Rethink Your Drink

Are you drinking your calories instead of eating them? 

Calories and sugar can sneak up on you when you drink them instead of eat them. Beverages sweetened with sugar do not provide nutritional value. They are made of simple carbohydrates, which breakdown in your body very quickly. This results in you not feeling full. Your body does not realize you have consumed calories. So after consuming a sugar-sweetened beverage, you would tend to eat like you normally do, which can lead to weight gain. For someone who has diabetes, it is very important to watch your carbohydrate intake. Some sugar-sweetened beverages have the equivalent carbohydrate grams of what is recommended for an entire meal. Yikes! Here is a list of popular sugar sweetened beverages:

  • Coke, 12 oz.: 140 calories, 39 g. carbs, 39 g. sugar
  • Sprite, 12 oz.: 140 calories, 38 g. carbs, 38 g. sugar
  • Pepsi, 12 oz.:   150 calories, 41 g. carbs, 41 g. sugar
  • Minute Maid lemonade, 12 oz.: 150 calories, 40 g. carbs, 42 g. sugar
  • Lemon-lime Gatorade, 12 oz.: 80 calories, 21 g. carbs, 2 g. sugar
  • Vitamin Water, 20 oz.: 125 calories, 32.5 g. carbs, 32.5 g. sugar
  • Lipton ice tea with lemon, 20 oz.: 130 calories, 33 g. carbs, 33 g. sugar
  • Tim Hortons coffee with cream & sugar, medium: 115 calories, 13 g. carbs, 13 g. sugar
  • Nesquick chocolate milk, 1 cup: 170 calories, 29 g. carbs, 28 g. sugar
  • McDonald’s Strawberry-Banana Smoothie 12 oz.: 210 calories, 47 g. carbs, 44 g. sugar
  • Starbucks caramel Frappuccino, grande: 410 calories, 66 g. carbs, 64 g. sugar
  • Ocean Spray cranberry juice, 8 oz.: 140 calories, 36 g. carbs, 36 g. sugar

Here are some healthier options from Botsford Hospital’s registered dietitians:

1. Make your own smoothie using milk, fresh fruit and ice. Try to keep your portion to 8 ounces or less.

2. Add some fresh fruit and herbs to your water. Place fresh fruit and herbs in a large pitcher of water, and give the water time to absorb the flavor. Get creative. You can always add a splash of soda water to replace the taste of soda pop. Some tasty combinations are:

  • Lemon + Lavender
  • Ginger + Lime
  • Lemon + Cucumber + Mint
  • Lemon + Blueberry
  • Orange + Pineapple

3. Instead of drinking a glass of juice, add 1-2 ounces of juice to your cup of water for a flavorful taste. This gives the beverage flavor without the full serving of calories and sugar.

4. Choose low-fat or fat-free milk, such as 1% or skim.

5. Skip or cut back on cream and sugar in coffee, or drink tea instead.

By: Nicole Kolin, Botsford Hospital dietetic intern and Michigan State University student Information sources:

1. Coca-Cola Company. Updated July 2013. Accessed July 9, 2013.

2. PepsiCo. Updated July 2013. Accessed July 9, 2013

3. Tim Hortons U.S. Nutrition Calculator. Accessed July 9, 2013.

4. Nesquik. Accessed July 9, 2013

5. McDonald’s USA Nutrition Facts for Popular Menu Items. Updated July 2013. Accessed July 9, 2013.

6. Starbucks. Accessed July 9, 2013.

7. Ocean Spray. Accessed July 10, 2013.

8. Accessed July 9, 2013.

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Can you get cancer from mammogram radiation?

Thyroid shield

Rumors urge patients to request a thyroid shield, shown here, during a mammogram. But experts at Botsford Breast Center explain they just aren’t necessary and may do more harm than good. Talk to your provider to find out what’s best for you.

Exposure to radiation can increase the risk of cancer. This is true, which is probably what caused a recent rumor that mammograms can cause thyroid cancer. So can you get cancer from your annual mammogram, the imaging test that is so vital to detecting and treating breast cancer early?

To answer this important question, we went to one of our experts:  Dr. Andrew Mizzi, an experienced Radiologist who reads and interprets mammogram images at the Botsford Breast Center.

Dr. Mizzi explains that while large amounts of radiation over a person’s lifetime can lead to the development of cancer, the radiation exposure from an annual mammogram is far less than what a person is exposed to in their natural environment (radiation is naturally occurring and we are exposed to it every day in small amounts).

Also, the new digital imaging technology used by most mammography centers, including Botsford Breast Center, reduces the amount of radiation “scatter,” which means radiation goes only where it needs to go – on the patient’s breast.

And finally Dr. Mizzi explains that even any risk of developing cancer from a mammogram is far outweighed by the benefit of screening for, detecting and treating breast cancer early.

So despite what you may hear, skipping your annual mammogram is not a good idea. And you really don’t have to request a thyroid shield as rumors urge. In fact, Dr. Mizzi explains that using a thyroid shield during a mammogram may actually interfere with the procedure and create a need for another image which will expose you to more radiation. The bottom line is if you’re concerned about your exposure to radiation, talk to your health care provider about the risks and benefits specific to you.

Whether you’re still concerned or not, the mammography experts at Botsford Breast Center will discuss your individual needs with you and help you detect breast cancer early in the safest way possible. If you’re due for a mammogram, make an appointment today.

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Telehealth: A program to trust

Kim Kleinlein and her daughter, Elizabeth, are thankful to have Kim’s parents, Diana and Don Luke, living close and enjoying good health again.

Kim Kleinlein, R.N, an experienced nurse, was on her way out of the country for a long-anticipated vacation. Her mother, Diana Luke, was about to be released after a long hospital stay. Kleinlein knew her mom and dad were nervous about the transition home. After all, her mother had been very ill with chronic obstructive pulmonary disease (COPD), which leads to a new diagnosis of chronic heart failure, and diabetes, two diseases which require daily monitoring.

Kleinlein had already moved her mother to Botsford during her hospitalization because she knew she would get the coordinated care she needed there. Now Kleinlein helped get her mother enrolled in a new Telehealth program offered through a partnership between Botsford Hospital and Residential Home Health (RHH). This partnership aims to avoid unnecessary hospital readmissions by staying on top of the daily measures necessary for maintaining health. “This program was an easy choice,” says Kleinlein. “I was already familiar with the staff and processes. I was impressed with their professionalism and the way they dealt with each patient as an individual.”

Residential installed monitoring equipment in Kleinlein’s parents’ home and trained her mom to use it. That meant someone was paying attention to her mother’s vital signs at all times. “Not only did this oversight force my mom to stay on track and not cheat,” says Kleinlein. “It also showed her the outcomes and successes of sticking with her care plan.”

In a sense, Residential acted as a surrogate for Kleinlein while she was out of the country.  “They provided fantastic support,” she says. “They allowed her to heal at home and me to enjoy my vacation.”

Visit for more information.

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Bon Voyage! Smart Traveling with Diabetes

Summer is just around the corner. Maybe you and your family are planning a relaxing getaway:  Outdoor BBQs, park visits, lying on the beach, road trips – they all sound wonderful, don’t they! If you have diabetes you know it’s important to take extra care when vacationing, but with mindful planning you can still enjoy your summer vacation.

Here are 8 tips for managing diabetes on vacation from Botsford Hospital’s registered dietitians.

  1. Meet with your doctor before you go. Getting an OK from your doctor is crucial for a safe trip. Let your doctor know that you are traveling and ask for advice or extra prescriptions for a long trip. Make sure you are up-to-date on immunizations.
  2. Pack extra medical supplies and store them properly. Bring double the amount of necessary diabetes supplies in case of a delay. Your medication and testing supplies should be in your carry-on luggage or with you at all times. It is also important to keep your medications dry and away from direct sunlight. Don’t leave your insulin in the car, as it may get overheated and lose its function.
  3. Take your medical ID. Make sure you keep your medical insurance card and emergency phone numbers handy, including your doctor’s name and phone number. It is wise to wear a medical alert ID in case of an emergency.
  4. Study your destination. Find out where to eat, where to seek help, and how much physical activity you will be engaging in. Locate the nearest medical facilities for an emergency. Keep time zone changes in mind so you’ll know when to take medication.
  5. Plan your meals. Map out the dining locations and try to eat at your regular meal hours. Go online or call ahead to request nutrition information if possible. Apply your carb counting knowledge to unknown foods or stick with familiar foods to avoid blood sugar spikes. Be mindful and avoid overeating.
  6. Stay hydrated. To help lower the body’s natural reaction to stress, drink plenty of fluids. Stick to water with fresh lemon and try to drink at least 64 ounces per day. Avoid sugary drinks and limit your alcohol intake. Do not drink alcohol on an empty stomach.
  7. Take care of your skin and feet. Put on sunscreen 30 minutes before sun exposures. Sun burns and bug bites can cause unwanted skin infections. Bring comfortable shoes that protect your feet (not sandals) and clean cotton socks. To keep good circulation, avoid socks with heavy seams and elastic. Be especially careful of hot pavement by pools and hot sand on beaches. Never go barefoot.
  8. Monitor closely. Keep a closer eye on your blood sugar levels. This is important because your normal routine has changed. Dining out and changes in physical activity can lead to unexpected blood glucose levels.

Want to learn more? Come to our Saturday Spotlight workshop on June 1st. Call Botsford Diabetes & Nutrition Services at (248) 477-6100 for details.

By Wen Guo, Botsford Hospital dietetic intern and Michigan State University student.

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Botsford Staffers Benefit from Healthy Competition

Dr. Steven Zuckerman

Dr. Zuckerman lost 8.9% body fat during the 10 weeks of the contest. Left: Before, Right: After.

Doctors and staff from Botsford Radiology and Botsford Breast Center take health pretty seriously. So when administrator David Gaffney suggested a friendly health and weight loss competition, they jumped on board.

Their “Smallest Loser” contest worked like this: Whoever loses the greatest percentage of body fat over 10 weeks, wins $100. Each of the 10 participants contributed $10 to the fund. The contest was a big success: The winner, Dr. Steven Zuckerman, lost an impressive 8.9% body fat and the team as a whole lost a total of 66.4 pounds!

The competition’s organizer and chief motivator, Laura Caruso, a mammography coordinator at the Breast Center, says the team’s key to success was simple:  healthful eating and more activity. One of her strategies for healthful eating is her daily strawberry and banana protein shake lunches. She shared her recipe with us here.

The team’s success didn’t come without challenges. The number one challenge faced by many members was eating healthy away from home such as at restaurants or celebrations which usually center on food. Yet the team prevailed, taking away a valuable lesson:  Find a happy medium – go out and have fun but don’t overdo it to the point of gaining weight. Instead, try adding a workout or eating extra healthful the day you know you’ll be indulging.

In the end, the whole team had fun and got a little healthier. They even plan on starting up another round!

Why not start your own health challenge? Just remember, it’s always good to talk to your doctor before you do.

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Heart Health Chat Recap: Ask a cardiac nurse

Botsford Hospital recently hosted a Facebook chat to answer questions about heart health, stress and healthy living. Our cardiac nurse expert who answered questions was Heather Glover, a registered nurse and manager of Botsford’s cardiopulmonary and cardiac rehab programs. Since her special interest is heart disease prevention and she’s an advocate for good health, exercise, attitude and life balance, she was a perfect fit to host the chat.

Below is a transcript of the questions and answers. You can see them in their original form here.

Please keep in mind that all answers and advice given by Heather Glover, RN is meant to be general health information. Always talk to your doctor if you have questions regarding your personal health care needs.

Heart Health Questions via Facebook and Answers by Heather Glover, RN:

1.     Can stress affect hearing? I’ve noticed that when I am under stress, it seems like a fan is lightly blowing and I don’t hear certain tones. When I’m more relaxed, it I don’t notice the ” white noise.” Any thoughts?

Heather’s Answer:What a great question! It turns out that it possibly can. Stress can

Heather Glover, RN is a cardiac nurse and manager of Botsford Hospital's cardiopulmonary and cardiac rehab programs.

affect us in so many ways. There are researchers now looking into how stress affects the hearing, because hearing loss and tinnitus (a ringing or roaring in the ears) are common complaints, more now than ever. Personally, I believe in stress reduction and management for sure; you may also want to consult an audiologist (a Physician specializing in hearing) for an evaluation; your family physician would be a great place to start. Good luck to you

2.     I am a 37-year-old male who plays hockey twice a week. I also live a fairly active life style. I feel I am in decent shape but I eat alot of pizza, fast food, etc. Should I be concerned about my heart health?

Heather’s Answer: Great job on keeping so active; it probably helps balance the ‘junk’ food. I’m a heart health advocate, so I would always tell you to be concerned, especially as we get older. Do you see a Physician regularly? Have you had your cholesterol checked? Besides not the healthiest food choices, fast food doesn’t offer a lot of nutritional value. A good engine needs quality gas to run at peak efficiency. The better you eat, the better you’ll feel (and maybe even score more often!)

3.     How do I tell the difference between indigestion and a potential heart warning sign? When my acid reflux flairs up, I notice my shoulder/arm hurting.

Heather’s Answer:  I feel for you; those symptoms are no fun, and can be scary. The truth is, you may not be able to easily tell the difference. If you are being treated for the reflux and are pretty regimented with your prescribed routine, but are still having the arm symptoms, it’s time for a doctor call/visit. Either way, talking with your doctor about your concerns and maybe getting a stress test/EKG/Physical exam, would be a good plan. There’s significant value in addressing your symptoms, getting your questions answered, and peace of mind. Here’s a list of the Botsford cardiology services that maybe helpful: Good luck to you

4.     I’m worried about the effects of too much stress on my heart. I’m overloaded at work, my aging mother has recently suffered her second heart attack and I’m worried about her, and I am a bit of a perfectionist. How can I tell if I’m overstressed and hurting my heart?

Heather’s Answer:  Wow,  you have a lot on your plate (sometimes I call it a platter!) My heart and well wishes go out to you and to your mom. Are you having symptoms of anything? Heart symptoms, especially for females, can be more than just chest pain….jaw pain, back pain, nausea/vomiting; any new symptoms definitely warrant a call/visit to your physician. Stress reduction is definitely a point for you. I’m a perfectionist, too, and there’s NO shame in asking for help. I’m sure you have family/friends who would love to be there for you. Don’t carry the weight of the world by yourself. Take care of yourself, so you can be there for others.

5.     I have to get a stress test. What is it like? What should I expect?

Heather’s Answer:  There are a few different types. In the Botsford Stress Lab, we have echocardiogram types and nuclear medicine types; both options have walking on the treadmill or medicine types (for those who have difficulty walking). If you’re walking, you’ll be tired and sweaty! You will be closely monitored with an EKG and blood pressure machine, and expert staff of course! If you’re not walking, you will be laying down with an IV infusion; again, expert staff are always at your side. Take a look at our website which gives you more info… Good luck to you!

6.     If I have a heart condition should I be careful of my stress level? Will it cause a heart attack?

Heather’s Answer:  Everyone should be careful about stress levels…it’s a stressful world out there. There are lots of ways to keep your stress level in balance…deep breathing, exercise, chatting with friends, taking a ‘time out’, etc. Stress and its effects can cause heart attacks, as well as other physical symptoms….another great reason to keep it in check. See my recent blog post…great question!! Good luck!

7.     What is your daily routine to be healthy?

Heather’s Answer:  I try to watch my diet; fruits and vegetables, limit breads/sweets. Over time, although it’s not always easy, I found that I feel better when I eat better. I try to keep active every day, and exercise at least 3-4 days per week….exercise does nothing but good things for a body from stress relief, to looking good, to feeling great! Lastly, balance is key. It’s a rough world out there some days; we have to find time to laugh, be silly, and enjoy life while we balance the rough spots and stressful times. Good luck to you

What do you think? Should we host another Facebook chat? Let us know or leave us a topic suggestion in the comments below.

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Recipe: Strawberry & Banana Protein Shake

Strawberry banana protein shakeAs a busy working mom it’s hard for Laura Caruso to prepare a healthy lunch to bring to work every day. So instead she keeps frozen bananas and strawberries in the break room freezer and whips up what tastes more like a delicious and refreshing summer treat than a lunch!

Laura is a mammography coordinator at Botsford Breast Center and she recently organized a “Smallest Loser” weight loss challenge with her radiology co-workers. She shared her protein shakes with her fellow contestants and they loved them! The shakes may have even played a role in the success of the contest. In all, the 10 team members lost more than 66 pounds over 10 weeks.

Laura’s recipe is below. Give it a try and let us know how you like it in the comments below. Can you think of any delicious variations? Laura’s “Smallest Loser” team would love to know!

Laura’s Strawberry & Banana Protein ShakeIngredients for a strawberry banana protein shake

  • 1 cup of ice
  • 1 ½ cup water
  • 1 cup frozen strawberries
  • 1 large banana
  • 1 scoop of protein power. Laura recommends “Pure Protein Vanilla Cream Whey Powder” which includes only 2g of sugar.

Put all ingredients into blender, blend until smooth and enjoy!

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Another Successful Cancer Screening Event!

Head and neck cancer screening at Botsford Cancer Center

A woman is screened for head and neck cancers at Botsford Cancer Center

This past Saturday marked another success for the community! Botsford Cancer Center held another free cancer screening, this time screening for head and neck cancers.

Even though spaces were limited, we were able to screen 64 people. Of those, 11 were referred for an immediate consult and 34 were recommended further evaluation. We are optimistic and hopeful that we may have caught cancer early and saved lives.

Most head and neck cancers begin in those head and neck areas lined with moist surfaces such as the nasal cavity, sinus, salivary glands, throat, voice box, or on the lips. Symptoms can include a lump or sore that doesn’t heal, a sore throat that doesn’t go away, difficulty swallowing or a change or hoarseness in the voice.

If you’d like a cancer screening but weren’t able to make it to our cancer screening event, talk to your doctor or contact a Botsford doctor.

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Importance of nutrition for cancer patients

Denise Cykiert, RD at Botsford Cancer Center

Joan (right), a patient at Botsford Cancer Center, samples fruit and yogurt parfaits made by Botsford dietitian Denise Cykiert during a cooking demonstration at the center.

If you’re fighting cancer, nutrition is a big concern.  It is extremely important for people with cancer to make food choices high in nutritional value, including vitamins, minerals, calories and protein because treatments like chemotherapy and radiation therapy can take a significant toll on the body.

While these cancer treatments are effective at treating the disease, they can destroy a portion of your healthy cells too.  Your body needs adequate calories and protein to rebuild itself, so it is important to choose foods high in nutritional value. If a person who is fighting cancer is not eating well, the healing process may be delayed and adverse effects can prevent the patient from completing the prescribed treatment plan, which in turn may affect the patient’s outcome.  If one does not take in enough calories, they may lose weight, feel overly fatigued, and generally experience a poorer quality of life.

On the other hand, foods that are high in nutritional value can promote healing, control the symptoms of cancer and reduce the side effects of cancer treatment. So at Botsford Cancer Center, we’re always on the lookout for foods and recipes that our patients can easily make at home to help nourish them through treatment. Easy to prepare, small snacks usually work best for our cancer patients, like this recipe for fruit and yogurt parfaits.

If you try the parfaits, let us know what you think in the comments below!

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Fruit & Yogurt Parfaits: Great nutrition for cancer patients

Fruit and yogurt parfaitFruit and yogurt parfaits are considered a multipurpose snack, packed full of nutritious benefits because they contain probiotics, protein, calcium, vitamin B2, vitamin B12, potassium and magnesium. The nutritional benefits are great for everyone, but cancer patients can especially benefit because nutrition is vital to successful cancer treatment. In fact, we like the nutritional value in these parfaits so much we recently demonstrated them for our patients and visitors at Botsford Cancer Center.

Fruit and yogurt parfaits pack a nutritional punch for cancer patients because they have a long list of benefits cancer patients need, including:

  • Osteoporosis prevention – Some chemotherapy treatments can cause bones to become brittle or bone marrow suppression, both of which can lead to osteoporosis (the thinning of bone tissue and loss of bone density over time). Vitamin D and calcium in yogurt will help strengthen bones. Check food labels to see which brands contain added vitamin D.
  • Maintaining gastrointestinal health – Probiotics (also known as “good bacteria”) help gastrointestinal conditions and help in maintaining bowel functions.  This is important for people with cancer because radiation and chemotherapy treatments can cause gastrointestinal distress such as nausea, vomiting, diarrhea and constipation.  Yogurt will provide the body with good bacteria that is used to fight off the “bad” bacteria which cause upset stomach. Also, some patients on antibiotics may need active cultures to replace bacteria that may be lost.  Yogurt with active cultures may also help with other gastrointestinal conditions such as lactose intolerance, colon cancer and inflammatory bowel disease.
  • Feeling fuller – Parfaits pack calories and protein into a relatively small serving which is important for cancer patients experiencing decreased appetite as a result of treatment. Choosing foods that are high in calories and protein and eating small, frequent meals can help maintain required nutrition when you just don’t feel like eating. Other options include semi-solid yogurt containing pieces of fruit and granola, drinkable yogurt and flavored dairy beverages.
  • Boost immune system function – Chemotherapy treatments may suppress the immune system by destroying both the good and bad cells. Make your parfait with blackberries, blueberries, raspberries, cranberries or strawberries to give your immune system a boost and it may also help to reduce your risk of several types of cancers.
  • Energy and bowel function – The bananas in the parfait are a great source of source of vitamins, minerals and fiber, which provide the body with energy and helps maintain bowel functions.

Fruit & Yogurt Parfait Recipe

Layer 1/3 cup vanilla yogurt into the bottoms of 4 tall glasses. Alternate layers of fruit, granola and yogurt until glasses are filled to the top. Serve parfaits immediately to keep granola crunchy.


  1. 1 cup (8 oz) regular yogurt (if you’re undergoing cancer treatment, it’s best not to use light or low-fat yogurt because you need your calorie counts up!)
  2. ¼ cup each of two types of fruit. For cancer patients, I recommend any two of the following to maximize the cancer-fighting potential:
    • Blueberries
    • Strawberries
    • Bananas
    • Mandarin oranges
    • Pineapple
    • Apple pie filling
  3. Your choice of crunch, recommend (1/2 cup):
    • Trail Mix
    • Granola
    • Cereal (like Kashi GO LEAN Crunch with toasted berries)
  4. Whipped Cream (3 oz)

Nutrition Information (per serving): Calories 707, Protein 24 grams

Try these delicious variations!

Apple pie a la mode pafait


  • 8 oz yogurt – apple cinnamon or vanilla flavor
  • Apple pie filling
  • Granola
  • Optional – cinnamon to sprinkle on top for garnish

Strawberry and banana parfait


  • 8 oz yogurt cup – strawberry banana flavor
  • Granola
  • Strawberries, sliced
  • Banana, sliced
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