uploads/2016/02/ABSwhateveryparent.pdfpreventchildabuse.org/wp-content/uploads/2016/02/ABStrauma.pdfpreventchildabuse.org/wp-content/uploads/2016/02/ABSteen.pdf

Other websites with great ideas for parents/caregivers:
https://childdevelopmentinfo.com/family-building/everyday-practices-to-make-your-child-feel-loved/#gs.4csgtk
https://childdevelopmentinfo.com/family-building/family-life-is-important-for-kids-mental-health-and-adjustment-to-life/#gs.4csmks

5 Tips for Practicing Empathy During the COVID-19 Pandemic

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With the current coronavirus pandemic going on around the world there have been many changes and disruptions in nearly every aspect of daily life. For many, change is difficult and with the added stresses of the economy, whether you have a job or not, are able to put food on the table and preventing you/others from getting sick, you may be feeling overwhelmed with anxiety and stress. The thought of the unknown and what’s going to happen next can affect your mental health as well.

One way in which we can combat the unknown is to show empathy towards others. There are many benefits to empathizing with others which may help you feel less alone and more connected with your loved ones and your community. Im times of uncertainty, empathy allows us to reach out and help others that need it most.

Empathy allows us to:

  • Boost our social connectedness in our communities so that we may increase helping behaviors.
  • Improve our ability to regulate our emotions during times of stress.
  • Better manage our anxieties and stress without feeling overwhelmed.

Some people are naturally empathetic in nature, but many need a little help to remember what empathy means and how they can cultivate their own empathy skills. The good news is this emotional skill can be learned – here are some ways to build empathy:

  • Listening to others.
  • Engage in acts of service.
  • Put yourself in another person’s shoes.

Tips for Practicing Empathy in Your Community

Staying connected – one of the best ways to fight feelings of isolation is to reach out to others. Showing empathy and engaging in helpful actions can increase your feelings of social connectedness. While practicing social distancing, self-isolation and quarantine, you may consider writing a note to a special friend or family member you haven’t spoken to in a while. You may also use your skills such as sewing for example, to help make masks for those in need. Maybe you can reach out to your neighbors, friends or family members that are unable to go out and buy groceries and offer to buy them and place them on their doorstep.

Be aware – how has the COVID-19 pandemic affected your life? Are your kids now being home schooled? Do you have food and other necessities to sustain healthy living during this uncertain time? How do you think your friends, family, neighbors or complete strangers would answer these questions? It is important to remember that while you may be doing okay, others are not. Many have lost their jobs, cannot feed their families and are unable to make healthy lifestyle choices. Some can’t afford childcare so they can continue to work and many are suffering from anxiety and depression due to their situation and circumstances.

“Empathy and the willingness to understand are a critical part of compassion which leads to action. Think of others and look for ways you can help in your community.”

Be kind – It’s okay if your routine is ever changing and what your ‘normal’ was is no longer possible. If your kids are watching too much television or are playing video games longer than you’d like, that’s okay. Everyone, all ages, are trying to cope with the unknown. This is a lot to deal with and everyone copes with fear, stress and anxiety differently. Focus on being kind to one another. Seek the positives in your new ‘normal’ and practice self-compassion by becoming emotionally flexible, navigate through your emotions and give yourself and your family a break.

Be considerate – sometimes we are quick to criticize others without knowing their circumstances or understand their situation that may impact their choices. Some people may feel overwhelmed with an overload of conflicting information from various outlets. While you cannot control how others behave, you can control your own actions by sharing only the facts by reliable sources. You can also gently remind others to kindly wash their hands, practice social distancing and stay home if they show any symptoms of COVID-19.

Help others – when the world feels unpredictable, find tangible ways to do good and make things better for others. This may provide comfort and a sense of control and empowerment.

Some ways to practice empathy:

  • If you are financially stable, look for ways you can support others who may be struggling.
  • Support your local businesses by buying food or gift cards from them and encouraging others to do the same.
  • Only buy what you need for the week, don’t overbuy.
  • Make care packages for healthcare workers, elderly neighbors or those who may have lost their jobs.
  • STAY HOME – follow the guidelines outlined by the CDC. Practice social distancing.

At NOAH, we practice empathy for our patients, staff and community daily. This is especially important during a public health crisis. Practicing empathy during COVID-19 not only opens your mind to what others are experiencing, but it also reminds us that we are in this together. Our behavioral health consulting and traditional outpatient counseling behavioral health staff work alongside our medical and dental teams to assess, diagnose and effectively treat the core-symptoms of our patients.