Author Archives: Joe Hilbert

  1. Medication Overuse Headaches: Can taking too much Tylenol or Ibuprofen cause daily head pain?

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    Many people rely on over-the-counter pain relievers like Tylenol (acetaminophen) or ibuprofen (Advil, Motrin) to manage headaches. While occasional use is generally safe, taking these medications too frequently can actually lead to a condition known as a medication overuse headache, also called a rebound headache. For some patients, this cycle can result in chronic or daily headaches that seem difficult to break.

    A recent article in Medical News Today highlighted how overusing headache medications may contribute to persistent head pain. According to Christina Camp, MSN, FNP-C, BSN, PCCN, of Shore Physicians Group’s Neurology Division, this is a pattern providers commonly see in patients who struggle with recurring migraines or tension headaches.

    “A medication overuse headache occurs when pain relief medications are taken too often,” Camp explains. “Patients may not realize that the medication they’re using to treat their headache could actually be contributing to more frequent headaches.”

    The cycle often begins with a primary headache disorder, such as migraines or chronic tension headaches. A patient experiences pain and takes acetaminophen, ibuprofen, or another headache medication. The headache improves temporarily. But when the medication wears off, the pain may return—leading to another dose.

    “You have a headache, you take medication, it improves,” Camp says. “When the medication wears off and the headache returns, you take more. Over time, the body becomes accustomed to that cycle.”

    Eventually, patients may notice they are experiencing daily headaches, headaches upon waking, or pain that seems less responsive to medication. In some cases, the medication provides only brief relief before symptoms return.

    Common medications associated with rebound headaches include over-the-counter pain relievers such as Tylenol and NSAIDs like ibuprofen and naproxen. Prescription migraine medications, including triptans, can also contribute to medication overuse headaches when used too frequently.

    “The concern is that you’re not allowing your body to regulate naturally,” Camp explains. “Occasional use of pain relievers is appropriate, but consistent daily use can perpetuate the headache cycle.”

    Breaking the cycle typically requires reducing or discontinuing the overused medication. “In many cases, the most effective treatment for a medication overuse headache is to stop the medication,” she says. “Some patients taper gradually, while others stop completely. Symptoms may temporarily worsen for a short period, but that often allows the body to reset.”

    If headaches persist after stopping over-the-counter medications, it may indicate an underlying migraine disorder that requires preventive treatment rather than repeated symptom management.

    “If someone finds they’re relying on Tylenol or ibuprofen regularly and it’s no longer providing meaningful relief, that’s a sign to seek medical evaluation,” Camp says. “A provider can assess the situation and determine whether a preventive treatment plan would be more appropriate.”

    Because headache disorders are highly individualized, proper evaluation is essential. A healthcare provider can perform a thorough assessment and develop a personalized treatment strategy to help reduce both headache frequency and reliance on daily pain medication.

    Christina Camp, MSN, FNP-C, BSN, PCCN, treats patients at Shore Physicians Group’s Neurology Division located at 700 Shore Road in Somers Point, NJ. To schedule an appointment with Christina, call 609-365-6202.

  2. Colonoscopies: A General Surgeon Weighs In on this Lifesaving Cancer Screening

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    It’s 2 a.m., and Shore Physicians Group General Surgeon Dr. John Millili rushes to the OR to treat a patient who came to Shore Medical Center with a sudden bowel obstruction caused by an undiagnosed colorectal tumor. These are the cases that upset Dr. Millili the most – the ones that could have been prevented with a routine screening.

    March is Colorectal Cancer Awareness Month, a reminder that one of the most preventable cancers still affects far too many people.

    “Unfortunately, too often I meet patients who haven’t kept up with their colorectal cancer screenings and are now facing serious complications,” says Dr. Millili. “They may arrive with a bowel obstruction from a tumor and need urgent, life-saving surgery, or we find the cancer has already spread. In many cases, these situations could have been prevented with routine screening.”

    Why Screening Matters

    Colorectal cancer usually begins as small growths in the colon called polyps. A colonoscopy allows doctors to detect and remove these polyps before they turn into cancer.

    “Colonoscopy is unique because it doesn’t just detect cancer—it can actually prevent it,” Dr. Millili explains. “Removing precancerous polyps stops the disease before it starts.”

    At-Home Tests Are Not Enough

    Tests like Cologuard or newer blood-based screenings can sometimes detect cancer early, but they cannot remove polyps.

    “Even if an at-home test is positive, a colonoscopy is still needed to identify and remove any growths,” Dr. Millili says. “Colonoscopies are the gold standard and I always recommend them over anything else.”

    Who Should Get Screened?

    Most adults should begin colorectal cancer screening at age 45, or earlier if they have risk factors such as a family history of colorectal cancer or certain gastrointestinal conditions like ulcerative colitis.

    “Patients are often surprised by how straightforward the procedure is,” Dr. Millili notes. “The peace of mind it provides is invaluable.”

    How to Get Started

    1. Talk to your primary care provider (PCP). Your PCP will review your health history, assess your risk factors, and provide a referral for a colonoscopy if needed.
    2. Schedule a gastroenterology (GI) consultation. Depending on your insurance, you may be able to book directly with a gastroenterologist. During this visit, the doctor will evaluate your needs and schedule your screening.
    3. Prepare for and complete your colonoscopy. Colonoscopies are outpatient procedures, usually quick and done under sedation. During the exam, doctors can detect and remove polyps, helping prevent colorectal cancer before it develops.

    Screening doesn’t just detect cancer early—it prevents cancer from developing in the first place.

    If you’re due for a screening, talk with your primary care provider and find a gastroenterologist at Shore Medical Center here.

  3. Go Green for Your Health: Simple Ways to Sneak More Greens into Your Diet

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    March is National Nutrition Month, making it a great time to take a closer look at one of the most powerful foods you can include in your diet: leafy greens. While St. Patrick’s Day may have passed, the “green” theme is still worth celebrating—especially when it comes to improving your health.

    According to Tiffany Rios, RD, CDE, with the Shore Physicians Group Endocrinology Division, leafy greens such as spinach, kale, arugula, and broccoli are among the most nutrient-dense foods available and can make a meaningful difference in overall health.

    “Greens are some of the most nutrient-dense foods on the planet,” Rios says. “They provide fiber, essential micronutrients, and compounds that support long-term health.”

    These vegetables are rich in vitamin K, folate, magnesium, potassium, iron, and antioxidants, which play important roles in the body. Vitamin K supports bone health and blood clotting, while folate helps produce healthy red blood cells and supports DNA synthesis. Magnesium helps regulate blood sugar and maintain healthy blood pressure.

    Adding just one extra serving of greens each day can support digestion, improve nutrient intake, and help protect long-term health.

    One simple way to boost nutrition is by adding greens to sauces you already cook with. Spinach, kale, or finely diced zucchini can be blended into red pasta sauce, making it more nutrient-dense without dramatically changing the flavor.

    Greens can also be incorporated into pesto. Traditional pesto includes basil, olive oil, garlic, Parmesan cheese, and pine nuts, but adding spinach, kale, or arugula provides additional vitamins and minerals.

    Rios recommends sautéing or roasting vegetables before adding them to sauces. Cooking them with a little olive oil enhances flavor and helps the body absorb fat-soluble nutrients like vitamin K.

    Smoothies are another easy way to increase your daily greens intake.

    Rios suggests a quick smoothie that includes spinach, frozen zucchini, frozen berries, almond milk, and protein powder or Greek yogurt.

    “Spinach blends well and almost disappears in a smoothie,” she says. “You’re getting nutrients like folate and magnesium without really noticing it.”

    Another creative option is mixing vegetables directly into proteins like burgers or omelets. Rios recommends grating zucchini and mixing it into a chicken, turkey, or beef burger along with spinach, egg, breadcrumbs, onion, and bell pepper.

    The shredded zucchini helps the burger retain moisture, creating a juicy patty while adding extra nutrients.

    “Small changes—like blending greens into smoothies or adding them to sauces—can make it easier to include vegetables regularly,” Rios says. “Over time, those small changes can make a meaningful difference in your overall nutrition.”

    Recipe: Spinach Chicken Burgers

    These flavorful burgers are a great way to combine lean protein with nutrient-rich greens.
    Ingredients

    • 1–1.2 lbs ground chicken
    • 1 cup frozen spinach, thawed and drained
    • ½ cup breadcrumbs
    • 1 egg
    • 1 tbsp Dijon mustard
    • 1 shallot, finely diced
    • 1 tsp garlic powder
    • ½ tsp salt
    • ½ tsp black pepper
    • Olive oil


    Directions

    1. Preheat oven to 400°F and line a baking sheet with parchment paper.
    2. In a bowl, combine ground chicken, breadcrumbs, egg, mustard, shallot, spinach, and seasonings. Mix until combined.
    3. Form into 6 patties and place on the baking sheet.
    4. Drizzle lightly with olive oil and bake for 18 minutes, flipping halfway through.
    5. Broil for 2 minutes to brown before serving.

    Tiffany Rios, RD, CDE, is a Registered Dietitian and Certified Diabetes Educator with Shore Physicians Group’s Endocrinology Division at 18 West New York Avenue, Somers Point, NJ. She offers nutrition counseling for people with a wide range of conditions and needs, including celiac disease, diabetes, and more. To schedule an appointment, call 609-365-5300.

  4. What Is Alpha-gal Syndrome? Understanding the Allergy Linked to Tick Bites

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    Many people in New Jersey are familiar with Lyme disease and other illnesses that can be spread by ticks. But there is another condition connected to tick bites that many people have never heard of. Instead of causing a bacterial infection, this condition can trigger a food allergy that affects how a person eats and lives every day.

    The condition is called alpha gal syndrome. It is an allergy that can develop after a bite from a lone star tick and causes the body to react to a sugar molecule called galactose alpha one three galactose, commonly known as alpha gal. This molecule is found in most mammals, including cows, pigs, lamb and deer. Humans do not naturally produce it, so when the immune system becomes sensitized to it, the body may treat it as a threat.

    One South Jersey resident who experienced this firsthand is Andrew Willson of Atco. An avid outdoorsman who enjoys hunting, fishing and spending time in wooded areas, Wilson had been dealing with persistent joint pain and physical discomfort for years. At first, he believed the aches were simply the result of an active life that included years of physically demanding work in law enforcement and the fire service.

    When the discomfort began affecting his daily activities, Willson sought care from Dr. Marlene Rodriguez, a primary care physician with Shore Physicians Group. After reviewing his symptoms and medical history, Dr. Rodriguez ordered a series of tests that included screening for alpha gal syndrome. The results showed that Wilson had developed the allergy. Once he adjusted his diet and began avoiding red meat and other mammal derived foods, many of the symptoms that had been bothering him improved significantly.

    Alpha gal syndrome begins when a lone star tick feeds on mammals that contain the alpha gal molecule and then bites a human. During the bite, traces of the molecule can enter the bloodstream. In some individuals the immune system responds by creating antibodies to alpha gal. Once those antibodies are present, eating foods that contain the molecule can trigger an allergic reaction.

    One of the unusual aspects of alpha gal syndrome is that symptoms often appear hours after eating, rather than immediately as with most food allergies. Reactions commonly occur three to six hours after consuming red meat or other mammal derived products. Because of this delay, people may not realize their symptoms are connected to something they ate earlier in the day.

    Symptoms can vary widely from person to person. Some individuals experience digestive problems such as stomach pain, nausea or diarrhea. Others may develop hives, itching or swelling. Some patients report fatigue or joint pain. In more serious cases the reaction can lead to anaphylaxis, a potentially life-threatening allergic response that affects breathing and blood pressure.

    Foods that commonly trigger symptoms include beef, pork, lamb and venison. Products made from mammals, such as gelatin, broths or certain medications that contain animal-based ingredients, may also cause reactions in some people. For that reason, patients with alpha gal syndrome often learn to carefully read labels and ask questions about ingredients.

    Fortunately, many foods remain safe. Poultry, fish, eggs, fruits, vegetables and plant-based foods do not contain the alpha gal molecule and are generally well tolerated. Managing the condition typically involves avoiding mammal-based foods and being aware of hidden ingredients that could trigger a reaction.

    In some cases, doctors recommend that patients carry an epinephrine auto injector, commonly known as an EpiPen, in case a severe allergic reaction occurs. Although Willson has never needed to use his EpiPen, carrying it offers peace of mind for both him and his wife, Diane Casey, knowing that treatment is available if an emergency were ever to happen.

    Because alpha gal syndrome is still relatively unfamiliar to many people, it is often underdiagnosed. Awareness of the condition is increasing as more physicians recognize the link between tick bites and the unusual allergy. For individuals who spend time outdoors where ticks are common, understanding the symptoms and seeking medical evaluation when unexplained reactions occur can help lead to earlier diagnosis and treatment.

    The contents of this article have been reviewed by Dr. Marlene Rodriguez, primary care physician, who treats patients at Shore Physicians Group office located at 2605 Shore Road in Northfield, NJ.

  5. When the Shoulder Slips: A Common Injury Weekend Warriors Shouldn’t Try to Fix Themselves

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    You don’t have to be a professional or Olympic athlete to suffer a dislocated shoulder. In fact, many of these injuries happen to “weekend warriors” and during everyday activities—playing pickup sports, slipping on ice, bracing a fall, or even walking a strong dog that suddenly pulls in the wrong direction.

    According to Dr. Tuan “Mickey” Bui, Orthopaedic Surgeon with Shore Physicians Group, the shoulder is particularly vulnerable because of how it’s designed. “The shoulder has more motion than any other joint in the body,” he explains. “It’s a ball-and-socket joint, but the socket is very shallow, which makes it less stable.”

    That incredible range of motion allows us to lift, reach, and rotate our arms freely—but it also means the shoulder is easier to dislocate. A dislocated shoulder occurs when the upper arm bone pops out of the socket, most often when the arm is forced away from the body. Dr. Bui says this commonly happens when people brace themselves during a fall or when the arm is suddenly pulled backward or to the side. This can be during sports, or even just falling down, especially down the stairs when a handrail is grabbed.

    These injuries aren’t subtle. “It hurts—a lot,” Dr. Bui says. “Your arm feels dead. You can’t move it, and visually, the shoulder doesn’t look the same on both sides.” Often, the affected shoulder appears flattened, and the person instinctively holds their arm still because movement causes intense pain.

    Two important structures help keep the shoulder in place: the labrum and the rotator cuff. The labrum is a ring of soft tissue that surrounds the socket. Dr. Bui uses an easy analogy to explain its role. “Think of the labrum like the rim of a dinner plate,” he says. “Without that rim, everything just slides right off.” When a shoulder dislocates, the labrum often tears, making the joint less stable and increasing the risk of future dislocations.

    Despite how painful shoulder dislocations are, one common mistake people make is trying to “pop” the shoulder back in themselves. While trained medical professionals can safely perform a controlled maneuver called a reduction, attempting this without proper training can do harm than good.

    “If you don’t know what you’re doing, you can damage the shoulder further,” Dr. Bui warns. Improper attempts can worsen labrum tears, injure nerves or blood vessels, or make an undetected fracture much worse. That’s why reductions should be left to professionals in emergency or sports medicine settings.

    Treatment doesn’t end once the shoulder is back in place. Recovery typically involves a sling, rest, and physical therapy. Younger patients may recover with rehab alone, while older adults are more likely to suffer rotator cuff tears during a dislocation—injuries that often require surgery.

    The bottom line: dislocated shoulders are common, painful, and serious. Whether the injury happens on a court, in the yard, or during a simple fall, resisting the urge to fix it yourself and seeking expert care is the safest way to protect your shoulder for the long run.

    Dr. Tuan “Mickey” Bui treats patients at Shore Physicians Group’s Orthopaedic Division offices located at 710 Centre Street, 2nd Floor in Somers Point, NJ. To schedule an appointment with Dr. Bui, call 609-365-6280.

  6. What May Be Causing Your One-Sided Headache

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    A headache on one side of the head can be frustrating—and sometimes concerning. While many headaches are related to stress, dehydration, or lack of sleep, persistent one-sided head pain may point to something more specific. A recent article in Medical News Today explored medical causes of unilateral headaches, including several neurological and vascular conditions.

    To better understand what may be behind one-sided head pain, Christina Camp, MSN, FNP-C, BSN, PCCN, of Shore Physicians Group’s Neurology Division, shared insight into several neurological and vascular conditions that can cause pain on one side of the head. “One-sided headaches can sometimes be linked to irritation of specific nerves or inflammation of blood vessels,” Camp explains. “The key is understanding where the pain starts, how it feels, and what triggers it.”

    One possible cause is occipital neuralgia, a nerve-related condition affecting the occipital nerves. These nerves run from the base of the neck up over the scalp.

    “The occipital nerves start at the base of the skull and travel upward over the head,” says Camp. “If they become irritated, patients often describe sharp, shooting, or electric-like pain in the back of the head, usually on one side.”

    She notes that many patients instinctively cup the back of their head in their palm when describing the pain. “It’s typically right where the skull meets the neck,” she says. Triggers can include muscle tension, poor posture, whiplash, head trauma, or compression of the nerve. “Sometimes we can identify the cause, and sometimes it just happens,” Camp adds.

    Another condition that can cause one-sided head pain is temporal arteritis, also known as giant cell arteritis. Unlike occipital neuralgia, this condition is vascular rather than nerve-related.

    “Temporal arteritis involves inflammation of the temporal artery, which runs along the temple area,” Camp explains. “Patients may notice tenderness in the temple along with persistent pain on one side of the head.”

    She emphasizes that this condition most commonly affects adults over age 50. “It’s something we take very seriously because, in addition to headache, patients can experience jaw pain when chewing or even vision changes. That’s why it’s important to rule it out.” Prompt evaluation is critical, as untreated inflammation can lead to complications.

    A third potential cause of one-sided pain is trigeminal neuralgia, which affects the trigeminal nerve—the main sensory nerve of the face.

    “The trigeminal nerve runs from the temple area down toward the cheek and branches toward the nose and jaw,” Camp says. “When it’s irritated, it can cause sudden, severe, electric shock-like pain on one side of the face or head.”

    She notes that even simple activities such as brushing teeth, chewing, washing the face, or exposure to cold air can trigger symptoms. “The pain is often brief but extremely intense,” she says.

    Because one-sided headaches can have multiple causes, Camp encourages patients not to ignore persistent or severe symptoms. “If you’re experiencing ongoing pain on one side of your head, it’s important to see a provider,” she says. “We can perform an assessment, determine whether testing is needed, and develop a treatment plan based on the underlying cause.”

    Christina Camp, MSN, FNP-C, BSN, PCCN, treats patients at Shore Physicians Group’s Neurology Division offices located at 700 Shore Road in Somers Point, NJ. To schedule an appointment with Christina, call 609-365-6202.

  7. It’s Not Too Late: Why Getting a Flu shot Still Matters this Season

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    Flu activity has increased steadily this season, with more people seeking care for influenza-like illness compared with some recent years. Healthcare providers across the region are reporting higher-than-expected case counts for this point in the season, reinforcing concerns that influenza remains a serious and ongoing threat. According to the Centers for Disease Control and Prevention (CDC), flu activity often peaks between December and February but can continue into spring, making vaccination important well beyond the fall months. Learn more about seasonal influenza at cdc.gov/flu.

    This year’s increase in flu cases is being felt in primary care offices, urgent care centers, and hospitals. Dr. Gregory Herman, a primary care physician with Shore Physicians Group, says one contributing factor may be lower vaccination rates.

    “I’m seeing about 40 percent of my patients who have not received a flu shot this year,” Dr. Herman said. “In past years, that number was closer to 25 percent. That’s a significant increase, and it puts more people at risk for severe illness.”

    Dr. Herman strongly recommends annual flu vaccination for nearly everyone six months of age and older. He emphasizes that it is not too late to get vaccinated, even as the season progresses.

    “People often think they’ve missed their chance, but that’s simply not true,” he said. “Flu activity can continue for months, and getting vaccinated now can still offer meaningful protection.”

    It’s also important for people to understand that the flu shot does not provide immediate immunity. Dr. Herman explains that it typically takes about seven days after receiving a flu shot for the body to build enough antibodies to become fully inoculated.

    “That window is exactly why I encourage people to act sooner rather than later,” he said. “Waiting increases the risk of getting sick before your immune system has time to respond.”

    Beyond personal protection, vaccination plays a critical role in protecting the broader community. Getting a flu shot helps reduce the spread of the virus, particularly to vulnerable populations such as older adults, young children, pregnant women, and individuals with weakened immune systems.

    “When you get vaccinated, you’re not just protecting yourself,” Dr. Herman said. “You’re helping protect your family members, coworkers, patients, and neighbors. It’s a shared responsibility.”

    As part of ongoing efforts to safeguard patients and staff during peak flu and RSV season, Shore Medical Center has updated its visitor policy. Keeping everyone safe remains the hospital’s top priority. During this time, children age 16 and younger are restricted throughout the hospital, except when they are patients or in extenuating circumstances approved by hospital leadership.

    In addition, through April 1, visitation in the Neonatal Intensive Care Unit (NICU) is limited to individuals whose identification matches the newborn. These temporary measures are designed to reduce the spread of respiratory illnesses and protect the hospital’s most vulnerable patients.

    Dr. Herman encourages anyone with questions about flu vaccination or seasonal illness prevention to speak with their primary care provider.

    “The flu shot is safe, effective, and one of the simplest steps you can take to stay healthy,” he said. “I highly recommend it.”

  8. A New Path to Migraine Relief? How CGRP Medications May Help

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    Migraines steal moments—quiet mornings, family dinners, or a much-needed night’s rest. For many people who live with them, the search for real relief becomes a revolving door of treatments: Botox, acupuncture, over-the-counter options, or long-standing prescription medications.

    Because these medications are appearing more frequently in TV commercials and online ads, many patients are curious about what they actually do and whether they’re right for them. To help bring clarity, Christina “Chrissy” Camp, MSN, FNP-C, BSN, PCCN—of the Neurology Division at Shore Physicians Group in Somers Point—explains how CGRP medications work and when they may be considered.

    Before discussing the newest treatment options, Chrissy emphasizes that effective migraine care starts with understanding the whole patient—not just the headache.

    “You’re coming to us because you don’t feel well,” she says. “So it’s important we don’t just cover up symptoms with medications without a full assessment. A headache can be caused by a lot of things, and I need to make sure we’re treating the right problem.”

    Sometimes, she explains, a headache that seems like a migraine could actually be something more concerning—such as a mild stroke—or connected to an issue like untreated sleep apnea, Vitamin deficiencies, or infectious diseases. In those cases, jumping immediately to migraine medication could mask the symptoms while the underlying condition goes overlooked. “We want to rule out the big, the bad, and the ugly,” she says. “My job is to make sure we’re not missing something important. That means reviewing records, ordering imaging when appropriate, looking at lab work, and really listening to the patient.”

    Once she determines a migraine is truly a migraine, Chrissy helps patients understand what’s happening inside the body. “A migraine is a neurological event,” she says. “When it starts, the body releases inflammatory markers that irritate blood vessels and make nerves hypersensitive.” One of the most important of these markers is CGRP—calcitonin gene-related peptide.

    Clinically, CGRP is a neuropeptide found throughout the brain and nervous system. During a migraine, levels of CGRP rise sharply, triggering blood vessels to dilate and increasing inflammation around the nerves that sense pain. This is what makes migraines feel so intense. CGRP medications work by blocking either the peptide itself or its receptor, interrupting this chain reaction. “By stopping that signal,” Chrissy explains, “we stop the symptoms from spiraling into a full migraine.”

    “Inflammatory markers ramp up irritation in the nerves and blood vessels,” Chrissy adds. “CGRP is one of the signals that tells the body, ‘Okay, this is turning into a migraine.”

    That’s where CGRP-targeting medications come in. She uses a local analogy to explain them. “Picture traffic on Route 9 going from Somers Point into Linwood,” she says. “Now imagine another line of traffic coming off Ocean Heights Avenue at Wawa that cuts across and stops that flow. CGRP medications block the migraine signal the same way—they prevent it from getting from point A to point B.”

    These newer medications come in two forms. Preventive options, like Emgality, Ajovy, and Aimovig, are monthly injections that reduce how often migraines occur. Acute medications—brands like Nurtec ODT or Ubrelvy—are taken at the first sign of an attack to stop it before it escalates. Both types are well tolerated and often work for patients who have exhausted other treatments.

    But none of that happens before Chrissy completes a thorough, personalized evaluation. “I don’t want to hand someone a medication when the real issue might be their sleep apnea, vitamin deficiency, or an infectious disease, or when I need to rule out a mild stroke first,” she says. “The goal is not just to make the headache go away—it’s to understand why it’s happening.”

    For those in our community who have struggled to find lasting relief, Chrissy’s thorough, evidence-based approach—and the potential relief made possible from CGRP medications—offers renewed hope. It’s a path forward grounded in understanding the whole patient and helping them reclaim more of the moments that matter.

    Chrissy Camp, MSN, FNP-C, BSN, PCCN, treats patients at Shore Physicians Group’s Neurology Division offices located at 700 Shore Road in Somers Point, NJ. To schedule an appointment with Reeva Salkin, call 609-365-6202.

  9. Blood Tests for Alzheimer’s: What They Can and Can’t Tell Us

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    New research has brought renewed attention to blood tests that may help detect biological markers associated with Alzheimer’s disease. These tests, which identify proteins such as amyloid and tau, have generated headlines for their potential to identify brain changes long before symptoms appear. But as promising as the science may be, they come with important limitations—and even more important context for patients and families.

    To help clarify the role these tests currently play in neurological care, insight was provided by Reeva Salkin, MSN, APN-BC, ANP-BC of Shore Physicians Group’s Neurology Division in Somers Point, NJ. Salkin evaluates patients who worry their memory lapses may signal something serious and understands both the appeal and the risk of relying too heavily on these newly publicized tests.

    “These blood tests can’t be done at your local lab,” she explained. “They have to be sent to a private specialty company and are used only in very specific cases. Even if the result is positive, it doesn’t necessarily predict what a person’s future will look like.”

    Salkin notes that test results—positive or negative—can easily lead to misunderstandings. “If the test shows certain biomarkers, someone may interpret that as an inevitable sign of Alzheimer’s, and that isn’t the case. But if it’s negative, a person might feel they don’t need to make healthy changes. Neither reaction is helpful.”

    Right now, these emerging tests support—but do not replace—a full evaluation. Alzheimer’s is diagnosed through careful history-taking, cognitive assessments, medical review, and imaging when appropriate.

    Salkin emphasizes starting with the basics because many common medical issues can mimic dementia and are far more easily treated. Vitamin B12 deficiency, thyroid disorders, vitamin D deficiency, and even infections can produce symptoms that look like early cognitive decline. “B12 deficiency is extremely common,” she said. “Addressing it can dramatically improve mental clarity.”

    Brain imaging, while useful, is also only one piece of the picture. Some individuals show age-related changes on MRI and function perfectly well, while others with normal scans experience real symptoms. This is why clinical context remains critical.

    When discussing what constitutes concerning symptoms, Salkin draws an important line. Occasional misplaced keys or a forgotten phone are not the red flags. “What concerns us are changes truly out of character—getting lost on the way to a familiar place, difficulty managing bills, or confusion that persists. Those are the cues to look deeper.”

    Yet despite the anxiety many patients feel, Salkin stresses that there is meaningful room for optimism. “Lifestyle plays a significant role,” she said. “Keeping the brain active, learning new things, staying socially connected—these can all influence cognitive health. If something feels mentally challenging, that’s good. It means the brain is engaged.”

    While Alzheimer’s blood tests may someday offer earlier insights, they are not intended as first-line screening tools, nor should they be interpreted without a larger medical context. As Salkin explains, “People are understandably worried when memory changes begin. The best approach is a thoughtful, step-by-step evaluation that looks at the whole person.”

    For now, the most effective path forward remains careful clinical assessment, attention to overall health, and habits that keep the mind active—long before turning to a specialized blood test for answers.

    Reeva Salkin, MSN, APN-BC, ANP-BC, treats patients at Shore Physicians Group’s Neurology Division offices located at 700 Shore Road in Somers Point, NJ. To schedule an appointment with Reeva Salkin, call 609-365-6202.

  10. Learning to Live Well with Celiac Disease: How Shore Physicians Group Dietitian Tiffany Rios Can Help

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    Being diagnosed with celiac disease can feel overwhelming at first. Suddenly, foods you’ve eaten your entire life—breads, pasta, sauces, even seasonings—may be off-limits. You find yourself navigating a whole new world, reading labels and probably feeling overwhelmed. But with the right support and guidance, it is possible to eat well, feel better, and protect your long-term health.

    At Shore Physicians Group, registered dietitian Tiffany Rios, RD, CDE, helps people with celiac disease make sense of this lifelong diagnosis. She not only explains why a strict gluten-free diet is medically necessary, but also teaches patients how to safely enjoy food at home, while traveling, and when dining out.

    Why Going Gluten-Free Matters

    Gluten is a protein found in wheat, rye, and barley. In people with celiac disease, eating gluten triggers the immune system to attack the lining of the small intestine. This damages the body’s ability to absorb vitamins and minerals, which can lead to nutrient deficiencies, fatigue, anemia, digestive issues, and even long-term complications like osteoporosis, other autoimmune conditions, and—in rare cases—intestinal cancer.

    Unlike people with gluten sensitivity, who may simply feel better avoiding gluten, those with celiac disease must strictly avoid it for life. Rios stresses that even small amounts of gluten can cause harm, which is why education and careful planning are essential.

    Learning Where Gluten Hides

    Reading labels is the first step. “Gluten can be sneaky,” Rios explains. “Because gluten is not recognized as a food allergen, there is no clear ‘contains gluten’ statement on ingredient lists, like you see for milk or tree nuts.” It’s found in many unexpected places, such as:

    • Soy sauce and marinades
    • Some seasoning packets
    • Soups and sauces that use wheat as a thickener
    • Oats, unless specifically labeled gluten-free (oats are often grown with wheat, and can be contaminated with gluten)

    The good news is that many companies go through the process of certifying that their product is gluten free. You can know it’s safe when you see one of the several variations of certified gluten free logos. The logo means it has been tested to ensure it contains less than 20 parts per million of gluten.

    In addition, there is such a thing as ‘gluten free wheat starch’ which is in some certified gluten free foods. Often, people with celiac are confused by this, but the wheat itself is not a problem for celiacs – it’s the gluten protein found in wheat. Gluten free wheat starch has been processed to remove the gluten and is safe for people with celiac.

    Whole Foods First

    Of course, the easiest and most nutritious way to eat gluten-free is by focusing on whole foods: fruits, vegetables, lean proteins, beans, nuts, seeds, and naturally gluten-free grains like quinoa and rice.

    “If you find it overwhelming to go gluten free, try focusing on whole foods like these that require no attention to labels,” Rios shares.

    Rios also works with patients to rebuild gut health using supportive strategies such as probiotics, L-glutamine, and digestive enzymes if needed, especially during the early stages of healing.

    Dining Out with Confidence

    Eating at restaurants can be one of the biggest challenges after diagnosis. Rios encourages patients to use resources like the Find Me Gluten Free app where customers can leave detailed reviews about restaurants that offer gluten free options. She also suggests joining regional Facebook groups for gluten-free dining recommendations and travel tips. In our area, there is “Atlantic County Gluten & Dairy Free” and “Gluten Free New Jersey”.

    Rios also educates patients on how to ask the right questions at restaurants to avoid eating foods that are cross contaminated. One of her favorite local places for gluten free meals is Josie Kelly’s.

    Kathleen Lloyd, who owns Josie Kelly’s Public House in Somers Point with her husband, Dermot, says their restaurant has become a safe haven for people with celiac disease. They’re proud to have over 40 five-star reviews on the Find Me Gluten Free app.

    “We know it can be scary for people with celiac disease to dine out, so we’ve gone to great lengths to have safe cooking processes in place, to train our staff to answer questions, and to provide a separate gluten free menu to enhance the guest experience,” Lloyd says. She adds, however, that it’s important guests always notify their server they are gluten free, because they’ll alert the kitchen staff to take those extra precautions, like changing gloves and utensils, and fully cleaning the grill.

    “Gluten free guests have many more options at Josie Kelly’s than most restaurants. We offer everything from small plates, soup, burgers and sandwiches to salads, entrees and desserts. You can enjoy a guilty pleasure like French fries cooked in our dedicated fryer, or our lamb burger with a gluten free bun. Or, choose something on the healthier side, like our vegan and gluten free garden pie, or a salad topped with lean protein. For dessert, we have a flourless chocolate cake elevated with strawberry and cardamom coulis, along with a variety of gluten free French macaron flavors.”

    Support for the Journey

    Adjusting to a gluten-free lifestyle is not just about avoiding certain foods—it’s about protecting your health for the long term. Rios works one-on-one with patients to create safe and nutritious meal plans, identify hidden sources of gluten, support digestive healing, recommend supplements where appropriate and provide trusted dining and product resources.

    “Celiac disease can feel like a big change, but once patients are educated and confident in what they’re eating, they feel so much better.”

    Tiffany Rios, RD, CDE, is a Registered Dietitian and Certified Diabetes Educator with Shore Physicians Group’s Endocrinology Division at 18 West New York Avenue, Somers Point, NJ. She offers nutrition counseling for people with a wide range of conditions and needs, including celiac disease, diabetes, and more. To schedule an appointment, call 609-365-5300.

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