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).

At RMD Primary Care, the health and well being of our patients and staff is of utmost importance to us.  We especially want our patients to be aware of the best practices to safeguard their health and their families against the spread of Coronavirus (COVID-19).  This includes measures to protect themselves from contracting the virus as well as what to do if you are experiencing any of its symptoms.

We strongly recommend following the guidelines outlined by the Centers for Disease Control and Prevention (CDC).  Since there is not yet a vaccine for the Coronavirus, it is important to be proactive in protecting ourselves.  These measures will help prevent the spread of Coronavirus and other respiratory illnesses, including influenza, in our community.  The following information comes directly from the CDC’s website, www.cdc.gov.

How to protect yourself

• Wash your hands often with soap and water for 20 seconds, especially after having been in a public place and after sneezing, coughing, or blowing your nose. Do not touch your face, eyes, nose, and mouth with unwashed hands.  If soap and water are not available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
• Avoid close contact with people who are sick. This is especially important for older adults and people with serious chronic medical conditions like heart disease, diabetes, and lung disease. Avoid crowds as much as possible and stay home to reduce the risk of being exposed.
• Avoid all non-essential travel.

Supplies to have on hand

• Any prescription medications that you may need.
• Over-the-counter medications and supplies (tissues) to treat fever and other symptoms
• Have enough groceries and household items so that you can isolate at home if infected. Stock up on non-perishable foods and limit trips to the store.

Watch for symptoms

These symptoms may appear 2-14 days after exposure to Coronavirus.

• Fever
• Coughing
• Shortness of breath

Emergency warning signs for COVID-19 include:

• Difficulty breathing or shortness of breath
• Persistent pain or pressure in the chest
• New confusion or inability to arouse
• Bluish lips or face

What to do if you are sick

• Call your doctor for advice if you develop symptoms of COVID-19. Do not go to the doctor’s office without calling first. 
• Isolate at home to keep from spreading the virus to others. Separate yourself from other people and pets in the household.
• Use a separate bedroom and bathroom if possible.
• Cover your mouth and nose with a tissue when coughing or sneezing. Dispose of tissues in a lined trash can.  Wash hands immediately with soap and water for 20 seconds.
• Avoid sharing personal household items.
• Clean and disinfect all high-touch surfaces every day. This includes counters, tables, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables.
• Wash laundry and bedding thoroughly.

Persons with confirmed COVID-19 should continue to isolate at home until instructed by their healthcare professional to discontinue.

Since the American Heart Association designates February as National Heart Month, let’s look at heart failure, a heart condition that is often misunderstood.  Heart failure is not a sudden heart attack, and it doesn’t mean the heart has stopped working.  What it does mean is that the heart is not pumping blood properly through the body.  This is a chronic condition that usually worsens over time and can be life threatening.

The heart’s job is to pump blood through the body so that oxygen and nutrients can be delivered to the cells.  When the heart becomes weakened, it no longer pumps efficiently.  It can no longer keep up with its workload.  This makes it hard for a person to manage normal daily activities such as walking or climbing stairs.  There are three types of heart failure- left-sided heart failure, right-sided heart failure, and congestive heart failure.

Symptoms of heart failure should not be ignored.  When heart failure is diagnosed and treated in the early stages, the patient will enjoy a better quality of life.  Warning signs of heart failure include the following symptoms.

Shortness of breath

When blood backs up in the pulmonary veins, fluid may leak into the lungs.  The resulting shortness of breath may occur during periods of activity but may also happen at rest or while sleeping.

Fatigue

Tiredness or fatigue can make simple activities difficult.  The heart is not pumping enough blood to meet the needs of the body.

Swelling

A build up of fluid in the body is called edema.  Fluid retention may cause swelling in the feet, ankles, legs, or abdomen.  The patient may gain weight.

Coughing or wheezing

This is the result of fluid collecting in the lungs.  It may become chronic.

Digestive problems

When the digestive system receives less blood, symptoms like nausea or loss of appetite may occur.

Confusion

Memory loss, confusion, and disorientation may occur when levels of sodium and other substances in the blood are lacking.

Increased heart rate

As the heart tries to beat faster to keep up with the body’s demands, the patient may experience heart palpitations or a racing heart.

Make an appointment to see your doctor if you are experiencing these types of warning signs.  Treatments for heart failure are available.  They include lifestyle changes, medications, implantable devices, and surgery.

An illness that starts out as a cold, flu, or other respiratory infection may develop into a cough that hangs on for weeks.  Other symptoms may resolve or improve within a week or ten days, but the nagging cough doesn’t go away.  When is it time to see the doctor?

Make an appointment to visit your doctor if you have the following symptoms.

• A cough that lasts more than three weeks
• Cough accompanied by a fever higher than 100.4 F
• Thick mucus (may be clear or colored)
• Wheezing or shortness of breath
• Chest discomfort
• Fatigue or difficulty sleeping

These symptoms may indicate acute bronchitis, which is an inflammation of the bronchial tubes.  Bronchitis is caused by viruses, the same types that cause colds and flu.  Bronchitis may be contagious, spreading from person to person through droplets produced when sneezing and coughing.  However, bronchitis that is a complication of another medical condition, such as asthma, is usually not contagious.  Bronchitis is common and usually not a cause for great concern.  A few people, though, may develop pneumonia.

Some factors that can increase the risk of developing bronchitis include exposure to cigarette smoke, gastric reflux, and having a compromised immune system.  Frequent hand washing can lower your odds of catching and spreading all respiratory infections.  Getting an annual flu shot helps minimize the risk for developing bronchitis as a secondary infection following a bout with the flu.

Treatment for bronchitis does not usually call for the use of antibiotics, which are not effective in fighting viruses.  The doctor may recommend a cough suppressant, pain relievers, drinking lots of fluids to thin mucus secretions, and getting plenty of rest.  A bronchodilator, or inhaled medication, can help open up airways.  A humidifier may also help to loosen up mucus.  Most people with acute bronchitis generally recover within a few weeks.

The answer is a resounding yes!  A strong immune system is the body’s first defense for fighting bacteria and viruses.  The immune system protects the body from illnesses and infections.  Although the immune system is complex, there are some simple lifestyle choices people can make to boost their immune system for better health.

Diet– A balanced diet is beneficial to the immune system.  Supplements can be helpful, but our bodies can get the nutrients and vitamins needed from the foods we eat.  Foods rich in antioxidants are known to boost the immune system.  Examples include many dark colored fruits and vegetables such as blueberries, raspberries, kale, spinach, tomatoes, and sweet potatoes.  Many herbs and spices are good sources of antioxidants and can be used as seasonings.  These include oregano, turmeric, cinnamon, and ginger.  Foods rich in omega-3 fatty acids enrich the immune system.  Excellent sources include oily fish such as tuna and salmon.  Some non-fish sources of omega-3 fatty acids are flax seeds, chia seeds, walnuts, and soybeans.

Sleep– Quality sleep is an important immune system booster.  The amount of sleep we need depends on the person’s age.  Average adults need 7 to 9 hours sleep each day.  Preschoolers need 10 to 13 hours of sleep daily.  Teenagers need 8 to 10 hours of sleep daily.  The body produces proteins called cytokines when we sleep.  Cytokines target infection and inflammation.  The National Sleep Foundation cites chronic sleep deprivation as a factor in decreased immune system response.

Stress– Chronic stress and anxiety can depress the immune system, making it less effective.  While we may not be able to eliminate all stress, there are some ways to help manage it.  Slowing down, reducing our commitments, meditating, exercising, reducing caffeine intake, and spending more time relaxing with family and friends are ways to alleviate stress.

Additional good health practices that can help boost the immune system are thorough hand washing, regular exercise, and getting an annual flu shot.  Talk to your health care professional for other ways to keep your immune system working as it should.

Cholesterol levels are measured by a blood test referred to as a lipid profile or lipid panel.  The numbers are broken down into LDL (low density lipoprotein), which is “bad” cholesterol and HDL (high density lipoprotein), known as the “good” cholesterol.  Most of the body’s cholesterol falls into the LDL category.

An overabundance of LDL cholesterol forms a build up of plaque along the walls of the blood vessels.  This plaque, if thick enough, can block blood flow causing a heart attack.  The lower the LDL number, the lower the risk of developing heart disease.

The high density lipoproteins absorb cholesterol and take it to the liver.  It can then be flushed from the body before it can block the blood vessels.  A higher HDL number on the lipid profile indicates a lower risk for heart disease.

An LDL number of 190 mg/dL or higher means a higher risk for heart disease.  An HDL number less than 40 mg/dL for men and less than 50 mg/dL for women indicates higher risk.  The lipid profile also measures triglycerides and gives the total cholesterol number.  The doctor takes all these numbers into consideration when recommending treatment options.  Diet and lifestyle changes may be recommended to try to reduce the risk, or the patient may be prescribed medication such as a statin drug.  Lifestyle changes can include eating a healthy diet, losing weight, exercising regularly, and quitting tobacco use.  The doctor will also consider the patient’s other risk factors including age, weight, gender, race, diet, and medical history.

Adults at average risk for heart disease should have a cholesterol test every five years, beginning at age 18.  The doctor may recommend testing more often if the patient is overweight, smokes, has diabetes, is physically inactive, or has a family history of heart disease.

To learn more about your cholesterol levels, contact RMD Primary Care to schedule an appointment.