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.

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.

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.

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

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.

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.

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 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.

Heatstroke

• 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 Loss.  Our 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. 

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

• 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.     

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.

Melanoma

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

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.

As women age, they become more at risk for developing osteoporosis, a disease that weakens bones and leaves them susceptible to fractures.  Affected bones become weaker and brittle.  Osteoporosis doesn’t have any painful symptoms, so those who have it may be unaware there is a problem.  Often the first indication of osteoporosis is a broken bone.  A bone density scan is a medical imaging test that measures the thickness and strength of the bones and determines whether osteoporosis is present.

Why are women at risk?

Women are four times more likely than men to develop osteoporosis.  Women who have gone through menopause are at increased risk because their hormone levels have changed.  Estrogen, a hormone that protects against bone loss, declines after menopause.  Other risk factors for osteoporosis include a family history of the disease, having a petite body frame, and living an inactive lifestyle.  Medical conditions such as rheumatoid arthritis, lupus, liver disease, and kidney disease increase the risk.  Some medications, including certain steroids and cancer drugs, may also increase a person’s risk.  Ethnicity is a contributing factor, as Caucasian and Asian women seem to have a higher incidence of osteoporosis.

When should a woman be tested?

A referral from a healthcare provider is generally needed for a bone density test.  Women aged 65 and older should have a test.  Women aged 64 and younger who are post-menopausal should consult with their doctor, who may recommend a bone density test depending on their other risk factors.  Many doctors advise a bone density test for women over age 50 who have fractured a bone, particularly a hip, wrist, or vertebrae.

What is a bone density test like?

A bone density test, also known as a DEXA scan, is a low-dose x-ray.  The scan takes 15-30 minutes and is totally painless.  No special preparation is required before the scan.  Areas of the body that are usually examined include the bones of the spine, hips, wrist, forearms, fingers, and heels.  The scan results are reviewed by a radiologist, and a report is sent to the referring physician.

Next Steps

The physicians at RMD Primary Care consider bone health to be an important women’s health issue.  Since osteoporosis is often called a “silent” disease due to its lack of symptoms, it’s important to have a bone density test to evaluate bone health.  Medications are available for the treatment of osteoporosis.  For more information about women’s health services available from RMD Primary Care, contact us today.

February is American Heart Month, a time to raise awareness about heart disease and its risk factors.  It’s an appropriate time for self-examination about lifestyle choices and how to better live a heart healthy lifestyle.  Heart disease is the leading cause of death for Americans and much can be done to prevent it.  Take steps now to reduce your risk and make healthy lifestyle choices.

Risk Factors

There are many risk factors for heart disease.  They can be divided into two categories: those we can change, and those we don’t have control over.  The more risk factors a person has, the greater the chance of developing heart disease.

The following risk factors are generally not in our control:

• A family history of early heart disease
• Congenital heart defects
• Age – over 45 for men and over 55 for women
• Ethnicity – risk is higher for African Americans, native Americans, native Hawaiians, and south Asians
• Women who have gone through early menopause
• Women who developed preeclampsia during pregnancy

Controllable risk factors including the following:

• High blood pressure
• High cholesterol
• Diabetes
• Unhealthy diet
• Overweight and obesity
• Smoking
• Sedentary lifestyle

Lower Your Risk

Following these measures can help reduce the risk for heart disease:

• Control blood pressure – Check it regularly.  Eat a healthy diet, limit sodium, exercise regularly, and manage stress.
• Lower cholesterol – Eat foods lower in fat and eliminate trans-fat.  Eat plenty of fruits, vegetables, and whole grains.  Increase consumption of soluble fiber.
• Maintain a healthy weight – Excess weight around the midsection increases the risk for heart disease.  Being overweight or obese also increases the risk of developing diabetes.
• Quit smoking – Smokers are 2 to 4 times more likely to develop heart disease than nonsmokers.  Smoking damages blood vessels and reduces blood flow from the heart.
• Stay active – Strive for 30-60 minutes of physical activity each day.  Activity doesn’t have to be vigorous or a sport.  Walking, biking, swimming, and gardening are all good ways to keep active.  Exercise helps to control weight and can alleviate stress.

Get Regular Health Screenings

Regular physical exams by a physician and health screenings are important.  They let you know what your numbers are and whether you need to make changes.  Problems can be identified early, when they may be easier to treat.  If you haven’t seen your doctor in a while, it’s time to schedule a health checkup.

The physicians at RMD Primary Care are available to provide for your healthcare needs.  Contact us today to schedule an appointment.    

Many people start the new year with goals for healthy living, and that may involve better eating choices, more physical activity, or weight loss.  The reality for many people is that the intentions are good but their follow through is lacking.  We understand the implications for our long-term health, but results are often difficult to achieve.

Importance of Maintaining a Healthy Weight

As we age, our metabolism changes.  It slows down, and the rate at which the body utilizes food decreases by 10 percent each decade after age 20.  This makes it easier for some people to put on unwanted pounds.  The loss of muscle,  natural hormonal changes, and a lack of physical activity all play a role in weight gain.

People who are overweight or obese are at higher risk for serious health problems.  Those who maintain a healthy weight reduce their risk of developing heart disease, high blood pressure, type 2 diabetes, breathing problems, sleep apnea, gallstones, and certain cancers.  Losing weight can help lower cholesterol, triglycerides, blood sugar levels, and insulin resistance.  Weight loss also reduces stress on the bones and joints, a plus for those suffering from osteoarthritis.

Lifestyle Changes that Impact Weight Loss

• Limit portion sizes – Eat smaller portions.  Most people consume more daily calories than they need.  This advice is even more important when eating at restaurants.  Their average serving sizes have increased over the years.  Patrons should plan to eat half their portion and take the remainder home for another meal.
• Make healthier food choices – Swap out less healthy foods for more nutrient-rich choices.  Eliminate high calorie snacks and processed foods with added sugar and salt.  Add more fruits, vegetables, and whole grains to the diet.  Choose lean proteins and low fat dairy products.  Substitute water for sugary beverages.
• Be physically active – Strive for 30 minutes of exercise five days a week.  Good examples include brisk walking, cycling, swimming, playing a sport, and gardening tasks.
• Stay hydrated – It’s easy to confuse thirst with hunger.  Drinking water helps increase metabolism.
• Get a good night’s sleep – Those who are tired are less physically active during the day and burn fewer calories.  Healthy adults should strive to get 7-9 hours of sleep each night.

Next Steps

If you have concerns about your weight, speak to your health care professional about it.  They will help you determine a healthy weight for you and advise about making lifestyle changes.  If you are having trouble dropping extra pounds, the physicians at RMD Primary Care offer medical weight loss services.  Contact us today to schedule an appointment.

Many people have difficulty getting through the holiday season without gaining a few pounds.  There can be numerous temptations that derail our best efforts and make us abandon our healthy habits.  But holiday weight gain is not inevitable.  The following tips can help us enjoy the seasonal celebrations with family and friends without feeling guilty in January.

Stay active.

Everyone is busy during the holiday season, but this is not the time to skip your regular exercise routine.  It’s easy to gain weight with all the festivities and extra treats, so physical activity is a great way to work off those extra calories.  Even if we travel away from home, there are opportunities to stay active.  Use the exercise room in the hotel, take a walk with family and friends, or play outside with the kids.  All these activities will burn calories.

Eat a balanced diet.

To balance out all the carbohydrate-rich foods consumed over the holidays, make sure to eat proteins, fruits, and vegetables.  Fiber rich foods help us feel more full, so we tend to eat less.  Don’t go to a party hungry.  Plan to eat some healthy snacks before going to avoid filling your plate with unhealthy, high-calorie foods.  Skip the second helpings or that extra trip through the buffet line.  Limit your intake of alcohol, which adds significant amounts of sugar and empty calories.

Get plenty of sleep.

Sleep deprivation may contribute to weight gain.  Studies show that individuals who are sleep deprived tend to eat more.  Fatigue from inadequate sleep can cause them to reach for unhealthy snacks high in sugar and fat for a quick energy boost.  They may skip their workout because they are too tired.  Poor sleep quality is associated with glucose intolerance, insulin resistance, and oxidative stress, all of which can have serious health effects.  Adults should get 7 or more hours of sleep each night.

Control stress.

Extra responsibilities and commitments, end-of-year work deadlines, and increased holiday spending can all lead to stress around the holidays.  Stress can affect our body, our mood, and our behavior.  High levels of stress can negatively affect sleep patterns.  Individuals may have difficulty falling asleep or have fragmented sleep with frequent awakenings.  Take steps to manage stress, such as getting enough exercise, eating a balanced diet, limiting caffeine and alcohol, practicing relaxation techniques, and setting aside time for hobbies or other things you enjoy.

Next Steps

The physicians at RMD Primary Care are available during the holiday season to provide for your healthcare needs.  Contact us to schedule an appointment.