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How to Treat ED (Erectile Dysfunction)

Many men are embarrassed when it comes to experiencing erectile dysfunction (the inability to obtain or keep an erection), but it is actually more common than you might think. Erectile dysfunction is a disorder that affects almost 50% of men between the ages of 40 to 70. Once you finally speak with your family medicine provider, you will find it is much more common than it first seems, and more importantly, there are many different treatment options available.

What Treatment Options Are There?

Treatment for erectile dysfunction can range from medications to lifestyle changes, to surgery. The more honest and open you are with your family medicine provider, the more likely your family medicine provider will be to properly diagnose your ED and get you started with the most appropriate treatment.

Certain medications may be used to enhance the natural chemicals in your body, in order to relax the muscles in your penis and increase blood flow, thereby enabling an erection. There are also medications that you can inject directly into the penis to produce an erection immediately. These injections use a very fine needle causing little to no pain. Penile suppositories are yet another option. Using a special applicator, a suppository is inserted into the urethra (the tube from which you urinate), causing an erection within 10 minutes.

Some ED is complicated by low testosterone levels. Hormone replacement therapy may also help correct low levels. Delivery methods include gels, patches, injections and oral medications. Sometimes medications are not enough, or there may be a reason, such as heart issues, that stop testosterone medications from being a good treatment option.

In such cases, a surgically implanted device, such as a penis pump may be considered. A penis pump is a hallowed tube placed over your penis. It uses a vacuum to pull blood into your penis. When an erection is accomplished, a tension ring can be placed around the base of your penis to hold the blood in and keep it firm.

Penile implants may also be considered. Penile implants are semi rigid or inflatable rods placed in both sides of the penis. These rods allow you to control when and how often you have an erection. All treatment options ultimately depend on the cause of ED, and the guidance of a qualified men’s health family medicine provider.

Common Causes of Erectile Dysfunction

The most common underlying causes of ED include: Heart disease, medications, neurological (nerve) disorders, diseases of the endocrine system, and lifestyle factors. Alcohol, nicotine, cocaine, marijuana, and heroin, for instance, can also cause erectile dysfunction. Some common medications that may contribute to ED include: antidepressants, antihistamines, diuretics, blood pressure medications, chemotherapy, hormone replacements, psychiatric medications, and Parkinson’s disease medications. However, you should never stop taking a medication without your family medicine provider’s approval, as this could be extremely dangerous.

If you have questions or concerns about erectile dysfunction, call Dr. Ishan Gunawardene at Advanced Medical in Wellington or Royal Palm Beach. He will take the time to properly diagnose and treat you, and answer any questions you may have. Call today at (561) 434-1935 or request an appointment online.

Chronic Inflammation and Diet: What helps? What Hurts?

Researchers have long known that there is a link between diet and health. Newer studies, aimed at reducing certain inflammation promoting foods and increasing other inflammation reducing foods, have shown that diet can not only make you feel better by reducing pain caused by inflammation. It may also help to reduce your overall risk for diseases such as diabetes and colon cancer.

Foods that Increase Inflammation

Many people know that junk food is bad for them. What they may not know is just how bad. Junk food may actually increase inflammation related pain. Foods such as white bread, donuts, fried foods, potato chips, sodas and other sweetened beverages, red meat, margarine, and other refined carbohydrates have all been linked to weight gain, diabetes, heart disease, and certain cancers.

If you will notice, the previous list of junk food contains things that aren’t normally found in nature in the form in which people tend to like to consume them (Contrary to popular belief, donuts don’t grow on trees). Since they are not a natural food source, your body may consider them invaders and respond by increasing inflammation in an effort to protect itself.  This is because the processes that cause inflammation are actually quite complex, and linked to your body’s natural defensive mechanisms.

When your body becomes inflamed, or swollen, in a given area, it allows white blood cells to fight potential invaders such as bacteria, pollens or chemical substances. While the response of your white blood cells may kill off unwanted guests, it can also leak certain substances into the tissues, causing them to become inflamed. Swelling and other protective processes in turn, create or increase pain by putting pressure on sensitive nerves.

The Good News: Foods that Help

Eating a diet rich in colorful fruits and vegetables, whole grains, nuts, berries, and healthy fats can go a long way towards reducing your waistline, health risks, and inflammation. Eating apples, blueberries, leafy greens such as spinach and kale lower the markers for inflammation. These same markers have a direct correlation to your chances of having a heart attack, stroke, or developing adult onset Type II diabetes, as well.

Anti-inflammatory foods include:

  • Leafy greens including spinach, collards and kale
  • Olive oil and coconut oil
  • Nuts such as walnuts, pistachios, pine nuts, and almonds
  • Fatty fish such as sardines, mackerel, tuna, and salmon
  • Tomatoes, apples, oranges, and grapefruit

If you are looking for an all-around healthier diet that lowers inflammation, increases energy, and boosts moods, the Mediterranean diet is hard to beat. With fruits and vegetables, fish, healthy oils and nuts, it also contains important trace minerals, antioxidants and polyphenols, which are protective compounds that occur naturally in some foods. If you are concerned about how your diet is affecting your inflammation, Dr. Ishan Gunawardene of Advanced Medical Clinic can answer all of your questions. To make an appointment with us in Wellington or Royal Palm Beach, request an appointment online or call (561) 434-1935 today.

Is it arthritis, or something else?

Is it Arthritis, or Something Else?

Getting to the bottom of the reason you may be experiencing swollen, stiff or sore joints is not always easy. If you have noticed that your joints are inflamed and painful or that your range of motion is diminished, you may have a form of arthritis.

Although there are two major forms of arthritis, known as rheumatoid (RA) and osteoarthritis (OA), there are actually over a hundred different forms of arthritis related disorders. The main difference between them is that OA is caused by wear and tear on your body, whereas RA is a form of disease known as an autoimmune disorder, in which the internal mechanisms that normally protect your body from attacks by bacteria and viruses become confused and attack your own joints and tissues instead.

Different Disorders: Overlapping Symptoms

Autoimmune disorders include fibromyalgia, lupus, psoriatic arthritis, gout and many others. Several of these disorders are known to mimic rheumatoid arthritis and can be a bit more difficult to pin down because the symptoms may overlap. Lupus, for instance, also known as SLE or Systemic Lupus Erythematosus, can affect internal organs, connective tissues, blood vessels and joints. So much so that it can be fatal.

Unlike Rheumatoid arthritis however, lupus does not typically deform or erode away the joints. The joint symptoms also tend to be less severe and the disease can seem to “hop around,” hitting different joints at different times. Some patients can have both rheumatoid arthritis and Lupus.

Lyme disease is an infection caused by a strain of bacteria called borrelia burgdorferi or Bb, which is carried by ticks and can be passed to humans through a bite. Lyme disease often causes flu-like symptoms such as fever, headache and neck stiffness, shooting pains or facial palsy. It is often accompanied by a noticeable “bull’s eye” ring around the bite. Lyme disease symptoms also usually occur in stages, which means it can be easily misdiagnosed.

Gout is another disorder that sometimes presents like rheumatoid arthritis. It is caused by high levels of uric acid that form tiny crystals within the affected joint(s). Gout is also extremely painful, even excruciating and often appears in a single joint with pain, swelling, warmth and redness. It can spread to others areas, and when left untreated can cause joint deformation that appears very similar to rheumatoid arthritis.

Get Your Symptoms Checked

If you have aching, fatigue, redness or swelling in or around your joints, or notice an unusual rash or redness on your face or other areas of your body, you should consult a family medicine provider. While most people think of arthritis as an older person’s disease, the truth is that it and other autoimmune diseases can strike young and old alike. Your family medicine provider can run the appropriate tests and to help determine the underlying cause and develop a treatment plan that works for you.

If you are concerned about how arthritis, or other autoimmune disorders are affecting your body, board-certified internal medicine specialist Dr. Ishan Gunawardene can help. He will take the time to talk to you, answer your questions and prescribe the necessary medications to help ease the symptoms of arthritis and other disorders. To make an appointment in Wellington or Royal Palm Beach, request an appointment online or call (561) 434-1935 today.

Hypertension. What You Don’t Know Could Kill You!

Known as the “silent killer,” hypertension does not necessarily present with symptoms; it often goes undetected, and therefore, untreated. The only way to determine if you have high blood pressure is to have it tested. Testing is both simple and painless and takes only a few minutes in a family medicine provider’s office.

Why is Hypertension Dangerous?

According to the Centers for Disease Control, high blood pressure increases your risk for a stroke or heart attack, the leading causes of death in the United States.  About one in every three adults will suffer at some time from high blood pressure.

That number breaks down to around 75 million people living with high blood pressure in the United States. Of those, approximately half have gotten their hypertension under control. Roughly 1,000 people die in the US each day with hypertension listed as a primary cause. Not only can high blood pressure lead to a heart attack, chronic heart failure or stroke, it can also damage other organs–including the kidneys, eyes, and brain.

When is Blood Pressure Considered High?

Blood pressure is considered high if the systolic number, which measures the heart at work, is 140 mmHg or higher and the diastolic, which measures the heart at rest, is 90 mmHg or higher. Although high blood pressure does not always present symptoms, it can cause symptoms such as dizziness, facial flushing or blood spots in the white of the eye from broken blood vessels. Some patients with extremely high blood pressure may also notice the sound of their heart beating in their ears. You should never wait for symptoms to arise to act on high blood pressure. Get your blood pressure checked regularly by a family medicine provider instead.

Both men and women are equally likely to develop high blood pressure at some point in their lives. For those under the age of 45, the risk is greater for men than woman. Over the age of 65, women are more likely to have high blood pressure than men. Race and ethnicity also play a role in who is at risk for hypertension. African Americans, for instance, are more likely to develop high blood pressure at an earlier age than their Caucasian counterparts.

How is High Blood Pressure Treated?

High blood pressure can usually be managed by a combination of medication, diet and exercise. Reducing your intake of salt, walking on a regular basis and eating a healthy diet have all been shown to reduce the risks of having high blood pressure. Additionally, your family medicine provider may prescribe any number of different medications to lower your blood pressure. The kind of medication and dose will depend on the severity of your symptoms as well as how well you respond to, or tolerate, a given medication.

If you are concerned about how hypertension is affecting your heart and other organs, board-certified internal medicine specialist Dr. Ishan Gunawardene of Advanced Medical Clinic can help. He will take the time to talk to you, answer your questions and prescribe the necessary medications or lifestyle changes necessary to lower your high blood pressure. To make an appointment with us in Wellington or Royal Palm Beach, request an appointment online or call (561) 434-1935 today.

Diabetic and Sleep Deprivation Go Hand in Hand

Sleep. We talk about it a lot; not getting enough and needing more are usually at the top of the list. For people with diabetes or those with pre-diabetes, the relationship between sleep and blood glucose level is antagonistic, as they both can negatively impact the other.

To start, not sleeping enough or sleeping too much can increase your risk for type 2 diabetes.  Additionally, diabetes complications like increased thirst and urination can make it harder for you to sleep; yet diabetes can also make you more tired and fatigued.

If you are diabetic, you know how difficult it can be to sleep if your blood glucose levels are not in check. Eating healthily and exercising are crucial to keeping blood glucose levels where they should be and in turn increasing your chances for a good night’s sleep. Test your blood sugar before bed, so that you can head off any problems that may interrupt your sleep later.

For those of you who are at risk of developing diabetes, your sleep habits can negatively impact your risk. It is not uncommon to reach for sugary and caffeinated drinks to help wake you up in the morning.  If you did not sleep well, these drinks may be your go-to, all the while adding to your weight and further increasing your risk for diabetes.

With that said, it’s also been noted that taking naps and sleeping extremely long stretches of time can also increase your risk. Disrupting your circadian rhythms and internal clock can lead to issues with your metabolism, cardiovascular system, and immune system.

So what does all this contradictory information mean when it comes to getting a good night’s sleep?  Ultimately, it means that your diet and exercise play a key role in the value of the sleep you get. If you are pre-diabetic, getting regular exercise and eating healthy can prevent diabetes as a whole and make it easier for you to sleep at night. You will also not be as fatigued during the day and can avoid the unhelpful and unnecessary naps.

For diabetics, regular exercise and diet can help keep your glucose levels within a normal range and may also help prevent the typical culprits that wake you up at night: frequent urination, restless legs, nervousness and overheating.

Diabetes Management in Wellington

If you are concerned about how your sleep is affecting your diabetes or your risk for diabetes, board-certified internal medicine specialist Dr. Ishan can help. He will assess your situation and offer lifestyle and dietary recommendations to help control your diabetes or reduce your risk. To make an appointment with our diabetes specialist in Wellington or Royal Palm Beach, request an appointment online or call (561) 434-1935 today.

Chronic Pain Effects on Your Quality of Life

Are you one of the millions of people affected by chronic pain, or do you know someone who is? If so, you know how it can limit everyday activities while also causing strain on your professional and personal relationships. The significant impact it has on your quality of life not only affects your physical health, but your mental and emotional health as well. This is not surprising, because when you know something is wrong with your body, especially when in pain, it can wreak havoc on your thought process.

Dealing with chronic pain can be just as emotionally draining as it is physically. It is not uncommon for you to avoid social activities due to pain or even just fear of pain. If you think you may have to engage in any activity that could lead to a flare up, you may start to fear activities and social events that you once enjoyed. This fear can sometimes be debilitating and often become more worrisome than the pain itself.

Chronic pain can have a significant effect on your interpersonal relationships. In addition to foregoing social outings and activities, it can also strain relationships with family, friends and even co-workers.  Oftentimes, others need to do more than their fair share of the workload because of your physical limitations. Or perhaps the burden of financially carrying the household once your pain becomes disabling puts a strain on your marriage. These circumstances can lead to feelings of guilt and stress, which in turn can worsen your pain.

Consequently, the fear, isolation, and constant dependence on others can lead to depression, which is very common for people dealing with chronic pain. Because chronic pain can cause depression and depression can make pain worse, it can quickly become a vicious cycle before you even know what hit you.

It is extremely important that if you think you are depressed, you seek professional help right away.  Signs of depression can include feelings of sadness, anger and hopelessness, lack of energy, difficulty concentrating, decreased appetite, and thoughts of harming yourself. Seeking professional help can break the cycle of pain and depression.

If you or someone you know is dealing with chronic pain, Dr. Ishan Gunawardene and board-certified family nurse practitioner Shariffa Gunawardene at Wellington Advanced Medical Clinic can help get to the root cause of your pain. For an appointment to discuss chronic pain treatments in Wellington, call (561) 434-1935 or request an appointment online.

Specializing in primary care and internal medicine, we will work with you to get your quality of life back. We don’t just want you to survive – we want you to thrive, physically and emotionally to enjoy life again.

Is Type 2 Diabetes Preventable?

With the alarming rise in diabetes diagnoses in recent years, it should come as no surprise that the medical community is doing all they can to thwart the increase. This includes empowering patients, both adults and children at risk of developing diabetes, through education.

There are 2 main types of diabetes: type 1 and type 2. Understanding the difference between these can help you understand your risk and prevention.

Type 1 diabetes, also called juvenile diabetes because it typically shows up in childhood, is a result of your body not producing enough insulin. While the cause is still not completely understood, genetics certainly play a critical role in its development. Type 1 diabetes accounts for 5% of diabetes in the adult population.

On the other hand, type 2 diabetes happens when your body produces enough insulin but you are resistant to it. It seems to be caused predominantly by lifestyle factors and makes up nearly 95% of adult diabetes. While genetics still may play some role, there are ways you can lower your risk for developing it.

Healthy lifestyle habits are a key component to lowering your risk. While there currently is no magic vaccine that prevents type 2 diabetes, there are simple lifestyle and diet changes that can greatly reduce your risk. These same changes also benefit other areas of your health, like your heart and lungs.

You are seven times more likely to develop type 2 diabetes if you are overweight. Moreover, if you are obese it makes you 20 – 40 times more likely to develop diabetes. Keep your weight within a healthy range to help lower your risk of developing diabetes.

Be active! Not only does exercise help you lose excess weight, but working your muscles also helps to improve their ability to use insulin and absorb glucose. This in turn can lower the stress on your insulin-making cells.

Watch what you eat. Spikes in blood sugar and insulin take a toll on insulin-making cells. This makes you more susceptible to developing diabetes. Choosing foods like whole grains that slowly and gradually increase your blood sugar and insulin, over starchy and sugary foods and drinks, can significantly lower your risk.

It goes without saying that quitting smoking can drastically increase your overall health, but did you know it could greatly reduce your risk of type 2 diabetes? Smokers are statistically much more likely to develop diabetes (and many other unnecessary diseases and disorders) than non-smokers. So please, quit smoking as soon as possible.

If you are concerned about your risk or want to be evaluated for your risk for diabetes, board-certified internal medicine specialist Dr. Ishan Gunawardene and Nurse Practitioner Shariffa Gunawardene at Wellington Advanced Medical are here to help. Through a comprehensive exam, our compassionate providers fully assess your risk, and then offer lifestyle and dietary change support. To make an appointment with one of our diabetes experts in Wellington or Royal Palm Beach, request an appointment online or call (561) 434-1935 today.

Is Bronchitis Contagious?

“I’ve got bronchitis, but don’t worry. It’s not contagious.”

Chances are you’ve heard that from your co-worker or a family member when they’re coughing…incessantly. There is a generally held belief that bronchitis is not contagious. While there is some truth to this belief, it is not entirely accurate.

Bronchitis caused by a bacterial or viral infection most certainly is contagious. This is the most common type of bronchitis. Chronic bronchitis is not contagious, when caused by tobacco use or environmental factors. However, people with chronic bronchitis may also have an undiagnosed viral or bacterial infection contributing to their symptoms, so they may still be contagious.

Bronchitis is the inflammation of your bronchial tubes that can cause chest tightness, coughing, shortness of breath and sometimes fever. For bronchitis caused by a bacterial infection, antibiotics may be prescribed to treat it. For a viral infection when antibiotics are not useful, you may take over-the-counter medication to help relieve symptoms. As with most viral infections, time and rest are the best medicine. Chronic bronchitis requires ongoing care with a chronic disease management specialist, such as Dr. Gunawardene.

Tips to Help Prevent the Spread of Bronchitis

Because viruses or bacteria typically cause bronchitis, the way you contract bronchitis is the same way you contract other types of flus, colds, and illnesses. So, breathing viruses or bacteria in or passing it from your hands to your mouth, nose, or eyes usually spreads bronchitis.

For this reason, it is important to practice safe hygiene method around those with bronchitis, colds, and the flu. Frequently washing your hands, sanitizing surfaces that collect germs, and keeping your hands away from your nose, eyes, and mouth can all help you avoid bronchitis and other bacterial or viral infections.

Most importantly, make sure you get your yearly flu shot. Many complications can develop from the flu virus including bronchitis, so if you can avoid getting the flu, you may just avoid getting bronchitis. If you do end up getting bronchitis, be sure to practice healthy hygiene habits. It is important to cover your mouth and nose when you sneeze and cough, and wash your hands often to avoid getting someone else sick. Also, keep your distance from those who have weakened immune systems and those with asthma and other breathing complications.

While bronchitis usually resolves itself in 7 to 10 days, if left unchecked it can lead to worsening symptoms, or even pneumonia. If you think you may have bronchitis, Dr. Gunawardene and board-certified family nurse practitioner Shariffa Gunawardene at Wellington Advanced Medical Clinic can evaluate and treat your symptoms. For bronchitis treatment in Wellington, call (561) 434-1935 or book an appointment online. Specializing in primary care and internal medicine, we will work with you to get you back to good health.

Is Your Gut to Blame for Your Migraine?

Have you ever experienced a migraine? Not just a headache – but a full blown thunderclap inside your head, with terrible nausea and hypersensitivity to light and sound to boot? Chances are that if you have experienced a migraine in the past, then you have already assessed the need to seek relief with board-certified internist Dr. Ishan Gunawardene. If not, it’s important to do so as soon as possible to make sure that the issue is not something more serious, and so that we can provide you with the relief you seek so your quality of life no longer suffers.

While medications and therapies can definitely help to stave off extremely painful migraines, it’s also important to recognize potential triggers in order to either avoid or prepare for them. Certain triggers are obvious, such as stress, changes in barometric pressure, physical exertion, and sleep imbalance. Less obvious are certain foods and medications that may overreact during digestion due to some very helpful and naturally occurring bacteria that we all carry around in our guts.

Studies show that there is a correlation between migraines and a higher than normal volume of a certain bacteria found in your gut and mouth. The bacteria break down nitrates into nitric oxide (NO), which regulates blood flow and oxygen release to the blood cells and aids the immune system by fighting off parasitic organisms.

However, people who suffer from migraines contain a much higher amount of these nitrate-modifying bacteria in their bodies, which means that more NO is produced than normal. As a result, the higher volume of NO could be what causes these migraines to occur.

Since the bacteria break down nitrates into NO, avoiding certain foods and medications that have a high nitrate content may help to prevent the triggering of a migraine. Nitrates can be found in processed meats like bacon, leafy vegetables like arugula and spinach, wine, and chocolate.

Medications that contain nitrates are nitroglycerin (Nitrostat and Rectiv), isosorbide dinitrate (Dilatrate-SR), and nitroprusside (Nipride). These are all vasodilators whose purpose is to lower blood pressure through widening your blood vessels. Too much nitric oxide could cause your blood pressure to drop too much, leading to a higher risk of stroke or heart attack, and potentially to a migraine based on new research.

Do you suffer from chronic migraines? Get the relief you need as soon as you need it. Our two convenient locations in Wellington and Royal Palm Beach are open Monday – Thursday, 9 am – 5 pm and Fridays, 9 am – 12:30 pm. Schedule an appointment with Dr. Gunawardene online or by calling (561) 434-1935.

Do you suffer from migraines?  What triggers have you faced before?  What do you do to prevent or cope with a migraine?

What is the Difference Between Type 1 and Type 2 Diabetes and Who is at Risk?

Diabetes is a word that’s often thrown around in conversation or in media coverage due to increasing awareness of this ever-growing disease. The information can be very confusing, as there are different types of diabetes with different causes, symptoms, and risk groups. Diabetes is typically diagnosed as either type 1 or type 2, and they can be quite different.

Here are some key differences between type 1 and type 2 diabetes:

Type 1 diabetes is also called juvenile diabetes due to the fact that most individuals with this disease are diagnosed before the age 20. Type 1 is an autoimmune disorder with no known cause, except for the possibility of being passed down through genetics.

Healthy bodies produce insulin in order to break down glucose from the food we eat and help the body’s cells to absorb it for energy. If you have type 1 diabetes, your body produces cells that create insulin but your body mistakes these cells as foreign bodies and destroys them, preventing you from producing insulin. In these cases, you are not able to absorb the necessary glucose without regular injections of insulin.

Type 2 diabetes is the most common type in the United States, and primarily affects individuals over the age of 45, those with high blood pressure or cholesterol, those with 120% or more of the recommended body weight, and those with a family history from a first-degree relative. Type 2 is brought on very slowly and is preventable if changes are made to one’s lifestyle and diet. Pre-diabetes alerts an individual to the oncoming of diabetes type 2 before the level of one’s blood sugar rises above the threshold of type 2. In order to prevent type 2 from occurring, one must recognize the changes they need to make in their diets and in daily activity and make a conscious effort to improve their condition before onset occurs.

Both type 1 and type 2 sufferers experience some of the same symptoms: frequent urination, constant thirst or dry mouth, chronic fatigue, blurred vision, excessive hunger, or sudden unexplained weight loss. Diabetes is a very serious disease and should be managed carefully and diligently. Other than gestational diabetes, which only occurs in pregnant women and resolves on its own most of the time, type 1 and type 2 diabetes are incurable. They must be diligently managed to maintain healthy blood sugar levels, and to avoid further complications.

Board-certified internal medicine specialist Dr. Ishan Gunawardene and his wife, Nurse Practitioner Shariffa, have helped many patients living with diabetes enjoy happier, healthier lives. Yes, a diabetes diagnosis may sound scary, but we can help you learn how to manage your diabetes through medication management and lifestyle and dietary changes. For more information on managing your diabetes in Wellington or Royal Palm Beach, request an appointment or call (561) 434-1935 today.

Do you suffer from type 1 or type 2 diabetes? What’s the most difficult thing about living with this disorder you’ve faced so far?