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Why Staying with The Same Family Medicine Provider Is Beneficial

Family medicine providers want to protect their one-one-one relationship with their patients. Therefore, having a good primary care provider (PCP) or family medicine care provider that has provided care for you anywhere from infancy to adulthood, is beneficial and important for many reasons. A family medicine provider who has taken care of you and sometimes other members of your family, will know you and your medical history inside and out.

For example, some health insurance allows the policy holder to go directly to a specialist when they feel the necessity to do so. However, your primary care provider has a unique knowledge of your health history, and can often consult with you about what type of specialist you may need to go to, or that you might not need to at all. They make it their goal to be the steward of your good health throughout the years, so having a little trust in their expertise can go a long way.

Staying with the same provider can ensure that you have the best care possible – they listen to your needs, and are able to give you their time and expertise every time they treat you. Since that relationship is developed over time, good quality service and care is guaranteed from a family medicine provider that has known you for a long period of time. Not everyone has the luck and luxury of having access to good healthcare, which is sad, but the rarity of it is a reality. As good care, and a good family medicine provider can often be taken for granted, when a place of good care and compassion is found, count that as a major blessing and stay put. Being with the same provider and practice as you grow up throughout the stages of life can be a very comforting thing when times get tough.

At Advanced Medical in Wellington and Royal Palm Beach, Florida, our continuity of care sets us apart from other practices. We ensure your treatment remains consistent and coordinated, so our patients will avoid unnecessary hospitalizations. Our practice understands the importance of quality of life and the meaning of true family health. By providing evidence-based medical care, our patients who stay with us long-term benefit by having a partner whose goal is to be a champion for their good health.

If it becomes necessary, we will refer you to the best family medicine providers or specialist that is fit to take care of your needs. To learn more about why staying with us is beneficial, call Advanced Medical in Wellington and Royal Palm Beach, Florida at (561) 434-1935 to request an appointment, or you can request an appointment online.

Is the Shingle Vaccine Dangerous?

Do you know anyone who has had shingles? If you do, you probably know that it is a very painful illness that can have many serious consequences. But what causes shingles? It is actually caused by the same virus that causes chickenpox. Once you have been infected by the Varicella-zoster virus (VZV) in an initial case of the chickenpox, the virus hides in your nervous system, and can become active again at any time. However, there are vaccines available to prevent this potentially dangerous illness. While there can be side effects from the vaccines, they are usually much milder than thedisease itself, making it safe for most people. So here’s what you should know when you are considering whether or not to get the vaccine.

What is Shingles? 

If you have ever had chickenpox, or even if you had such a mild case of chickenpox that you were unaware of being ill, then you are at risk of developing shingles. This disease usually starts with tingling, burning, or itching on your skin, in one area, on one side of your body. For example, it may start on one side of your head or face, on one ankle, or on one side of your chest. The most common places are on the chest and back, but again, it only happens on one side of the body. In addition, you might feel like you are coming down with a flu, and you might have a headache. Within a few days, a rash with blisters will appear where the burning or tingling first occurred. The pain you experience with the rash can be anywhere from mild to severe, is usually a stabbing or burning sensation, and will often interfere with sleep and other activities. The blisters will generally open in about 3 to 4 days, and they will crust over, dry up, and fade within 3 to 4 weeks.

The worse thing about shingles (other than the pain during the acute illness) is that it can lead to serious or debilitating complications, especially as you get older. Once the blisters open, there is a risk of a bacterial infection. However, the most common complication of shingles is lingering pain after the infection is gone. Postherpetic neuralgia (PHN) which often feels like burning in the area that the infection occurred, can linger from months to years after the rash disappears, interfering with sleep, causing depression, and greatly decreasing your quality of life.

If the shingles rash occurs around an eye, you are at a greater risk of getting inflammation of that eye. This will not only cause severe eye pain and sensitivity, but can cause permanent loss of vision. Additionally, inflammation of an ear due to shingles can cause facial weakness on the affected side. 

What Increases the Risk of Shingles? 

It is estimated that about 20% of all people will experience shingles at some point in their life. Of course, it can only occur if you have had chickenpox. And while anyone who has had chickenpox can get shingles, it usually affects people over the age of 50. Additionally, anyone with a weakened immune system is at greater risk of getting shingles. This can include people with chronic illnesses, like diabetes, but having cancer or cancer treatment poses an even greater risk. Likewise, people who take medications that suppress the immune system, such as steroids like prednisone, antirejection medications following an organ transplant, or those who take medications for rheumatoid arthritis, are at a greater risk. People who are infected with the human immunodeficiency virus (HIV) are more likely to contract any infection, including shingles. 

Should You Get Vaccinated? 

If you are 50 years of age or older, you should consider receiving a shingles vaccine. There are two types of vaccines available, and which one you should receive depends on your individual circumstances.

The live attenuated vaccine (Zostavax) was the only vaccine available against shingles in the United States until recently. It is approved for people 60 years of age and older. As the name states, this vaccine contains a live virus, which can pose the risk of developing active shingles. The benefit of Zostavax is that it has been found to decrease the incidence of shingles by over 50%, to decrease the average length of painful symptoms during an outbreak, and to decrease the incidence of PHN by over 65%. However, studies have shown that protection against shingles wanes about 8 years after vaccination.

The inactivated recombinant zoster vaccine (Shingrix) was recently approved for use in the United States for people 50 years of age and older. This vaccine contains proteins from the zoster virus, but does not contain the active virus. It is given in 2 injections, about 2 to 6 months apart, and appears to give very good protection against shingles, especially in older patients. Because there is no active virus in the vaccine, it cannot cause any infection, and is safe for people with a weakened immune system. 

What are the Risks? 

Although rare, because Zostavax contains a live virus, the risk exists for developing shingles even months later. For this reason, the vaccine is not recommended for people with a weak immune system. It is ok to receive this vaccine if you live with someone with a weakened immune system, but if you develop any shingles blisters, you should avoid contact with this person until the blisters are gone. Otherwise, the most common side effect associated with the vaccine is pain, redness, and swelling at the injection site, lasting up to about 3 days. Other complications are extremely rare.

The only side effects that have been reported with Shingrix are pain, redness, and swelling at the injection site.

There are two additional reasons that you should never receive a shingles vaccine. Zostavax should never be given to a pregnant woman, although this would be highly unlikely as it is only recommended for people 60 years of age and older. Additionally, people with known allergies to gelatin or neomycin should not receive either vaccine.

All things considered, receiving the right shingles vaccine, at the right age, greatly reduces your chance of contracting this painful and sometimes debilitating illness. If you have any questions about whether you should receive the vaccine, or which vaccine is right for you, please contact us at Advanced Medical PA, where our mission is providing quality health care in both internal medicine and primary care. Call us at (561) 434-1935 to request an appointment, or request one online.

Insider Tips for Choosing the Best Primary Care Provider

What Qualifications are You Looking For? 

A primary care provider is your most personal contact to the healthcare system. He or she is your partner in health as well as your advisor, your confidant, and the one professional you can turn to when you have a problem with your health. However, this role can be filled by a number of different types of specialists.

An internal family medicine provider specializes in the care of all adults. They are often considered the detectives of medicine, because they are experts at identifying, diagnosing, and treating adult illnesses. However, they are also very qualified in helping you prevent illness and improve your health.

On the other hand, a family practice specialist is board certified to provide primary care for patients throughout their lifespan. This means that they treat infants, children, adolescents, adults, and seniors. You may be looking for a primary care provider that can care for your entire family, and stay with you throughout your life. If that is the case, you may want to research family practice providers.

Some providers decide to get additional training to treat a specific population. A geriatrician is a specialist who is board certified in the treatment of patients 65 years of age and older. If you are looking for a primary care provider that has a deeper understanding of the unique needs of an older adult, than you may be looking for a geriatrician.

Other primary care providers include pediatricians and OB/GYN (obstetrics and gynecology) specialists. Regardless of your choice, you should make sure that your family medicine provider is board certified in their area of expertise. This means that they have not only completed medical school, a residency, and sometimes a fellowship, but also that they have had the required testing that certifies that they are experts in their field.

What’s Important to You? 

Once you have narrowed down your search to specialty, it’s time to take inventory of what is important to you. Depending on where you live and what kind of transportation is available, you may want a primary care provider whose office is close to your home or your work. How about office hours? Do you need to find someone who is available evenings or weekends, or that can see you in an emergency? And if you call after hours, will you talk to your provider or an associate, a covering family medicine provider, a nurse practitioner, a family medicine provider’s assistant, or a nurse? This might be something that will add weight to your decision. You may also have a preference for hospital facilities, so find out where they have affiliations or privileges.

You should also take personal needs and beliefs into consideration. If you have a chronic illness such as diabetes or heart disease, you may be looking for a primary care provider that specializes or has a focus in one of these illnesses. Everyone has different styles or approaches from a provider that they are comfortable with. Do you need a family medicine provider that lays everything out for you and spells out a plan, or would you prefer someone who gives you options and lets you choose? Personal style can be of great benefit, or can be a deterrent to achieving health, because if you are not comfortable the advice you are given, you probably won’t follow it.

Ask Around

Now that you have developed an inventory of what you are looking for in a family medicine provider, it’s time to get some recommendations. Ask your friends who they see, and why they have chosen their provider. Ask them to list their pros and cons, in their opinion, because remember that you might think differently. You can ask people other than your friends too. Ask your coworkers, your kid’s teachers, and even other family medicine providers like your specialists or your kid’s pediatrician. Once you’ve compiled a list, you should check with your insurance company directly because online and published lists are not always accurate. You don’t want to spend time inquiring about family medicine providers that are not on your plan, and you certainly don’t want to find out they don’t take your insurance after you’ve made an appointment. Finally, there are a number of websites that offer reviews of providers. Don’t just look at the numbers, but read the written reviews, because again, what is important to someone else may not be important to you.

Make Your Decision In Person 

When you are pretty sure of your choice, make an appointment. It is important that the impression you have formed is an accurate one. This is your opportunity to ask questions, discuss your health concerns, and see how well you communicate. In all likelihood, if you’ve done your homework, you will have a match, but take this opportunity to get to know your provider. When making the very important choice of choosing your primary care provider, you should feel comfortable in knowing that this is someone you can have a long and trusting relationship with, because your health depends on it.

We would be happy to answer any questions you may have about our practice and the primary care services we provide. At Advanced Medical, PA, we pride ourselves in providing personal and individualized, quality health care. To learn more about us and the services we offer, or to schedule a visit, call us at (561) 434-1935 to request an appointment, or request one online.

Why Do We Get Sick in the Winter: Your Primary Care Providers

What Causes Colds and Flus? 

The common cold and the flu are not caused by changes in temperature, but by viruses. However, the reason they seem associated with the cooler months is because different viruses are more active at certain times of the year. For instance, rhinoviruses, which have many different strains, are some of the most common causes of a cold. These microscopic germs are at their peak during the cooler months of fall and spring. By contrast, the many strains of influenza viruses peak during the winter months. Once exposed to the human body, these viruses are carried around in our respiratory systems. When they are expelled through a cough, sneeze, or nasal secretions, droplets containing the viruses contaminate the air as well as any surfaces they may land on. Once a virus infects a host, it uses the body’s cells to replicate (multiply), instigating a response from our immune system.

Our Bodies 

Our immune system is what causes the miserable symptoms we experience with a cold or flu. When an invading organism is identified by the immune system, a number of different types of cells and chemicals are released and sent to the site of the infection. They create an inflammatory response that causes our rise in temperature, the achiness and chills associated with an infection, and an increase in lung and nasal secretions. While our immune response is actively fighting the infection, these additional secretions become a risk for others, as it makes it easier for the virus to be spread when we cough or blow our noses.

Even though cold weather does not cause infections, it can contribute to our risk of getting sick. For instance, cold air, as well as dry warm air from our heaters, can cause the tissue inside our noses to become dry and cracked. This makes it easier for germs to enter into our system. Additionally, the cold weather may make the cilia (little hairs) in our noses less effective at their job of sweeping germs away. Our immune system itself may not work as well in the cold weather, either. We defend against viruses by not allowing them to replicate. However, this mechanism may be slower when the environment is colder.

Having a chronic illness also puts you at greater risk for catching a cold or the flu. For example, people who have asthma are more likely to have an asthma attack in cold weather. When the lungs become inflamed during an attack, they are more susceptible to pick up an infection. In fact, any chronic illness that makes your immune system weaker, like diabetes or heart failure, puts you at even greater risk during the colder months.

Our Environment and Our Behavior 

As a rule, humans are not fond of staying outside in the cold weather. It may be fun to participate in winter sports or play in the snow with the right clothing on, but eventually everyone wants to come in from the cold. Because this is a communal response, we tend to congregate inside buildings that are heated with dry air. So now we have a lot of people inside, breathing the same air that causes our nasal passages to become dry and cracked. During that time of the year, chances are that some of us will already be infected, even if we don’t have symptoms yet. So any coughing, sneezing, or running noses increases the chances of someone else getting sick. The dry air (whether inside in the heat or outside in the cold) also makes it easier for the viruses to get around. Trapped in tiny droplets of moisture that stay suspended even longer in dry air, these viruses are free to move around and find their way into someone’s respiratory system. If the rooms are poorly ventilated, which is often the case, the chance of more people getting infected goes up.

Can you think of anywhere that lots of people who might be carrying a virus are congregated routinely during the colder months? That’s right – school. From kindergarten to college, filled heated classrooms and dormitories create a perfect environment for “catching cold”. Hence, from fall to spring, both the cold and the flu have ample hunting grounds for human hosts.

What Your Primary Care Provider Knows that Will Keep You Healthy

So, viruses are more active in the cooler months, the environment helps to create a perfect breeding ground for airborne infections, and our natural survival instinct to keep warm increases our chances of getting sick. However, there are some other human behaviors that we can change to prevent some of these illnesses, and your primary care provider is a perfect place to look to for advice. The following are a few tips you should remember during cold and flu season.

First, try not to share. When you cough or sneeze, cover your mouth. Also make sure and wash your hands frequently, especially after coughing or using tissues; and keep your hands away from your face because every surface you touch has the potential of carrying germs. You can also protect others from illness. If you are sick, stay home until you are feeling better.

You should also be aware of your environment. Know that if you are in an enclosed or poorly ventilated space, you are more at risk. This would include offices, classrooms, dormitories, and airplanes. If you can, try to alter your environment by making sure there is good ventilation, and humidification.

Finally arm yourself to fortify your defenses. Eat a healthy ad well-balanced diet. You should also get daily exercise and plenty of sleep. However, one of the most important things you can do to help your immune system is by staying up to date with your vaccines. This includes the flu vaccine, which is available every year beginning in September. This vaccine is made from an inactivated virus. That means it is not alive and it cannot give you the flu. What it does, is provoke your body into making specific antibodies (fighting cells) against the most common flu virus strains for the season. The most common side effects are a sore arm, and possibly mild flu-like symptoms, which are caused by your immune system’s healthy response to the vaccine. The flu is a very serious illness that not only causes severe and prolonged symptoms, but also is responsible for many deaths each year. That is why your primary care provider will recommend that each person receive the vaccine each year, beginning at six months of age.

If you have any more question regarding cold and flu season, or how your primary care provider can help you stay healthy, we are happy to discuss this and any other healthcare concerns you may have. Please call Advanced Medical, PA, at (561) 434-1935 to request an appointment, or request one online.

What Does Being a Family Medicine Provider Mean?

Health is not only a reflection of the state of your body. It has a great deal to do with you and everything around you. In fact, the World Health Organization defines health as “a state of complete physical, mental, and social well-being”. Your lifestyle, your genetics, your financial situation, your stress level, your workplace environment, the wellbeing of your family – the safety of your community and society in general – are some of the many factors that your family care provider will have knowledge of as he or she guides you to a healthier state. So what exactly does it mean to be a family care provider?

Family Medicine 

Family medicine is a medical specialty that involves the care of individuals and families throughout the lifespan. In each stage of life, people have characteristic risks and unique needs. An infant is completely dependent on others for survival. Toddlers need guidance and encouragement as they learn about their environment and how to interact with others and society. Teenagers are in a stage of rapid growth and development, when positive and negative environmental and social influences can shape their futures. And older adults are faced with the natural challenges associated with aging. A family medicine provider understands each of these stages and is uniquely qualified to promote health, prevent illness, and treat diseases for their patients at all ages.

The Role of the Primary Care Provider

Your family care provider will be the primary care provider for your entire family. Today’s healthcare system is large and complex. When you are healthy, it may be simple to make it to your annual check up. However, staying healthy is a little more complicated. Your primary care provider is the one person in the system that knows you (and your children and spouse) and has your best interest at heart. He or she will not only perform annual exams, but will make sure you have all the recommended screening tests like mammograms or cholesterol levels done. They will also advise you of necessary immunizations to prevent avoidable infections, as well as educate you on a healthy lifestyle.

These are all very important activities to keep you free from illness – strong of mind and body. However, having a primary care provider is even more important when you do get sick. Knowing your medical history, including the medications you take, what works best for you, and what your preferences are, are invaluable when treating someone with an acute illness. You want a provider that you know and trust, to turn to when you are at your most vulnerable.

Benefits of Having a Family Care Provider 

Have you ever had to see a provider that you did not know in an urgent situation? Imagine experiencing a new and concerning symptom – one distressing enough that you feel the need to go to the family medicine provider. If you do not have a family care provider, you can expect to either spend a great deal of time explaining your past history, or at worst, receive treatment based on partial or inaccurate information. A family care provider, as the name would suggest, knows you and your family. You, most likely, have established a good relationship, and have shared your complete medical history. This would also have included your family history, such as any relatives who may have had heart disease, cancer, diabetes, or any other potentially hereditary illnesses.

This provider will be aware of information that you may not realize is important, but that can make a big difference in your recovery, like whether you are married or have children, if you live alone, if you have a support system, whether you have transportation, and whether you are able to get a new prescription filled. Medicine is not only treating disease; it is understanding the needs of each individual patient within their unique environment and set of circumstances, and finding a way to help them achieve their highest level of health.

Your family care provider will also be in touch with your community. Infection and disease often occurs in patterns that are unique to geographical locations. For instance, antibiotics that may be effective against bacteria in Florida may not be the right choice in New Jersey.  Additionally, they will be aware of what is “going around” in the local schools and workplaces. Your family care provider is in the position to protect not only you from injury or illness, but also your spouse or children. He or she will guide you so that you can anticipate potential risks, take action to prevent injury or illness, and recover quickly if you do become ill. Having a family care provider that you know and trust is the first step in securing a healthy and happy life for you and each member of your family.

If you are interested in finding our more about primary care, family medicine, or the services we provide at Advanced Medical, PA, please call us at (561) 434-1935 to request an appointment, or request one online.

Types of Primary Care Providers

So, a primary care provider is not just a title, or a box to check off on paperwork. It is the designation you give to someone with whom you have a very personal relationship. The role of the primary care provider is to oversee your overall health, to guide you to a healthy lifestyle, to recommend things that will prevent illness, to anticipate your needs and help you understand what to expect, and to treat you when you do become ill. Your primary care provider should be your “go-to” when you have health concerns, because they know you best. They can provide most of your medical care, and they will refer you to the appropriate specialist when necessary.

In choosing a primary care provider, it is important to remember that people are not all one-size-fits-all. Neither are family medicine providers. You have unique needs and should choose a primary care provider that best fits those needs. Primary care is a role, and not a specialty. Family medicine providers have a number of different specialties, each with advanced training in the care of a specific population, can provide primary care services. In fact, internists, family practice providers, pediatricians, geriatricians, and women’s health providers are all qualified primary care providers.

Internal Medicine Providers

Family medicine providers who specialize in internal medicine, also known as internists, are experts in the care of adult patients. Their focus is not only on health promotion and disease prevention, but also in the diagnosis and treatment of both acute and chronic illness. Internists are extremely good diagnosticians, often referred to as the detectives of medicine, which is why they are experts at treating patients who are experiencing health challenges. However, their goal is to keep you as healthy as possible, which is why they will also make sure you are getting your scheduled immunizations, are up-to-date on appropriate screening like mammograms and cholesterol levels, and understand the lifestyle choices that promote good health.

Family Practice Providers

Family practice providers have specialized training in the care of individuals and families throughout the lifespan. This means that they are qualified to care for infants, children, adolescents, adults, pregnant women, and older adults. The focus of family medicine is very comprehensive, treating the whole individual, with a focus on health promotion and disease prevention. However, like internists, they will also treat both acute and chronic illnesses for their patients.

Pediatricians 

While some people prefer to have one family medicine provider for the entire family, others feel more comfortable having a family medicine provider who specializes in the care of children as the primary care provider for their kids. Pediatricians are board certified in the care of infants, children, and adolescents, ranging from newborns to the age of 21. Childhood is a time of rapid growth and development. Important developmental landmarks mark each stage of life, and it is important to not only be observant that they are being met, but to also foster activities and behaviors that help children learn and grow. Additionally, a lifetime of healthy habits, including staying current on immunizations, having regular checkups, eating healthy diets, and getting adequate exercise can be fostered throughout childhood. A pediatrician is not only an ideal source of guidance and information, but is also highly qualified to treat illnesses associated with childhood.

Geriatricians

Just like children, older adults are faced with challenges unique to their age. Not only is chronic illness more common in adults 65 and older, but also, additional syndromes such as falls, memory loss, and hearing loss become more prevalent. As we advance in age to 65, 75, 85 years, or older, it becomes increasingly beneficial to be under the care of a provider with specialized knowledge of the care of older adults. A geriatrician is a provider that has such training. They are board certified in caring for adults 65 and older, and like other primary care providers, will address health promotion, disease prevention, and management of illnesses, recognizing the unique and multidimensional needs of their patients.

Obstetrics and Gynecology (OB/GYN) Providers

Women have very unique healthcare needs throughout their lifespan. As such, some women, especially during their childbearing years, choose to elect their OB/GYN provider as their primary care provider. Women who are pregnant, or who are trying to get pregnant, have very specific concerns, including nutrition, exercise, and the safe use of medications. Additionally, hormone irregularities as well as illnesses associated with the reproductive tract can have a significant impact on a woman’s overall health. For these reasons, family medicine providers that have specialized knowledge of women’s health issues, such as OB/BYN providers, are a reasonable choice for primary care.

At Advanced Medical PA, we are concerned about the health and wellbeing of you and your entire family, and we are committed to helping you maintain good health. If you have questions about primary care or the services we provide, please call us at (561) 434-1935 to request an appointment, or request one online.

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.

Dealing with Arthritis Pain at Home

There are many different types of arthritis, but osteoarthritis (OA) is the most common form. Also known as degenerative joint disease (DJD), it is caused by “wear and tear” of the joints and can result in considerable chronic pain, which can then lead to disability. Some of the risk factors for developing OA include obesity, muscle weakness around the joint, repetitive activity, and previous joint injury. The pain associated with OA is caused by an erosion of cartilage, narrowing of the joint space, and deformity of the bone within the joint; and the most common sites of the body to develop OA include hands and fingers, the big toe, hips, knees and spine. If you experience pain in your joints, it is important to discuss this with your family medicine provider. Once diagnosed, the goal of treatment is to minimize pain and to help you maintain independence in performing your everyday activities. The following are some things that you can do at home to deal with arthritis pain, and to improve your quality of life.

Weight Control

Being overweight is a contributing factor to developing OA, and it will continue to worsen the condition over time. Any extra weight you might be carrying increases the load and stress on your joints, leading to further degeneration. Your overall good health is greatly affected by your intake of foods with high nutritional value. Your joints are no exception to this rule. Studies show that even a small amount of weight loss can improve your joint health, so increase the fruits and vegetables, whole wheat grains, and low-fat proteins in your diet, while decreasing the amount of simple sugars, starches and high fat foods; and watch your portion sizes. Remember that regardless of your food choices, if you take in more than you put out, you will gain weight. Ideally, you body mass index (BMI) should be between 18.5 and 24.9.

Exercise Balanced with Rest

Regular, gentle exercise is important to maintain joint function and will help with pain management. While physical therapy can be very beneficial, there are a lot of exercises that you can do at home. Water exercise is an exceptional way to increase joint movement, while minimizing stress on the joint. Bicycling is another excellent choice. Isometric exercises, which improve muscle strength and support joint function, involve contraction of muscles without joint movement. For instance, holding a plank position allows the contraction of multiple muscle groups, while avoiding undue stress on any one joint. Another important way to protect your joints is to strengthen the muscles around them by performing weight-bearing exercise. To start out, it is best that you perform exercises that use your own body weight, such as squats, calf raises, lunges or push-ups. It has been found that moderate to vigorous exercise, at least three times per week, can lead to marked improvement in joint pain. But remember, before starting any exercise program, you should discuss it with your family medicine provider.

As helpful as exercise is to joint health, it is important to not overdo it. Listen to your body. If something is painful, stop. Also, if you find your joint pain increases throughout the day as a result of normal activities, stop and take a break. Rest will often result in a decrease or resolution of pain. And, make sure you are getting adequate amounts of sleep at night.

Heat/Ice

The application of heat will often relieve the pain of arthritis. Try a hot shower or bath when your joints are aching. Gel pads that can be warmed in the microwave are available over the counter, but follow the directions carefully on the package and check the temperature with your wrist before applying it to your painful joints. However, electric heating pads should be avoided because of the risk of burns and fires. You might also try applying an over the counter liniment or preparation with camphor, eucalyptus, or capsaicin, which many people find does a good job in relieving arthritis pain.

Ice is another way to treat joint pain, although often not as effective as heat. In particular, if you are experiencing inflammation or swelling from overuse or injury, ice may be beneficial. When you use ice, make sure to not put the ice pack directly on your skin. Instead, place a small cloth or towel between the pack and your skin to protect your skin from injury. If you don’t have an ice pack, try a frozen bag of corn or peas.

Medication

The most important thing to remember is to discuss any medication you are taking with your family medicine provider. There are many products that you can obtain over the counter that may not be good to take over an extended period of time. For instance, NSAIDs such as ibuprofen or naproxen may be good for an acute injury, but taken on a regular basis, these drugs can cause kidney problems, heart problems, and stomach problems. They also increase your risk of bleeding. The number one drug of choice to control arthritis pain is acetaminophen. It is safe and effective for most people if taken as directed on the packaging. However, everyone is different so please discuss all over the counter medications with your family medicine provider before taking them.

To learn more about arthritis, its treatment, and what you can do to control pain and improve your joint function, call Advanced Medical PA at (561) 434-1935 to request an appointment, or request one online.