Category Archive: Physician Articles

  1. Hernias and the Battle of the Bulge

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    A newly discovered bulge that has suddenly surfaced in the abdomen or groin area accompanied by pain could be the first sign of a hernia. Dr. John Millili of Shore Physicians Group in Somers Point, New Jersey said while hernias are quite common, you should not ignore them.

    What is a Hernia?

    Dr. Millili explained a hernia is when an organ such as the intestine or even fat will push through an opening or weakness in the muscle wall or tissue of the abdomen. Typically, the first symptom of a hernia is a bulge accompanied by tenderness or pain in that area. Sometimes the bulge will appear to get smaller when they lay down. That is misleading, according to Dr. Millili who said the bulge itself does not get smaller. Instead, the forces on it decrease when they recline. It is not going away. Over time that bulge will likely increase in size and be accompanied by a dull ache. Someone with a hernia will often complain of pain while lifting or experience a sense of feeling full. Occasionally hernias will not have any symptoms and will be discovered during a routine physical exam for an unrelated problem.

    Types of Hernias

    Although there are many different types of hernias, Dr. Millili explained that 95% of them fall into four categories:

    • Inguinal hernia- An inguinal hernia is a bulging of the abdominal contents through a weak area in the lower abdominal wall. Inguinal hernias can occur on either side of the groin, according to Dr. Millili, at the inguinal canals, which are the two passages through the lower abdominal wall. Although hernias are more common in men, a small percentage of women may develop inguinal hernias as well. An inguinal hernia in women may contain part of the female reproductive system, such as an ovary. When this occurs, the peritoneum, the abdominal cavity lining, bulges through a weak area in the abdominal wall.
    • Incisional hernia-An incisional hernia may develop after any type of abdominal surgery when there is a weakness in the abdominal wall. The weakness could allow tissue or an organ to push through and form a hernia. The first symptom of an incisional hernia might be a bulge near the previous incision accompanied by pain, according to Dr. Millili.
    • Umbilical hernia-As its name indicates, the umbilical hernia occurs in the belly button area, where the umbilical cord passed through. Here fat or occasionally intestine will protrude through. The first indication of the hernia will be a bulge near or below the belly button. The bulge, along with the discomfort, is most often noticed when straining or coughing.
    • Ventral hernia-Dr. Millili explained a ventral hernia might occur anywhere along the abdominal wall. He added that surgery to repair the ventral hernia can be complex due to the other organs along the abdominal wall.

    What to do first

    At the first sign of a bulge, Dr. Millili suggests that patients contact their primary care physician who will assess the bulge and then direct the patient to a specialist or a surgeon. “The primary care physician will determine if their patient has a hernia that may need surgery,” said Dr. Millili. “Don’t wait for the pain to go away or for the bulge to go away on its own. It is not going to. If it is a hernia, the patient will need surgery to resolve it.” Surgery for a hernia can be either laparoscopic or open. Dr. Millili said it depends on several factors including the size of the hernia and any other organs that might be near the hernia.

    Dr. Millili said the surgery typically can be completed on an outpatient basis, with a return to normal activities in several weeks. One of the complications of not addressing the hernia quickly, aside from the discomfort of the hernia, is the onset of sudden pain from an incarcerated or strangulation hernia. “This is when the organ, normally the intestine, pushes the wall of the abdomen and the blood flow to that portion of the protruding organ is cut off,” said Dr. Millili. “This is an emergency when it occurs. The organ can suffer necrosis if the blood flow is cut off. This is a “middle of the night” type of emergency surgery when there is an incarcerated or strangulation hernia.”

    Contributing Factors to Hernias

    Dr. Millili said anyone could get a hernia. However, several contributing factors make it more likely for someone to develop a hernia. Examples include, athletes or people whose jobs require them to routinely lift a lot of weight; people with obesity; and smokers and people with COPD. He did add that having one hernia does not mean the person is necessarily prone to have another. There are complications for not taking care of a hernia while it is smaller, such as a bowel obstruction.

    Other factors that make the hernia more uncomfortable include straining while in the bathroom, coughing or lifting anything heavy. Dr. Millili suggested avoiding those things that will cause any more discomfort.

    The good news is that the hernia can be repaired. Dr. Millili said on average a person will be out of work for two weeks and back to their normal activities within a month.

    To schedule an appointment with general surgeon Dr. Millili at his 649 Shore Road office in Somers Point, visit or call 609-365-6239

  2. Is Something Uninvited Lingering at Your Summer Barbecue?

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    Summer is a great time of year for spending days outdoors with friends and family at the pool and at the beach. Summer barbecues are a big and fun part of the summer scene. But if the host is not vigilant, or if they purchased something that might be contaminated, what can come along with those barbecues is a most unwelcome guest – foodborne illnesses.

    According to Dr. Steven Cetel of Shore Physician Group, some of the more common foodborne illnesses are salmonella, campylobacter, E. coli, listeria, clostridium botulinum (botulism) and norovirus. Dr. Cetel said the norovirus is one that is easily spread on cruise ships due to the close personal contact.

    The Food and Drug Administration considers when two or more people get the same illness from the same contaminated food or drink, the event is called a foodborne illness outbreak. The FDA investigates outbreaks to control them, so more people do not get sick and they learn how to prevent similar outbreaks from happening in the future.

    Turn up the Heat

    Even if you love a juicy, rare hamburger right off the grill, it might not be the best plan. Dr. Cetel advised that undercooked meats and seafood are a high risk for foodborne illnesses. “They usually have some viruses and bacteria already in the meat and cooking them fully kills the germs so we do not get infected,” said Dr. Cetel. He added that any handling of raw foods, including eggs, requires hand washing and cleaning the surface before touching anything else.

    Contracting Foodborne Illnesses

    Dairy products and the sun do not make a good match. Dr. Cetel advises that foods containing dairy and those with mayonnaise like potato salad or chicken salad should not be left out for longer than 1-2 hours. With warmer temperatures, that time is reduced. “Bacteria grow and spread much quicker at warmer temperatures. Refrigerating dairy helps to keep bacteria from growing to the point where it could cause any symptoms,” said Dr. Cetel. “The most common way people will contract any foodborne illness is by eating undercooked or spoiled foods. We can also contract them from person-to-person contact.”

    The Centers for Disease Control and Prevention estimates that 1.5 million people in the U.S. get sick annually from Campylobacter, the most common bacterial cause of intestinal distress. The source is normally raw or undercooked poultry or anything prepared nearby that touched it. It can also be contracted as a result of contact with animals or drinking untreated water.

    Avoiding Illnesses

    Dr. Cetel advised cooking meat and seafood fully as the best defense against getting sick. He added that food should not be left outside unless it is in a cooler during in warmer temperatures. Additionally, Dr. Cetel recommended taking basic precautions, like washing hands regularly, especially after using the restroom, and not touching your face helps you prevent the spread of illness when working in the kitchen.

    Listeria is another culprit in many foodborne illness cases each year. It can be found in raw vegetables and fruits like cantaloupe due to contaminated soil or from contaminated manure that was used as a fertilizer. It can also come from unpasteurized milk and certain processed foods like soft cheeses, hot dogs and deli meats, according the FDA. The rule of thumb here is to keep foods cold, wash fruits and vegetables before eating them, and wash hands frequently.

    Symptoms and Treatment of Foodborne Illness or Food Poisoning

    Dr. Cetel said that food poisoning symptoms will come on about 6-8 hours after the exposure to the spoiled food. Symptoms include nausea, stomach cramps, vomiting and diarrhea. “The best way to treat these symptoms is to make sure you stay hydrated. Most of the time antibiotics are not needed and the symptoms will go away within a few days. Limiting solid food intake for a day or so can be helpful to allow the GI tract to heal. The BRAT diet (bananas, rice, apple sauce and toast) is best introduced slowly. When the GI tract is inflamed it does not absorb food well early on and it can make the symptoms worse. The BRAT diet is a good start as those foods are easily digested.

    To make an appointment with Dr. Steven Cetel of Shore Physicians Group in the Northfield office, located at 2605 Shore Road, call 609-365-5300 or in the Margate office located at 9501 Ventnor Avenue in Margate, call 609-822-4800.

  3. What is Making Me Sneeze?

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    Beautiful flowers, grass and budding trees are everywhere in the spring and while nature is certainly a season to marvel, those same flowers and trees may wreak havoc on people who suffer with seasonal allergies. The tree pollen allergy is at its peak from March through mid-May. Grass pollen is at its peak season from mid-May to mid-July and ragweed season runs from mid-August through the first frost.

    Beware of the Invaders

    According to Dr. David Totton, Ambulatory Pharmacist with Shore Physicians Group, “An allergy is basically the body’s immune system responding to a substance it identifies as an invader. The body sees it as foreign and the immune system has an allergic response to that invader,” said Dr. Totton. “This time of year, pollen is the most common allergen.”

    The immune system does more to protect the body. As Dr. Totton explained, the immune system recognizes this invader, resulting in mast cells sending a message to release histamines. Those histamines boost blood flow in the area where the immune system detected the invader. If it is pollen, the immune system will launch the trigger, sending histamines to the nose and prompting the thin membrane walls to produce more mucus. That mucus in turn will cause a runny nose, trigger sneezing and may result in coughing and watery eyes; classic allergic reactions.

    The Job of Antihistamines

    In the midst of allergy season people are reaching for something to squelch the nagging sneezing, runny nose and watery eyes. For many, antihistamines will do the trick. Dr. Totton said there are histamine receptors all over the body but said the seasonal type allergies due to pollen and grasses normally affect the lungs and the nose. Antihistamines will suppress or block the histamine-induced response in the body, normally swelling, and it will stop the sneezing, itching, sore throat and watery eyes.

    Types of Antihistamines

    There are different types or strengths of antihistamines, and some will cause drowsiness. As Dr. Totton explained, there are two generations of antihistamines. The first-generation antihistamines block histamine receptors and also cross the blood-brain barrier and block central nervous system and cholinergic receptors as well. These may cause drowsiness, headache and dry mouth, nose and throat. Dr. Totton said diphenhydramine products such as Benadryl are among those first-generation antihistamines that have the unwanted side effect of sedation.

    Shore Physicians Group Ambulatory Pharmacist services include:

    • Medicare Annual Wellness Visit (No copay) Available In Office or Via Telehealth
    • Comprehensive Medication Review:
      • Are all your medications safe and effective for you?
      • Is the Medication you’re on appropriate for all health conditions?
      • Are there any potential interactions between medications that could increase side effects, or reduce effectiveness?
      • Can you save money on your current medications?
    • Answer Your Medication Related Questions:
      • When is the best time to take the medication?
      • Should you take them with/without food, and can you safely take them with your supplements?
    • Review over-the-counter products including, vitamins and supplements
    • Comprehensive Health Risk Assessment
    • Assess Vaccination History
    • Complete Routine Preventative Screenings
    • Many more services included

    Ask to schedule a visit with Ambulatory Pharmacist Dr. Totton when you see your primary care provider.

  4. What is that Tingling in Your Hand Telling You?

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    Pins and needles, mild tingling or your hand feels like it “fell asleep” can happen occasionally to anyone. But when the tingling becomes more frequent or it does not resolve itself, it could be a signal that something more serious is going on and it is time to speak with a physician.

    What Causes the Tingling?

    Orthopaedic surgeon Dr. Jasmine Bauknight of Shore Physicians Group in Somers Point specializes in hand and upper extremity procedures and said tingling and numbness in the hand and wrist are not uncommon. “There are a number of reasons a person would have numbness in their hand and fingers,” said Dr. Bauknight. “It could be something as simple as sleeping in a position where it puts pressure on a nerve. The temporary reduction of blood to the nerve may cause that pins and needles feeling. Many people unknowingly sleep with their wrists or elbows bent and that puts additional tension on the nerve. The numbness in the hand or wrist could also be caused by many other reasons including pressure on the median nerve or carpal tunnel syndrome.”

    Other than carpal tunnel syndrome, Dr. Bauknight said some of the other reasons a person may experience numbness or pins and needles in their hands and wrists could be due to cubital tunnel syndrome, cervical spondylosis, thoracic outlet syndrome, peripheral neuropathy, diabetes, as well as sleep posture.

    Our Complex Hand

    The human hand is amazing. It can pick up, pull, push, grip, grab, and high five and take hold of a hand. The hand is made up of the wrist, palm, and fingers and consists of 27 bones, 27 joints, 34 muscles, over 100 ligaments and tendons, and many blood vessels and nerves. The wrist is made up of eight small bones (the carpal bones) plus the two long bones in the forearm, the radius and ulna.

    As Dr. Bauknight explained, the hand is very complicated, and broken bones, injured ligaments, and pinched nerves can happen anywhere. The kitchen is a prime spot for hand accidents, and cuts that occur in a split second can damage nerves, tendons and ligaments and may require multiple stitches and possibly even surgery.

    Carpal Tunnel Syndrome

    Numbness and tingling in the hand and arm may result from a compressed nerve in the wrist, according to Dr. Bauknight. “Carpal tunnel syndrome is actually a compression neuropathy, where the median nerve is basically getting squeezed under ligaments and tendons as they pass through the carpal tunnel. The nerve does not like to be compressed and may result in tingling, that numb pins and needle feeling. It may also cause weakness in the hand or diminished grip strength and even dropping things, depending upon the severity of the compression.” Dr. Bauknight added that wrist anatomy along with patterns of hand use may contribute to the severity of the individual’s carpal tunnel syndrome.

    Carpal Tunnel Syndrome Treatment

    Treatment for carpal tunnel syndrome may include rest, ice, wrist splints or braces, exercises, cortisone injections and surgery if necessary. Dr. Bauknight said, left untreated, carpal tunnel syndrome can lead to weakness, a lack of coordination in the fingers and thumb and may impact the individual’s ability to grip as well as their range of motion. Dr. Bauknight cautioned that people suffering with symptoms of carpal tunnel syndrome should not put off seeing their physicians because the symptoms can get worse. They may result in irreversible changes such as weakness and muscle-wasting and in some cases, Dr. Bauknight said the beefy part of the palm can flatten out.

    If surgery is necessary, Dr. Bauknight indicated there are two different techniques: open carpal tunnel release or endoscopic. The open carpal tunnel release involves an incision in the wrist. The ligament is cut to allow the release. The endoscopic technique is a done with a small incision in the wrist and using a tiny camera-guided instrument, the surgeon releases the ligament. The more rapid recovery is via the endoscopic procedure but both have a good outcome for the patient. They will need to follow with therapy post-surgery.

    Avocado Hand

    Dr. Bauknight warned that something as simple as making a bowl of guacamole can turn into a trip to the emergency room and possibly require surgery from one quick cooking shortcut. Avocados are a big part of many meals but a sharp knife can easily go right through that leathery and slippery avocado skin and into the hand holding it, Dr. Bauknight said. She adds that cooks will too often try to quickly remove the pit by smacking it with a sharp knife in an attempt to yank it free from the fruit. “The hand is so complex and compact. A sharp knife can go right through the skin and cut nerves and tendons. Stitches to repair the damage is only part of the problem. I can make the repair but there will need to be weeks of physical and occupational therapy for them to regain their full range of motion.”

    To make an appointment with Dr. Bauknight at the new 710 Centre Street Somers Point location to discuss your hand discomfort, call Shore Physicians Group’s Orthopaedic Division at 609-365-6280.

  5. Is Food Affecting Your Mood?

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    Mood and food go hand in hand, a reality every person might experience; from the baby that shrieks to be fed to cranky holiday dinner guests when the meal is late. Being hungry, tired, or having unhealthy eating patterns can influence mood swings, according to Tiffany Rios, Shore Physicians Group Registered Dietitian and Certified Diabetes Educator, who added that blood sugar fluctuations and nutritional imbalances are often to blame.

    “The right food can support a healthy mood, but the wrong foods can potentially exacerbate problematic inflammation and underlying causes of depression,” Rios said. To aid the body in improving the symptoms of depression Rios suggested adding probiotics, omega-3 fatty acids, and vitamin D and B-vitamin rich foods.

    Some examples of B-vitamin rich foods include beans, lentils, eggs, leafy greens and bananas as well as omega-3 rich foods like fatty fish, walnuts, chia and flaxseeds. Vitamin D can be found in egg yolks, organic cow’s milk, mushrooms, and fatty fish like sardines, tuna and salmon.

    Sugar Plays a Big Role

    Rios explained that excess sugar consumption is correlated with several disease states including dysbiosis: a condition where there are more harmful bacteria populating in the gut than helpful bacteria. This relates to depression because up to 95% of our serotonin is produced in the digestive system. Serotonin is the key hormone that stabilizes mood, feelings of well-being, and happiness. This hormone impacts your entire body. It enables brain cells and other nervous system cells to communicate with each other. Serotonin also helps with sleeping, eating, and aids digestion. So, if the digestive system is off balance, it really can affect our mood.

    Be On the Lookout for Other Forms of Sugar

    To make improvements, Rios indicates the easiest thing to do is reduce the added sugar in your diet. As a reminder, Rios said sugar can be found in many forms in the foods we consume, like evaporated cane sugar, molasses, and brown rice syrup to name just a few. Sugar might have many aliases, but it is still added sugar intake. When reading the ingredient list on foods look for words ending in “ose” like fructose, sucrose, maltose, or dextrose; they are all added sugars. Be wise to added sugar with ingredients like concentrations of juices, fruit nectars, honey, and agave.

    “Read the ingredient labels and remember, the higher up the list the ingredient is, the more of it there is in the product,” said Rios. “If you see that a food has greater than 8g of added sugar per serving, keep in mind that is equivalent to eating two packets of sugar.” The recommended daily allowance of sugar is about 25mg but Rios said in the case of sugar, less is better.

    “These sugars can exacerbate the growth of harmful bacteria that stunt our ability to digest and absorb the nutrients needed to support a healthy mood,” said Rios. “Try taking a probiotic AND consuming probiotic rich food like kefir, plain yogurt, asparagus, sauerkraut and kombucha,” said Rios. “Non-starchy vegetables are excellent sources of pre-biotic fiber and support a healthy gut as well.”

    Foods That Can Throw the Body Off

    Eating large quantities of fast foods, processed foods, added or refined sugar can alter blood sugar levels, and when blood sugar levels are unstable this can very often lead to fatigue and lethargy, which are often a precursor to depressed mood, according to Rios. “While added sugar can cause issues for our mood, the lack of certain microorganisms may also play a role,” said Rios. “Lastly, alcohol is a known depressant and causes added stress on the liver to detoxify the body. So, if you are feeling down and drinking more than four drinks per week, you might want to reconsider your habits.”

    Can Too Much Protein Have a Similar Effect on Mood?

    Eating too much of anything can make us feel lethargic because it is excess stress on our bodies to store the nutrients as fat. It places a burden on our liver which can throw our metabolism off track. When it comes to protein, choosing the right types of protein is important. Lean meats, fish, eggs and legumes are less associated with depression than fatty meats or fried foods.

    To avoid that sluggish feeling, Rios said to try to stay away from fried foods, large portions and refined sugars.

    Charge It Up!

    Rios suggested that to get your gut health back on track, try to build a diet that is diverse in plant rich polyphenols, fiber and lean proteins. Reduce your intake of added sugars, processed foods and choose more home cooked high fiber meals more often. Choose beans, lentils, eggs, fatty fish, organic dairy products, high fiber grains like quinoa or whole wheat breads, non-starchy vegetables, fresh fruits like bananas and berries, nuts and seeds.

    To schedule a consultation with Tiffany Rios call 609-653-5300.

  6. Underactive or Overactive? Know the Symptoms of Thyroid Disease

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    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.

  7. Health Myth or Fact?

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    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.

  8. Can Winter Weather Ruin Your New Year?

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    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.

  9. 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.

  10. 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.