Comments Off on Shore Physicians Group Endocrinology Division Moves to Somers Point
Shore Physicians Group’s Endocrinology Division has relocated from Northfield to its new standalone office at 18 West New York Avenue in Somers Point.
The new location features ample and convenient patient parking and is next to Shore Outpatient Rehabilitation, which serves as the meeting site for the Diabetes Prevention Program. Shore Physicians Group Endocrinology providers include Drs. Vijay babu Balakrishnan MD, CCD and Matthew H. Corcoran, MD; Advanced Nurse Practitioner & Certified Diabetes Educator, Denyse Gallagher, APRN-BC, CDE; and Registered Dietitian & Certified Diabetes Educator, Tiffany Rios, RD, CDE.
The endocrinology team treats endocrine-related disorders including type 1 and type 2 diabetes; thyroid disorders; osteoporosis; adrenal disorders; diseases of the parathyroid; pituitary disorders; cholesterol disorders; medical management of weight loss; polycystic ovarian syndrome; testosterone deficiency and transgender care.
Shore Physicians Group’s endocrinology team embraces the latest technology in endocrinology, including continuous glucose monitoring and insulin pumps for patients with diabetes, and comprehensive thyroid care.
To schedule an appointment with an SPG endocrinology provider, please call 609-365-5300.
Comments Off on Underactive or Overactive? Know the Symptoms of Thyroid Disease
Small but Mighty Thyroid The thyroid gland sits at the front of the throat, and at roughly the size of your thumbs held together in the shape of a butterfly, it plays a large role in the body’s overall health.
What Does the Thyroid Do? That small organ works with every organ in the body, according to Shore Physicians Group endocrinologist Dr. Matthew Corcoran. “In infants, the thyroid performs an essential function for growth and proper neural development. In adults the thyroid controls our metabolism and really impacts every organ in our body. From our heart to our gut, the thyroid plays a very important role by constantly releasing a steady amount of thyroid hormones into the bloodstream as our body needs it.”
How Do We Know We Have a Problem with Our Thyroid? Dr. Corcoran said there are a variety of symptoms that signal something is off. For many, the symptoms are vague and non-specific. Patients will come to visit Dr. Corcoran with complaints of feeling sluggish, or they have noticed changes in their hair or their skin, depression, constipation, or may have concerns with weight management. “While these symptoms can mean different things, they can be symptoms of hypothyroidism, which is an underactive thyroid,” said Dr. Corcoran.
When the thyroid is overactive, or a condition known as hyperthyroidism, patients will come in with heart palpitations, tremors, and sweating, among other symptoms, according to Dr. Corcoran. He said both hyperthyroidism and hypothyroidism can present cognitive issues for patients, like problems focusing.
Causes of Thyroid Problems Hashimoto’s disease is the most common cause of hypothyroidism, according to Dr. Corcoran. It is an autoimmune disorder where the immune system attacks the thyroid and can damage it, and the thyroid is not able to make enough of the necessary hormones and throws off the body’s metabolism.
Though there are multiple causes of hyperthyroidism, Grave’s disease is the most common cause of an overactive thyroid. Dr. Corcoran advised that Grave’s disease symptoms can be wide ranging because the thyroid works with so many other body systems. Patients will complain of irritability, anxiety, fatigue and frequent sleep disturbance. They may be concerned about weight loss despite not changing their normal eating habits. Women may have a change in their menstrual cycle and for men, erectile dysfunction and reduced libido can accompany hyperthyroidism.
Family Link Anyone can develop Hashimoto’s disease but it occurs more often in women who have a family history of thyroid disease. Likewise, Graves’ disease is more likely discovered in women younger than 40. Both of the autoimmune disorders are linked to a family history of thyroid disease, according to Dr. Corcoran. “Anyone can have thyroid disease but we do see the family link as another important piece of the equation when diagnosing and choosing a treatment plan for our patients.”
Treatments If the patient is diagnosed with Hyperthyroidism or an over active thyroid, they will be managed initially with medication that will slow it down. In the case of Hypothyroidism or an underactive thyroid, the patient can be managed with hormone treatment to speed it up. Whether that treatment will work to slow the thyroid down or help it to speed up, successful management of their thyroid disease is achievable.
Finding Nodules “Sometimes in our exam we will find the patient has a nodule on their thyroid and we recommend further evaluation with ultrasound,” said Dr. Corcoran. But he added that many people have a nodule and never know it and it never gives them a problem. “Often nodules are discovered incidentally during imaging such as carotid artery Doppler studies,” said Dr. Corcoran. Of the nodules detected, the vast majority are benign with only 4-6 % cancerous.
Thyroid Cancer While thyroid cancer numbers are increasing over the last few decades, according to Dr. Corcoran, it is something most patients do very well and thyroid cancer does not have to negatively impact their lifestyle.” He added that should a patient need surgical management or thyroid removal, they will usually do very well. The patient who has their thyroid removed will take hormone replacement for the rest of their lives.
Piecing Everything Together Dr. Corcoran said because so many symptoms of thyroid disease are similar it takes a lot of understanding to find the best course of action for each patient. “Endocrinology is so appealing because it is a cognitive field where the physician and the health care team collect all the data and put all the pieces together like a puzzle to get the best outcome for each patient.”
Dr. Corcoran and the Endocrinology practice will open their new office at 18 New York Avenue in Somers Point on February 22, 2021. To make an appointment call 609-365-6328 or 609-365-5300.
Who Do You Trust? Can you catch the flu from the flu shot? Is gluten bad for you? Can you skip sunscreen on a cloudy day? Who knows the truth? Is it your mother or the neighbor who likes to give advice?
There are few things in our day-to-day life as loaded with misinformation or made-up facts than personal health. It is one of those common areas where scientific fact and emotional response find themselves overlapping. It’s not a surprise that some things get misstated or misinterpreted in the translation from one person to another and another. Compounding the misinformation are the ad campaigns for new products, headline-catching fad diets and inevitably questionable tips and alternative facts about diet and exercise.
Trust your healthcare expert When it comes to health information, your best bet is to talk to your healthcare provider. Kelsey Allen, MSN, RN, RNP-BC, a nurse practitioner with Shore Physicians Group’s primary care practice in Margate, added her expertise to the health “fact or fiction” debate.
Will the flu shot give you the flu? The answer is no. Allen said the flu vaccine is made from and inactivated or killed form of the flu virus and it cannot give you the flu. Should you get sick after the flu vaccine, Allen said that you were likely going to get sick anyway and it had nothing to do with the vaccine itself.
Should you starve a cold or feed it? The old adage, “feed a cold and starve a fever” has been around for centuries. But is it true? The truth is, according to Allen, eating stimulates a kind of immune response to combat viral infections. So that bowl of steaming hot chicken soup will help warm you up as well as help you fight off that bug.
Is starving yourself an effective tool for weight loss? This received a strong “No” from Allen. “While starving yourself may result in weight loss initially, it is not an effective tool for long term weight loss. Sometimes starving yourself to achieve a weight loss may lead to a weight gain.” This kind of diet, without a sustainable plan other than to just eat very little is too difficult to maintain. A few days of extreme food restriction can then lead you to overeat and undo the calorie deficit you created. Dramatic changes in eating habits to achieve a quick fix weight loss can also lead people down the path of eating disorders.
Will eating before bed make you overweight? Allen said the consensus is that the time of day you are eating doesn’t matter, it is what you are eating. If your daily calorie intake does not exceed the calories you expend, you will not gain weight. Typically, eating at night occurs after dinner, and usually involves snacking on higher calorie foods, which would lead to weight gain.
If you are hungry before bed, don’t starve yourself. Instead, have a small protein-packed snack that could increase your metabolism. As long as you are on track for the day with calories and expending more than you take in, then eating something before bed will not hamper your goals.
Is gluten bad? The whole gluten-free lifestyle is mainstream, with grocery store shelves filled with foods that are gluten free. But is gluten really bad for you? Allen said, no, gluten is not bad. “With the exception of people who have celiac disease or are gluten intolerant, there is no evidence to suggest you should avoid gluten for health reasons if you tolerate it well.”
Individuals who have celiac disease require a strict gluten free diet because gluten causes an adverse reaction in the body which damages the intestines and can lead to serious health problems.
You only need sunblock when the sun is out This is another myth busted. Allen said, “Ultraviolet rays are always present during the day, whether it is cloudy or not. Sunscreen is necessary year-round. The only time sunscreen is not necessary is at nighttime. To decrease exposure to UV rays, use a sunscreen with a broad-spectrum SPF value of 15 or higher and take other precautions like limiting your hours of exposure and wearing a hat and sunglasses.
Are veggie chips just like eating vegetables? “Veggie chips are a misleading snack that convinces people they are eating healthy,” said Allen. “The vegetables in the chips lose most of their nutritional value when made into chips and are definitely not a substitute for fresh vegetables.” That myth is busted and it is a much better choice to reach for fresh broccoli over green chips made with broccoli that are also packed with salt and saturated fat. For some real veggie chips consider making your own by slicing vegetables, drizzling some olive oil over the top and baking them.
Tryptophan in turkey makes you sleepy Myth! The verdict is in and the turkey has been found not guilty. Just because you want to take a long nap after that huge Thanksgiving dinner, don’t blame the tryptophan. Allen said the turkey is not the only source of tryptophan as it is also present in other meats as well. The drowsiness felt after a big meal is likely caused by the high carb stuffing and mashed potatoes that sit innocently alongside the turkey.
Is sitting too long the new smoking? Smoking has been associated with increased risks of chronic disease and premature death, said Allen. “While leading a sedentary lifestyle does have risks, smoking and a sedentary lifestyle are two very different things and cannot be equated. However, regular exercise can help decrease many risks of chronic disease.”
To make an appointment with Kelsey Allen MSN, RN, RNP-BC or another member of the Shore Physicians Group team at the Margate office located at 9501 Ventnor Avenue, call 609-822-4800.
Comments Off on Can Winter Weather Ruin Your New Year?
A pretty snowfall blanketing everything in sight when looking out the window is picture perfect. When you are digging out your car from an overnight snowstorm, however, it may put a whole new spin on how you view that winter weather.
Urgent Care versus Emergency Department Dr. John Kulin, director of Shore Urgent Care in Northfield, said winter weather definitely brings in more patients with fractures, sprains and contusions associated with slips and falls on the ice and snow. X-rays are available on-site at Shore Urgent Care. “Patients with more significant injuries such as head injuries, major trauma or extremity injuries with significant deformity should go to the Emergency Department. Otherwise, urgent care is the best place for most,” said Dr. Kulin.
Be Prepared The most important things you should do to stay safe during the winter months is be prepared and use common sense. Dr. Kulin suggested having food and water available should there be a power outage and have contact information at hand with a plan of where to go if you should lose power and heat. Make arrangements for snow removal prior to a storm. Have heating equipment properly maintained annually and do not go out in a storm or immediately after unless it is absolutely necessary.
Weekend Warriors Saturday and Sunday hours at Shore Urgent Care do see an increase of patients who have hit the slopes on their skis and snowboards and then return home, seeking care closer to home, according to Dr. Kulin. Broken fingers and wrists can be taken care of in the office if the deformity from the break is not too severe.
Dr. Kulin said, “We X-ray to rule out a break and then go with the normal resting, elevating and icing the affected area. Typically, these patients will be examined and an X-ray ordered to rule out a fracture or break. Depending on the extent of the injury, it may require anti-inflamatories or splinting, immobilization and crutches along with follow-up with their primary care provider or a specialist to assess proper healing.”
Be Wary of Chest Pains and Shortness of Breath In the winter months, Shore Urgent Care does experience an uptick in patients with complaints of chest pains and shortness of breath. “Chest pains and shortness of breath are common complaints in the urgent care setting and among the most difficult to deal with,” said Dr. Kulin. “There are many causes for chest pain or shortness of breath, some minor and some life threatening. The patient’s past medical history is a good indicator. If a patient has a history of asthma but has run out of their inhaler, this is a safe and easy visit to the urgent care. On the other hand, when a person is having chest pain, heaviness or shortness of breath after exertion, it is very concerning for a serious heart related issue.”
Dr. Kulin explained that most new onset chest pain or shortness of breath without definite cause is problematic. Chest pain or shortness of breath after exertion should be evaluated in the emergency department, according to Dr. Kulin who added that patient’s safety is always paramount.
Bears Hibernate but People Should Not All too often a rather sedentary lifestyle is adopted in the winter. But the winter can also bring the region wet and heavy snowfall. Dr. Kulin advises those who are not active to avoid heading out to shovel snow. “Shoveling snow is a labor-intensive activity, especially heavy and wet snow. But if you cannot get someone to shovel for you, then work slowly and deliberately, tackling the job in small increments. Do NOT ‘work up a sweat’ or try to elevate your heart rate. If you develop any shortness of breath, chest heaviness, tightness or pain especially if it radiates to the back, neck or arms, stop immediately and call 911,” said Dr. Kulin.
Carbon Monoxide Poisoning Winter weather also means the heater and the fireplace will likely be in use. Dr. Kulin said typically they will see patients at Shore Urgent Care who are complaining of headache or nausea that are not related to any cold or flu but related to improper ventilation or a blocked chimney or heating duct. “Everyone needs to remember that carbon monoxide monitors should be used if you have any type of combustible heat such as oil, gas- especially non-vented, kerosene or wood. Carbon monoxide is odorless, tasteless, and colorless.” He said common causes of carbon monoxide poisoning include: malfunctioning cooking appliances, clogged chimney, auto exhaust or idling vehicles, or malfunctioning oil, wood, gas or coal furnaces. Likewise, it could result from a malfunctioning clothes dryer, wood burning fireplace, gas log burner or any unvented space heater, gas or fuel burning appliances in cabins or campers, barbecue grills, ceiling mounted heating units, and pool or spa heaters.
Carbon monoxide poisoning occurs when carbon monoxide builds up in your bloodstream. When too much carbon monoxide is in the air, your body replaces the oxygen in your red blood cells with carbon monoxide. This can lead to serious tissue damage, or even death. A simple plug-in carbon monoxide monitor will detect the presence of carbon monoxide build-up.
Shore Urgent Care is located at 2605 Shore Road in Northfield, New Jersey. Hours are Monday through Friday 8 a.m. to 8 p.m. and Saturday and Sunday, 9 a.m. to 5 p.m. Telehealth visits are also available by calling 609-365-5333 and the patient service representative will inform you of the next steps. Drug screening is available Monday through Friday, 10 a.m. to 5 p.m.
For many men and women, multivitamins are part of their everyday startup routine. They are the number one dietary supplement but the real question is, are those multivitamins really doing anything for you?
Look to your diet Dr. David Totton, Ambulatory Pharmacist with Shore Physicians Group in Somers Point offered his advice on multivitamins. “In general, most people will get the daily required amount of vitamins and minerals through consuming a well-balanced diet and do not require a multivitamin supplementation,” said Dr. Totton. “There are, however, certain instances where multivitamin supplementation may be beneficial, such as during pregnancy, different dietary strategies or if a deficiency is found on routine lab work.”
What is in your Multivitamin? But what is really in most multivitamins? Dr. Totton said what most people are referring to when they say multivitamins are specifically multivitamins with minerals which generally contain the daily required amounts of vitamins A, B, C, D, E, and K along with potassium, iodine, zinc, calcium, magnesium and/or iron. Dr. Totton suggests if you choose to take a multivitamin, choose one that best fits your individual needs. The multivitamins are available in a variety of formulations based on age, sex and specific nutritional needs.
No Thanks, Herbals Herbal supplements such as St. John’s Wart and ginko are usually lacking research and do not go through the same regulatory processes set in place for most other supplements. “I recommend looking for products that contain the recommended daily allowances and the United States Pharmacopeia (USP) seal of approval on the label. This certifies that the product contains all ingredients listed on the label in the declared potency and is free from contaminants,” concluded Dr. Totton.
Who Benefits from Multivitamins? Dr. Totton points out that those who follow a vegetarian or vegan diet are often found to be lacking in some essential nutrients due to their strict dietary restrictions. “Some of the ones to be mindful of are vitamins B12, D, calcium and iron. Vegetarians and vegans may benefit from a multivitamin, however they should be aware that most multivitamins contain low amounts of calcium and iron so they may require a specialized product or individual supplements to meet their specific needs,” said Dr. Totton.
One group that is advised to take a multivitamin is pregnant women. Dr. Totton said those multivitamins are to support healthy development of the child. “During pregnancy it is important to be cognizant of six key nutrients: folic acid, iron, calcium, vitamin D, DHA (Omega-3’s), and iodine. The expectant mother needs the folic acid for proper development of the nervous system and can prevent birth defect such as spina bifida,” explained Dr. Totton. “Prenatal vitamins are also unique in that the vitamin A component comes in the form of beta-carotene (which is converted to vitamin A in the body). This is important because the consumption of too much vitamin A during pregnancy can increase the risk of birth defects, however this risk does not apply to beta-carotene.”
Cut it out! Dr. Totton offers Medicare wellness visits in conjunction with the primary care physicians at Shore Physicians Group. He suggests to patients during a review of their medications, that if they are currently taking a multivitamin that has not been prescribed by their physician, they should discuss the necessity of taking the vitamin at their next visit. “You may find that you do not need it and that is one less expense and one less pill to worry about each day,” added Dr. Totton.
Acidic beverages can actually aid in the absorption of certain supplements, like the iron supplement ferrous sulfate. Dr. Totton cautions patients from adding grapefruit juice to their diet without first consulting their doctor or pharmacist because it can interact with certain medications and increase the risk of adverse effects.
According to Dr. Totton, multivitamins do not generally interact with most medications, but there are a few notable exceptions. “If you take the blood-thinner warfarin (brand name Coumadin), you should talk to your doctor before taking any product that contains vitamin K as this can decrease the effectiveness of your blood-thinner. Depending on which multivitamin product you take, there may be high enough levels of calcium or magnesium to interact with thyroid hormone medications such as levothyroxine (brand name Synthroid). In this case, it would be recommended that you space the two products out by at least 4 hours.”
The Best Way to get the Vitamins Rather than taking a multivitamin, Dr. Totton suggested we all adopt a diet that includes plenty of fruits, vegetables, whole grains, good protein sources and healthy fats. Those components will provide most of the nutrients your body needs. While consuming multivitamins at the recommended dosage is not harmful with the only downside being the cost of the supplement, Dr. Totton said to save the money spent on unnecessary supplements and instead incorporate more healthy foods on a daily basis.
Dr. Totton is seeing patients at all Shore Physicians Group’s primary care offices. To make a Medicare Annual Wellness Visit appointment, contact your SPG primary care provider.
Comments Off on Pumpkins Earn Superstar Status All Year Long
A real sign that fall is approaching is when pumpkin spice is included in so many delicious drinks and coffees, snacks and desserts as well as wonderful hearty and savory foods. Truth be told, pumpkins are not just for the fall. According to Registered Dietitian and Certified Diabetes Educator Tiffany Rios, of Shore Physicians Group, pumpkin is a superstar that can supply its delicious nutritional benefits all year long.
Why Is Pumpkin a Must Have Food? As Rios explained, adding pumpkin to your diet packs a big benefit. “Pumpkins are a nutrient-dense food that are also low in calories. They are 90% water and contain 83 calories with less than 1 gram of fat. They are very high in fiber which takes the stomach longer to process. This helps you feel full for a longer time.”
Trust Your Gut The mighty pumpkin packs healthy digestive benefits as well. “High fiber foods feed healthy gut bacteria which plays a great role in health and immunity,” said Rios. “It’s low in saturated fat and high in minerals like magnesium, which make pumpkin a healthy food choice. It is also loaded with beta carotene, an antioxidant that may help protect against cancer, fight inflammation and improve skin appearance. It can also increase the skin’s defenses against UV radiation.”
The Eyes Have It Vitamin A plays a crucial role in vision by maintaining a clear cornea, the outside covering of the eye. One cup of cooked pumpkin provides 245% of the recommended dietary allowance of Vitamin A, according to Rios.
Pick Your Pumpkin While we are thinking pumpkin pies and pumpkin spiced muffins, there are much healthier ways to get the nutrients from pumpkins and subtract all the sugar. That grande pumpkin latte that tastes so yummy at your favorite Starbucks packs a wallop. When it’s made with two percent milk and whipped cream, it adds up to 380 calories, not to mention 14 grams of fat, 52 grams of carbohydrates and 50 grams of sugar. The American Heart Association’s recommended daily allowance of sugar is 25 grams. Rios suggested a little cinnamon and stevia to give pumpkin a delicious flavor minus the sugar. But she suggested energy bites, pasta sauce, healthy cookies and roasted pumpkin seeds as excellent and varied ways to enjoy the best pumpkins have to offer.
Comments Off on Which COVID 19 Test Should You Get?
The pandemic, COVID 19, its vaccine and testing are constantly in the news. But do you understand how the tests work and which is the most appropriate for you?
How the PCR Test Works Dr. John Kulin, DO, FCUCM, physician at Shore Urgent Care in Northfield explained the differences in the two basic COVID 19 tests – the PCR test and the antigen test. Dr. Kulin said the COVID Polymerase Chain Reaction or PCR test is a laboratory-based molecular test that is the gold standard for COVID testing. “It is the most accurate form of testing we have readily available. The PCR detects the virus’s genetic material,” said Dr. Kulin. “Results take from 36 hours to 7 days to return from the lab.”
Understanding the Antigen Rapid Test Dr. Kulin went on to explain the rapid test, or COVID antigen test, is what is called a Point of Care (POC) test. “The antigen test looks for specific proteins on the surface of the virus. It can be done in any office or urgent care setting that is licensed to perform POC testing.” Dr. Kulin explained that can provide rapid results, in roughly 15 minutes, but states, “The antigen test is not as accurate overall as the PCR test.”
When Should a Person Be Tested? “People should be tested as soon as they develop COVID-19 symptoms or if they have had a high risk exposure to someone diagnosed with COVID,” according to Dr. Kulin. “A high risk exposure is defined as being exposed to a person with known suspected COVID 19 and has close contact exposure.” According to the Centers for Disease Control and Prevention, close contact exposure is defined as being within 6 feet for a total of 15 minutes or more over a 24-hour period.
Exposure to an individual would include the two days before they began to show COVID 19 symptoms or if they have no symptoms in the two days prior to testing. Dr. Kulin suggests it is best to wait three to five days after a suspected high risk exposure to get tested, which will increase the likelihood that the test will give a valid result. Testing too soon, like someone running to be tested the day they are exposed, will probably lead to a negative result because the viral particles will not have been replicated enough at that point to be detected.
What is the Most Effective? The PCR test is the most accurate and effective in all people, according to Dr. Kulin. The antigen testing has proven to be almost as accurate in patients who have two or more symptoms and are tested within the first five days of symptoms.
The PCR or molecular test is much more sensitive at picking up the presence of the virus in asymptomatic people. For those patients without symptoms, Dr. Kulin said the antigen test is much less sensitive, meaning there is a higher percentage of false negative tests. “Your ordering medical provider will assess each person’s symptoms, exam and exposure risk when deciding which test is the best to order,” added Dr. Kulin.
Reason for a False Testing Result Not obtaining a good or proper sample is the most frequent reason for a false negative COVID test result. The PCR test requires a specimen to be obtained from the back of the nose to be accurate, according to Dr. Kulin. He added that false positives are a part of all testing as well and related to the testing type.
The Difference Between Seasonal Flu and COVID 19 COVID 19 and seasonal flu symptoms are very similar and people can contract both at the same time. Dr. Kulin explained that both COVID 19 and the flu can have varying degrees of signs and symptoms, ranging from being asymptomatic with no symptoms to severe symptoms.
Common symptoms that COVID 19 and flu share include: fever and chills, cough, shortness of breath or difficulty breathing, fatigue, sore throat, runny or stuffy nose, muscle pains or body aches, headache and some people may have vomiting and diarrhea, though this is more common in children than adults. “COVID 19 seems to cause more serious illnesses in some people,” said Dr. Kulin. “Other signs and symptoms of COVID 19 that differ from the flu may include a change or loss of taste or smell.”
What’s the Hold Up? The sheer volume of testing being done right now is slowing down the process and is the main reason it is taking so long for the results to be returned for COVID 19 testing. “The national labs have been overwhelmed. There are also supply shortages including testing swabs and viral transport media,” said Dr. Kulin. He added that Shore Urgent Care has been lucky to have a relationship with a New Jersey-based lab that typically been returning results in 48 hours or less.
For more information on COVID testing at Shore Urgent Care, click here.
Shore Urgent Care, located at 2605 Shore Road in Northfield has newly expanded hours 8 a.m.-8 p.m., Monday through Friday, 9 a.m-5 p.m. Saturday and Sunday. Drug screenings are available Mon-Fri. 10 a.m.-5 p.m.
Comments Off on Is it Safe to Get Multiple Vaccines?
Traditional Cold and Flu Season Vaccines are a hot topic as we move into the traditional cold and flu season and flu vaccine clinics are widely available. Crowding the vaccine discussion is the highly anticipated Covid 19 vaccine, though still in development, it is on the fast track for approval and the first rounds of distribution within the next few months. Time and science will tell if the Covid 19 vaccine will be a single injection or a two-dose vaccine. Pneumonia is also a concern during the winter months, especially for the over 65 population. The Center for Disease Control and Prevention (CDC) is encouraging routine vaccines.
Rolling up Your Sleeve Should people be concerned about getting the flu vaccine and then the Covid 19 vaccine within a few months and for seniors, factoring in the pneumonia vaccine? Ambulatory Pharmacist, Dr. David Totton, PharmD, of Shore Physicians Group specializes in taking a comprehensive medical assessment of each patient’s prescription medications and vaccinations along with any herbal supplements and over the counter products. According to Totton there is no reason to be concerned about getting the vaccines in close proximity.
According to Dr. Totton, “As outlined by the CDC, Scientific data show that getting several vaccines at the same time does not cause any chronic health problems. When every new vaccine is licensed, it has to be tested along with the vaccines already recommended. All approved vaccines have been shown to be as effective in combination as they are individually. Furthermore, it is already common practice to give multiple vaccinations at once and some formulations even contain multiple vaccines combined into one shot. These vaccination strategies have all been proven to be safe and effective.”
Adding Shingles and Pneumonia Vaccines into the Mix Both the shingles and the pneumonia vaccines are fairly common for seniors, but should those over 65 be concerned about getting them this year along with their annual flu shot with the knowledge of the Covid 19 vaccine on the horizon? Dr. Totton said it is best to proceed with routine vaccinations as recommended. “Delaying vaccination only prolongs the time in which you lack protection from preventable diseases and put you and your family at greater risk. The newer shingles vaccine, Shingrix is recommended for all adults over the age of 50. Pneumonia vaccination is routinely recommended for adults age 65 and older but may be given sooner depending upon your other health problems, smoking status and risk of pneumonia,” said Dr. Totton.
Can you overload on Vaccines? “There is no such thing as an overload of vaccines,” said Dr. Totton. “Our current vaccination schedule and recommendations are the culmination of decades of research into proper vaccine timing. As mentioned earlier, all approved vaccines are tested in combination with one another as recommended to ensure they are producing the immune response that we need while also maintaining the health and safety of the patient.” Totton advised that patients should discuss any questions related to vaccines with their primary care physician at their next appointment.
Importance of vaccines during pandemic According to the CDC, efforts to reduce transmission of Covid 19 such as stay-at-home and shelter-in-place orders, have led to decreased use of routine preventive medical services, including immunization services. Ensuring that routine vaccination is maintained or reinitiated during the COVID-19 pandemic is essential for protecting individuals and communities from vaccine-preventable diseases and outbreaks. Routine vaccination prevents illnesses that lead to unnecessary medical visits, hospitalizations and further strain the healthcare system. For the 2020-2021 influenza season, flu vaccination will be paramount to reduce the impact of respiratory illnesses attributed to influenza in the population and resulting burdens on the healthcare system during the pandemic. Communicating the importance of vaccination to patients and parents/caregivers as well as the safety protocols and procedures outlined in this guidance can help provide reassurance to those who may otherwise be hesitant to make an appointment for vaccination visits.
CDC Vaccine Recommendations during the Pandemic According to CDC guidelines, routine vaccination is an essential preventive care service for children, adolescents, and adults (including pregnant women) that should not be delayed because of the COVID-19 pandemic. Because of COVID-19-related reductions in people accessing vaccination services, the CDC is reminding all physicians that it is important to assess the vaccination status of all children and adolescents at each patient visit to avoid missed opportunities for vaccination and ensure timely vaccine catch-up. All vaccines due or overdue should be administered according to the recommended schedule, unless a specific contraindication exists, to provide protection as soon as possible as well as minimize the number of healthcare visits necessary.
Dr. Totton is seeing patients at all Shore Physicians Group’s primary care offices. To make a Medicare Annual Wellness Visit appointment, contact your SPG primary care provider.
Comments Off on Understanding Common Football Injuries
Football is back! The pandemic has created cancellations, delays and disruptions but college and professional sports have returned and unfortunately, so have many of the injuries that athletes encounter on the field. Shore Physicians Group Orthopedic Surgeon Dr. Mickey Bui treats many sports related injuries from varsity players to weekend warriors.
Kinds of Sports Injuries We hear the injury reports each week; separated shoulders, ACL tears, high ankle sprains, and rotator cuff injuries. But what are they, how severe are they and how long will my favorite player be sidelined? Dr. Bui said that recovery time is dependent upon the severity of the injury and if surgery is required or if the athlete is able to recover through rehabilitation and physical therapy.
Mounting injuries Dr. Bui said media analysts and sports physicians alike are discussing the possible reasons this football season has been marred with so many injuries already. “It could be due to the lack of a pre-season and shortened training camp due to Covid 19,” said Dr. Bui. “Likewise, the stickiness of the synthetic turf that the games are played on can lend to injuries, especially at specific stadiums like the Meadowlands where the New York Jets and the New York Giants both play their home games. He specifically mentioned the September 20 game at the MetLife Stadium that resulted in a number of players suffering ACL tears that sidelined players.
What we Knee(d) to Know Even the strongest athlete can find themselves on crutches from knee and ankle injuries. Often while watching a game the announcer will mention players who are out with an anterior cruciate ligament (ACL), a medial collateral ligament (MCL) or a lateral collateral ligament (LCL) tear. Dr. Bui offered some insight into what constitutes those injuries and how long before the player can get back into the game.
“A crude rule of thumb for ligament injuries is: no surgery when sprained and surgery when torn. Saquon Barkley of the NY Giants and Nick Bosa of the 49ers are just two of the stars recently to have torn their ACL’s, which is the most common knee ligament injury. The ACL is inside the middle of the knee and it stabilizes the knee during cutting and twisting maneuvers,” said Dr. Bui. “It also prevents the development of knee arthritis later in life by stabilizing the knee.”
Using an analogy, Dr. Bui said to think of a knee injury like driving on wheels with loose lug nuts and therefore having wobbly wheels. “The MCL and LCL are on both sides of the knee and prevent the knee from being bow-legged or knock-kneed. They can be injured with a blow to the side of the knee.” According to Dr. Bui, a sprain can often recover in 4-6 weeks with a brace but a full tear is a season-ending injury.
Explain the Sprain A sprain is a common grid iron injury whether you are a Philadelphia Eagle or a weekend warrior playing flag football with friends. Dr. Bui explained that a regular sprain would be considered a low ankle sprain, similarly rolling the ankle is really the same thing and probably the most common injury for all athletes. Those sprains occur in the area where the ankle ligaments connect the leg to the foot.
“Sprains rarely need surgery but recovery can range from ‘walking it off’ to two to three months out of the game. Surgery is only for people who have recurrent sprains resulting in a chronically unstable ankle,” said Dr. Bui. “A high ankle sprain is actually an injury to ligaments that connect the two bones of the leg itself, the tibia and fibula. They also rarely need surgery, but do take a longer time to heal, usually 3-4 weeks, minimum.
Shouldering the Pain It is not an uncommon sight to see a football player leaving the field after a particularly rough tackle holding one arm motionless and the injury report is later a separated shoulder. Dr. Bui explained the dynamics of the injury by first spelling out the anatomy of the shoulder. The shoulder is comprised of two joints: the main joint is the glenohumeral joint which is the ball and socket and it is the main part of the shoulder that moves when the arm moves. When this pops out of place it is known as a shoulder dislocation.
The second joint in the shoulder is the acromioclavicular joint. It connects the collarbone to the shoulder blade with a series of ligaments and there is barely any motion here. The joint functions to connect the arm to the torso. “When these ligaments are torn at the AC joint, it is called a shoulder separation because one of the connections between the torso and the arm is torn off,” said Dr. Bui.
Repairing a separated shoulder and getting the patient back on the field is very individualized. “Mild separations can heal in one to three weeks in a sling. There are multiple ways to fix shoulder injuries, both open and arthroscopically, all with similar results,” said Dr. Bui.
A Pain in the Hip Many athletes suffer with hip pain making it hard to compete at an optimum level. Dr. Bui explained a common cause for hip pain is a hip labral tear. “Unlike shoulder labral tears which are usually due to a loose shoulder, hip labral tears are due to a tight hip. Hip labral tears can also occur in the one-normal hip of athletes who ask their hips to do extreme motions: gymnasts, cheerleaders, baseball infielders and catchers, soccer players and hockey players. The pain often comes on slowly and often players can play through the season, and we will shut them down for treatment during the off-season to try and get them back on the field without missing any time.”
Rotator Cuff Injuries are Not Kid’s Stuff Weekend warriors and older athletes are prime targets for rotator cuff injuries according to Dr. Bui. “Rotator cuff injuries are very rare in young people, athletes or not,” said Dr. Bui. “In fact, rotator cuff tears happen for very minimal injuries in middle aged people and for no reason at all in older people. We are lucky this barely happens in young people because a rotator cuff repair surgery is usually career ending in a competitive, overhead athlete who use their upper arm and shoulder to throw. If the patient has a completely torn rotator cuff muscle, surgery is usually the best answer for shoulder function.” Dr. Bui added, “Many tears or partial tears can be rehabbed without surgery.”
For more information about sport injuries or to schedule an appointment with Shore Physicians Group’s Orthopedic Division call 609-365-6280.
Comments Off on Is My Flavored Seltzer Bad for My Health?
Pop, Fizz, oh what a gas Pop the tab or unscrew the cap on your favorite carbonated beverage and you hear an instant pop and fizz. It tells your senses that a beverage is ready to enjoy, but there is science behind that distinctive sound. These drinks are mostly water with added carbonation, or CO2. The CO2 makes the pressure inside the can or bottle far greater than the outside air pressure, and the sound you hear is the initial pressure equalizing itself. C02 is added to soda, sparkling water and the very popular flavored seltzers, but be careful. That fizzing sound you hear may keep the drink from going flat, but the carbonation may be wreaking some havoc on your bladder, according to Shore Physicians Group Urologist Dr. Meredith Jankowski, a Penn affiliated surgeon.
“The carbon dioxide that is used to give drinks their bubbles can be a real bladder irritant, just like caffeine, alcohol, and spicy food.”
Healthier but not exactly healthy In the last five years sales of carbonated, flavored sodas has declined while sales of flavored seltzers and sparkling waters has grown. According to Beverage Industry Magazine, sparkling water and seltzer sales have increased 15.8% over the past four years. Without the sugar and coloring, you might think seltzers and sparkling waters are the healthy choice over traditional soda.
“I give kudos to those who were steady soda drinkers and have switched to flavored seltzers. They have eliminated the sugar that can lead to problems like kidney stones, weight gain, tooth decay, a higher risk of heart disease and type 2 diabetes,” said Dr. Jankowski. “But the carbonation is still going to create the same type of irritation as soda which is an urgency or frequency to urinate. The irritation is like a tickle you can’t scratch.”
Dr. Jankowski explained the irritation from the seltzers or coffee and ice tea are not doing any permanent damage to the bladder, it just may increase that full-bladder feeling and trips to the bathroom. She added that the seltzers often contain some kind of citric acid that can actually help to cut down on kidney stones.
“My real concern is when people think they have made the healthy choice by eliminating soda and use the seltzer in place of water. Seltzer is not water. What the body needs to be properly hydrated is water and it is really important for anyone to remember to drink about 50 oz. of water each day.”
Dr. Jankowski said she recognizes that is not always easy or convenient to drink 50 oz. of water every day but it is what the body needs to be at its optimum performance level. “The most important thing for people to remember is that only 25% of their daily intake of fluid should be from sources other than water.”
How can we tell if we are properly hydrated? Dr. Jankowski said urine should be clear and pale yellow in color. Dark or honey colored urine suggests the individual is not drinking a sufficient amount of water.
Dr. Jankowski added that people who enjoy popping the top on a hard seltzer should be cognizant that the alcohol in their spiked seltzer is four to five percent alcohol and is a diuretic along with being a bladder irritant and may deplete the body of water it needs to function properly.
“I advise people to remember when they are drinking alcohol to also drink water so they remain hydrated.”
