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.

A regular physical exam is an integral part of maintaining your overall physical health.  It helps your primary care physician (PCP) determine your general health status.  This is a prime opportunity for patients to talk to their doctor about any health concerns they may have.  It is recommended that patients see their health care provider at least once a year for a physical exam or wellness check.  This is a more comprehensive visit than going just when feeling ill.  Some people have recently postponed these physical exams due to concerns about COVID-19.  However, these exams are too important to put off, and the doctor’s office will ensure that patients can safely visit.

Your healthcare provider may want to perform specific tests during the visit.  These may include listening to your heart to look for any abnormal heart rhythms or other irregularities.  They may listen to your breathing to make sure there are no problems with the lungs.  The doctor will also listen for sounds in the abdomen to check for issues with the bowel and intestines.  Weight, pulse, and blood pressure will be checked.  A urinalysis may be ordered.

Routine blood work may be performed to check cholesterol, triglycerides, blood sugar, hemoglobin, and other levels.  Periodic blood work may be required if the patient is taking some prescription medications.  A basic metabolic panel helps the doctor determine whether certain organs in the body are functioning correctly.  Abnormal levels in the blood work may be an indication of diabetes, liver problems, kidney disease, or cancer.  Medications may be prescribed or modified, depending on the results of the blood work.

An annual physical is the time for the doctor to make sure vaccinations are up to date.  Vaccinations are important for protecting children from disease, but adults may also need a booster shot.  The CDC recommends that older adults receive vaccinations for flu, shingles, pneumonia, and pertussis (whooping cough).

A physical exam appointment helps patients determine whether they have been effectively managing any chronic health conditions.  This is the perfect time to ask questions and raise any concerns regarding their health or medications.  The doctor can advise on any lifestyle changes that need to be made in the areas of diet, exercise, alcohol use, and smoking.

Don’t put off that regular physical exam.  Make an appointment today at RMD Primary Care.  Call 678-430-3627 to schedule an appointment or for questions.

June is Alzheimer’s and Brain Awareness Month.  Most of us know someone with Alzheimer’s disease, the most common type of dementia.  Symptoms of the disease usually begin with memory loss, but eventually involve the parts of the brain that control thought, memory, language, and reasoning skills.  Alzheimer’s impacts a person’s ability to carry out daily tasks and activities, including the ability to communicate.

The main risk factor for Alzheimer’s is age.  Symptoms may begin to appear around age 60.  Women are twice as likely as men to develop Alzheimer’s, primarily because they live longer.  A family history of the disease may also increase the risk.  Researchers are studying other possible risk factors such as having high cholesterol and high blood pressure.

The Alzheimer’s Association lists 10 early signs and symptoms of Alzheimer’s disease.

• Memory loss that disrupts daily life – This may include forgetting recently learned information such as dates, appointments, or events.
• Difficulty in planning or solving problems – There may be challenges managing finances, paying monthly bills, or following a recipe.
• Trouble completing familiar tasks – Examples may include getting lost driving to familiar places or having difficulty running familiar errands.
• Confusion with time and place – The person may lose track of dates or the passage of time.
• Difficulty understanding visual images and special relationships – This may lead to difficulty reading or judging distances.
• New problems with words in speaking or writing – The person may struggle to find words or follow conversations.
• Misplacing things – They may be unable to retrace steps to find things. Others may be accused of taking items.
• Decreased or poor judgment – There may be difficulty making decisions or making poor decisions.
• Withdrawal from work or social activities – There may be a loss of interest in hobbies or activities previously enjoyed.
• Changes in mood, personality, or behavior – Examples may include confusion, fear, suspicion, or depression.

Understanding Alzheimer’s Awareness

There is no cure for Alzheimer’s.  Treatment includes managing and slowing down symptoms and helping those affected maintain their mental function.  If you notice some of these changes occurring in a loved one, make an appointment to discuss them with their doctor or contact RMD Primary Care. Alzheimer’s awareness is key for treating symptoms.

Arthritis is a medical condition characterized by pain, swelling and stiffness in a joint.  Other symptoms include redness, tenderness, and decreased range of motion.  These symptoms generally become worse as we age.  People of all ages, races, and sexes may develop the condition, although it tends to be more common among women.  Arthritis can cause permanent changes in the affected joints.

There are two main types of arthritis- osteoarthritis and rheumatoid arthritis.

Osteoarthritis

This type of arthritis involves damage to the cartilage at the ends of bones, where they meet at a joint.  It is typically caused by wear and tear over a period of years.  Bone grinding on bone causes pain and inflammation.  In addition, the connective tissue attaching muscles to bone can be damaged.  An injury to a particular joint or an infection can also lead to osteoarthritis.

Rheumatoid arthritis

This is an autoimmune disease in which the body attacks the lining of the joint capsule (synovial membrane).  Cartilage and bone can be destroyed over time.  Joints may become deformed.  The inflammation from rheumatoid arthritis can affect other parts of the body including the eyes, lungs, heart, and blood vessels.  Rheumatoid arthritis usually affects joints of the fingers and toes first before spreading to knees, hips, shoulders, and other larger joints.  The same joints on both sides of the body are generally affected.

Other types of arthritis include:

• Psoriatic arthritis– sometimes affects people with psoriasis
• Ankylosing arthritis– causes spinal vertebrae to fuse
• Gout– a sudden, severe pain and swelling at the base of the big toe
• Juvenile idiopathic arthritis– a type of arthritis affecting children under age 16

Diagnosis

See your doctor if you have pain, redness, and swelling in a joint.  The doctor can check the joint for range of movement.  An x-ray can show bone damage and cartilage loss.  A CT scan can pinpoint bone and surrounding soft tissue damage.  A sample of joint fluid can help determine the type of arthritis.

Treatment

Treatment usually includes over-the-counter or prescription medications to reduce pain and inflammation.  Medications that slow the immune system are used to treat rheumatoid arthritis.  Corticosteroids can be given orally or by injection to reduce joint inflammation.  Joint replacements are commonly done to replace knees and hips damaged by arthritis.

Warm weather and growing plants usher in spring allergy season.  Unfortunately, this year allergy season is overlapping with the COVID-19 virus.  Understanding the symptoms of each can help us determine whether we need to call the doctor.

Spring allergies are often triggered by pollen that is released by trees, flowers, and grass that have started growing after being dormant all winter.  The wind blows the grains of pollen around, causing it to settle on cars, walkways, and decks.  We track it into our houses on our shoes and clothing.  It’s even carried in by our pets.  Our bodies produce histamines to attack these various allergens.  Histamines cause the unpleasant symptoms and reactions commonly associated with allergy season.

Allergy Symptoms

Typical allergy symptoms include the following:  runny nose, congestion, itchy and watery eyes, sneezing, coughing, scratchy throat, postnasal drip, ear congestion, and headache.  Most people with seasonal allergies do not have a fever.  They typically do not have body aches, pains, or extreme exhaustion.  Allergies are not contagious.  They are not spread from person to person like colds, flu, or COVID-19.  Most people suffering from seasonal allergies have had them before.

Allergy Treatments

Many over-the-counter medications are available to treat common allergy symptoms.  Doctors can prescribe stronger medications, if needed.  Those with asthma may need to use a bronchodilator to manage some symptoms.

COVID-19 Symptoms

The main symptoms of the COVID-19 virus are a fever, dry cough, shortness of breath, and difficulty breathing.  Fatigue, loss of appetite, and loss of taste or smell have also been experienced by those with COVID-19.  Additionally, some patients have complained of gastrointestinal problems such as nausea and diarrhea.  Sneezing and runny nose are not typical symptoms of COVID-19.  The COVID-19 virus is spread through coughing and close personal contact with an infected person.

If you believe your symptoms are just related to seasonal allergies that you have experienced in the past, you may not need to call your doctor.  You may be able to alleviate the symptoms with over-the-counter medications that were previously helpful.  If you believe you may be infected with the COVID-19 virus, call your doctor for instructions.

Do not go to the doctor’s office without calling first. 

Isolate at home, preferably away from others in the household, to keep from spreading the virus.

We strongly recommend following the guidelines outlined by the Centers for Disease Control and Prevention (CDC).