What's up Doc?
Question & Answer with Danville Regional's Chief Medical Officer -
Dr. Saria Carter Saccocio
Best of Breastfeeding
Question: What are the benefits of breastfeeding?
Breastfeeding is important for the health and wellness of both mother and baby. Three out of four mothers start out breastfeeding, according to the Centers for Disease Control and Prevention. However, we have a ways to go to reach our Healthy People 2020 goal of 82%.
Benefits of breastfeeding start with the bonding experience immediately after delivery between mother and baby. The skin to skin contact is warm and comforting to the infant. At the same time, close contact causes the release of oxytocin, a hormone, relaxing the mother and assisting with milk flow.
Colostrum, the initial milk after birth, is rich in nutrition and antibodies that protect against infections. As the milk thins over the first several days after birth, the composition of the breast milk adjusts to include essential nutrients to provide complete nourishment and continued antibodies. Breast milk is easier for the baby to digest. While formula is a good substitute, it is not an exact chemical make-up of breast milk. The American Academy of Pediatrics recommends exclusively breastfeeding for the first six months of life, and continuing for at least twelve months.
Babies that are breastfed experience fewer ear infections, diarrhea, allergies, and respiratory infections. Risk for asthma, diabetes, and sudden infant death syndrome are also reduced. Some studies show that infants who are breastfed compared to those who are formula fed may be protected from certain leukemia and lymphoma cancers. Research suggests that breastfed babies may have a higher IQ than formula fed babies.
Mothers stand to benefit greatly from breastfeeding, too. Ovarian and breast cancer rates are lower in women who breastfeed. In addition, diabetes, heart disease, and even postpartum depression are decreased for breastfeeding mothers. Women can get a jump on weight loss back to their pre-pregnancy weight since breastfeeding burns calories.
Economically, breastfeeding is a win-win. Mothers who breastfeed tend to miss less work due to the decreased risk of infant infections. Formula can cost up to $1,500 dollars in the first year of life. Breast milk is free!
Though breastfeeding can be challenging initially, the benefits for infant and mother are great. However, certain health conditions exist that may not allow for successful breastfeeding. Speak with your physician to discuss your options and what is best for you and your baby.
Got the Bug?
Question: I caught the stomach flu and so has my family, how do we stop it?
The stomach flu is actually not flu at all. Gastroenteritis is the medical term for inflammation of the stomach and intestines which leads to sudden nausea, vomiting, and diarrhea. Most often what we see in the US is a virus or bacteria as the culprit, though parasites and chemicals can be responsible for these dreaded GI symptoms, too. Recently in Virginia, we have seen an uptick of norovirus cases. Norovirus is the most common cause for acute gastroenteritis, according to the Centers of Disease Control and Prevention.
Norovirus can easily spread through food and water, person to person contact, or by touching contaminated surfaces such as door knobs and keyboards. The virus can occur any time of year, however, we see a greater number of cases in the winter since folks are inside in close quarters due to the cold weather and holidays when friends and families gather. It typically starts with nausea and vomiting followed by abdominal cramps and diarrhea. You may also experience body aches, a low-grade fever, and headaches.
The good news…the norovirus should run its gastroenteritis course within one to three days without requiring antibiotics since it is a virus and not a bacteria. Vomiting and diarrhea may lead to dehydration and will require replenishing fluids in your body. Avoid sugary beverages such as fruit juices and carbonated drinks with caffeine which can irritate the stomach lining. Sports drinks and “oral rehydration solution” such as Pedialyte can help prevent low sodium or potassium levels. Gradually re-introduce food as tolerated, starting with bland foods like soda crackers or toast and eventually you can add back milk products, meat, and fatty or fried foods to avoid a return of abdominal cramps and diarrhea. For children, the American Academy of Pediatrics now recommends to advance to a well-balanced diet within 24 hours, since delay of adequate nutrition prevents the gut healing quickly enough.
If you experience severe vomiting and diarrhea lasting more than a couple days, blood while vomiting or in your stool, a fever greater than 101 F, or pain localized to the lower right abdomen, contact your primary care provider. Dehydration may be severe enough to require aggressive fluid replacement.
Prevent catching the GI bugs by washing your hands with soap and water. Hand gel can help but is NOT a substitute for warm water and soap suds. Wipe down contaminated surfaces with bleach-based cleaners. Wash clothes on the longest cycle and machine dry them to avoid lingering virus on soiled laundry.
Feel better! Avoid the Bug!
Did You Take Your Medicine Today?
The last time you were given a prescription after visiting the doctor did you pick it up at the pharmacy? Did you take your medicine? Did you take every pill, including refills? If you didn’t follow through, you are not alone. In fact, 20-30% of all prescriptions are never filled. Of those medications picked up from the pharmacy, only half are taken as directed.
Unfortunately a heavy burden of increased healthcare costs, emergency room visits, hospitalizations, pain, suffering, and even death are the result of medication non-adherence. Non-adherence costs an estimated $2,000 per patient every year in physician visits. According to the Centers for Disease Control and Prevention, 125,000 people die each year due to medications not taken as recommended. Sadly, more people will die in 2014 from non-adherence than breast, colon, and prostate cancer combined.
Concerns of taking a medicine, the need for it, and the ability to pay for treatment are the most common reasons for non-adherence. People are often fearful of the side effects of medications recommended and potential interactions with the other drugs they take. High blood pressure or high cholesterol, may not seem urgent to treat because symptoms are uncommon until the damage is life threatening. In fact, only half of patients with high blood pressure take their medicine long term. In addition, the price of medications can serve as the greatest hurdle to taking medicine as prescribed. Both brand name and generic drugs can be very expensive, particularly when an individual has multiple chronic diseases requiring a laundry list of pills to take daily.
Communication between patient and provider is the key to better health. Have you ever been afraid to tell your doctor that you didn’t understand what they told you, that the pills they prescribed caused intolerable side effects, or that you were embarrassed to admit that you couldn’t afford to take all the pills and would have to choose between taking your medicine or eating? I encourage you to speak up, ask questions, and express your concerns. As physicians, we should do the same. We are a team, the patient and provider. Open communication can prevent suffering and save lives.
If the cost of medication is your greatest hurdle, consider contacting Partnership for Prescription Assistance (PPA) www.pparx.org or call toll-free at 1-888-4PPA-NOW. PPA connects patients who are uninsured or financially in need to resources that offer medicines for free or nearly free. They have assisted nearly 8 million people to gain access to medication and much needed healthcare.
Speak up…ask questions…seek help to pay for your medicine. Let’s talk!
Sinus or Migraine?
Question: I have a throbbing headache. Is it a sinus headache, or am I experiencing migraine?
Most often what appears to be a sinus headache is actually a migraine. In a study of 100 people who self-diagnosed themselves with sinus headaches, only 3 had true sinus headaches, 86 had migraines, and 11 had other types of headaches.
Common symptoms associated with sinus headaches due to infection include thick nasal discharge, fever, chills, bad breath, and tenderness of the face over the sinuses (lower forehead and upper cheeks).
Migraine headaches are throbbing or pulsating in nature, debilitating, and last between 4 hours to several days. They involve one side of the face or head but can change sides with the next migraine. Nausea and vomiting are also associated with migraines. An easy way to remember these symptoms is the word or mnemonic, P-O-U-N-D.
Pulsating or throbbing in nature
Onset of duration 4-72 hours
Unilateral or one-sided
Nausea and vomiting
In addition, photophobia (sensitivity to light) and phonophobia (sensitivity to sound) are often present. People experiencing a migraine prefer to find a dark, quiet room. Prior to the onset of a migraine, you may see flashing lights, blind spots, or numbness and tingling of the arms and legs. These symptoms are referred to as an aura, or warning symptoms.
Many individuals identify triggers that cause their migraines. A short list of known triggers include chocolate, cheese, red wine, heat, hunger, dehydration, stress, lack of sleep, and even menstrual cycles. Trigger factors are unique to the person and avoiding them may reduce the frequency of headaches.
Prevention is the first step to avoid these debilitating headaches. Reducing stress, getting plenty of sleep, staying hydrated, and avoiding known triggers can help minimize the number of migraines. Several different classes of medications are used to both prevent and treat migraines. Generic ibuprofen, known as Advil or Motrin, can stop a migraine and is a cheap over-the-counter alternative. Some people will require prescription medications to alleviate their symptoms and should be seen by their primary care provider. Unfortunately, some individuals will experience migraines that are not easily treated and may require care by a neurologist, or doctor that specializes in headaches and other neurological conditions.
You wake up in the morning with a sore throat, cough, and a headache. Do you take Motrin and get on with the day, or should you call the doctor’s office to get an appointment and ask for antibiotics?
Most sore throats are caused by viruses, not bacteria such as strep throat, or Group A streptococcus. Common symptoms of a viral sore throat include cough, runny nose, red eyes, and sometimes diarrhea. Strep throat is more likely to be severe and presents with sudden onset of fever, pus on the tonsils, swollen neck lymph nodes, and absence of cough. There may also be tiny red spots found on the back of the throat and a skin rash that feels like sandpaper.
Strep throat is more common in children ages 5 to 15. It is more prevalent in the late winter and early spring, but is diagnosed year round. A rapid strep test in the doctor’s office can identify the bacteria. If this test is normal but there is still concern for symptoms consistent with strep, a throat culture can be obtained to confirm the results. Both tests are performed by swabbing the back of the throat. While the rapid strep results are back in minutes, a throat culture may take up to 1-2 days.
Viral sore throats are typically treated with over-the-counter medications to relieve the pain and discomfort. Throat lozenges or sprays, Tylenol, Motrin, cool liquids, and rest may help. Strep throat is treated with antibiotics like penicillin or amoxicillin. Antibiotics should be taken for at least a day before returning to school or work to prevent spreading the strep infection to others.
If you woke up this morning with a sore throat, coughing, and a mild headache, you are probably infected by a virus. Avoid antibiotics unless you have been tested for strep. Though a cold virus can make you feel as miserable as if you had a bacterial infection, antibiotics will not speed up the recovery process. Stick with mom’s chicken soup, cough drops, and Motrin. Call your physician if your symptoms worsen or do not improve after several days.
Shingles to Vaccinate Or Not to Vaccinate
Question: What is shingles? Should I get the vaccine?
Shingles is a painful rash that is caused by the herpes varicella zoster virus. This is the same virus that causes chicken pox. After being infected with chicken pox, the virus does not go away. It goes dormant, or silent in the nerve root. Age, stress, illness, and other factors that weaken the immune system can cause the virus to “wake up”. Flu-like symptoms, headache, itchiness and/or tingling are often experienced followed by little blisters appearing in a band or strip. Shingles can occur anywhere on the body, including the eyes which can be extremely painful. The quicker antiviral treatment is started, the sooner the recovery. It takes about 2-4 weeks for the rash to heal. Some individuals experience pain after the rash disappears that ranges from mild to severely disabling, called post herpetic neuralgia or PHN.
Over half of all shingles cases occur in people over the age of 60. The risk for PHN increases significantly with age. In fact, one third of the US population will experience shingles in their lifetime. The good news is that a vaccine exists that can prevent shingles. The vaccine, or Zostavax, is available for individuals over 50.
Zostavax is a shot, most commonly given in the arm. Unlike the flu shot, you only need it once in a lifetime to prevent shingles and reduce the likelihood of PHN. Zostavax can also prevent shingles from occurring again if you have already experienced this painful condition. As with any medication, side effects are possible. The most common side effects include headache and rash at the site of injection. If your immune system is weakened by disease, certain cancers, radiation, or medications such as steroids, Zostavax should not be given. Speak with your physician to determine whether this vaccine is right for you.
Holiday Blues...or Something Else?
Tis the season for turkey, shopping, traveling, and celebrating the holidays! The flurry of activity between now and the New Year is exciting and joyful for some, while for others the added stress can be detrimental to their mental health.
Feeling overwhelmed during the holidays is common, due to hectic schedules and seasonal expectations such as family gatherings, shopping, and holiday parties. Avoid the holiday blues by following a few simple tips. Reach out for social support from friends and family. Write a check list to keep track of holiday duties. Set aside time for free or inexpensive activities such as window shopping, watching favorite holiday movies on TV, and playing board games with family and friends. Stick to a planned budget for holiday giving to prevent dreading your January bank and credit card statements. Be mindful of excessive alcohol intake, as the festivities create an atmosphere of celebration with libation. Most importantly, take time to relax and enjoy the present.
If the holiday blues seem to linger, you may be experiencing seasonal affective disorder or depression. Decreased sunlight and colder temperatures in the fall and winter can contribute to seasonal changes in your mood leading to seasonal affective disorder. This mental health condition can be treated with light exposure, medications, and counseling. Depression can also present during the holidays or may worsen during this time of year. If you feel sad for an extended period of time and experience several of the following symptoms, you may be depressed.
- Sleeping too much or too little
- Decreased interest in life or daily activities
- Guilt or self-blame
- Energy loss or feeling tired all the time
- Difficulty concentrating
- Eating too much or too little
- Slowing of speech and activity
- Suicidal thoughts
Depression can often be treated with medication and counseling. If you think you may be depressed, talk to your doctor. If you do not have a doctor or need help right away, mental health resources in the community are available to you. Call 1-800-273-TALK (8255) to speak with a trained counselor 24/7 for free. While many of us add exercise, weight loss, or healthier eating to our list of New Year’s resolutions, let’s not forget the importance of mental health and happiness. Peace be with you!
Early Detection is Key to Controlling Diabetes
November is the start of the holiday season - a time to celebrate fun, family and food. It also is a time to consider a medical condition for which as many as 79 million American adults is at risk of contracting: diabetes. November is American Diabetes Month. If you aren’t living with diabetes yourself, chances are that at least one of the friends or loved ones with whom you will celebrate in the coming weeks has been touched by the disease.
Diabetes is a condition that causes blood sugar levels to rise higher than normal. Our bodies break down the food we eat into glucose, or sugar, so it can be used for energy. A hormone called insulin helps the glucose to get inside our cells. When our bodies don’t make enough insulin or the insulin we have isn’t being used properly, sugar starts to build up in the blood. Complications from diabetes can include blindness, heart disease, hearing loss, kidney failure, severe nerve damage leading to limb amputations, and strokes.
More than 25 million Americans currently have diabetes. This number is on the rise, and more than one in three American adults suffers from prediabetes, which occurs when blood glucose levels are higher than normal but not high enough to be considered diabetes. People with prediabetes who do not change their lifestyles usually develop type 2 diabetes, otherwise known as adult-onset diabetes, within three years.
Changing your lifestyle to incorporate regular physical activity, weight loss, and a healthy diet with lots of fruits and vegetables can help maintain blood sugar levels. This can help prevent diabetes in those who have prediabetes and assist those who have diabetes in better managing their disease.
The worst complications from diabetes often occur when the disease goes unchecked. With the help of healthy lifestyle changes, insulin medication and blood sugar monitoring, we can prevent these from happening. Symptoms of diabetes include:
- Urinating often;
- Feeling very thirsty or very hungry even when you have just eaten;
- Extreme fatigue;
- Blurry vision;
- Slow-healing cuts and bruises; and
- Tingling or numbness in the hands and feet.
If this list looks familiar to you, talk to a doctor as soon as possible. If you can detect your diabetes early, you and your doctor can help control it together.
Prediabetes, unfortunately, has almost no symptoms, so people should carefully assess their risk factors for type 2 diabetes. These include:
- Being 45 years of age or older;
- Being overweight;
- A family history of type 2 diabetes;
- Engaging in physical activity less than 3 times a week;
- Having had diabetes while pregnant (gestational diabetes); and
- Having given birth to a baby who weighed more than 9 pounds.
If one or more of these factors describes you, talk to your doctor about your diabetes risks and get your glucose levels checked.
To learn more about diabetes and take a risk factor test, visit the American Diabetes Association at www.diabetes.org. To locate an area physician who can help you manage your diabetes call 1-800-424-DOCS (3627).
Sources: American Diabetes Association and Centers for Disease Control and Prevention
Smokeout: Perfect time to be a quitter
Great American Smokeout Day is November 21st…are you ready? Considering 70% of all smokers want to quit, there’s a good chance that you have at least thought about it.
The American Cancer Society challenges every smoker to quit for a day, hopefully motivating some to stop permanently. One in three cancer deaths are caused by smoking. You have the opportunity to save your life, and perhaps others due to second-hand smoke. Because 95% of smokers who attempt to quit on their own will relapse, I encourage you to speak with your physician for help. Physicians are trained to provide treatment methods that can help you double the likelihood for your success.
Realistically, quitting smoking may be the most difficult step towards living a healthier life. There are many reasons why people don’t try. First, there is a lack of awareness that smoking kills and at the least harms the quality of life for those exposed to smoke. Second, smokers are afraid to quit or think they can’t. In addition, smokers often think they can’t afford to quit. The truth is…you can’t afford not to quit smoking.
If you are ready to take the challenge, consider the following tips. Set your quit date for November 21st, along with many others across the US. Embrace your social support network of family and friends by sharing your plan. Ask them to assist you in removing all cigarettes, ashtrays, lighters, and matches before November 21st.
Quitlines are a free resource that can also help improve your ability to quit tobacco. By calling 1-800-QUIT-NOW (7848-669), you will be connected to a trained expert in Virginia that can help you personalize a plan that works for you.
Schedule an appointment with your physician right away to receive guidance on the best treatments available. There are patches, inhalers, pills, and even gum that can help reduce the craving to smoke. Some treatments may have side effects or require you to follow specific directions for safe and effective use. If you suffer from mental illness, such as depression or anxiety, quitting smoking may be more challenging and possibly require higher doses of medication.
If you’re pregnant, the sooner you stop the better. The health of you and your baby are effected by smoking tobacco before, during, and after your baby is born. There is no “safe” level of tobacco smoke exposure for babies. The more you smoke, the greater the risk of having a miscarriage, stillbirth, premature or a low birth weight baby. In fact, second-hand smoke is more poisonous because of the burning chemical than the smoke inhaled by a smoker. Second-hand smoke also increases the risk of SIDS, or sudden infant death syndrome.
Join millions of smokers November 21st, be courageous, and stop smoking. You can do it!
How to Save a Life!
If you are a woman living in Virginia, you have a greater chance of being diagnosed and even dying from breast cancer than women in most other states. In fact, if you are an African American woman in Virginia your risk of dying from breast cancer is even higher.
Many of us would guess that a family history of breast cancer increases your chances the most, when advancing age is actually the strongest risk factor for being diagnosed. Some other risks include obesity, lack of physical activity, increased alcohol use, and menopause after age 55. Breast cancers in African American women are often found in the later stages which may contribute to higher mortality rates. In addition, a more aggressive or deadly type of breast cancer, called estrogen receptor-negative, is more common in African American women. For these reasons and others, early screening mammograms lead to early diagnosis which is the key to a greater chance of survival.
While you can’t control your family history, age, and when you start menopause, you can choose to exercise more, eat healthier, and lower your alcohol intake. Remember, your body is your temple so be kind to yourself.
Expert medical opinions differ in regard to when to get your first mammogram. The American Cancer Society recommends beginning mammograms yearly at 40, while the United States Preventive Services Task Force recommends beginning at 50 and repeating every two years. Speak with your doctor to help you decide what is best for you.
The good news: if diagnosed early the survival rate can be 90% and higher. October was Breast Cancer Awareness month, but that doesn’t mean there’s only one season for screening. A mammogram may cause brief discomfort, but it can save your life.
Be brave, be courageous, get a mammogram!
Flu Season...It's Back!
Last year’s flu season was the most dangerous in recent years. More patients, adults and children alike, visited the doctor and required hospitalization because of the flu virus. The best defense we have against the flu is the vaccine. Receiving a flu shot not only can limit the severity of illness, but it can also save your life.
Flu viruses spread by persons infected who cough, sneeze, or even talk within 6 feet of others. The virus can live on doorknobs and phones up to 24 hours which can also lead to infection. Many people are not aware of the fact that you can be spreading the virus 24 hours before you feel sick and remain contagious up to 7 days after symptoms begin.
It’s difficult to sometimes tell the difference between a cold and the flu. Both illnesses present with fever, chills, cough, body aches, tiredness, runny nose, and headache, but the flu is generally more severe. When you are infected with the flu, you feel like you have been hit by a Mack truck. Younger children, older adults, and patients with chronic conditions like asthma, diabetes, and heart disease are at risk for serious complications such as pneumonia. People who smoke are also at greater risk of flu infections.
If you become infected with the flu, prevent the spread to others by staying away from public places such as work, church, and other social gatherings for at least a week. Go see your doctor right away if you think you are sick with the flu. Medication to treat the flu works best if started within 48 hours of getting sick. Wash your hands with soap and water when possible, or use alcohol-based hand sanitizer.
Avoid the flu altogether by asking your doctor for the flu vaccine. The Centers for Disease Control and Prevention (CDC) recommends everyone over the age of 6 months receive the vaccine. Now most individuals with egg allergies can be safely immunized. If you are afraid of shots, ask about the vaccine that can be given as a nasal spray.
Do not delay getting your flu vaccine. It takes about 2 weeks before your immune system is fully prepared to fight against flu viruses after receiving the vaccine. If you have questions about the flu or the vaccine to prevent getting sick from the flu, ask your primary care provider. Let’s keep our community healthy this season.
Feel Good at Fifty Gentleman
Have you had your tune-up? When it comes to cars and maintenance, I bet most men know when it is time to check and change the oil. Many would recommend taking the truck around the block routinely and not letting it sit in the driveway to maintain the engine. And all of you would agree that gas is what goes in the tank. You would never add junk for fuel.
If you want to prolong the life of your vehicle, maintenance and tender loving care are essential. Your body works the same way. When was the last time you checked what’s under the hood? Fifty is a good age to check your cholesterol, sugar, and blood pressure to prevent heart attacks and strokes.
Protect your engine by watching what you eat, exercising, and avoiding hazards to your health. Minimize fast food to no more than once a week. The fat and salt content are typically higher running through the drive through as compared to what’s at home on the dinner table, especially if you limit the food you eat out of a can or prepared and frozen. When was the last time you exercised? Did you know that cutting the lawn counts? The more you move your body the more likely you are to live longer.
There’s a reason why smoking cigarettes while filling up your gas tank is hazardous to your health. Of course, there’s a chance of fire but the greatest risk is to your body. Fifty is a good time to quit using tobacco, or at least begin trying. At least seventy percent of all smokers want to quit and seventy percent have tried. Since it takes about seven attempts to quit, start now so that you can enjoy the rest of your life - as well as those around you. Start with a toll-free call to 1-800-QUIT-NOW. Smokers who contact quitlines double their chances of quitting successfully.
Careful how much alcohol goes in your system. Over time it takes a toll on your body. For men, drinking more than two servings a day increases the risk of heart attacks, strokes, and liver damage to name a few reasons to cut back. If you are struggling to cut back or quit, you may be suffering from depression. Mental health is equally important to your overall health and wellness. Reach out for help. Treating depression extends your life span and quality of life.
Cancer is a scary word for many. As a result, sometimes we avoid important cancer screenings such as colonoscopies for colon cancer. A colonoscopy at fifty can save your life…just do it! The good news is that if the results are normal, you can avoid another check for ten years. Ask your doctor about your risks for prostate cancer as recent recommendations for prostate screening have changed.
We are creeping up on flu season. Don’t forget your flu shot. And finally, don’t wait to step on a nail or get a dirty cut before your next tetanus vaccine. This combination shot can also protect against the whooping cough which is making a comeback in this part of the country.
On your mark, get set, go!
Wise Woman...Longevity for Life
Ben Franklin once said an ounce of prevention is worth a pound of cure. Ladies, he was absolutely right!
The average patient needs 25 preventive services. Chances are your doctor runs out of time to address every health concern, often leaving health screening for last. Focusing on health maintenance not only prolongs your life but adds quality to your golden years.
If you’ve made it to your fifties, there are some screening tests that you have likely been recommended to you and others that will be this decade. Ask your doctor which cancer screening exams are appropriate for you. Cervical cancer deaths in the US have decreased by 74% due to successful screening practices. Early detection and treatment of breast cancer is also an important component of maintaining women’s health. Have you scheduled your colonoscopy? Colon cancer is the second most common cause of death from cancer but is often preventable if diagnosed at the polyp stage.
Heart disease is the number one cause of death. Screening for and treating obesity, diabetes, high blood pressure and cholesterol help prevent a heart attack or stroke in addition to other conditions. Counseling for tobacco use and alcohol abuse can be life-saving for both your physical and emotional health.
A healthy mind helps preserve a healthy body. People with depression are more likely to struggle with chronic disease and experience a shortened life expectancy. Screening and treatment of depression improves quality of life and the ability to manage overall health and wellness.
Out of all preventive measures available, vaccines are responsible for the greatest impact on health and wellness. Whooping cough, or pertussis, has recently made a comeback. The Tdap vaccine can prevent pertussis and prevent transmission to you and your loved ones from a serious infection. If last year’s flu season is an indicator of the severity we should expect this year, get in line early to receive the vaccine and build up your immunity. Be well!
Home Safe - Speak Up!
Nearly 1 in 5 patients admitted to the hospital across the US will be readmitted within 30 days, according to the Center for Medicare and Medicaid services. Furthermore, studies show that about 20% of these readmissions may be avoidable. There are steps that you can take to prevent taking a trip back to the hospital. Interested?
Picture this. For three days you have been coughing, running a fever and your diabetes seems to be out of control. When you visit your primary care provider, they tell you that you have pneumonia and need to go immediately to the hospital.
- YOU are the MVP, the Most Valuable Player! The health care team includes all players, especially you. Speak up, ask questions, and be heard. Your safety depends on every member of the team working together, focusing on the same goal…getting you home safely.
- Understand the reason you are in the hospital. Often times the reason why a patient is admitted to the hospital is not quite clear. In this case, is it the pneumonia or the worsening of your diabetes? It is likely that both conditions are responsible for why you are in the hospital.
- Get Educated. Ask questions and request information that can help you stay out of the hospital once you are healed. For example, it is important to understand that your risk for pneumonia was greater and you probably got sicker because of your diabetes. Be sure that before you are discharged that you have all of your questions answered and feel confident that there is a plan in place that addresses the reasons why you were taken to the hospital in the first place.
- Set expectations. You can expect many of the following to be addressed before you go home: what to eat, what level of activity is safe, medications to be taken, and when to follow up with your physician. Remember, you are the MVP and can help the team by providing your input.
- Involve your family and friends. When you are ready to go home safely, your family and friends will step in as team players. They care about you and want to help you feel better. Let them!
Following these five steps will help you avoid getting sick and having to return to the hospital. Of course, once you are home if you feel worse call your primary care provider right away so that they can help get you back on track. The best care is the right care, at the right place, at the right time.
Get ready for the Health Insurance Marketplace
Here are seven things you can do now
Dr. Saria Saccocio Contributing columnist newsadvance.com
(Editor’s note: The Register & Bee is debuting today a new occasional Health Talk column written by Dr. Saria Saccocio, chief medical officer at Danville Regional Medical Center.)
Over the past several months, words like “health reform” and “insurance marketplaces” are all the buzz.
But what exactly do they mean and how do they impact you? The Health Insurance Marketplace is a key part of the health reform law that will make health insurance more accessible to people across the country beginning Oct. 1.
Think of the marketplace as an online travel site like Hotwire or Priceline, where people can compare, view and buy health insurance that has been approved by their state and/or the federal government. The details are meant to be transparent, and insurance plans must treat you fairly. They cannot deny you coverage because of a pre-existing condition. For example, if you have previously been diagnosed with cancer, this information cannot be used to keep you from purchasing health insurance. In addition, every plan must cover basic health services, including visits to the doctor, hospitalizations, maternity care and prescriptions.
And even more good news, the government is providing increased opportunities to lower the cost of health insurance, making it more affordable and providing low-cost options to many people.
So how do you learn more and get ready for the marketplace to open? There are seven simple things you can do now to get ready for Oct. 1:
- Learn about different types of health insurance. Through the marketplace, you’ll be able to choose a health plan that gives you the right balance of costs and coverage.
- Make a list of questions you have before it’s time to choose your health plan. For example, “Can I stay with my current doctor?,” “Can I use my local hospital?” or “Will this plan cover my health costs when I’m traveling?”
- Make sure you understand how insurance works, including deductibles, out-of-pocket maximums, copayments and coinsurance. You’ll want to consider these details while you’re shopping around.
- Start gathering basic information about your household income. You may qualify for a break on the cost of your health insurance, so you’ll need income information to find out if you’re eligible for a discount.
- Set your budget. There will be different types of health plans to meet a variety of needs and budgets, and breaking them down by cost can help narrow your choices.
- Find out from your employer whether they plan to offer health insurance. This is especially important if you work for a small business.
- Explore current options. You may be able to get help with insurance now, through existing programs or changes that are in effect already from the new health care law. Visit http://www.healthcare.gov/ for information about health insurance for adults up to age 26, children in families with limited incomes (CHIP), and Medicare for people who are over 65 or have disabilities.
The best place for the latest, most accurate information on the marketplace is http://www.healthcare.gov/. Here you can get updates, learn about the application process, and find out detailed information state-by-state.
In addition, Danville Regional Medical Center will be providing resources about enrollment into the new Marketplace in the months to come.
Health insurance has many benefits and undoubtedly helps keep people well and our community healthy. As we continue to learn more and prepare for the Marketplace to open, Danville Regional Medical Center is committed to keeping you informed. Oct. 1 will be here soon, and we want to you to be prepared.
Dr. Saria Saccocio is the chief medical officer at Danville Regional Medical Center. Disclaimer: No individual should use the information, resources or tools contained within this column to self-diagnose or self-treat any health-related condition. Diagnosis and treatment of all health conditions should only be performed by your doctor or other licensed health care professional.
Pregnancy Brain…The Real Thing
When a woman is pregnant, her body produces outrageous levels of progesterone and estrogen (15-40 times more). These high levels are often blamed for “pregnancy brain”. In addition, oxytocin, a hormone produced when the baby delivers, is released causing the uterus to contract upping the ante for lack of clarity postpartum. As if this wasn’t enough, sleep deprivation experienced after delivery creates more fog on the brain.
What to do? SLEEP WHEN YOU CAN! Sleep is underrated. The old adage, “sleep when the baby sleeps” only works for the first born. After that, the little rascal siblings are relentless! Don’t be afraid to ask for help. Call on your family and friends to give you a little mommy rest.
Spring is here...and so are the mosquitoes!
Enjoy the warm weather and the great outdoors, but be sure to protect yourself against blood-sucking insects. Did you know that only female mosquitoes have a test for human blood? Interestingly, our blood serves as a fertilizer for their eggs.
Fact or fiction? Mosquitoes prefer some human beings over others. Fact! They are attracted to people with high levels of cholesterol. This does not mean that if you are bit by a mosquito that you should rush to your doctor for a prescription of cholesterol reducing medication. It may be that you are efficient at metabolizing cholesterol.
Mosquitoes are also drawn to carbon dioxide, movement, and heat. Bigger people, as opposed to children, pregnant women, and exercisers seem to be the most appetizing victims.
While most often a mosquito bite is a nuisance, there is a risk for serious illness. They transmit illnesses including West Nile Virus, dengue fever, and malaria. Though dengue fever and malaria are rare in the US, West Nile Virus is quickly growing in numbers. Last year there were over 700 cases identified, including 11 in Virginia and North Carolina.
DEET-containing insect repellents are proven to be the most effective chemical repellant on the shelves. For those who choose to avoid the traditional chemical preventive measures, many alternatives are now sold. To name a few, soy bean oil-based, citronella, cedar, peppermint, lemongrass, and geranium products may provide short term protection. Oil of eucalyptus has been proven to be longer lasting and is safe in children 3 years and older.
Enjoy the holiday weekend, but if you happen to be the 1 out of every 10 people who mosquitoes find attractive be prepared and avoid unwanted admirers. Protect yourself!
I Can't Hear You...What Did You Say?
According to the National Institute on Deafness and Other Communication Orders, 17% of adults suffer from hearing loss. If you fall into this category, I recommend hearing testing. The question is who do you turn to for diagnosis and treatment of hearing loss.
Both Ear, Nose, and Throat (ENT) doctors, otolaryngologists, and audiologists are trained to detect the cause of hearing loss. Once hearing impairment is determined, audiology testing is typically performed to assess the source, severity, and potential treatment. If the reason for hearing loss can be corrected with surgery, the ENT doctor performs the surgery. If a hearing device is needed, they will likely refer the patient to an audiologist. ENT physicians and audiologists often work together to ensure that patients with hearing loss receive the appropriate care.
”Fibromyalgia is a condition that causes widespread pain throughout the body, including pain on both sides of the body as well as above and below the waist. There are 18 very specific "tender points", and the diagnosis requires over half of the tender points to be present.”
Individuals may have the following symptoms:
· Neck pain
· Low back pain
· Sense of joint swelling
· Numbness and tingling
· Sleep disturbances
· Memory issues such as difficulty finding words
Dr. Saccocio provided this guide for what does and does not help the symptoms of fibromyalgia:
What can help?
· Dry, warm weather
· Restful sleep
· Physical activity
· Cognitive behavioral therapy (counseling)
Medications that DO work:
Some medications in the following classes (ask your doctor)
· Muscle relaxants
· Anti-seizure medicine
Medications that do NOT work
· Ibuprofen or naproxen (Advil or Aleve)
· Narcotics such as morphine or Percocet
As always check with your health care provider if you suspect you may have symptoms of fibromyalgia or any other condition because he or she can take a detailed personal history and help you figure out what options are available for you.
Latest Flu Season in 29 Years!
Snow wasn’t the only delayed event in Danville this year. This flu season is the latest to arrive in 29 years!
According to the Centers for Disease Control and Prevention (CDC), we have finally entered flu season as of February 23rd. All 50 states in the US have now reported the flu is officially here in rising numbers. The good news is that this year’s flu severity so far is much less than previous years. There may be a couple of contributing factors:
- The most common flu virus this season is the same strain as the most common flu virus last year. There is a possibility that many individuals retained immunity and are somewhat “protected”.
- More people have been vaccinated by November of 2011 than any other year. The flu vaccine not only helps to prevent the flu, but it also can reduce the severity of the illness.
There is no way to predict how long this flu season will last. However, research shows that in cold weather the flu virus tends to be more viable. When it’s cold outside, individuals tend to spend more time huddling indoors which can increase the risk of spreading the virus. As Spring quickly approaches, we may see more folks outdoors in warmer climate but there’s no way to tell if in the end it will make any difference.
It’s not too late to vaccinate! We are now at the peak of flu season which means the greatest risk of infection is now. Ask your doctor if you should receive the flu vaccine.
Common Cold Myths
- Chicken soup helps fight a cold-FACT!
- Thins mucus and increases its clearance from the airways
- Helps prevent dehydration, like other fluids
- Feed a cold starve a fever-MYTH!
- Eating nutritious foods are needed to maintain a healthy immune system
- Try the chicken soup
- Exercise is good during winter months for helping to fight off infection-FACT…EXCEPT!
- Stress reducer
- Boosts your immune system
- Reduces the number of colds
- Do not exercise vigorously if you have a fever or severe respiratory symptoms-this may worsen your condition
- Vicks vaporub on feet cures coughs
- Mentholatum, the active ingredient, relieves congestion
- Typically rubbed on the chest, may be used on the feet but may not have full effect secondary to distance from the respiratory system (might as well rub on your chest…unless it’s the smell that bothers you)
- Do not use in children <2 years of age due to the potential to irritate the airways and increase mucus
Hand Sanitizer: Friend or Foe?
The fear has been that hand gels and foams may potentially increase the resistance of common bacteria to create “superbugs”. First things first…hand washing with soap and water long enough to hum the Birthday Song twice is always the best option. Hand sanitizers may not kill all germs, including some viruses and bacteria spores which can be eliminated by traditional soap and water.
However, when you’re on the go hand sanitizer is most convenient for cleaning hands that are not visibly soiled.
Alcohol-based hand sanitizers should contain at least 60% alcohol (isopropanol, ethanol, or n-propanol) in order to kill bacteria sufficiently after rubbing hands vigorously for approximately 30 seconds. Alcohol-based hand sanitizers have NOT been proven to lead to resistance to bacteria.
Non-alcohol based hand sanitizers (benzalkonium chloride, triclosan, and povidone-iodine) are also products sold in the US. Triclosan, the anti-bacterial ingredient in soaps, has demonstrated resistance in controlled studies but was not implicated in the cross-resistance of bacteria to common antibiotics such as ciprofloxacin and ampicillin. One of the risks with non-alcohol formulas is the risk of becoming contaminated with bacteria during production or during the life of the product.
The trouble is that anti-bacterial hand gels, foams, and lotions are still relatively new to the market. Current research does not implicate these hand hygiene items as dangerous. In fact, some studies indicate that hand sanitizer reduces absenteeism from school and work when used as directed by reducing upper respiratory and gastrointestinal illnesses. The truth is more research is necessary to determine the long term risks and benefits.
And yes, plain old soap and water works just as well as anti-bacterial soaps. What is important is hand hygiene awareness and best practices. So either sing your Birthday Song when lathering up or count to 30 with your favorite smelling hand gel, and most importantly…DO IT OFTEN!
Hand-foot-and-mouth disease is a self-limited, common viral infection in young children. A parent can expect their child to experience any one of the following: fever, sore throat, malaise, blisters in the mouth, a rash that may blister on the hands, feet, and buttocks as well as loss of appetite.
The most common complication is dehydration due to the painful sores in the mouth. If your child is unable to tolerate fluids, see your physician.
This infection is NOT treatable with antibiotics since it is a virus. Children may remain infectious for weeks. The best way to prevent hand-foot-and-mouth disease is good hand hygiene (washing hands) due to its transmission from person-to-person contact. Interestingly, adults may spread the disease without experiencing symptoms.
Kidney Infection (pyelonephritis)
- Kidney infection is a urinary tract infection (UTI) that moves upwards from the bladder to the kidneys:
- UTI symptoms: burning upon urination, increased frequency, increased urgency, and suprapubic pain
- Signs and symptoms of migration of infection to the kidneys: fever, chills, nausea, vomiting, and lower back or side pain
- Up to 30% of women diagnosed with a UTI have a kidney infection.
- It is absolutely necessary to contact your physician for testing and treatment. The treatment for a kidney infection is antibiotics. Antibiotics should be taken for the entire course. Stopping treatment before completion can lead to relapse of the infection and increase resistance of bacteria to antibiotics. If nausea and vomiting prevents toleration of fluids, hospitalization may be necessary for IV fluids and antibiotics.
Scarring from Minor Burns
- Pressure treatment with gel pads made of silicone may assist in prevention of scars.
- Moisturize-keep the wound moist to assist in wound healing. Cover with a bandage and apply either antibiotic ointment or petrolatum.
- Massage-once healed apply lotion and massage 15-30 seconds daily.
- Avoid hydrogen peroxide or vitamin E as they may impair the healing process.
- Avoid sun exposure which can delay healing and even cause skin discoloration of scar tissue.
Road to Recover After Foot Surgery
The quickest way to heal after surgery is to follow the instructions given to you from your physician and follow up as scheduled. The purpose is to avoid infection and for the surgical incision to close as intended. Depending on the size and location of the incision, sutures will be removed accordingly.
No matter if sutures, staples, or surgical glue is used the general care should be the same. Always keep the site clean. If you have been told to wash the area, showering is best to avoid over soaking. Allow the area to completely air dry prior to replacing the bandage. It is typically okay to use antibacterial ointment but avoid vitamin E which has been touted in the past to speed up the healing process. Studies have disproven this theory, and in fact vitamin E can cause skin irritation in the form of contact dermatitis.
Other medical conditions can slow the healing process, such as malnutrition and diabetes. Be sure and eat a well balanced diet and check with your physician if you have any concerns about how your overall health may affect your healing.
Get well soon!
Sarcoidosis is a peculiar disease that affects young to middle-aged adults. In the US, it is more common in African Americans and slightly more prevalent in women. It is thought to be an abnormal immune response that creates targets of inflammation throughout the body. The most common organs involved are the lungs, skin, eyes, and lymph nodes.
Many individuals with sarcoidosis do not have any symptoms and only discover the diagnosis by accident by having a chest x-ray. For those who do have symptoms, initially they may feel tired or experience fevers. Most symptomatic patients will develop lung involvement leading to a dry cough, wheezing, and shortness of breath. Skin nodules, red eyes, or swollen lymph nodes may even appear. The course of illness varies from a single episode to several years of progressive symptoms.
Sarcoidosis may be treated with medications that suppress the immune system, including steroids. Unfortunately there is no cure for this disease, however, only 10% of cases lead to severe disability.
Blood Type Diet-Fact or Myth?
In 1996, Peter D’Amo wrote Eat Right 4 Your Typeclaiming that diets should be personalized according to blood type A, B, or O. For example, O type individuals are recommended to eat a high protein diet. According to D’Amo, the O type dates back 30,000 years and humans were considered hunters. He also states that A type individuals should eat more vegetables since this type originated from the beginning of agriculture, and B types tolerate dairy best.
There are no clinical trials or any solid scientific evidence that supports the blood type diet theory. What is recommended is a diet high in fruits and vegetables with limited fats and oils. An excellent resource for healthy eating choices is www.ChooseMyPlate.gov. A balanced diet with moderate proportions and routine exercise is the best way to maintain or lose extra pounds. Make an appointment with your doctor to discuss ways to lead a healthy lifestyle.
Reflex Sympathetic Dystrophy Syndrome
Reflex Sympathetic Dystrophy Syndrome (RSDS), is a form of a condition called Complex Regional Pain Syndrome (CRPS). It is an uncommon pain syndrome that is caused sometimes by injury or trauma, stroke, heart attack, or even infection. The severity of injury does not necessarily increase the risk of experiencing CRPS. For example, a mild ankle sprain can potentially be a trigger for developing this condition. It is thought that the immune system may be involved, but it is unclear who will suffer from CRPS and exactly why it occurs.
Most often the pain begins in an arm or a leg and can extend to the opposite limb. Initially, the patient may experience burning, swelling, sensitivity to cold, and hair and skin changes. The skin over time may change in color to be pale and white, red and shiny, or even blue.
An early diagnosis helps to prevent long term damage such as muscle or bone loss. Pain medications, anti-depressants, steroids, topical creams, anti-seizure and bone loss medications are all potential treatments for CRPS. Other helpful therapies include physical therapy, local and spinal electrical stimulation, application of heat and cold, and biofeedback or other proven stress relievers.
Maintaining movement and daily activities as much as possible is a very important factor in recovery and minimizing long term effects. If you feel you are experiencing these symptoms, contact your physician.
Vitamin D participates in the regulation of the immune system in some studies. In addition, low levels have been associated with cancer, diabetes, depression, high blood pressure, multiple sclerosis, falls and many other conditions. While adequate levels of Vitamin D are necessary, it should not be considered as the panacea or cure all for disease.
There are two forms of Vitamin D, D2 and D3. Vitamin D2 comes from plants and D3 is found in oily fish and is produced when the skin is exposed to sunlight. D3 is also the type of Vitamin D sold over-the-counter.
As of 2010, the Recommended Daily Allowance (RDA) is 600 International Units (IU) for individuals between 1 and 70 years of age as well as pregnant and breastfeeding women. For ages 71 years and older, the RDA dose is 800 IU per day. Low levels Vitamin D may require higher dosing.
There is minimal risk for toxicity when Vitamin D3 is supplemented less than 2,000 IU daily, according to the National Academy of Sciences. However, higher doses can be dangerous if not monitored by your physician.A s always, if you take supplements of any kind it is important to discuss with your doctor.
- Flu vaccine causes flu
- All sinus infections require antibiotics
- Vitamin E supplement is good for your heart
- Beta carotene supplement is good for your health
- Allergies-non-drowsy medication is “better” than traditional antihistamine
- All sore throats are strep
- Chocolate causes acne
- The tryptophan in turkey makes you sleepy
- Acute back pain should be treated with rest
- Skipping breakfast is a good way to lose weight
- Second-hand smoke outside is not harmful to non-smokers
- All heart attacks present with chest pain
- Hypertension – decreasing salt intake can be just as important as taking blood pressure medicine
- Diabetes –
- uncontrolled increases your blood pressure and risk for congestive heart failure
- healthy lifestyle (exercise and healthy eating habits) just as important as taking medications
- eye exams to prevent blindness
- foot care prevents amputations
- Tobacco use
- November 17 is Great American Smokeout Day-Go tobacco free!
- Quitting takes 7-9 times
- Quit lines double chances of staying quit (1-800-Quit-Now)
- Medications double chances of staying quit
- Preparing for doctor’s visits
- Bring a relative or friend
- Bring a list
- Bring list of medications INCLUDING over-the-counter supplements and herbal therapies
- Don't hesitate to ask questions if you don’t understand
- Sudden Infant Death Syndrome (SIDS)
- Back to sleep and pacifiers proven to reduce risk
- Baby should not sleep in the bed with parents
- Exposure to second-hand smoke greatly increases risk
Best of Breastfeeding
Got the Bug?
Did You Take Your Medicine Today?
Sinus or Migraine
Is It Strep?
Shingles to Vacinate Or Not to Vaccinate
Early Detection is Key to Controlling Diabetes * Smokeout! * Save a Life
Flu Season * Feel Good at Fifty Gentleman
Wise Woman * Home Safe
Get ready for the Health Insurance Marketplace* Pregnancy Brain...The Real Thing
Spring is here...and so are the mosquitoes!
Latest Flu Season in 29 Years!
Common Cold Myths * Hand Sanitizer: Friend or Foe? * Hand-foot-mouth Disease * Kidney Infection (pyelonephritis) * Scarring from Minor Burns * Road to Recover After Foot Surgery * Sarcoidosis
Blood Type Diet: Fact or Myth? * Reflex Sympathetic Dystrophy Syndrome * Vitamin D3 * Medical Myths * Medical Pearls