Archives for October 2017

Why Do You Need to See a Family Medicine Provider Today?

While it might be convenient to make an appointment for the same day for an annual physical, this may not necessarily be realistic nor the best plan of action for you. Having a productive annual visit generally means that you have laboratory or other screening tests prior to seeing your provider. Conversely, sometimes it is not necessary to go straight to the family medicine provider when you come down with a cold. Viral upper respiratory infections often run their course with little more intervention than rest, fluids, and some over-the-counter medications. However, there are situations when you should have a same-day appointment. There are also certain symptoms that require an emergency room visit.

When Should I Have a Same Day Appointment? 

There are many instances when people will call the family medicine provider for advice over the phone, when they should really be seen in person. While a great deal of information can be retrieved from a conversation with your family medicine provider, there are times when he or she needs to evaluate you before ordering tests or treatments. The following list is not all-inclusive, but reviews a few of the more common complaints that require an office visit.

Upper Respiratory Symptoms

When your have had a cold for about 5 days and the symptoms are not getting better, or are worsening, it is probably time to see your family medicine provider. This is especially true if you are running a fever. You may need an antibiotic. On the other hand, you might not. Sometimes a cough and shortness of breath may be caused by bronchitis, or could be as serious as heart problems. Your provider will not be able to determine this over the phone, and having a family practitioner that can see you the same day may save you a trip to the emergency room or to urgent care.

Pain or Difficulty Urinating

Often times, problems urinating can be the result of a urinary tract infection (UTI). The first line of treatment for this is usually increasing your fluid intake and giving your body a few days to fight the infection. However, if the symptoms persist, you may need a urine culture to determine what is causing the problem, because an untreated UTI can lead to complications. These symptoms can also be caused by other illnesses, including certain sexually transmitted infections. Additionally, they may be consistent with

postmenopausal syndromes in women, or prostate problems in men.

A Fall Resulting in Pain or Swelling

The older you are, the more concerning a fall may be. And while the treatment for a traumatic injury that causes swelling is RICE (rest, ice, compression, and elevation), it is usually a good idea to have your primary care provider evaluate you. In the event that they find a fracture or significant injury to a joint, he or she can refer you to a specialist for further treatment.

Vomiting, Diarrhea, or Severe Abdominal Pain Lasting Longer than a Few Days

Viral gastroenteritis or even food poisoning is something that most younger, healthy people will recover from in a few days, but if you are not improving after 3 days of rest along with a bland diet and drinking fluids, it is time to see your primary care provider. If you are running a fever, it is even more important to be evaluated. First of all, you may need to have a few tests to find the cause of these symptoms. Additionally, vomiting and diarrhea causes loss of both fluids and electrolytes, which can lead to more problems. This is especially true with the young, the old, and the chronically ill; so making a same-day appointment would be in your best interest.

Bloody or Black Stools

Stools with bright red blood may well be from hemorrhoids, however, if accompanied by other symptoms such as abdominal cramping or diarrhea, it can be more serious. Additionally, even if it is hemorrhoids, chronic blood loss can cause anemia. If you are experiencing black stools, it could be an indication that you have bleeding somewhere higher in your gastrointestinal system – which runs from your esophagus to your anus. Seeing your primary care provider is an important first step to determine if and why you are bleeding internally.

When Should I Go to the Emergency Room? 

Even if you do have a primary care provider that offers same-day appointments, there are times when you should bypass the office and go straight to the emergency room. While this is not an exhaustive list, the following are clear indications for emergency room care. Chest pain, especially if it is associated with activity, could indicate you are having a heart attack. Other symptoms to look for in this situation would be neck, shoulder or arm pain, shortness of breath, or dizziness. If you feel palpitations, which can be a feeling of your heart beating fast and hard, or of having skipped beats, you should be evaluated in the emergency room, especially if you are feeling weak, lightheaded, dizzy, or are having chest pain. If you are feeling short of breath or are wheezing, the emergency room is the best place to be evaluated. Additionally, any time you have any neurological changes, such as confusion, dizziness, severe headaches, weakness, difficulty talking or swallowing, or an uneven smile, you should be taken to the emergency room or call 911. This would include whether the changes came on spontaneously, or after you had a head injury. In fact, any severe trauma, including a head injury should be evaluated in the emergency room.

Advanced Medical has caring and attentive medical staff, who are committed to providing quality health care to all their patients. They believe in continuity in primary care, and are available for same-day appointments. Call today at (561) 434-1935 to schedule an appointment, or book an appointment online.

Signs of ADD/ADHD You Shouldn’t Ignore

Let’s face it. Little kids are balls of energy, capable of running circles around most adults. On a good day, they could exhaust even the most seasoned parent. Childhood is the time for exploration, pushing boundaries, and discovering limits. Toddlers, preschoolers and even younger school-age children are busy learning how to be functioning members of society. There will be missteps and moments when they just can’t “play by the rules”, but knowing when this behavior is developmentally appropriate, and being able to identify when there might be something more going on, will allow parents, teachers and caregivers the insight to ensure that all children are given what they need to succeed. Attention deficit hyperactivity disorder (ADHD) affects 8-10% of children, and is a disorder that results in hyperactivity, difficulties in concentration or paying attention, and problems with impulse control. While adults can also have the disorder, it always originates in childhood, often diagnosed in the preschool or early school-aged years. If untreated, it can affect the child’s concentration, school performance, behavior, emotional wellbeing, and social skills. So, it is important to know what the signs of ADHD are that should not be ignored.

What is ADHD?

ADHD is a diagnosis that consists of a persistent pattern of hyperactivity, impulsiveness, and inattention that interferes with a person’s ability to function in society, whether it be at school, home, work, or with friends. While adults may also be affected, the symptoms typically begin in early childhood. Generally, this might be seen in a child’s inability to remain seated, difficulty waiting their turn, trouble concentrating, or frequent daydreaming. There are different subtypes of the disorder, with some being more hyperactive and others struggling with maintaining focus and paying attention. The disorder occurs more commonly in boys, and is diagnosed about half the time by the age of 4. Additionally, estimates indicate that up to 70% of children affected by ADHD carry some form of the symptoms into adulthood with them.

There is no clear evidence identifying a single cause of ADHD. It can even appear to be inherited some of the time. Other risk factors that have been suggested as contributing to the disorder are smoking, drinking, or exposure to toxins during pregnancy, prematurity, prolonged labor and lack of oxygen during birth. Things during childhood that may also contribute to the development of ADHD are head injuries, infections, cerebral palsy and exposure to lead. Frequently, those with ADHD may also have tics (spastic contractions of muscles, often of the face), learning disabilities, genetic disorders, and/or psychiatric disorders. While we know that an imbalance in chemicals in the brain, as well as a decrease in activity in some areas of the brain, are contributors to the problems associated with ADHD, there are no known definitive causes that have been identified.

What are the Signs that Shouldn’t Be Ignored?

The signs of ADHD fall under two categories: hyperactivity and inattentiveness. While the signs of hyperactivity usually develop by 4 years of age and peak at about 8, the signs of inattentiveness are often not noticeable until the child is a little further advanced in school, at 8 to 9 years of age. It is important to understand when to look for these signs because these same behaviors may be appropriate, depending on the developmental age of the child. For instance, it is perfectly normal for a toddler to be very active; and likewise, a 5-year old child should not be expected to have the attention span of a 10-year old.

The following are a list of signs that you should report to your family medicine provider, for the child who is 4 or older.

  • Being fidgety or having difficulty sitting still
  • Leaving the classroom or not sitting in his/her seat as directed
  • Running and climbing excessively
  • Having trouble participating in quiet activities or games
  • Activity resembling someone “driven by a motor”, or constantly moving
  • Excessive Talking
  • Blurting out answers or interrupting
  • Trouble with waiting for turns

 This next list contains signs you should report to your family medicine provider, in a child who is 8 years old or older.

  • Difficulty paying attention and staying focused
  • Frequent careless mistakes
  • Not appearing to listen when spoken to
  • Difficulty following instructions
  • Disorganization
  • Forgetting or losing necessary supplies; or forgetful in general
  • Disliking activities that require mental concentration
  • Easily distracted
  • Poor follow-through abilities

The preceding list includes many of the signs your family medicine provider will be looking for when evaluating your child for ADHD. However, the presence of one or more sign, especially if the pattern is not consistent, does not mean your child has ADHD. It does mean that it is in your child’s best interest to discuss your concerns with your child’s family medicine provider, so that if necessary, appropriate treatment can be recommended.

We are concerned about the health and well-being of you and your family. If you have questions about any signs or symptoms your child may have, or if you would like more information about ADHD or any other health concerns, call Advanced Medical PA at (561) 434-1935 to request an appointment, or request one online.

From the Family Medicine Providers Desk: The Complete Guide to Hypertension

Your blood pressure is a measure of how much pressure is exerted against your arteries and your organs by the blood being pumped by your heart. The higher the pressure, the harder your heart has to work. Hypertension is diagnosed when someone’s systolic blood pressure (top number) is consistently greater than 140, or their diastolic pressure (bottom number) is consistently greater than 90. This doesn’t mean that if you have a single reading that is high, you have hypertension. But if you do have such a reading, you should be monitored to make sure it comes back to normal.

There are some instances in which hypertension can be caused by another treatable problem, but about 95% of diagnosed people have essential hypertension, which often has no one identifiable cause. In these cases, there are a number of lifestyle choices that can be made to lower blood pressure, and in many instances, blood pressure medications will be needed. What is important to remember is that hypertension is a chronic illness. There are usually no symptoms, so there will be no warnings if it goes uncontrolled.  Once you are diagnosed, it is essential to follow your family medicine provider’s advice, continue a healthy lifestyle, and take your medications as prescribed for the rest of your life.

There are many things that contribute to hypertension – some factors you cannot control, while others you can. For instance, it is more common in men than women, more common in African American men, as well as older adults. Sometimes, hypertension can also be genetic, or hereditary. Obviously, these are things that you can’t control. However, being overweight or obese, being inactive, smoking, eating a diet high in sodium, and stress all contribute to hypertension; and these are things that you can control.

So what can you do to ensure that your blood pressure is under control? First, make sure that you have regular checkups with your family medicine provider. Since hypertension often goes undiagnosed, this is an important step in catching it early. Then, if you are found to have high blood pressure, take a look at the things that you can change in your life.

Your diet can have a great influence on your blood pressure. If your body mass index (BMI) is greater than 25, you should plan to lose weight. Try to eat more fruits and vegetables, as well as whole grain foods. Also limit the high fat foods, including meats. Fish is a great source of protein without all the fat that many cuts of beef contain. Stay away from fast food and limit alcohol to no more than 2 drinks per day. You should also limit the amount of caffeine you consume, restricting coffee to less than 2 cups per day. Also, make sure you lower your sodium intake. Anything canned, frozen, boxed or processed will tend to have more sodium. It is important to read labels, but fresh food is always a better choice. Make sure to also avoid foods high in sodium such as olives, soy sauce, Chinese food, bacon, and condiments. And put that saltshaker away!

In addition to diet, exercise will not only help you lose weight, but will help to keep your blood pressure regular. The recommendation is for at least 30 minutes of exercise most days of the week. If you are not active, start slow. Check with your family medicine provider before starting any exercise program, and walking is a great place to start. If you can’t tolerate 30 minutes per day, start with 10 or 15, but increase the time just a little each day until you meet your goal. And if you are a smoker, take a look at what that does, and stop smoking. Talk to your provider about this, because there are ways to help you kick the habit.

If you still have a blood pressure over 140/90 after making changes to your lifestyle, it may be time to start on medication. Your provider will determine which medication will be of most benefit. Sometimes you may need more than one prescription, but it is very important that you take all the medication as prescribed, every day. Remember, hypertension often has no symptoms; it is quietly doing damage to your heart and other organs. So don’t think that because you feel fine, that you don’t need your medication any more. If you have any concerns, discuss them with your provider. It is also a good idea to monitor your blood pressure at home from time to time, and keep a log to bring to your family medicine provider visits.

Finally, even if you are vigilant about your lifestyle, and about taking your medications, there may be times when your blood pressure is high enough to require emergency treatment. If you have a blood pressure higher than 180/110, or if you experience chest pain, shortness of breath, numbness, weakness, vision changes, problems speaking, or a severe headache, you should go to the emergency room or call 911.

If you would like to learn more about hypertension, you can visit the website of the American Heart Association. Advanced Medical has the caring and attentive medical staff you need to help monitor and treat conditions such as high blood pressure. Call today at (561) 434-1935 to schedule an appointment, or book an appointment online.