Summer is the perfect season to relax and enjoy outdoor activities.  Backyard barbecues, pool parties, and picnics at the park are family favorites.  The following health and safety tips will help ensure everyone has a good time.

Avoid Sunburn

Protecting your skin from sun damage is a key factor in preventing skin cancer, the most common type of cancer in the U.S.  According to the Skin Cancer Foundation, 1 in 5 Americans will develop skin cancer by age 70.  A history of sunburns increases the risk for skin cancer.  To prevent sunburn, avoid sun exposure between the hours of 10am and 4pm when UVA and UVB rays are strongest.  Wear sunscreen with an SPF of 30 or higher.  Apply sunscreen 30 minutes before going outdoors so the skin has time to absorb it.  Reapply every two hours.  If swimming or sweating heavily, sunscreen may need to be applied more often.  Wear a hat to shade the face, scalp, and neck.  Wear sunglasses to protect the eyes from the sun.

Prevent Insect Bites

Insect bites can be more than just a summer annoyance.  Insects can carry disease.  Mosquitos can cause

illnesses such as West Nile Virus, encephalitis, and dengue fever.  Avoid outdoor activities during dawn and dusk, which are peak mosquito times.  Wear an insect repellent on exposed skin or wear clothing that covers arms and legs.  Eliminate areas of standing water in your yard to prevent mosquitos from breeding.

Prevent tick bites by staying out of wooded areas and high grass.  Keep to the middle of the trail when hiking.  Use an insect repellent that is effective against ticks.  Shower soon after coming indoors and check your body for ticks.  Serious diseases including Rocky Mountain Spotted Fever and Lyme Disease are transmitted to humans through tick bites.

Stay Hydrated

When outside in the heat, drink plenty of water to replace fluids that the body loses through sweating.  Carry a water bottle when working outside or exercising.  Avoid alcohol and caffeinated beverages as they are not effective in preventing dehydration.  Signs of dehydration include dry mouth, headache, dizziness, muscle cramps, and little to no urination.

Minimize Risks of Food Poisoning

Don’t allow a family picnic to become a source of food poisoning.  Uncooked meat and foods containing mayonnaise, eggs, and dairy can spoil within a couple of hours if not refrigerated or kept on ice in an insulated cooler.  Make sure meats are grilled to a proper temperature on the inside to avoid E. Coli infections.  Steaks should be cooked to an internal temperature of 145 degrees and ground meats should be cooked to 160 degrees.  Wash hands thoroughly after handling raw meat and thoroughly clean utensils and platters that have touched raw meats.

RMD Primary Care provides a number of General Practice and Family Medicine services for your family’s health.  Contact us today for an appointment.

Inflammation is a response from the body’s immune system to fight off infection.  This is one way the body protects itself.  Chemicals from the white blood cells are released into the blood or tissues.  The blood flow to the infected or injured area is increased to promote healing.  Inflammation can be acute, or short-lived, and chronic, meaning long lasting.  Unfortunately, people can have excess inflammation in their body without even realizing it.  Certain autoimmune disorders like rheumatoid arthritis and lupus can lead to chronic inflammation.  Other medical conditions that are linked to chronic inflammation include cancer, diabetes, heart disease, lung disease, and kidney disease.

Symptoms of inflammation

Common symptoms of inflammation include redness, swelling, warmth, and joint pain.  Other notable symptoms include muscle stiffness, fever, chills, fatigue, and headaches.  Chronic inflammation in the body can cause damage to the joints, the digestive tract, the heart, kidneys, and other organs.

Medical treatments

A number of over-the-counter drugs can treat inflammation.  Common medications that treat inflammation include aspirin, ibuprofen, and naproxen.  These are known as NASAIDs, or nonsteroidal anti-inflammatory drugs.  There are prescription drugs that also treat inflammation.  A physician can prescribe the appropriate ones, based on what type of underlying condition is being treated.

Anti-inflammatory diet

Lifestyle changes can be effective in reducing inflammation.  Doctors may advise their patients to modify their diets to include foods that are known to be anti-inflammatory.  An anti-inflammatory diet would eliminate many processed foods and include more fresh fruits and vegetables.  Green leafy vegetables such as spinach, kale, and collards would be included in an anti-inflammatory diet.  Tomatoes, strawberries, blueberries, apples, oranges, and cherries are healthy additions.  Many of these foods are high in antioxidants and polyphenols, which help reduce inflammation.  Beverages like coffee and tea, especially green tea, are also rich in polyphenols.  Healthy oils, like olive oil, and fish that are high in omega-3 fatty acids including salmon, tuna, and sardines may help manage inflammation.  Whole grain breads and pasta, almonds, walnuts, and spices like ginger and turmeric also aid in fighting inflammation.

Foods to avoid

The following foods should be eliminated as much as possible from the diet, as they may actually increase inflammation.  These include white bread and rice, red meat, processed meats, saturated fats, refined carbohydrates, processed snack foods, foods high in sugar, and foods containing trans fats including processed baked goods and fried foods.  Cooking oils and margarines that are high in omega-6 fatty acids, including corn oil, safflower oil, and sunflower oil should also be eliminated.  It’s important to read food labels.  Excess alcohol is discouraged, and sugary beverages like sodas should be replaced with water.

If you would like to learn more about how an anti-inflammatory diet may be beneficial to you, contact your healthcare provider today.

According to the National Institutes of Health, sleep affects our mental and physical health.  When we try to fit so many things into our busy lives, we often sacrifice sleep.  The National Sleep Foundation recommends that adults get between seven and nine hours of sleep each night.  People who are well rested are more alert during the day, focus better, and have faster reflexes.  People who are tired are less productive, pay less attention to detail, feel higher levels of stress, tend to be moodier, and are more likely to be involved in driving accidents.  The body repairs and rejuvenates itself each night as we sleep.  However, sleep deprivation over time can have negative effects on our hormone levels, immune system, blood pressure, heart health, and mental health.

So, what can we do to enjoy a better night’s sleep?  Here are three tips that may help.

Reduce caffeine intake

Caffeine may be robbing you of a good night’s sleep.  Caffeine is a chemical found in coffee, tea, chocolate, and some sodas.  It’s a stimulant that acts on the body’s central nervous system, increasing alertness and reducing fatigue.  Caffeine interferes with adenosine receptors in the brain.  Adenosine is what tells the brain that the body needs rest.  Caffeine can last as long as six hours in your system, so consuming caffeine late in the afternoon or in the evening can certainly affect a person’s ability to fall asleep at bedtime.  Eliminate caffeine intake late in the day, or switch to decaffeinated coffee or tea.

Limit use of electronics at bedtime 

Many people have become accustomed to using electronics right before bedtime.  This includes looking at laptops, tablets, cell phones, and TV in bed.  The blue light produced by these devices may make it more difficult to fall asleep.  Children and teens are especially sensitive to blue light.  It prevents the body from releasing melatonin, a sleep hormone, by tricking the brain into thinking it’s daytime.  Technology also stimulates the brain, making it harder to relax and fall asleep.  For better quality sleep, try eliminating electronics from the bedroom.

Establish a bedtime routine  

Establish a regular routine of going to bed at the same time each night and waking up at the same time each morning.  Irregular sleep habits can interfere with the body’s natural circadian rhythm.  Any activities before bedtime should be relaxing.  A warm bath may be helpful for some.  Avoid bright lighting in the bedroom.  This can also interfere with melatonin production.  Make the bedroom a quiet and relaxing place.  Try to minimize external light and noise.

Sleep plays a key role in health, so make a good night’s sleep a high priority.  If you’ve tried these tips and continue to have difficulty getting a good night’s sleep, talk to your healthcare provider.  Contact RMD Primary Care to schedule a visit with one of our doctors.   

Dietary fiber is defined as the plant components of our food that are not broken down by our digestive enzymes.  It is sometimes referred to as roughage.  Dietary fiber is essential for a healthy diet, and doctors often urge patients to eat more of it.  But many people don’t know whether they are getting enough fiber, or what foods will help boost their daily intake.

How does fiber work?

There are two components of dietary fiber – soluble and insoluble.  Both types are important for the body.  Soluble fiber dissolves in water.  It delays gastric emptying of the stomach, which means we feel full longer.  Soluble fiber may reduce cholesterol levels and help control blood sugar.  Insoluble fiber does not dissolve in water.  It promotes bowel health by attracting water to the stool, making bowel movements easier to pass.

Benefits of fiber

Our body benefits from fiber in many ways.  Fiber regulates bowel movements and prevents constipation.  It helps lower the risk of developing diverticulosis and colon cancer.  Fiber helps control body weight by lowering fat absorption.  This helps prevent obesity.  Fiber slows down the digestion rate of carbohydrates, regulating blood sugar levels.  This lowers the risk of developing type 2 diabetes.  Fiber helps regulate cholesterol levels by preventing some cholesterol from being digested.  This can reduce the risk of cardiovascular disease.

Fiber recommendations

Here are the USDA’s recommended amounts of daily fiber.

• Men age 50 and under – 38 grams per day
• Men over 50 – 30 grams per day
• Women age 50 and under – 25 grams per day
• Women over 50 – 21 grams per day

It is better to get dietary fiber from whole foods we eat rather than from supplements.  Whole foods provide vitamins, minerals, and other nutrients that supplements lack.

Foods high in fiber

Try to increase your fiber intake if your diet contains too many refined carbohydrates, sugar,  white bread, pasta, and processed foods.  Nutrition labels on packaged foods list the amount of dietary fiber in each serving.  Foods rich in fiber content include fresh vegetables, fruit, whole grains, and nuts.  Here are some examples of foods that may be included in a high fiber diet:  beans, peas, lentils, artichokes, broccoli, Brussels sprouts, kale, avocado, baked and sweet potatoes (with the peel), raspberries, bananas, oranges, apples and pears (with the skin), raw almonds and pistachios, oatmeal, whole grain bread, and whole grain pasta.  Raw fruits and vegetables are often higher in fiber that canned varieties.

Speak to your healthcare provider if you think you may need more fiber in your diet.  Contact RMD Primary Care to schedule a visit with our doctors. Our dedication lies with helping our patients live happier, healthier lives.

A urinary tract infection, or UTI, is an infection occurring anywhere in the urinary tract.  Most UTIs are caused by bacteria, which cause inflammation in the urinary tract.  The most common site for infection is the lower urinary tract, which involves the bladder and urethra.  Upper tract UTIs, involving the kidneys and ureters, are less common but often more serious.

Although both men and women can develop a urinary tract infection, the incidence in women is much higher.  More than 50% of women will develop a UTI during their lifetime.  Up to 30% of women will experience recurring infections.  UTIs account for many doctor visits each year.

Symptoms of a urinary tract infection are easy to recognize and generally unpleasant.  When the upper tract is infected, the patient will feel pain and tenderness in the upper back and sides.  This may be accompanied by fever, chills, nausea, and vomiting.  Symptoms of a lower urinary tract infection include increased frequency of urination and a feeling of urgency to urinate without passing much urine.  There is typically a burning sensation when urinating.  There may be blood in the urine, and urine may be cloudy or dark colored.  A strong odor may be present in the urine.  Women may experience pelvic pain, while men may have rectal pain.

A person who suspects they have a urinary tract infection should see a doctor.  During the examination, the doctor will ask about symptoms and collect a urine sample.  The sample will be tested for the presence of white cells, red cells, and bacteria.  Additional tests may be ordered if the patient has recurrent infections.

Home remedies are not usually successful in treating UTIs.  Most patients will need an antibiotic.  The patient should finish the entire prescription of antibiotics, even if the symptoms are gone.  Drinking lots of water is recommended to flush the bacteria from the system.  Over-the-counter medications can be taken to reduce pain.

The following tips may help prevent a UTI.

• Drink lots of water and urinate often. Do not hold urine for long periods.
• Avoid alcohol and caffeine. These drinks can irritate the bladder.
• Wipe from front to back after urinating.
• Urinate following sex.
• Avoid the use of diaphragms or spermicide for contraception.
• Avoid scented feminine hygiene products.
• Wear cotton underwear, which helps keeps the genital area dry. Bacteria thrive in warm, moist conditions.

Disposable single-use wipes have become so popular during the COVID-19 pandemic that stores can barely keep them on the shelves.  In an effort to stay healthy and protect themselves from the COVID-19 virus, consumers have bought wipes to clean and disinfect surfaces in their homes, cars, and offices as well as their hands.  However, all disposable wipes are not the same.  Some are labeled antibacterial and others are marketed as disinfectants.  Understanding the difference is important.

Some wipes are only approved to kill bacteria.  These antibacterial wipes are meant to clean the skin and hands.  They may not kill viruses, and COVID-19 is a virus.  Antibacterial soaps and wipes are regulated by the FDA, because they are classified as drugs.  Although washing with soap and water is still the best way to clean hands, antibacterial wipes can be used when we are not able to wash.  They are convenient to use after touching surfaces such as door knobs, light switches, shopping carts, and common surfaces that others may have touched.

Wipes that are labeled disinfectant should kill bacteria, viruses, and mold.  Disinfectant wipes are believed to be effective against the virus that causes COVID-19 because they are known to kill related viruses.  However, many have not been tested specifically for use against COVID-19.  Product disinfectant claims are regulated by the EPA because they are considered pesticides.  The chemicals used are intended to kill microorganisms.  The EPA gives the product a registration number, which should be on the label.

Disinfectant wipes kill viruses, including those that cause colds and flu, on non-porous surfaces.  In the home, these wipes can be used to disinfect commonly touched surfaces such as door knobs, refrigerator handles, appliance knobs, counter tops, light switches, bathroom fixtures, keyboards, cell phones, and game controllers.  The disinfectant on the wipe usually has to remain on the surface for several minutes to effectively kill bacteria and viruses.  The surface should look visibly wet.

It is important to read labels and follow the manufacturer’s instructions for use.  Some wipes should not be used on surfaces that will have contact with foods.  Many wipes can damage the finishes of leather, wood, granite, and marble.  The same wipe should not be used to clean multiple surfaces, as this just tends to spread the bacteria and viruses from one to another.  Do not use disinfectant wipes on toys that may end up in a child’s mouth.  Never use disinfectant wipes to clean hands, as the chemicals may cause an allergic skin reaction.

Diabetes is a rising problem in the U.S. today.  The Centers for Disease Control and Prevention (CDC)

estimates more than 30 million adults have been diagnosed with diabetes.  Another 7 million adults meet the laboratory criteria for diabetes but are not aware they have the condition.  The American Diabetes Association (ADA) cites diabetes as the 7^th leading cause of death in America.  Since November is Diabetes Awareness Month, let’s examine what causes diabetes and what the health implications are for those with the disease.

Diabetes is a disorder that causes elevated blood sugar levels.  Our bodies break down the carbohydrates we eat into glucose.  The pancreas releases a hormone called insulin that allows glucose to enter the cells and be used as energy by the body.  When there isn’t enough insulin, or the body is unable to use insulin to effectively manage the glucose levels, symptoms of diabetes will manifest.

Some symptoms of diabetes include increased thirst and urination, increased hunger, fatigue, blurred vision, sores that are slow to heal, unexplained weight loss, and numbness or tingling in the hands or feet.  Not all people will experience all symptoms.  The symptoms may start quickly or develop slowly over time.

The two most common forms of diabetes are type 1 and type 2.  Type 1 diabetes most often develops in children and young adults.  People with this type of diabetes must take insulin because their body no longer produces its own.  They may also need to take other medications to help regulate their glucose levels.

Type 2 diabetes is more common.  In this case the body may not make enough insulin or doesn’t use insulin effectively.  This may be called insulin resistance.  The onset of type 2 diabetes is usually middle age or older.  Poor lifestyle choices can contribute to the development of type 2 diabetes.

Risk factors for the disease include a family history of diabetes, obesity, sedentary lifestyle, age, and ethnic background.  Diabetes occurs more often in individuals with Hispanic, African American, Asian, Native American, and Pacific Island heritage.  Although we can’t control some of the risk factors, making good lifestyle choices can help prevent diabetes.  Choices to manage include eating a balanced diet, maintaining a healthy weight, exercising regularly, quitting smoking, and managing blood pressure.  Diabetes can lead to serious health-related problems such as heart disease, stroke, kidney disease, liver disease, eye disease, nerve problems, and foot problems.

A mammogram is the best way to detect breast cancer in its early stages.  The procedure utilizes low-dose x-rays that help radiologists identify changes in breast tissue even before a lump or mass can be felt.  Early detection of breast cancer makes the disease easier to treat.  Breast Cancer Awareness Month each October serves as a reminder for women to talk with their doctors about scheduling a mammogram if due for one.

A woman who does not have any breast issues or cancer symptoms will be given a screening mammogram.  The procedure can pinpoint any areas of the breast that appear abnormal.  Comparing the new mammogram to any previous mammograms on file allows the radiologist who reads the x-rays to see changes in the breast tissue.  Changes such as calcifications, cysts, and masses will indicate a need for further testing including a diagnostic mammogram, ultrasound, or biopsy.  A 3-D mammogram (breast tomosynthesis) shows advantages in detecting breast cancer in women with dense breasts.  However, not all medical facilities offer 3-D imaging.

Some women may experience brief discomfort and pressure during the mammogram.  A little tenderness following the procedure is normal.  Over the counter pain relievers will ease the discomfort.  Since many women feel breast tenderness right before their menstrual period, it is often better to schedule a mammogram for the week following their period.

The American Cancer Society makes the following recommendations regarding mammograms.

Women ages 40 to 44 – may start having an annual mammogram if they wish.

Women ages 45 to 54 – should have an annual mammogram.

Women age 55 and older – can continue with annual mammograms or may have one every two years.

Women with a family history of breast cancer should talk to their doctor about their risk for developing breast cancer.  The patient and her doctor should make an informed decision regarding the appropriate timing for her screening tests.

Doctors often order a lipid panel as part of routine blood work during a physical examination.  This test assesses a patient’s risk of developing cardiovascular disease, which includes heart attacks and strokes.  Lipids are fats and fatty-like substances found in the blood.  Cholesterol is one such fat.  People who have high cholesterol levels are more likely to develop heart disease.  A lipid panel measures cholesterol levels and helps the physician determine whether any treatment or lifestyle changes are necessary.

A person should fast for 9-12 hours before a lipid panel is done.  This ensures that the blood work is not affected by any food that was recently eaten.  Three cholesterol levels are reported in a lipid panel – total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C).

HDL-C – This type of cholesterol is often called good cholesterol.  It takes excess cholesterol to the liver to be removed from the body.  A level of 60mg/dL or higher is optimal, lowering a patient’s risk for heart disease.  A level of 40mg/dL is low, showing an increase in risk for heart disease.

LDL-C – This type of cholesterol is known as bad cholesterol.  It gets deposited as plaque on the walls of arteries, narrowing them and decreasing the blood flow.  Doctors ideally want this number to be less than 100mg/dL.  Levels higher than 100mg/dL may be considered elevated, borderline high, or high.  A change of diet, exercise, weight loss, or cholesterol medication may be discussed with the patient as strategies to help them lower the bad cholesterol to a more normal level.

Total cholesterol – This is a measure of all cholesterol.  For total cholesterol, a result of 200mg/dL or lower indicates normal levels.  A result higher than 240mg/dL is considered high.

A lipid panel also measures triglycerides in the lipoprotein particles.  High levels of triglycerides are associated with cardiovascular disease.  A result of 150mg/dL or more is considered high.  The same strategies used to lower bad cholesterol are also recommended for lowering triglycerides.

The American Heart Association recommends that adults ages 20 and older have a lipid panel every 4-6 years.  Higher risk individuals with heart disease, diabetes, or a family history of high cholesterol should have their levels checked more often.  An individual may have high cholesterol without knowing it, as there are often no symptoms.

What is meningitis?

According to the Centers for Disease Control and Prevention (CDC), meningitis is an inflammation or swelling of the protective membranes covering the brain and spinal cord.  Although meningitis can have several causes, the most common types are caused by bacteria and viruses.  Outbreaks of some types of meningococcal disease have been reported on college campuses in recent years.  Many states now require that incoming college students be  vaccinated against meningococcal disease, particularly those who will be living in campus housing.  The CDC highly recommends the vaccinations.  It is considered preventative health.

Viral Meningitis

The most common type of meningitis is caused by viruses.  While these infections are serious, they are usually less severe than bacterial meningitis.  Early symptoms may seem like flu.  There may be a high fever, stiff neck, severe headache, vomiting, seizures, confusion, sleepiness or difficulty waking from sleep.

Bacterial Meningitis

Symptoms are generally the same as the viral type. However, the onset of symptoms is very rapid.  Bacterial meningitis can be life threatening.  Swelling of the tissues around the brain can lead to paralysis, stroke, and death.

Meningitis diagnosis and treatment

Testing for meningitis is done through blood samples, nasal or throat swabs, and the drawing of spinal fluid for examination.  There is no specific treatment for viral meningitis.  Antibiotics are not used.  Some antiviral medications may be effective.  Most patients with mild cases will be able to recover on their own.

Patients with bacterial meningitis must receive immediate treatment with intravenous antibiotics.  Sometimes corticosteroids are given to reduce brain swelling.  If not treated quickly enough, a patient may develop sepsis and can die.  Bacterial meningitis can cause permanent disabilities including hearing loss and brain damage.

Meningitis Vaccines for meningococcal disease

The CDC recommends that preteens ages 11-12 years old receive the MenACWY vaccine.  This vaccine protects against four different strains of meningococcal bacteria.  A booster dose should be given at age 16.  Teens and young adults ages 16-23 may also get a MenB vaccine.  The preferred age is 16-18 years, and multiple doses give the best protection.  This vaccine protects against a less common strain of meningococcal disease.  If your teenager has not received these vaccines, talk to your healthcare provider at RMD Primary Care about getting vaccinated.