May is Mental Health Awareness Month. One of the most widespread things affecting mental health in our society today is the overuse of electronics, including video games and social media. Trond Harman, a Licensed Clinical Social Worker at Keystone Pediatrics Chambersburg, often sees problems related to this in his child and teen patients. In today’s article, he shares some information about how electronics can affect mental health.

What are some of the ways electronic use is connected to mental health?

The use of electronics and mental health are connected in multiple ways with one another. The first, and probably most prevalent, is that electronics, video games, and social media tend to lead individuals to living a much more isolated life. Many times, people will spend hours at a time playing video games or being on some other form of electronic device, which leads to isolation from the outside world.

The argument that I normally hear about being too isolated while on electronics and social media is the fact that there is interaction with other people. This is done through things such as online gaming where you will play as a team and you can interact with these individuals through the use of microphones. The problem is that the players they are gaming with end up being more important to some people than even their own family. I have had numerous situations with teenagers where their parents will tell me that the child will drop everything to engage in playing a game with people that they have no connection to or even know on a personal level.

What problems can this cause?

Isolation leads to people struggling with normal social interactions. I have seen a lot of teenagers who have many issues with a basic reciprocal conversation because they have anxiety when speaking to someone face-to-face. This is an issue that I am seeing more and more of every day. It leads to anxiety levels increasing because of the fear they have of speaking to someone in person.

Another issue that goes along with engaging in these types of interactions is that many times the people with whom you are interacting online may be from another time zone. I have had numerous cases of teenagers playing video games until all hours of the morning and then not being able to wake up for school. The person they were playing video games with may have been in a time zone where it was daytime or an hour where they were not losing sleep or having it interfere in their lives. I have observed this leading to truancy issues with school because of the lack of sleep or the child’s anxiety with leaving the home.

Finally, when you over-engage in using electronics, it leads to a sedentary lifestyle. There are numerous problems that can be caused by this. One of them is that you are more prone to having weight issues, which can lead to low self-esteem and possible depression. Another problem with a sedentary lifestyle is the lack of exercise. There are numerous studies that correlate exercise to good mental health.

What mental health conditions can too much use cause?

The most prevalent mental health issues that are caused or can be contributed to electronics and social media use are depression and anxiety. People develop increased anxiety related to the struggling with basic interactions. They are alone in their home when they are engaging in many of these activities and their anxiety levels increase when they have to go out into the world. The more people are alone and isolated from others, the more likely they are to be depressed. A lot of people will tell you that they have many friends, but when you dig deeper into these friendships they are based on people they know online.

Can it become an addiction?

It can become an addiction and it is actually recognized as Internet Addiction Disorder (IAD) in many other countries. It is not yet recognized in the United States and therefore getting treatment for the addiction can be tricky. The most likely way that people get treatment is through some other diagnosis recognized in the Diagnostic and Statistical Manual of Mental Disorders, which is used by clinicians and insurance companies to classify mental health conditions. The problem is most likely listed under something such as anxiety, depression, or some other obsession related to internet usage such as gambling or pornography. While there are numerous programs around the country that specialize in treating this condition, the person would need to have a diagnosis from the manual for their treatment to be covered by insurance. Internet Gaming Disorder has been added to the manual’s appendix, and will likely make it into the manual itself in the near future.

It can be difficult to determine if and when treatment might be needed for internet addiction, but according to researchers from the University of Iowa’s College of Medicine, “Internet addiction is characterized by excessive or poorly controlled preoccupations, urges or behaviors regarding computer use and internet access that lead to impairment or distress.” Treatment options for internet addiction include inpatient and outpatient treatment facilities, counseling, therapy and support groups.

In the next article, I will give some advice about how much use is too much for both adults and children, and give some tips to parents for helping their kids and teens make healthy choices when it comes to electronics use.

This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

The Keystone Health Employee Spotlight for May shines on Shavonne Statum, Office Coordinator at Keystone Community Outreach!

Shavonne started her journey at Keystone in June of 2013 at our Chambersburg Pediatric office. When Keystone opened its Community Outreach site on Lincoln Way East in the summer of 2016, Shavonne applied for and received her current position.

“Ultimately, it was Keystone’s mission statement that led me here versus other health care facilities in the area,” Shavonne said. “It gives me a sense of pride when I hear patients talk about how grateful they are for a service that Keystone provided them when no other facility would, due to lack of insurance or inability to pay at the time of service.”

Everyone who visits Keystone Community Outreach and crosses Shavonne’s path can count on a warm greeting and a smile.

“I always start off each day with a big smile and a cheerful ‘Good morning!’ she said. “I think it’s important to spread a little sunshine first thing in the morning to set the tone for the day. I love the fact that we all like to have fun here. It’s a great atmosphere, and patients enjoy the warm welcome too. I love to see people smile and I’m glad that I can be a part of the reason they do so.”

When she’s not welcoming visitors at the front desk, Shavonne keeps busy with many other tasks.

“We typically see patients from 9 am until 5 pm Monday through Friday, with extended hours until 7 pm on Tuesdays,” she said. “You can find me doing a variety of different things such as checking patients in, answering calls, scheduling, scanning, testing, attending meetings and trainings, or working on reports.”

Shavonne enjoys knowing that the effort she and her co-workers put in each day has a lasting impact in our community and beyond.

“I love meeting new people and being able to assist those in need,” she said. “We are fortunate enough to see patients from many different areas. Knowing we are able to help change lives for the better, gaining trust and understanding and building relationships within our community is what makes me most proud of what we do.”

When she’s not at work, Shavonne’s family life and hobbies keep her very busy.

“My immediate family consists of my fiancé Robert, my sons J’Vaughn and J’Lhen, and the newest addition, our baby girl Milan! I come from a huge, close knit, loving family. We always find reasons to get together and if we don’t have a reason, we just make one up. Our family is so large that our family reunions take place in a different city or state each year. The location is decided by the committee, which I’m a part of, and lasts for three days. We have a president, vice president, treasurer, historian, secretary, etc. on the committee. We’ve gathered in places like Charlotte, NC, Kissimmee, FL, Memphis, TN, and Mt. Laurel, NJ just to name a few. Next year is a special celebration in which our reunion will be hosted via a cruise liner. What can I say, we love to have fun!”

Shavonne’s hobbies include reading, dancing (including Zumba), trivia, cooking, baking, skating, swimming, traveling, and sports. She is a team mom for both of her sons’ sports teams which include football, track and field, and Amateur Athletic Union travel basketball.

When asked what people may be surprised to know about her, Shavonne revealed two hidden skills: “I am a certified phlebotomist and also have my Commercial Driver’s License,” she said. “I was teaching preschool in 2009 and we didn’t have enough bus drivers to go on many field trips. I decided to obtain my CDL so I could drive the children myself.”

While she’s originally from Chambersburg, Shavonne moved her family to Shippensburg last year.

“I like the small-town feeling this area provides,” she said. “Wherever I go, I run into people who know me or my family. I often hear ‘Are you related to…’ It’s a great feeling to know that people know you come from a great family! However, one day I plan on moving to Wake Forest, NC. That’s my dream location!”

Thank you, Shavonne, for all that you do for Keystone and our patients!

Interoception is the least known sensory system that the most people should be talking about.

April is Autism Awareness Month. While many things are still unknown about Autism Spectrum Disorder, researchers, therapists, and the loved ones of those affected are working each day to unravel the mysteries surrounding it. Emily Mason, an occupational therapist at Keystone Pediatric Therapies, works with children and adolescents who live with autism and other medical conditions, and helps them develop the skills they need to be successful and to lead a better quality of life.

One challenge that comes with autism and some other disorders is the ability to process sensory information. In today’s article, Emily shares some information about interoception – the least known sensory system.

What is interoception?

To put it simply, interoception is the sense that allows people to feel internal sensations within their bodies. There are receptors located throughout the inside of our bodies such as in the stomach, heart, lungs, muscles, etc. These receptors pick up on signals within the body, which are then sent to the brain to be translated into body states such as hunger, thirst, being sick, tired, having to use the bathroom, etc.

For example, your body may feel your stomach growl and your brain start to feel foggy. That message is sent to your brain, and your brain interprets it as feeling hungry. You then are able to act on that signal, such as by going to get a snack or having a meal.

So, is the interoceptive system also connected to feeling emotions?

Yes! Our bodies pick up on internal cues and sensations that are also linked to emotional experiences. In most cases, each emotion feels differently within the body.

For example, your muscles may be tense, your heart may be racing, your face may feel hot and your voice may be yelling. Your body picks up on these internal cues and again, sends them to your brain to be interpreted – in this case, interpreted as feeling angry. At this point, you are able to utilize coping skills to return your body to a calm state.

What does interoception have to do with self-regulation?

Having good interoceptive awareness is critical for self-regulation. When a person feels discomfort, whether it be from hunger, anger, feeling cold, etc., they are urged to act in order to remediate that discomfort. This action may come in the form of utilizing coping skills, getting a snack/drink, going to the bathroom, etc. The urge to act and self-regulate is dependent upon being aware of the internal sensations, which is what we call Interoceptive Awareness (IA).

What happens if a person does not have good interoceptive awareness (IA)?

Individuals with poor IA have increased difficulty regulating their body states and emotions. If you do not notice the sensations that communicate you are becoming anxious, you are not going to implement any coping skills to help self-regulate. Therefore, that individual will become more and more anxious until they have a panic attack or breakdown. The individual may know what coping skills to use when anxious; however, if they cannot feel when they are anxious, they cannot use the coping skills and they become ineffective. This same concept can be applied to anger, sadness, etc.

Is there a connection between autism and poor IA?

While there is limited research on the link between autism and poor interoceptive awareness, evidence suggests that interoception may be a critical piece that is being overlooked during the treatment of individuals with autism. Poor IA is connected to many difficulties that these individuals face on a day-to-day basis such as difficulty with self-regulation, social skills, etc.

Can therapy help?

Occupational therapists can work with individuals with poor IA to increase awareness of internal body signals and give those signals meaning. If the individual has increased awareness of his or herself, it can lead to greater awareness of their environment and others. Overall, this can lead to improved quality of life and greater participation in daily activities.

This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

The Keystone Health Employee Spotlight for April shines on Kelby Kitzmiller, Maintenance Technician II.

Kelby began working at Keystone in April 2016.

“When I saw the job opening I was immediately interested because I had experience in the maintenance and construction field,” Kelby said. “I quickly filled out an application and was later brought in for an interview. When I received the phone call that I had a job with Keystone, I was thrilled. The experience I have had thus far has been one of the best and I look forward to many years here.”

Kelby can be found at any Keystone Health building on any given day, performing a variety of tasks to keep each facility and its surrounding grounds looking nice and operating smoothly. He will tell you that no two days are the same in his line of work.

“One of the best parts of being employed at Keystone is that every day is different,” he said. “There are various tasks that must be completed and I still learn something new every day. When it comes to my work, I am very particular and want it all to be perfect.”

When asked what his favorite thing is about working at Keystone, Kelby couldn’t pick just one answer.

“Honestly, everything,” he said. “Everything about Keystone makes me proud to work here – the people, the family-oriented atmosphere, and best of all I like coming to work every day. I extremely enjoy my employment with Keystone and plan to retire from here.”

Kelby was born and raised in Chambersburg, and has no plans of leaving the area.

“It’s where I met my wife in high school, and where I plan on retiring,” he said. “All of my family and friends live in this area.”

In his free time, Kelby enjoys a variety of activities.

“I have many hobbies that I enjoy,” he said. “But if I had to pick, my favorites would be hunting, fishing, exploring the world with my wife, and being with friends and family. I also try to eat right and stay busy as much as possible.”

Kelby and his wife reside in Shippensburg, and they will soon have a family of three.

“My family is growing,” he said. “By the end of this month, we’re having a baby boy. I’m extremely excited about that!”

Thank you, Kelby, for all that you do for Keystone and our patients!

For children living with autism spectrum disorder (or ASD), navigating in the world around them can be challenging. Joel Desotelle, licensed pediatric occupational therapist and program director of Keystone Pediatric Therapies in Chambersburg, sheds some light on sensory problems and treatment for children living with ASD.

How The Senses Affect Children Living With ASD

In order to do everyday tasks, our brain needs information to be able to think, problem solve, plan and organize. That information comes in through our senses (sight, hearing, touch, taste, smell, balance and movement) and is quickly sorted and distributed throughout the brain. Each brain center works together to use this information to help us survive, learn and accomplish daily goals (such as getting dressed, completing homework, learning a new subject, etc.). Individuals living with autism struggle to manage all of this sensory information, making these tasks a lot harder.

Common Problems

For an individual to grow and learn skills, the brain centers need talk to each other. This requires a good network of “roads” and the “fuel” (brain chemistry) to get those messages around. While the cause of autism is not fully understood, we do know that individuals living with ASD lack a good road system and brain chemistry for the brain to work efficiently.

The Effect Of Sensory Processing Issues

The world around us moves quickly. From birth, our brains take in an enormous amount of information, helping us to learn and grow. As we get older, we start to talk and work together, sharing information in real time. But what happens if a person’s brain can’t keep up or cannot handle all this information? These individuals struggle to learn and understand, and quickly look for ways to compensate, withdraw from and/or react to these challenges. As time passes, core skills are missed and each child struggles to keep up.

ASD Is Hard For Everyone InvolvedWhether it’s your child, relative, student, patient or client, everyone involved in the child’s life wants to help. ASD is a puzzle because the problem is not black and white. Without understanding all of the issues and how to address them (and in what order), it is easy to set the bar too high or too low for these great kids. Do they truly understand your comments, a situation or the expectations of an activity? This can lead to frustration for everyone involved, putting a strain on relationships and family life.

Treatment: Where to Start

The best way to help individuals with ASD is to start with the basics. Occupational therapists use sensory integration and other strategies to build roads and get the brain chemistry in a good place. These strategies also help to integrate reflexes that can persist in children with ASD, while improving self-regulation and attention and laying the groundwork to work on core skills (awareness, comprehension, initiation, etc.). It is important to work with your occupational therapist to identify where your child needs to start and develop a roadmap for treatment. Starting in the wrong place can lead to further delays, stress and even unwanted behaviors.

This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

That’s right! Keystone Behavioral Health will be relocating to a brand new building!

Our new address of May 7th, 2018 will be: 110 Chambers Hill Drive, Chambersburg. We will begin seeing patients at this location at 7:30 am on May 7th.

For directions from our old location (820 Fifth Avenue, Chambersburg), click here: MAP

If you have any questions at all, please feel free to call us at (717) 709-7930. Our phone number will not change.

March is Colorectal Cancer Awareness Month. According to the Centers for Disease Control, colorectal cancer is the third most commonly diagnosed cancer, and the second leading cause of death from cancer in the United States.

Dr. Kerry Whitelock of Keystone Internal Medicine shares some important information everyone should know about how to take control of their health.

What Are Some Symptoms Of Colorectal Cancer?

Warning signs include blood in stool, unexplained weight loss, abdominal pain, rectal pain, anemia and a change in bowel habits. It is important to note that these are some common symptoms and are not the only indicators of colorectal cancer. In fact, people with early stages of colorectal cancer often have no symptoms at all. That’s why regular testing is so important.

Who Should Be Screened?

If you are at average risk, you should be screened regularly between the ages of 50-75. Depending on your risk factors, including a family history of colorectal cancer, your doctor may recommend screening earlier than 50 or later than 75. Screening is not recommended for those older than 85 years of age.

Other factors that can put people at a higher risk include being overweight, tobacco and alcohol use, lack of exercise, a diet that is high in fat and low in fiber, and health conditions including Crohn’s disease and ulcerative colitis.

What Testing Options Are Available?

The most commonly known testing method is the colonoscopy. This procedure allows the doctor to view the inside of the colon, and to remove any polyps, or abnormal growths, that are found. There is a prep protocol that must be followed, but it is short-term and allows the gastroenterologist to view the entire colon. The colonoscopy itself is usually painless as anesthesia is used for patient comfort. If the results are normal, most people will not require another screening for 5-10 years.

A yearly fecal immunohistochemical test, or stool FIT test, is an alternative screening method. No prep or dietary restrictions are involved. This is a stool test that can be done in the privacy of your own home and is then mailed away for the results. If the results are negative, the patient does another FIT in a year. If the results are positive, then the patient needs to have a colonoscopy for further evaluation.

It is important to not put off screening because colorectal cancer can be detected at a curable stage in patients who have no symptoms. Several studies show that people who undergo screening have lower mortality rates than patients who do not get screened. There is no best strategy to screening for colorectal cancer. The best strategy is the test that the patient can consistently carry out. If you are between the ages of 50-75, have a family history of colorectal cancer, or are experiencing any symptoms, now is the time to talk to your doctor.

This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

If you think skipping out on routine teeth cleaning is no big deal, think again. Research has shown a direct link between oral health and total health. Oral issues can develop and progress quickly, whether or not you notice them.

Dental professionals are not only concerned with fixing teeth, but also clean them, aim to ensure your gums are healthy, and check for abnormalities that may otherwise go unnoticed and could be a sign of larger health issues. By keeping on top of your dental cleanings and checkups, you’re doing yourself a big favor in the long run.

Dr. John Palm, Dentist and Medical Director at Keystone Dental Care, shares some information about what your oral health may be telling you about your overall health, and how to treat one of the more common symptoms – dry mouth.

Oral Cancer

If you don’t know the signs of oral cancer and don’t seek treatment, it can quickly progress and become life-threatening. If you have any of the following symptoms, you should seek medical attention.

White or red discoloration in the mouth – if you notice any change of color inside the mouth, including the gums, it could be a sign of oral cancer caused by the human papillomavirus (HPV). This is especially prevalent in older males.

Sores, lumps, swelling, or thick patches – these symptoms can be found anywhere in the mouth or throat. Accompanying issues include trouble moving your jaw or tongue, difficulty swallowing, chewing or speaking, a sore throat that doesn’t heal and discomfort wearing dentures due to swelling.

Diabetes

One in three people with diabetes don’t even know they have it. This is very dangerous, because untreated diabetes can threaten your heart, eyes, kidneys, mouth and more. Oral symptoms could be among the first signs that you need to see a doctor and be screened for diabetes. These symptoms include:

Bad/fruity-smelling breath – people with diabetes may develop a sweet and fruity odor on their breath as their body is struggling to get rid of excess chemicals.

Sore gums or teeth – if your gums are sore, swollen or bleeding it could be a sign of gum disease, which is common in diabetic patients. If your mouth is slow to heal after a burn or a cut, it could also be an indicator of diabetes.

Dry mouth – this is marked by excessive thirst, and can cause soreness, ulcers, infections and tooth decay. Smoking makes this problem even worse. It’s important to see a dentist regularly, because a dentist’s trained eye can spot dryness in the mouth before symptoms even begin.

How To Treat Dry Mouth Symptoms

While dry mouth can be a sign of disease, it can also be caused by things such as stress, some medications, and cancer treatments. If you’re suffering from this condition, there are things you can do to alleviate the symptoms.

Sipping small amounts of water during the day will help keep your mouth moist. However, drinking too much water will reduce the mucus film in your mouth and can make problems worse. Avoid drinking many acidic beverages (carbonated drinks, wine, and fruit juices) and stick with water, especially while eating. Chewing sugar-free gum or sucking on sugar-free hard candies may also help; if you get gum or candies sweetened by xylitol, it may even help prevent tooth decay.

Oil-based lip balms or ointments with Vitamin E will soothe dry lips, and using humidifiers in your home (especially at night) can provide relief. There are also over-the-counter saliva moisturizers available. If you are still experiencing dry mouth after trying the above treatments, you can discuss prescription medications with your dentist or healthcare provider.

Autoimmune Diseases

The immune system is designed to protect our bodies from disease. However, in those suffering from autoimmune diseases, the immune system attacks healthy cells in the body by mistake. Some autoimmune disorders include: inflammatory bowel diseases (such as Crohn’s disease and ulcerative colitis), rheumatoid arthritis, lupus, and Sjögren’s syndrome. Any of the following symptoms could be a sign that something isn’t right within your body.

Bumps or ulcers in the mouth – raised bumps that look like cobblestones on the gums may or may not be painful, but they could signal inflammation related to an autoimmune disease. Small, painful ulcers in the mouth (also known as canker sores) can be another indicator of larger health problems.

Difficulty swallowing, change in speech and/or taste, and mouth dryness – Autoimmune diseases can affect the glands that produce saliva. If enough saliva isn’t being produced or if it has a thick consistency, you may want to see a doctor.

Jaw swelling and/or pain – this can be a sign of inflammatory arthritis in the TMJ (temporomandibular joint), which affects about 50% of people with rheumatoid arthritis.

Changes in the tongue or lower lip – if you notice your tongue or lower lip is swollen or enlarged, or that your tongue has taken on a dry, cobblestone appearance, your body could be telling you there is a bigger problem.

Anemia

People with anemia have a lower red blood cell count than normal, and their bodies may not get enough oxygen-rich blood supply. If you know you have anemia, be sure to tell your dentist before they begin any procedures as this can affect care.

Sore, smooth, and/or swollen tongue – these signs may be accompanied by the tongue appearing more pale than normal.

Paleness of the gums, tongue, or mouth – if the tissue in your mouth is abnormally pale it could be a sign that your body isn’t producing enough red blood cells.

Acid Reflux or Gastroesophageal Reflux Disease (GERD)

When many people think of acid reflux or GERD, they think of heartburn. However, untreated GERD can lead to serious health issues, including cancer. It can also lead to oral health problems.

Tooth erosion – the gastric acid found in those with chronic reflux often leads to tooth erosion – even without heartburn or other obvious symptoms. If your dentist notices your tooth enamel is weakening or eroding, it could be a sign of something more.

Chronic Kidney Disease

This disease affects your body’s ability to properly filter waste and toxins, and can lead to gradual and permanent loss of kidney functions over time. If left untreated, it can be fatal. People with diabetes and high blood pressure are especially at risk of developing chronic kidney disease.

Bad breath – As your kidneys lose their ability to filter wastes from your body, your breath will take on the scent of urine. If you notice a scent that smells like fish or ammonia on your breath, it might be time to see a doctor.

This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.