Five Ways to Reduce Your Risk of Cardiovascular Disease

women running for cardiovascular health

Cardiovascular disease (CVD) is the leading cause of death globally.  CVD includes coronary artery disease, stroke, aortic disease, and peripheral artery disease.  The risk of cardiovascular disease increases with age and is most common in those over age 50.  While genetics is a factor in the risk of developing cardiovascular disease, our lifestyle choices also play a role.  The following are some ways that people can help reduce their risk.

Maintain a Healthy Weight

Being overweight increases the risk for heart disease.  Carrying excess weight increases inflammation and puts added stress on the heart.  Eating a heathy diet and controlling portion size help in maintaining an appropriate weight.  A heart healthy diet includes fruits, vegetables, whole grains, lean meat, low fat or fat free dairy, and healthy fats such as olive oil.

Keep Physically Fit

Strive for 30 minutes of physical activity daily.  Even light to moderate activity is beneficial.  The American Heart Association recommends combining aerobic exercise with resistance training.  Regular exercise lowers blood pressure, helps maintain a healthy body weight, and lowers the risk of developing diabetes.  Being more active has the added benefit of helping people think, feel, and sleep better.

Get Quality Sleep

Senior man sleeping in the bedroom at home. recommended sleep helps prevent risk of heart attack, high blood pressure, obesity, and diabetes.

Many people get less than the recommended seven hours of sleep each night.  Those who don’t get enough sleep are at greater risk of heart attack, high blood pressure, obesity, and diabetes.  People with obstructive sleep apnea tend to have high rates of cardiovascular disease.

Don’t Smoke

The chemicals in tobacco damage the blood vessels by causing them to thicken and narrow.  Smoking tends to make the blood more likely to clot, which can block blood flow.  Cigarette smoke lowers oxygen levels in the blood, raising blood pressure and heart rate.

Manage Medical Conditions

  • Monitor cholesterol levels – A complete cholesterol test, or lipid panel, is a blood test that measures cholesterol and triglycerides in the blood.  High cholesterol levels indicate a risk factor for cardiovascular disease.
  • Control blood pressure – High blood pressure, or hypertension, is a risk factor for heart disease and stroke.  High blood pressure damages arteries that provide blood flow to the heart.
  • Manage diabetes – Diabetes can damage blood vessels and cause circulatory problems.  People with diabetes are twice as likely to have a stroke or heart attack than those who don’t have diabetes.  The most common test for diabetes is a fasting blood test to measure blood sugar levels.

People with these medical conditions should have regular screening tests, eat a healthy diet, and take their medications as directed.

RMD Primary Care

The physicians at RMD Primary Care provide a number of services to support the health and well-being of patients.  Contact our office to schedule an appointment.

Five Common Complications of Diabetes

Young diabetic patient teenage woman using applicator to attach glucose sensor on arm.

Diabetes is a chronic disease in which the body is unable to process sugar as it should.  In type 1 diabetes, the pancreas makes little or no insulin.  In type 2 diabetes, the body is unable to use insulin as it should.  Type 2 diabetes is much more common and often affects people in middle age and older.  People with diabetes must manage their condition and carefully monitor their blood sugar levels to avoid serious complications.

The following are five common complications of diabetes:

Heart Disease (cardiovascular disease)

senior man with heart disease

Heart disease is one of the most common complications of diabetes.  It not only affects the heart but also the blood vessels.  People with type 2 diabetes are twice as likely to develop cardiovascular disease than those without diabetes.  Blood vessels will eventually stiffen and narrow, decreasing blood flow.  Decreased blood flow to the heart can cause a heart attack, and a decrease of blood flow to the brain can cause a stroke.

Kidney Disease

Diabetes that is not well controlled can lead to diabetic nephropathy.  The blood vessels in the kidneys become damaged and do not filter waste as they should.  This can allow fluid to build up in parts of the body, leading to swelling of the arms, legs, feet, and lungs.  End-stage kidney disease may require dialysis or a kidney transplant.

Diabetic Retinopathy

This condition causes vision loss and blindness as the blood vessels in the retina are affected.  The risk increases the longer the person has had diabetes.  Damaged blood vessels in the eye can actually leak fluid or blood.

It’s important for diabetics to get a comprehensive eye exam annually including dilation of the eyes.  There may not be noticeable symptoms in the early stages of the disease, but early detection can help prevent vision loss.

Diabetic Neuropathy

This is a type of nerve damage that can occur with diabetes.  Symptoms can include pain and numbness in the feet, legs, hands, and other parts of the body.  Diabetic neuropathy can be painful and disabling, and the damage cannot be reversed. 

Foot Complications

Diabetes can cause nerve damage and poor circulation.  People may develop serious foot problems including infections, ulcers, bone and joint damage.  Ulcers and infections may be slow to heal.  There may be yellowing of the toenails.  If blood flow is cut off, tissue will die.  This complication can lead to amputations of the toes or foot.

RMD Primary Care

Our physicians at RMD Primary Care help patients manage their diabetes.  We recommend eating a healthy, balanced diet and maintaining a healthy weight.  Following a daily regimen of exercise and healthy physical activity is important.  Medication may be necessary to control the condition and prevent long-term complications.  Contact us to schedule an appointment with one of our providers.

Is it a Cold, the Flu, or Covid?

Woman with flu in bed, she use thermometer to measure temperature

Colds and flu are common this time of year.  Covid cases are also on the rise again.  People are more likely to spread these respiratory illnesses during the colder months because they spend more time indoors.  Viruses tend to spread more easily in smaller spaces with drier air.  Recent studies have shown that the nasal cavity is more sensitive to cold temperatures, and there may be a weaker immune response to respiratory viruses.  During the holiday season, people may find themselves in crowded places such as shopping malls, parties, and special events where they may be exposed to those who are ill.

What causes colds?

The common cold can be caused by over 200 different viruses, with rhinovirus being the most common.  These viruses generally affect the upper respiratory tract, causing inflammation of the membranes that line the nose, throat, and sinuses.  Colds are easily spread through airborne droplets when an infected person sneezes, coughs, or touches a surface that someone else then touches.  Colds generally cause mild illness.

What causes flu?

man sick on couch with flu

Flu is caused by influenza viruses.  It can cause mild to severe illness that affects the nose, throat, and sometimes the lungs.  Symptoms of flu come on suddenly and can include sore throat, runny nose, headache, fever, muscle aches, chills, dry cough, and shortness of breath.  Influenza viruses also spread through tiny droplets.  Young children, seniors, and those with weakened immune systems are particularly at risk for serious illness.  The best way to prevent flu is by getting an annual flu vaccine.

What causes covid?

Covid-19 is caused by the SARS-CoV-2 virus, a corona virus.  Covid can attack the respiratory system and lungs.  It is very contagious and spreads quickly.  Symptoms resemble those of the cold, flu, or pneumonia.  Some people suffer only mild illness while others become severely ill.  A Covid-19 test is used to diagnose the illness.  Vaccines are available to help prevent severe complications.

When should I see a doctor?

People with a cold can usually treat their symptoms at home.  People with flu symptoms should be tested for flu.  Antiviral medications can be prescribed to help shorten the flu and prevent complications.  People who test positive for covid but have only mild symptoms may be able to recover at home.  Paxlovid may be prescribed for those who are at higher risk for severe illness.  People who are having difficulty breathing should go to the emergency room.

RMD Primary Care

The physicians at RMD Primary Care recommend that patients get an annual flu shot and stay up to date on covid vaccines.  If you have tested negative for covid but think you may have the flu, contact our office.

Who Should Get the Shingles Vaccine?

Senior vaccination concept. Elderly getting immune vaccine at arm for flu shot, pneumonia, and shingles(MMR) in hospital by nurse. Doctor giving an injection to older people patient in clinic.

Shingles is a painful skin condition that can develop in anyone who has had chickenpox.  More than 95 percent of American adults have had chickenpox.  Shingles causes a blistery rash that can occur anywhere on the body.  Early symptoms of shingles are pain, tingling, burning, and itching in the area where the rash will eventually appear.  The rash may not be visible for several days.  Some people may also have a headache and fever.  According to the CDC, one in three people in the U.S. will develop shingles in their lifetime.

What causes shingles?

The varicella-zoster virus, one of the herpes viruses, causes shingles.  It’s the same virus that causes chickenpox.  The virus can stay dormant for years in the body of anyone who has had chickenpox.  When something triggers the virus to become active again, the person will develop shingles.

Who is most at risk for shingles?

  • People over age 50
  • Those with weakened immune systems, such as cancer patients
  • People who have recently been ill
  • Those who are under stress

Is shingles contagious?

Shingles (Disease), Herpes zoster, varicella-zoster virus. skin rash and blisters on body

Shingles is not contagious.  It doesn’t spread from person to person, although those with shingles can spread chickenpox through the fluid in the blisters.  A person can have shingles more than one time, although the rash usually affects a different place on their body.

Are there complications from shingles?

People over age 60 are more likely to have serious complications.  The pain from the rash may continue long after the blisters have healed.  Serious complications include neurological problems such as facial paralysis and swelling of the brain.  Hearing and balance issues are other complications.  Shingles around the eye can lead to vision problems.

Who should be vaccinated for shingles?

Shingrix has been the recommended shingles vaccine in the U.S. since 2017.  It replaced an earlier vaccine called Zostavax.  Two doses of the Shingrix vaccine is recommended for those age 50 and older who are in good health.  Shingrix vaccine is more than 90 percent effective at preventing shingles, and immunity remains strong for at least seven years.  People can get Shingrix even if they have had the previous vaccine, have already had shingles, or don’t know if they have had chickenpox.

RMD Primary Care

The physicians at RMD Primary Care can treat patients who develop shingles.  If you suspect you may have shingles, you should make an appointment with the doctor as soon as possible.  Patients can get more information about the Shingrix vaccine from their healthcare provider.  Contact our Lawrenceville office today.      

Mammogram Technology for Dense Breasts

Dense breasts are common.  According to the National Cancer Institute, nearly half of women who are age 40 and over who have mammograms are found to have dense breast tissue.  While not abnormal, it’s not possible to detect dense breast tissue during a physical examination.  However, dense breast tissue does show up on a mammogram.

Dense breasts contain more glandular tissue, the part of the breast that makes milk.  Glandular tissue is more likely to develop cancer, putting women with dense breasts at higher risk.  Dense breasts also make it harder to detect cancer using conventional mammography.  Since dense breast tissue appears white on a mammogram, cancerous lumps may be hidden.

Factors that Influence Breast Density

  • May be inherited
  • More common in younger, pre-menopausal women
  • Having a low body mass index (BMI); having a thin body type
  • Using post-menopausal hormone replacement therapy

Breast density can decrease following menopause.

3D Mammography Improves Cancer Detection

Conventional 2D mammography produces flat images.  There will be a top view and a side view of each breast.  Overlapping tissue in these images can make it more difficult to detect cancers.  It’s even more problematic when the breast tissue is dense.

Radiologists are better able to see through dense breast tissue with 3D imaging, or breast tomosynthesis.  This 3D technology produces multiple images, which look like slices.  The radiologist can examine each layer looking for abnormalities.

Abnormal areas are sometimes seen on conventional mammograms.  However, there are also false positives.  This outcome causes anxiety and stress for women who have to return for additional testing, such as an ultrasound.  3D mammography is more precise, so the number of false positives is reduced.

While 3D mammography is becoming more common, it’s not available everywhere.  Women with dense breasts may particularly benefit from 3D mammography, as well as women who are at higher risk for developing breast cancer.  Those women should definitely seek out a facility that offers it.

Schedule Your Annual Breast Cancer Screening

October is Breast Cancer Awareness Month, the perfect time for women to schedule their annual mammogram.  RMD Primary Care encourages women to be proactive in managing their healthcare.  Our physicians offer women’s health appointments as part of our Family Medicine Services.  Fall is a good time of year for women to take care of their health issues, preventative tests, and cancer screenings.  Women’s health also includes menopause and the symptoms that come with it.  Contact us to schedule your annual pap smears, breast exams, and mammogram referrals.

Health Benefits of Omega 3 Fatty Acids

Close-up on a woman eating salmon for dinner at a restaurant - fish rich in omega 3 fatty acids

Omega 3 fatty acids have been studied for years.  There are a number of health benefits to adding them to your diet.  Some benefits include lowering the risks of heart disease, improving cognitive function, reducing inflammation, and preventing certain eye diseases.

Omega 3s are found naturally in some fish such as salmon, tuna, herring, mackerel, and   sardines.  Nuts and seeds including walnuts, flaxseed, and chia seeds contain omega 3s.  They are also found in plant oils including soybean oil, flaxseed oil, and canola oil.  In addition, omega 3 fatty acids are available in over-the-counter supplements like fish oil and krill oil.

The following are some of the health benefits of adding omega 3s to the diet:

Heart Health

Studies have shown that omega 3 fatty acids lower triglyceride levels and help protect against some heart problems.  Omega 3s may help lower blood pressure.  They also keep blood platelets from clumping together, which prevents blood clots from forming.  Research suggests omega 3s may raise good (HDL) cholesterol levels.

Cognitive Function

Some research has shown that a diet rich in omega 3 fatty acids may lower the risk of developing dementia, Alzheimer’s disease, and other issues associated with cognitive function.  They may help improve mild memory loss in people with early age-related cognitive decline.  Studies show that people may receive the most benefit when taking omega 3 supplements in the early stages of decline.  However, supplements may have little effect on those with more severe cognitive impairment.  Other research shows that omega 3 supplements may be effective in treating symptoms of depression and anxiety.


Adult woman supporting her elderly mother on a morning walk. Concept of active aging and low inflammation.

Omega 3s have strong anti-inflammatory properties.  They are helpful in reducing chronic inflammation and providing joint lubrication.  They may be effective in relieving joint stiffness and pain for those suffering from different types of arthritis including osteoarthritis, rheumatoid arthritis, and gout.

Eye Disease

Taking omega 3 supplements is effective in treating inflammation and reducing symptoms associated with dry eye disease.  Research suggests that omega 3s lower the risk of developing age-related macular degeneration (AMD), a disease that affects the central vision.  AMD is a common cause of vision loss in seniors.  Omega 3s may help in the prevention of the disease, but do not slow its progression if the disease is already present.

Dietary Notes

Omega 3 fatty acids are not produced naturally in the body, so they must be obtained from food sources or supplements.  Fish oil supplements are generally considered safe when taken as directed.  Possible side effects include nausea, diarrhea, heartburn, and an unpleasant taste in the mouth.  Diabetics should consult their doctor before taking fish oil supplements, as they may increase blood sugar levels.

The physicians at RMD Primary Care are happy to answer questions about maintaining a healthy diet or the benefits of dietary supplements.  Contact us today to schedule an appointment.

Tips to Prepare for Your Doctor’s Visit

Hispanic women preparing list for doctor appointment

RMD Primary Care believes patients should be actively involved in their healthcare.  This is especially important when a patient sees a primary care physician as well as specialists.  It’s essential that all your doctors are aware of medical treatments recommended by other providers.  An average doctor’s visit is 15-20 minutes.  To get the most out of that time, a patient needs to be prepared.  That way, the patient doesn’t feel rushed, and the doctor can be thorough.  It’s frustrating to go home after an appointment and realize there were questions you didn’t ask or concerns that weren’t brought up.

Along with bringing an ID and your insurance card, here are some other tips to help patients prepare for their visit.

Make a List

A list helps people remember the important things.  If you are a new patient, write down your medical history, a list of current medications with their dosages, and any over-the-counter supplements being taken.  Prioritize your concerns.  The list might include any new symptoms to mention, worsening pain, questions about your medications or prescription refills, or any side effects from your current medications.  Are there concerns about blood work or test results?  Are you due for any vaccines?  Are there questions about upcoming medical procedures?  Is a referral to a specialist needed?  It is easy to forget something when there is not a list.

Update Your Doctor

Tell your doctor about any new prescriptions from other providers.  Inform your doctor if you’ve been seen by a specialist, had any recent surgeries by other physicians, or been to the emergency room or been hospitalized.  Let your doctor know if there have been recent changes in weight, energy level, sleep habits, mobility issues, or pain.  Update the doctor about recent accidents or falls.

All these concerns are important for the doctor to know.  Be honest with the doctor about how you are feeling.  Give specific details to help explain.  These details help the doctor determine the best course of treatment.

Take a Family Member or Friend

Sitting in the medical waiting room lobby, the mature adult mother watches as her young adult daughter shakes hands with a primary care doctor.

A family member or friend may be able to help you remember details.  They can remind you to ask questions or relate concerns you might not have mentioned.  This person can listen to the doctor’s instructions and take notes, if necessary.  They may help you clarify anything that was not understood.

Good communication is key.

A successful doctor’s visit depends on good communication between the patient and the doctor.  Don’t withhold information.  Your honest input helps the doctor diagnose your condition and determine appropriate treatment.  Contact RMD Primary Care to schedule your next appointment.

Recognizing Heat-Related Illness

women dealing with heat related illness.

Summer heat has arrived!  With high temperatures in Atlanta and Lawrenceville often exceeding 90 degrees, coupled with high humidity levels, it’s easy to become overheated.  While anyone can be affected by the heat, those most susceptible include children younger than age 4, seniors aged 65 and older, those who are obese, people with certain medical conditions, and workers whose jobs require them to be outdoors.  Excessive heat can be deadly.  Never leave people or pets in a parked car.  The following are strategies to help cope with high summer temperatures:

Stay Hydrated

Hydration is essential.  Drink plenty of fluids, especially when outdoors.  Water is the best choice, but other good options include sports drinks with electrolytes, milk, coconut water, and fruit juices (without added sugar).  Avoid sodas, energy drinks, alcohol, and beverages that contain caffeine.  Caffeine and alcohol are diuretics, which means they increase urine output.

Full length profile view of a Hispanic man with a beard drinking some water from a bottle and resting from working out at a park to stay hydrated.

Avoid Strenuous Activities

Limit exercise to the cooler parts of the day and stay inside during peak sun hours.  When outside wear loose fitting, light-weight clothing and a hat.  Use sunscreen to protect skin from sunburn.  Pace yourself and rest in the shade as necessary.

Cool Off in Air Conditioning

 Stay in the air conditioning as much as possible.  Close blinds and curtains on windows that face the sun.  Use the stove and oven less.  Take a cool bath or shower.

Heat-Related Illnesses

Heat exhausted construction worker that is sweaty and dizzy.

Heat exhaustion and heat stroke are heat-related illnesses.  It’s important to recognize the signs and take immediate action.

Heat Exhaustion

  • Heavy sweating
  • Muscle cramps
  • Headache
  • Dizziness
  • Weakness
  • Fainting
  • Nausea or vomiting

Heat exhaustion is serious.  It’s important to take appropriate steps to cool the person down and provide fluids.


  • Hot, dry skin with no sweating
  • Extremely high body temperature
  • Rapid pulse
  • Dizziness
  • Confusion
  • Throbbing headache
  • Seizures
  • Unconsciousness

Heatstroke is a medical emergency.  Call 911 for help.  While help is on the way, cool the person by whatever means available.  Immerse them in a cold bath or cover them with wet sheets.  Apply ice packs to the groin, armpits, neck, and back.  If conscious, give fluids.  Untreated heatstroke can cause organ failure, brain damage, and death.

The physicians at RMD Primary Care specialize in General Practice, Family Medicine, and Medical Weight LossOur doctors are Board Certified in Family Medicine and Internal Medicine.  We believe that quality healthcare begins with preventative care and health maintenance.  If it’s been a while since your last health checkup, contact our office to schedule an appointment. 

Talk to Your Doctor About Memory Loss

Senior hispanic women with memory loss

When people begin to experience memory loss, they may talk to their family practice doctor.  Many primary care physicians are often the first ones to suspect a diagnosis of dementia or Alzheimer’s disease, a particular type of dementia.  Their doctor will evaluate general health and do initial cognitive screenings to identify conditions that affect how well the mind is working.  The primary care physician may refer the patient to a specialist, such as a neurologist or geriatrician, for further assessment and treatment.

Does memory loss mean dementia or Alzheimer’s?

Memory loss is not the only symptom of dementia or Alzheimer’s disease.  It’s normal to experience some memory loss or forgetfulness with age.  Mild memory loss may never progress to dementia, and most people are able to carry on with daily activities without problems.  In a small percentage of people, memory loss may deteriorate to the point that they can no longer care for themselves.

June is Alzheimer’s and Brain Awareness Month.  This is an appropriate time for individuals and families to review common early symptoms of dementia and Alzheimer’s disease.

Cognitive Changes

  • Memory loss
  • Forgetting important dates or events
  • Misplacing things
  • Getting lost in familiar places
  • Difficulty communicating
  • Asking the same questions over and over
  • Inability to concentrate
  • Difficulty problem solving or reasoning
  • Poor decision making
  • Difficulty completing complex tasks
  • Difficulty planning and organizing
  • Inability to manage finances or pay bills
  • Reliance on family members to handle familiar tasks
  • Confusion

Psychological Changes

Wife Comforting Senior Husband Suffering With Dementia
  • Personality changes
  • Depression
  • Anxiety
  • Fearfulness
  • Agitation
  • Inappropriate behavior
  • Withdrawal from social activities or hobbies previously enjoyed
  • Paranoia
  • Hallucinations

Talk to Your Physician

Many times these early signs are noticed by family members.  Concerned family members may want to document symptoms or behaviors that are causing concerns.  They can offer to accompany the person to doctor appointments, if possible.  If not practical, they should at least encourage the person to speak to their physician about these important health concerns.

RMD Primary Care

The physicians at RMD Primary Care specialize in General Practice, Family Medicine, and Medical Weight Loss.  We believe that quality healthcare begins with preventative care and health maintenance.  Preventative care includes regular physical exams and health screening tests tailored to a patient’s age, health, and family history.  This helps us identify issues early before they become serious complications.  If it’s been a while since your last health check, contact our office to schedule an appointment.     

May Is Skin Cancer Awareness Month

woman putting sunscreen on her face. young latina with her eyes closed and smiling taking care of her skin with creams.

Skin cancer is the most commonly diagnosed cancer in the U.S.  One in five Americans will develop skin cancer by age 70.  Unprotected sun exposure over the years has left many people vulnerable.  Many of these are affected by actinic keratosis, the most common precancer.

Skin cancer is one of the most preventable cancers.  Using a broad-spectrum sunscreen with an SPF of 15 or higher helps protect skin from harmful UVA and UVB light rays.  Reapply sunscreen as directed, especially after sweating or swimming.  Stay out of the sun during peak hours of intensity.  Cover up with clothing, a hat, and sunglasses.  Avoid tanning beds.  Indoor tanning increases the risk for skin cancer.

The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma.  The American Cancer Society recommends people ages 20-40 have a professional skin cancer exam every three years, particularly if they live in sunny climates.  People over age 40 should have a skin cancer screening annually.

Basal Cell Carcinoma

This is the most common type of skin cancer.  It may look like a flesh-colored, pearl-like bump or a patch of pinkish skin.  It can form anywhere on the body but is common on the head, neck, and arms.  People with fair skin are particularly vulnerable.

Squamous Cell Carcinoma

The second most common type of skin cancer is squamous cell carcinoma.  People with lighter skin are most likely to develop it.  The cancer can look like a scaly patch, a red bump, or a sore that doesn’t heal.  It is commonly seen on the face, ears, neck, arms, back, and chest.


Photos of melanoma without magnification and with a tenfold magnification using a dermatoscope

Melanoma is the deadliest form of skin cancer because of its tendency to spread.  It can develop in a mole or appear as a new dark spot.  The spot will look asymmetrical and have irregular borders.  Existing moles that change in shape, size, color, or feel should be examined by a physician.  Melanoma commonly is seen on the legs of women and on the chest and back of men.  Early diagnosis is crucial for successful treatment.

Next Steps

Mole dermatoscopy. Doctor examines the patient's mole with a dermatoscope for prevention of melanoma, close-up.

The physicians at RMD Primary Care can perform surgical biopsies of suspicious skin cancer lesions or moles.  There is minimal discomfort to the patient as the site is numbed first.  The specimen will be sent to a lab for analysis and testing.  If skin cancer is diagnosed, we can refer patients to a specialist.  Contact us for an evaluation appointment if you have any areas of concern.

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