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.

Each October women are reminded of the importance of early breast cancer detection.  Breast cancer is the second most common type of cancer in women, following skin cancers.  A mammogram is the best way to detect breast cancer in the early stages, when it is easier to treat.  Women of any age can develop breast cancer, so it’s important to be aware of risk factors and proactive about health care decisions.

Most women who develop breast cancer have no family history of the disease.  However, a woman’s risk does increase if she has a first-degree relative (mother, daughter, sister) with breast cancer.  Having multiple other family members with the disease on either the mother’s or father’s side of the family also increases the risk.  Given this family history, even very young women can develop breast cancer.

According to the Centers for Disease Control (CDC), other risk factors for developing breast cancer include the following:

Age–  The risk increases after age 50.

Taking Hormones–  Hormone replacement therapy during menopause can raise the risk.

Reproductive history–  Having a first pregnancy after age 30 or never being pregnant increases risk.  Early menstruation (before age 12) or late menopause (after age 55) exposes women to hormones longer, increasing their risk.

Dense breasts–  Dense breast tissue makes cancers harder to detect and raises the risk level.

Genetic mutations–  Inherited changes to specific genes such as BRCA1 and BRCA2 increases risk.

The best breast cancer screening tool is a mammogram.  It can detect cancers that are too small to be felt or cause symptoms.  The American Cancer Society recommends that women of average risk begin annual screening mammograms at age 45.  Some doctors recommend mammograms at age 40, depending on risk factors.  After age 54, a woman who has not had any abnormal mammograms can continue to have a mammogram every other year through age 74.  Women who have higher than average risk factors for the disease should follow the recommendations of their health care provider.

Adults are less able fight off infections as they age.  Chronic diseases can weaken the immune system.  It is important for seniors to receive certain vaccines to help them live healthier lives.  Here are several vaccinations recommended for seniors by the Centers for Disease Control.

Flu vaccine (influenza)-  Flu is a contagious respiratory illness that affects many people each winter.  Seniors are at higher risk for developing serious complications.  It’s especially important to be protected against flu if you suffer from a chronic medical condition such as COPD, diabetes, or heart disease.  An annual vaccine is necessary as the virus changes each year.  It takes about two weeks for the body to build up full immunity, so get vaccinated early in the season.  A higher dose version is available for seniors.  Medicare Part B covers the cost of the vaccine.

Pneumonia vaccine –  Pneumonia is a serious lung infection that can cause significant complications for seniors, people with chronic diseases, and smokers.  The vaccine is recommended for all adults age 65 and older.  There are two types of pneumonia vaccines that protect against different types of pneumonia.  The PCV13 vaccine is given first.  A year or more later the PPSV23 vaccine can be given to protect against additional types of pneumonia.  With these two shots, a senior will most likely be protected for the rest of their life.  The vaccines are covered by Medicare Part B.

Shingles vaccine-  Shingles is a painful blistering rash caused by the dormant chicken pox virus that suddenly becomes active.  One in three adults gets shingles during their life.  Since older adults are more likely to have serious complications, the vaccine is recommended at age 60.  The older single dose version is about 51% effective for approximately five years.  The newer 2-dose vaccine is about 90% effective but has a few more side effects.  The newer vaccine is not as readily available at this time.  A person can still receive the newer vaccine even if they have already had the single dose version.  The vaccine is partially covered by Medicare Part D drug plans.

Tdap vaccine-  Tdap protects against tetanus, diphtheria, and pertussis (whooping cough).  Tetanus bacteria enters the body through cuts and wounds.  Diphtheria and pertussis are contagious diseases spread through coughing and sneezing.  Adults who have never had a Tdap vaccination should receive one, especially if they are grandparents who have contact with infants too young to be vaccinated.  The Tdap vaccine is partially covered under Medicare Part D.

Speak with your health care professional at RMD Primary Care to find which of these vaccines is right for you.

Most of us enjoy outdoor activities during the hot summer months.  However, exposure to the sun for as little as 15 minutes can damage skin and eyes.  The sun gives off harmful radiation in the form of ultraviolet (UV) rays that are not visible and are present even on cloudy days.  Exposure to UVA and UVB rays is a major risk factor for most skin cancers.  People with fair or light skin are more susceptible to sun damage, but darker-skinned people are also affected.

UVA rays can cause long-term damage to skin and premature aging.  Effects from overexposure to the sun include wrinkles, dark spots, pre-cancerous actinic keratoses, and some skin cancers.  UVB rays are responsible for sunburns and are believed to cause most skin cancers.  Ultraviolet rays are stronger in the spring and summer months.  The rays are more damaging during the hottest part of the day, between 10 am and 4 pm.  They can reflect off surfaces like water, sand, and pavement.  Cloud cover lessens the exposure to UV rays, but they can still penetrate clouds.  Weather reports often list a UV Index, which measures how strong the UV light will be.  The higher the number, the greater the risk.

Our eyes are also at risk from exposure to UV rays.  Eye problems related to sun damage include cataracts, macular degeneration, sunburn of the eye surface, and cancers of the eyelids.

How do we protect our skin and eyes from sun damage?  Use a broad spectrum sunscreen with an SPF of 15 or higher on any exposed skin.  Reapply sunscreen every two hours and after swimming.  Wear a hat with a broad brim to protect the face, ears, scalp, and neck.  Avoid straw hats with holes that allow the sun to get through.  Long sleeve shirts and long pants protect the arms and legs.  UPF rated clothing offers protection from UVA and UVB rays.  Stay in the shade when possible.  To protect the eyes, wear sunglasses that block UVA and UVB rays.  Wrap around sunglasses work best to protect from the side.  Don’t forget sunglasses for your children.  Their eyes need protection from UV radiation too.  Sun damage to the eyes and skin can be cumulative from childhood.

June is a month to celebrate men.  Not only is June known for Father’s Day, but it is also recognized as Men’s Health Month.  It is a time to raise awareness of preventable health issues and an opportunity to encourage the men in our lives to get regular health checkups.  Here are some ways to promote better health for the men we love including husbands, fathers, brothers, and sons.

Get a physical–  On average, adult men do not see their healthcare providers as often as women do.  They may wait until there is a real problem.  Regular physical exams enable the physician to monitor blood pressure, heart rate, cholesterol levels, and weight.  A physical allows for routine blood work and PSA screenings for prostate cancer to be performed.  Early detection is key when treating such health conditions as heart disease, diabetes, and cancer.

Encourage regular exercise–  Regular exercise has many health benefits.  Exercise helps with weight reduction, helps maintain strong bones and muscles, increases energy levels, decreases stress, aids in relaxation, can improve brain function, improves mood, enhances sexual function, and can reduce the risk of developing chronic disease.

Encourage healthy eating habits–  Heathy eating is a lifestyle choice.  The benefits include avoiding excess weight gain and boosting energy levels.  Healthy eating can prevent major health problems such as heart disease, high blood pressure, stroke, and diabetes.

A healthy diet includes plenty of fruits and vegetables, lean meats, whole grains, and low fat dairy products.  Avoid sugary drinks, processed baked goods, fried foods, white bread and processed meats.  Many of these items have high levels of sugar, salt, and trans fats while offering little nutritional value.

Encourage the men in your life to take care of their physical health and well-being so they can live a long and happy life.

As children move into their teenage years, there are many health concerns that may affect them.  Teens deal with peer pressure and stress, issues of weight and body image, problems of drug and alcohol use, and questions about puberty, sex, and relationships.  They may be hesitant to discuss these concerns with parents or their family doctor.  Open lines of communication may help teens work through some of these concerns.  Here are five common health concerns of teenagers.

Eating Disorders and Obesity – Obesity is a significant concern for children and adolescents.  According to a report in American Pediatrics, obesity puts them at risk for diabetes and heart disease.  Overweight children and teens are less likely to participate in a sport or get adequate exercise.  Changes in lifestyle and diet can help promote weight loss and improved health. 

Many eating disorders develop during adolescence and can have serious health implications.  Common eating disorders include anorexia nervosa, bulimia (binging and purging), and binge-eating disorder.  It is important to seek treatment early.

Lack of Physical Activity – As teenagers spend more time on their Smartphone, computer, or watching TV, they tend to be less physically active.  Sedentary lifestyles lead to an increase in health issues including obesity, diabetes and heart disease.  Teens may need to be encouraged to exercise more or participate in a sport.  Parents can set a good example by being physically active themselves.

Sexually Transmitted Disease and Pregnancy – Teens need to be aware of the risks and complications of STDs and how to protect themselves.  Parents should ensure their teen has had the HPV vaccine to protect against human papillomavirus.  This common virus can cause cancers of the cervix, vagina, vulva, penis, anus, and the back of the throat.  Teens who are sexually active should understand the use of contraception to prevent unplanned pregnancy.

Drug and Alcohol Use – Alcohol use by teenagers can lead to other risky behaviors including drunk driving and unsafe sex.  Marijuana, cocaine, and amphetamines continue to be commonly abused drugs among teenagers.  In addition, abuse of prescription drugs, particularly painkillers, is on the rise.  Smoking among US adolescents has declined in recent years, just as it has in the general population.  Those who do smoke develop more respiratory illnesses.  Many teens are unaware that use of e-cigarettes or vaping is also unhealthy.

Suicide – The third leading cause of death for teenagers is suicide.  There are many contributing factors including family problems, loneliness, isolation, depression, and substance or alcohol abuse.  More males than females are likely to choose suicide, and many were reluctant to seek help.  Good family communication can help.