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.

Almost half of the U.S. adult population suffers from hypertension, or high blood pressure.  Many people don’t have symptoms, so they don’t realize they have it.  Hypertension is called the silent killer because it puts individuals at risk for heart disease, stroke, kidney failure, and other serious medical conditions.

How is blood pressure measured?

Blood pressure refers to the blood pushing against the arteries.  Blood pressure is measured in two numbers – systolic pressure and diastolic pressure.  The first number, systolic, measures the pressure in the arteries when the heart beats.  Diastolic pressure, the second number, measures pressure in the arteries when the heart rests between beats.  A normal blood pressure reading is less than 120/80 mmHg.

Tips for managing high blood pressure

If you have been diagnosed with high blood pressure, it’s important to take steps to help manage the condition.  The following lifestyle changes can help:

• Physical activity – Strive for 30 minutes of exercise five days a week.  Examples include walking, cycling, swimming, dancing, tennis, and gardening (including mowing and raking leaves).
• Maintain a healthy diet and weight – Eat a diet rich in fresh fruits and vegetables, whole grains, poultry without the skin, fish high in omega-3 fatty acids, nuts, legumes, olive oil, unsalted seeds (pumpkin, flax, sunflower), and low-fat dairy products.  Limit saturated fats and trans fats, salt, red meat, sweets, sugary drinks, fried foods, and process foods.  Limit alcoholic beverages.  Cut down on portion size and lose a few pounds, if necessary.  People who are obese may want to consider a medical weight loss program.
• Don’t smoke – Nicotine raises blood pressure and heart rate, narrows the arteries, and hardens their walls.  If you are a smoker, get help to quit.
• Get enough quality sleep – Blood pressure goes down during sleep.  Being awake for longer periods means blood pressure stays elevated.  Six to eight hours of uninterrupted sleep is recommended.
• Manage stress – Chronic stress and anxiety can contribute to high blood pressure.  Find ways to reduce stress such as meditation, hobbies, reducing caffeine, and regular exercise.

Next Steps

Sometimes lifestyle changes are not enough to lower blood pressure.  Prescription medications are available to bring blood pressure down to acceptable levels.  The physicians at RMD Primary Care can evaluate your blood pressure and answer any questions you may have.  If it has been a while since your last physical exam, contact us today to schedule an appointment.

Fall offers a bountiful harvest of healthy seasonal produce to incorporate into your diet.  Not only are these fruits and vegetables delicious, but studies have shown that many are packed with vitamins, minerals, antioxidants, and dietary fiber.  They may also help protect against heart disease, diabetes, and obesity.  Most fall produce is readily available at grocery stores and local farmers markets, and it stores well at home until you are ready to use it.

The following fall season fruits and vegetables are among the best nutritional choices:

Apples

Hundreds of varieties of apples are available and at their best in the fall.  Apples contain  vitamin C, potassium, and antioxidants.  They are rich in dietary fiber, which aids in digestive health and moderates blood sugar levels.  Apples are delicious eaten raw or cooked.

Pears

Pears are another fall season fruit rich in fiber, vitamins, potassium, and copper.  The antioxidants in pears support immune health, reduce inflammation, and may help improve insulin sensitivity.  Pears can be eaten raw, baked, grilled, or in salsas.

Dark Leafy Greens

This category includes spinach, kale, Swiss chard, arugula, and collard greens.  These vegetables are low in carbohydrates, cholesterol, sodium, and calories.  They are good sources of vitamins, minerals, antioxidants, and fiber.  Besides salads, these greens can be added to soups, pesto sauce, stir-fry, wraps, or steamed as a side dish.

Broccoli

This fall vegetable contains many vitamins including A, D, E, K, and B vitamins.  One cup of broccoli provides as much vitamin C as an orange.  Broccoli is also a source of calcium, iron, potassium, and zinc.  The sulforaphane in broccoli has been shown to have anti-cancer properties.

Carrots and Parsnips

These closely related vegetables are good sources of fiber, vitamins C and K, and other nutrients.  They contain both soluble and insoluble fiber, which aids in digestion.  They can be prepared in many ways and used in salads, soups, stews, purees, and casseroles.  Although parsnips are usually eaten cooked, they can be eaten raw.

Brussels Sprouts

Brussels sprouts are related to cabbage, kale, and broccoli.  They are low in calories and a good source of protein.  In addition, brussels sprouts are high in calcium and vitamin K.  Roasting them in the oven reduces the harsh taste that some people dislike.

Winter Squash

Although the name suggests another season, winter squash becomes available in early fall.  Technically a fruit and not a vegetable, they have a long shelf life and can be stored for several weeks.  Popular varieties include acorn, butternut, delicata, and pumpkin.  Winter squash is rich in vitamins A and C, potassium, fiber, and antioxidants.  The seeds can also be roasted and eaten.

Next Steps

The physicians at RMD Primary Care are happy to answer questions about maintaining a healthy diet.  If It’s been a while since your last physical, it may be time to see one of our doctors for a checkup.  Contact us today to schedule an appointment.

Urinary tract infections (UTIs) can occur at any age, but the incidence increases as people age.  It is among the most common infections in older adults, particularly those living in nursing homes and other long-term care facilities.  The infection is more prevalent among women than men, although men with an enlarged prostate are also at greater risk.

 What causes UTIs?

UTIs are caused from bacteria entering the urinary tract.  The infection can affect any part of the urinary tract, although most infections typically involve the bladder and urethra.  More than 90 percent of bladder infections, or cystitis, are caused by E. coli bacteria from the intestines.  A serious UTI can spread to the kidneys.

Why are UTIs common in the elderly?

Many elderly have weakened immune systems.  That makes it more difficult for them to fight infections.  Diabetes and other diseases can weaken the immune system.  The elderly may not be drinking enough fluids, especially water.  Fluids help people urinate more frequently, allowing bacteria to be flushed from the urinary tract.  The elderly may fail to change urinary incontinence pads when wet.  Seniors that have a urinary catheter are also more prone to develop UTIs.

What are symptoms of UTIs?

Younger people who develop a UTI may have symptoms that include a frequent urge to urinate, pain or burning when urinating, pain in the lower abdomen, cloudy or odorous urine, blood in the urine, and fever.

Elderly adults can develop these same symptoms, but they may also have some entirely different symptoms that many don’t associate with a UTI.  Other symptoms in older adults can include a sudden change in behavior, poor motor skills, loss of coordination, falls, restlessness, agitation, confusion, delirium, and hallucinations.  Doctors are not sure why some of these symptoms differ so much from younger people with UTIs. 

How are UTIs treated?

UTIs are treated with antibiotics to kill the bacteria.  It’s important to take all the medication, even if feeling better.  Elderly adults with symptoms such as confusion or delirium, are sometimes given antipsychotic medication to reduce stress and agitation.

Older adults with UTIs may need the help of family members to ensure they take their medication and receive proper care to prevent reinfection.  Those living in long-term care facilities will have to depend on staff and caregivers to help them heal and take preventive measures to prevent recurring infections.

Next Steps

UTIs are a common health problem for older adults, and they particularly affect women’s health.  The physicians at RMD Primary Care are happy to answer your questions about urinary tract infections.  Contact us today to schedule an appointment.  

People generally don’t give much thought to their gallbladder until they begin to have problems with it.  Many don’t know what the gallbladder does, other than it has something to do with digestion.  Gallbladder issues affect approximately 15 percent of the U.S. population and often require medical treatment.  Those at risk for gallbladder disease include people over age 40 who are overweight.  Women are twice as likely as men to have problems.  People with diabetes and those with a family history of gallbladder disease are also at higher risk.

What is the function of the gallbladder?

The gallbladder is a small organ located in the upper right of the abdomen, under the liver.  The liver produces a liquid called bile, which is stored in the gallbladder.  The stomach signals the gallbladder to release bile into the small intestine to help break down fats.  Bile is released through a series of tubes called bile ducts.

Two Common Gallbladder Problems

• Gallstones – These are bits of crystallized bile that can develop in the gallbladder.  They may cause no symptoms at all, or they can cause pain, inflammation, and nausea.
• Cholecystitis – This is inflammation of the gallbladder, often caused by a gallstone blocking a bile duct.

Symptoms of a Gallbladder Attack

• Abdominal pain in the upper right side, under the rib cage.  Pain can last several hours and may even be mistaken for a heart attack.
• Nausea or vomiting
• Fever and chills
• Light-colored stools
• Brownish urine
• Yellowing of the skin or whites of the eyes (jaundice)

Treatment Options for Gallstones

• Medication for pain
• Antibiotics to treat infection
• Medication to break down the stones
• Lithotripsy – Non-surgical procedure using shock waves to break gallstones into pieces small enough to pass
• Surgery to remove gallbladder. This can be done laparoscopically in a minimally invasive procedure.

Ways to Prevent Gallbladder Disease

• Maintain a healthy weight through diet and exercise.  Obesity increases the risk factor.
• Eat foods high in fiber including whole grains. 
• Eat fresh fruits and vegetables.
• Eat more foods that are low in refined sugars.
• Avoid foods high in fats.  Choose low fat dairy and lean meats, fish, and poultry.
• Avoid very low calorie diets and rapid weight loss.
• Get regular exercise.

Next Steps

The physicians at RMD Primary Care are happy to answer your questions about gallbladder disease.  If it’s been a while since your last physical, it may be time to see one of our doctors for a checkup.  Contact us today to schedule an appointment.

Men over age 50 can continue to enjoy healthy and active lives.  Sometimes this involves making lifestyle changes to address particular health concerns that often accompany aging.  Many older men develop chronic diseases such as high blood pressure, diabetes, and heart disease.  Some of the risk factors for these health issues are out of our control including age, race, and family history.  However, other risk factors and lifestyle choices can be controlled.  The following tips can help men over 50 to stay fit and healthy.

Stay Active

Regular exercise helps keep the body healthy and flexible.  It also relieves stress, elevates mood, and can improve brain function.  An active lifestyle improves heart health, helps maintain muscle strength, and reduces the risk of some diseases.  Aerobic exercise gets the heart pumping, and strength training builds muscle.  Men who have not been active should discuss any new exercise plan with their physician.  The CDC recommends 30 minutes of exercise, five days a week for men aged 50 and over.

Quit Smoking

Men who smoke should quit.  Those who kick the habit will have more energy and breathe better.  Quitting smoking reduces the risk of high blood pressure, stroke, and heart disease.  Those who have difficulty quitting should consult their doctor for help.

Lose Weight

Gaining weight is not a normal part of aging.  Obesity is a risk factor for diabetes, heart disease, and some types of cancer.  Excess weight puts stress on the bones, muscles, and joints.  Osteoarthritis of the hip and knee are associated with obesity.  Being overweight affects our ability to be active and negatively impacts quality of life.  Contact your doctor for help with medical weight loss.

Maintain a Healthy Diet  

A diet that is lower in fat, sugar, and sodium can reduce the risk of developing high blood pressure and heart disease.  Cut back on the amount of processed foods consumed, and eat more fruits, vegetables, and lean meats.  Eating complex grains and more fiber promotes regularity and colon health.  

Drink in Moderation

Alcohol should be limited to two drinks per day.  Alcohol use can worsen some health conditions including diabetes, high blood pressure, stroke, ulcers, osteoporosis, and memory loss.  Mixing alcohol with many medications can be dangerous.  In older adults, consuming too much alcohol can lead to balance issues and falls.

Get Regular Health Screenings

Men over 50 should see their doctors for regular checkups and health screenings.  Health screenings should including blood pressure, cholesterol, colon cancer (colonoscopy), prostate cancer (PSA blood test), and type 2 diabetes (Fasting plasma glucose test and A1C test).

Next Steps

If it’s been a while since your last physical, it may be time to see a doctor for a checkup and men’s health screenings.  The physicians at RMD Primary Care are here to answer your questions about men’s health issues.  Contact us today for an appointment. 

According to the Georgia Department of Public Health, tick-borne illnesses increase during the spring and summer months.  Ticks are more active as the weather gets warmer.  They live near the ground in wooded and brushy areas and attach to people as they walk through these overgrown areas.  People who camp, hike, hunt, and participate in similar outdoor activities are at risk of exposure to ticks.

There are several tick-borne diseases that can affect Georgians.  Some may be familiar while others are lesser known illnesses.

Rocky Mountain Spotted Fever

This bacterial infection is carried by wood ticks and dog ticks.  A characteristic symptom is a red rash that starts on the wrist and ankles and then spreads up the arms and legs to the trunk.  Other symptoms include a high fever, fatigue, severe headache, chills, muscle aches, and joint pain that start within a week after the tick bite.  The infection is treated with antibiotics.

Ehrlichiosis

This bacterial infection causes flu-like symptoms including moderate fever, chills, severe headache, vomiting, diarrhea, loss of appetite, and sometimes a rash in children.  Can be treated with antibiotics but causes serious complications if left untreated.

Anaplasmosis

Although caused by a different bacteria, this disease has symptoms similar to those of ehrlichiosis.  A rash is rare with anaplasmosis.  Can be treated with antibiotics.

Lyme Disease

Deer ticks spread the bacteria that causes Lyme disease.  Prevalence in Georgia is low, although people that visit New England, mid-Atlantic states, and the upper mid-west may become infected.  The characteristic symptom is a red rash at the site of the bite that resembles a bulls-eye.  Other symptoms include fever, headache, tiredness, muscle aches, and joint pain.  Lyme disease can be successfully treated with antibiotics in the early stages.

Heartland virus

Scientists at Emory University recently confirmed that this tick-borne disease has been found in lone star ticks in Georgia.  These ticks have a distinctive white spot on their backs.  Symptoms include high fever, diarrhea, muscle pain, and low white blood cell and platelet counts.  Cannot be treated with antibiotics.

Prevention of Tick Bites

Stay on clear paths as much as possible.  Wear long sleeved shirts and pants with pants legs tucked into socks. Light colored clothing makes it easier to spot ticks before they attach.  Use insect repellant and shower soon after coming indoors.  Conduct visual checks on the body for ticks.

Tick Removal

Grasp tick firmly with tweezers and pull until tick releases from skin.  Clean the bite with soap and water and wash hands thoroughly.  Use alcohol on the bite site.

When to Call the Doctor

Contact RMD Primary Care if the tick has been attached more than 24 hours or if the entire tick cannot be removed.  Call if the bite becomes infected or if symptoms such as fever, headache, unusual fatigue, joint pain, or stiff neck develop.  The medical staff at RMD Primary Care is happy to answer your questions about tick bites.