Author Archives: Joe Hilbert

  1. Should You Take a Multivitamin?

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    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.

  2. Pumpkins Earn Superstar Status All Year Long

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    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.

    Rios said adding pumpkin to a sauce and putting it over zucchini noodles, sneaking it into healthy cookies or even adding it to a smoothie are other great ways to incorporate pumpkin in your diet.

    To make an appointment with Tiffany Rios at the Shore Physicians Group office in Northfield call 609-365-5300.

  3. Which COVID 19 Test Should You Get?

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    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.

  4. Is it Safe to Get Multiple Vaccines?

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    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.

  5. Understanding Common Football Injuries

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    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.

  6. Is My Flavored Seltzer Bad for My Health?

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    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.”

  7. Is Food Giving You a Headache?

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    If you enjoy your lunch but find yourself an hour later with a pounding headache do you blame it on your neighbor’s dog barking? Or when it happens more frequently, do you look at your lunchbox and question if the foods you are eating could be the source of your headache?

    Tiffany Rios, registered dietitian and certified diabetes educator with Shore Physicians Group, said there are a wide variety of causes for headaches including illnesses, food or chemical allergies, back or neck strain, aspartame, artificial sugars, heredity, and hormone imbalance among others. Rios pointed out that in Today’s Dietitian Magazine it spells out how certain foods can trigger neurovascular and neurochemical effects, mostly by way of causing inflammation. . Chemicals like tyramine, octopamine, phenylethylamine, and histamine can be produced by our body in response to certain foods and can exacerbate inflammation that may trigger a headache.

    Everyone’s Body Reacts Differently
    “The response to food is very individualized,” said Rios. “Sodium and nitrates can cause a reaction in many people. High sodium amounts in foods can deplete fluids and cause dehydration and in turn headaches.” She explained that people who overindulge in wine may well find themselves with a headache but if a small amount of wine still results in a headache, then it is possible the tannins and nitrates in the red wine are the culprits.

    As a registered dietitian Rios will tell her patients to eat avocados for their nutrition content, but she added that they should not eat overripe avocados or bananas because they become high in tyramine when they are past their prime and can cause headaches.

    Common Foods that May Trigger Headaches

    • Aged cheese (bleu cheese, cheddar, feta, gorgonzola, parmesan, and Swiss)
    • Alcohol, especially wine
    • Canned soups
    • Canned or processed meats
    • Beans (fava, garbanzo, lima and pinto)
    • Chocolate
    • Nuts
    • Olives
    • Onions
    • Over ripe avocados, tomatoes and bananas
    • Raisins
    • Smoked and pickled foods
    • Soy Sauce

    How to Avoid Headaches
    Hydration is a key to feeling good and Rios said she advises patients if they are drinking any alcohol, even in moderation, to remember to stay hydrated. “Alcohol is a diuretic and it is important to counterbalance the alcohol with water. Drink a glass of water between drinks. Coconut water is also a good choice.”

    “I take a holistic approach to each patient and address all of their concerns through food and nutrition,” explained Rios. She advises her patients to have body awareness -noticing what foods cause headaches. Consuming most food from nutrient dense sources and staying hydrated are all strategies to prevent and combat food-related headaches.

    She also advises patients to avoid foods with a lot of additives, dyes, MSG and high sodium. Another choice if headaches persist is to consider allergens and discuss having a Mediator Release Test (MRT) panel run that screens for allergies.

    If You Bite It, Write It
    Keeping a food journal will go a long way to help identify the foods that may be triggering headaches. Rios suggests her patients write everything down for at least one week and then review that food log with the dietitian to better understand which foods are good choices and, in some cases, what might be a better choice.

    To make an appointment with Tiffany Rios, RD, CDE about healthy food planning or weight loss call 609-365-5300.

  8. #Shorehealthcareheroes: Shore Physicians Group’s Certified Medical Assistants

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    Bethel Road Office: Left to Right, Gyorgi Szaniszlo, Victoria Carrero, Lisa Nickel, Theresa Grey, Kerry Burns, Patricia Taylor

    We are proud to celebrate Shore Physicians Group’s Certified Medical Assistants who have been true #shorehealthcareheroes throughout the pandemic. The traditional responsibilities of these healthcare professionals include a variety of clinical and administrative functions to help our patients and assist our providers. With the pandemic, however, “traditional” was no longer an option, and they had to adapt and react to a new set of rules and expectations. In a matter of days, SPG consolidated its offices, and telehealth became the primary conduit for patient/provider interaction.

    “When we initially consolidated offices and transitioned to 70 percent of our patient interactions via telehealth, our certified medical assistants didn’t skip a beat,” explains Lindsay Richter, Director of Operations for Shore Physicians Group. “Our Certified Medical Assistants were responsible for transitioning all office appointments to virtual appointments and assisting our patients with connecting to their providers. In addition, they were supporting the providers who continued to see patients in the office.”

    Practically overnight, the medical assistant staff had a complete change in workflow. Everyday tasks became more complex with technology being the new way to deliver service to patients. They were doing most of their work virtually rather than seeing patients in the office, performing intakes, prepping charts and more. They even helped troubleshoot when patients had difficulty connecting via telehealth with their providers.

    “We have an incredible team of Certified Medical Assistants, who adapted, came together and persevered through teamwork,” added Richter.

    On June 1, Shore Physicians Group opened all of its offices, and once again the Certified Medical Assistants needed to switch gears and readjust to another “new normal” and brand-new set of challenges.

    “Now that we are seeing 70 percent of our patients in the office, our medical assistants are screening patients, disinfecting surfaces and equipment, escorting patients in and out of the building, while completing their everyday tasks,” said Richter. “Even now, they do not go to the lobby to bring the patients to the exam room like they used to do. They go to our patients’ cars, and take their temperatures and screen them prior to them entering the building. They still manage to care for our patients who are on site and off site with a positive attitude, despite the increased workloads.

    “Their ability to adapt has been incredible, and we are so proud of them. We would never have been able to support our providers and patients, along with keeping our facilities safe for us all, without our incredible medical assistants. They are all #shorehealthcareheroes.”

  9. Do You Have Antibodies to Covid-19?

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    Much has been discussed about the role of antibodies to the COVID-19 virus. But what are antibodies?

    Shore Physicians Group Primary Care Physician Dr. Michael Giunta answers these questions and more.

    Infection with COVID-19, like other viruses, produces an antibody response. Antibodies are proteins that are produced by the immune system to help stop intruders from harming the body. There are several types of antibodies that form either by exposure to a specific “intruder” or through vaccination. For example, the measles vaccine is given so the body generates a defense (antibodies) against measles, should you come into contact with that threat.

    Similarly, there is now testing available at Shore Medical Center that can detect the presence of antibodies. All asymptomatic patients are eligible to have this testing performed. It is a blood test that the FDA has made available under an Emergency Use Authorization (EUA). Antibodies most commonly become detectable 1-3 weeks after symptom onset.

    According to the American Medical Association, serology tests should not currently be used as the basis for any “immunity certificates,” to inform decisions to return to work, or to otherwise inform physical distancing decisions. Doing so may put individuals, their household and their community at risk. Serology tests should also not be used as the sole basis of diagnosis of COVID-19 infection.

    The American Medical Association has provided additional guidance for antibody testing: Use of serology tests should currently be limited to population-level seroprevalance study, evaluation of recovered individuals for convalescent plasma donations, and in other situations where they are used as part of a well-defined testing plan and in concert with other clinical information by physicians well-versed in interpretation of these results.

    COVID 19 presents many unknowns. It is best to discuss any testing decisions with a healthcare provider in the proper clinical setting. We have providers readily available to discuss any concerns you have!

    Dr. Giunta, and all Shore Physicians Group Primary Care providers are available for appointment to discuss COVID-19 antibody testing with you. For an appointment with Dr Giunta, who treats patients at the Shore Physicians Group office located at 401 Bethel Road in Somers Point, call 609.365.6200.

    All Shore Physicians Group offices are now open.

  10. Diet and Wellness Tips for You and Your Family

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    During these challenging times many of us are struggling with a mixture of emotions, lack of routine and structure, and stress. How we manage these emotions and stressors can impact our overall mental, emotional, and physical health as well as our susceptibility to illness.

    Tiffany Rios, Shore Physicians Group’s Registered Dietician and Certified Diabetes Educator, shares with you some tools and strategies to manage your nutrition and wellness during this difficult time.

    1. If you find yourself mindlessly eating or emotionally eating in response to stress, create a list of non-food related rewards. Things like going for a walk, hugging your children, journaling, facetime with a friend/family member, or listening to your favorite music, are all examples of activities that can help us with soothing difficult emotions.
    2. Before you eat do a “gut check”: Rate hunger levels before eating, try to eat when you’re a 3 (Hungry but not starving) and stop when you’re a 6 (satisfied but not stuffed). If you are finding you are not a 3 and reaching for food, try one of the soothing/non-food related rewards. Drink 16 ounces of water with lemon and wait 30 minutes. If you’re still reaching for food- check again to see what level your hunger is at.
    3. Try Downloading helpful apps to manage stress such as: Headspace / Eat Right Now. Both aimed at improving awareness, mindfulness, and supporting reduction in emotional eating.
    4. If you’re cooped inside with kids, see if you can cook meals together and learn new recipes. This may serve as a great distraction and family activity.
    5. Exercise is imperative for our mental and physical health, aim to move for 30 minutes a day, outside if possible to maximize Vitamin D.
    6. Try adhering to an eating schedule; Eating 3 balanced meals daily about 4 hours apart. An example might be: breakfast and 9, lunch at 1 and dinner 6-7, can promote normalcy and help balance blood sugars. Avoid eating meals late at night which can impact sleep ( a very important piece of health)
    7. With limited visits to the Supermarket, you may need to make your groceries stretch. In addition to fresh produce, try purchasing some healthy items with longer shelf lives such as: frozen fruit/vegetables, canned beans/tuna, and dry oats/unsalted mixed nuts, and protein powder. Have a mixture of healthy pantry items to whip up a healthy meal.
    8. Do one thing for someone else daily. Research shows helping others builds positive emotions.
    9. Make sure to get ample Vitamin C and D, both important for our immune system. Oranges, Broccoli, and peppers are high in Vitamin C, whereas egg yolks, salmon/sardines, and Greek yogurt boost our Vitamin D levels.
    10. Stay connected with friends and family- having a sense of community is a known factor in mental and emotional health.

    Finally, we all know these are challenging and unprecedented times. Each day give yourself credit for one positive thing you did for your health that day. With all of the negative going on it’s important to remember to encourage ourselves to continue doing positive.

    I hope you will find these tips to be helpful. And, from me and my family, thank you to all of our healthcare workers!

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