Category Archive: Physician Articles

1. Pickleball Pains: The Hidden Risks and Winning Strategies for Injury Prevention

   June 29, 2023 5:23 pm Comments Off on Pickleball Pains: The Hidden Risks and Winning Strategies for Injury Prevention

   Welcome, fellow sports enthusiasts and pickleball aficionados! As an orthopaedic surgeon specializing in sports medicine and shoulder surgery, Dr. Dante Marconi of Shore Physicians Group has witnessed the rise of pickleball’s popularity firsthand. He would like to shed some light on a topic that often goes unnoticed: pickleball injuries.

   While this exciting sport brings joy to countless players of all ages, it’s crucial to be aware of the potential risks and learn how to prevent injuries. So, let’s dive into the world of pickleball and explore common injuries and winning strategies to keep you in the game for years to come!

   The Pickleball Craze

   Pickleball is a delightful fusion of tennis, badminton, and ping pong that has taken the sporting world by storm. It is easy to learn and low-impact, making it a favorite among both seasoned athletes and newcomers looking for a fun way to stay active. With millions of players worldwide, pickleball has become a social phenomenon, filling courts with laughter, camaraderie, and, unfortunately, occasional injuries.

   The Reality of Pickleball Injuries

   While pickleball is generally considered a safe sport, it’s not immune to its share of bumps, bruises, sprains, strains, and fractures. According to recent studies, pickleball-related injuries have steadily increased over the years, paralleling the sport’s exponential growth. According to UBS analysts, this year there will be an estimated 67,000 emergency room visits related to pickleball injuries, 366,000 outpatient visits and 9,000 outpatient surgeries. This upward trend emphasizes the importance of understanding and mitigating potential risks.

   The Top Culprits

   To ensure your pickleball experience remains injury-free, it’s crucial to recognize the most common types of injuries. Sprained ankles, strained muscles, tennis elbow (yes, even in pickleball!), and rotator cuff injuries frequently top the list. The sudden stops, starts, and lateral movements involved in the game can strain joints and muscles, especially if players fail to warm up properly or overexert themselves. Dehydration can commonly lead to injuries or other serious medical problems.

   The severity of ankle sprains can vary, and some significant injuries can take more than six weeks to heal. Ankle fractures can also occur, leading to 3+ months of recovery before return to sport. Strained muscle recovery also depends on the level, which can take weeks to months before returning to sport. At times, players with overuse injuries, such as tennis elbow, can play through the symptoms. However, athletes may need treatments such as strapping, physical therapy, injections, and even surgery.

   Similarly, rotator cuff injuries have a large spectrum of symptoms, and treatment will depend on the severity. Achilles tendon ruptures and foot fractures can also be seen.

   An overwhelming majority of these injuries occur in players 60 years or older; therefore, increased awareness must be present in this age group.

   Preventing Pickleball Pitfalls:

   Now that we’re aware of the risks let’s explore some strategies to stay injury-free and make the most of our pickleball adventures:

   1. Warm Up and Stretch: Always dedicate time to warm up your muscles and joints before stepping onto the court. Gentle stretches and light aerobic activity will help prepare your body for the game ahead.
   2. Choose the Right Equipment: Invest in quality pickleball shoes with proper arch support and cushioning to minimize the risk of foot and ankle injuries. Additionally, consider using tendinitis straps or compression sleeves to support vulnerable joints.
   3. Know Your Limits: While it’s tempting to give your all during each rally, it’s essential to recognize your physical limits and gradually build your stamina. Overexertion can lead to fatigue, muscle strains, and even more severe injuries.
   4. Technique Matters: Learning proper pickleball technique and footwork is essential. Enlist the guidance of an experienced coach or join a beginner’s class to ensure you’re using the correct form and reduce unnecessary stress on your body.
   5. Listen to Your Body: Pay attention to any discomfort or pain during and after playing. Ignoring persistent aches can lead to further damage. If you experience chronic pain or a recurring injury, consult a medical professional promptly.

   Pickleball offers a fantastic opportunity to stay active, have fun, and forge lasting friendships. By understanding the risks, recognizing common injuries, and implementing injury prevention strategies, we can all enjoy the game while minimizing the risk of sidelining injuries. So, grab your paddles, gather your friends, and let’s keep pickleball a sport filled with exhilaration and laughter for years to come! Remember, a healthy game is a happy game!

2. Sunburn SOS: Unleashing the Power of Prevention and Healing

   June 28, 2023 4:57 pm Comments Off on Sunburn SOS: Unleashing the Power of Prevention and Healing

   Dr. John Kulin of Shore Urgent Care Shares Tips to Safeguard Your Skin from Scorching Sunburns
   Basking in the warm rays of the sun can be a blissful experience, but without the right protection, it can quickly turn into something quite unpleasant. Sunburn is not only painful but it can also lead to long-term skin damage and increase your risk of skin cancer. To help you navigate the sunny days with confidence, Dr. John Kulin of Shore Urgent Care shares essential information to help you enjoy the sun safely. So, grab your sunglasses and SPF, and let’s dive into the world of sun protection!

   Sunscreen Types: Finding the Right Shield

   When it comes to choosing a sunscreen, there are several options to consider, but which type is right for you?

   1. Chemical Sunscreens: These sunscreens contain chemicals that are absorbed into the skin and absorb UV rays, blocking them from damaging the skin. They typically contain active ingredients like avobenzone, oxybenzone, or octinoxate.
   2. Mineral Sunscreens: These products work by forming a physical barrier on your skin, rather than being absorbed. They reflect and scatter UV rays. Look for ingredients like zinc oxide or titanium dioxide. While in the past they’ve appeared thick and white on the skin, there are now options that are clear when applied.
   3. Hybrid Sunscreens: As the name suggests, these sunscreens combine chemical and physical blockers to provide broad-spectrum protection.

   Choosing the Right SPF

   Sun Protection Factor (SPF) is a measure of how well a sunscreen protects against UVB rays, which are the primary cause of sunburn. The SPF number indicates the duration of protection compared to not wearing sunscreen.

   For everyday activities and minimal sun exposure, a sunscreen with SPF 30 is generally recommended. However, if you’re planning to spend extended periods outdoors or participate in activities with intense sun exposure, opting for SPF 50 or higher will provide added protection. Additionally, if it is at the start of the summer season or you have fair skin, an SPF of 50-65 is recommended.

   Tanning Doesn’t Mean Skipping Sunscreen

   Contrary to popular belief, tanning does not grant immunity from the damaging effects of the sun. Even if you tan easily or already have a golden glow, sunscreen remains a crucial part of your skincare routine. While it may take longer for tanned skin to burn, it is still susceptible to harmful UV radiation that can lead to premature aging and an increased risk of skin cancer.

   Sensitive Skin, Children, and Babies

   Individuals with sensitive skin require extra care when choosing sunscreen. Look for products labeled “hypoallergenic” or “designed for sensitive skin.” Physical sunscreens with zinc oxide or titanium dioxide are often better tolerated by sensitive skin types.

   For children and babies, it’s crucial to use sunscreen formulated specifically for their delicate skin. Opt for mineral-based sunscreens with a high SPF, and consider additional protection like broad-brimmed hats, sunglasses, and lightweight clothing that covers their arms and legs.

   The Importance of Reapplication

   Applying sunscreen once in the morning isn’t sufficient for a full day of protection. Sunscreen should be reapplied at least every two hours, or more frequently if you’re sweating heavily or swimming. Even water-resistant or waterproof sunscreens can lose their efficacy over time, so be diligent with reapplication.

   Cloudy Days and Sunscreen

   Cloudy skies might give the illusion of safety from the sun’s harmful rays, but don’t be fooled! UV radiation can penetrate clouds, leading to sunburn. Make applying sunscreen a part of your daily routine, regardless of the weather.

   Clothing as an Extra Barrier

   Clothing can offer additional protection against the sun. Look for garments labeled with an ultraviolet protection factor (UPF) rating of 50 to 75. The higher the UPF, the more effective the clothing is at blocking UV rays. Wearing wide-brimmed hats, sunglasses, and long-sleeved shirts can provide further coverage.

   Take Extra Care on Open Water

   Do you enjoy being on a boat, surfing or paddleboarding? If so, be mindful that the sun reflects off of the water and can cause sunburn in some unsuspecting places, such as on the underside of your nose, under your chin and even on the roof of your mouth when your mouth is open.

   Treating Sunburn at Home

   Despite our best efforts, sunburn can still happen. If you find yourself with rosy, painful skin, here are some tips to ease the discomfort:

   1. Cool Compresses: Apply cool, damp cloths or take cool baths to soothe the burn.
   2. Moisturize: Apply a gentle, fragrance-free moisturizer or aloe vera gel to keep your skin hydrated.
   3. Over-the-counter Pain Relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, can help reduce pain and inflammation. You can also try the over-the-counter steroid hydrocortisone cream, but use it sparingly and not on your face.
   4. Do Not Pop Sun Blisters: If you start to develop sun blisters – the small, fluid-filled blisters that can occur with a sunburn – do not pop them. Blisters form to help the skin heal, but if you pop them it can lead to infection.

   When to Seek Urgent Care

   While most sunburns can be treated at home, severe cases may require medical attention. Seek urgent care if you experience the following:

   1. Severe blistering over a large area of your body.
   2. Intense pain or high fever.
   3. Signs of infection, such as increasing redness, swelling, or pus.
      

   Remember, prevention is always better than a painful sunburn. Prioritize sun protection by applying sunscreen correctly, seeking shade during peak sun hours, and wearing protective clothing. With these practices in place, you can enjoy the great outdoors while keeping your skin healthy and happy all summer long!

   Shore Urgent Care is located at 2605 Shore Road, Northfield, NJ, and is open Monday through Friday, 8am to 8pm, and Saturday and Sunday, 9am to 5pm. We’re located just a short drive from your favorite shore towns. For more information, call 609-365-5333.

3. Are Nitrates Nutritional?

   4:26 pm Comments Off on Are Nitrates Nutritional?

   According to Tiffany Rios, RD, CDE, of Shore Physicians Group, it’s no secret that nitrates in our food have garnered a lot of attention in recent years. While some nitrates naturally occur in certain plants, others are added to processed meats.

   Research has shown that nitrates from plants and those added to meat behave very differently in the body. Natural nitrates in plants, such as spinach and beets, are converted into nitric oxide, which has been linked to improved heart health and increased exercise performance. On the other hand, nitrates added to processed meats, such as bacon and hot dogs, can be converted into harmful compounds called nitrosamines, which have been linked to an increased risk of cancer. As consumers become more health-conscious, it’s important to understand the difference between natural and added nitrates and make informed choices regarding our food, says Rios.

   To strike a balance, Rios recommends consuming nitrates through a well-rounded diet that includes plenty of fruits and vegetables while minimizing processed and cured meats. By being mindful of your nitrate intake, you can reap the benefits of this important compound while reducing your risk of health complications.

   Recent studies have shown that consuming plant-based foods high in nitrates can significantly improve heart health. These nitrates are converted into nitric oxide in the body, which helps to relax blood vessels and improve blood flow. This can lead to lower blood pressure and reduced heart disease and stroke risk. Foods high in nitrates include leafy greens like spinach and arugula, and beets and root vegetables like carrots and turnips. Rios says adding these foods to your diet can be an easy and delicious way to support your heart health. Additionally, nitrate supplements and beetroot juice have become increasingly popular among athletes due to their potential to improve endurance and performance.

   Another recent study led by the University of Exeter has found that drinking beetroot juice can significantly reduce fatigue during exercise. The study shows how the nitrate found in beetroot juice helps to reduce the uptake of oxygen, making exercise less tiring. This breakthrough discovery could revolutionize how athletes and fitness enthusiasts approach training routines. With the use of beetroot juice, they can push themselves harder for longer periods without feeling as fatigued or exhausted. To receive the benefits, people should consume beetroot juice 1½ to three hours ahead of the event to most closely match the dosing schedule used in studies. This is great news for anyone looking to improve their endurance levels and achieve their fitness goals.

   Rios states that by understanding nitrates’ benefits and risks, you can make informed decisions about your diet and overall health. So, next time you’re at the grocery store, choose plant-based sources of nitrates like spinach and beets instead of processed meat products. Your body will thank you!

   To learn more or to make an appointment with Tiffany Rios, call 609.365.5300. Tiffany treats patients at the Shore Physicians Group Endocrinology office at 18 West New York Avenue in Somers Point, NJ.

4. How to Overcome Menopause-Related Sleep Troubles for a Better Night’s Rest

   June 27, 2023 3:04 pm Comments Off on How to Overcome Menopause-Related Sleep Troubles for a Better Night’s Rest

   Menopause is a natural biological process that marks the end of a woman’s reproductive years, occurring at the average age of 51 years old. While it’s a normal transition, menopause can be accompanied by a range of symptoms that can disrupt mood and sleep. In fact, up to 61% of women report experiencing sleep disturbances during menopause. But you don’t merely have to suffer through these sleepless nights – your doctor can help you find solutions to menopause-related sleep troubles.

   Dr. Megan McQuarrie is a primary care physician with Shore Physicians Group’s Ocean City office who is passionate about helping her patients manage menopause symptoms for a better quality of life. In this article, she shares solutions for women who are struggling during this transition.

   How Menopause Affects Sleep

   During menopause, the body undergoes significant hormonal changes that can affect sleep.

   “Fluctuations in estrogen and progesterone levels can cause hot flashes, night sweats, and mood swings, all of which can make it difficult to fall and stay asleep,” says Dr. McQuarrie. “Additionally, menopause can bring about changes in sleep architecture, the natural pattern of sleep stages that occur throughout the night. Women going through menopause may experience more light sleep and less deep sleep, which can leave them feeling less rested in the morning.”

   When the natural sleep-wake cycle is disturbed, cortisol levels rise. This change in hormone levels leads to significant symptoms throughout the day, such as irritability and mood swings and thereby affects sleep long-term.

   Solutions and Treatments

   While menopause can be challenging, there are several strategies that women can use to improve their sleep quality and reduce sleep disturbances. Here are some that Dr. McQuarrie recommends:

   Lifestyle Changes

   Making healthy lifestyle changes can go a long way in improving sleep during menopause. These include:

   • Regular exercise: Exercise can help regulate hormone levels and improve sleep quality. Dr. McQuarrie says, “Aim for at least 30 minutes of moderate exercise most days of the week. A few examples include brisk walking, gardening, and doubles tennis.”
   • Healthy diet: Eating a balanced diet can help regulate hormone levels and reduce symptoms of menopause. “I recommend avoiding spicy or acidic foods that can trigger hot flashes,” says Dr. McQuarrie.
   • Stress reduction: Stress can exacerbate menopause symptoms, so finding ways to manage stress is important. Dr. McQuarrie suggests women try practices such as meditation, yoga, or deep breathing exercises. You can find free videos and resources online to guide you through these practices.
   • Sleep hygiene: Good sleep hygiene practices can help promote better sleep. Try creating a comfortable sleep environment, avoiding screens before bed, and establishing a regular sleep schedule.

   Medical Treatments

   In some cases, Dr. McQuarrie may recommend medical treatments to manage menopause symptoms and improve sleep. These can include:

   • Hormone therapy: Hormone therapy can help regulate hormone levels and reduce symptoms like hot flashes and night sweats.
   • Medications: Dr. McQuarrie recommends starting with melatonin supplements, because it is the most natural and safe medication to improve sleep. However, some patients may benefit from low-dose antidepressants and nerve pain medications to improve sleep, reduce hot flashes and stabilize mood.
   • Vaginal estrogen: Vaginal estrogen can help alleviate vaginal dryness and discomfort, and improve lower urinary tract symptoms, which can lead to a more restful sleep.

   Menopause is a natural part of life, but it can be accompanied by sleep disturbances that can affect overall health and well-being. By making healthy lifestyle changes and seeking medical treatment when necessary, women can improve sleep quality and reduce the impact of menopause on their lives. It is important to talk to your doctor about symptoms you are experiencing so they can help you better manage it, and to rule out other causes of disturbed sleep, mood and vaginal symptoms.

   Dr. Megan McQuarrie is a primary care provider who practices at Shore Physicians Group’s Ocean City office located at 1645 Haven Avenue, Suite C. She is Board Certified in Family Medicine and has an additional Certificate of Added Qualification in Sports Medicine (CAQSM). To learn more or to schedule an appointment, call 609-399-6263.

5. Why Protein Shakes Might Be Right for You

   May 24, 2023 9:26 pm Comments Off on Why Protein Shakes Might Be Right for You

   If you look at the advertisements and promotional material for a typical canister of protein power, you will likely see a high-performing athlete in action. But according to Dietitian and Diabetes Educator Tiffany Rios, RD, CDE, of Shore Physicians Group, you don’t need to be a bodybuilder or even an athlete to receive the benefits of a protein shake.

   Protein has many functions, including supporting muscle mass, which in turn increases metabolism, keeps the body strong, and prevents falls. Protein also can help reduce hunger levels and stabilize blood sugars. Unfortunately, many people do not get enough protein in their daily diet, so protein powder can be a convenient way to meet protein needs on-the-go.

   Many protein powder options are on the market, making it challenging to know which one is right for you. Rios recommends three things to look for in a protein powder before you make your choice.

   1. Protein Source: Pea, brown rice, whey, casein, egg, and hemp are the primary protein powder sources. When selecting a protein powder, tolerance and taste preference are of utmost importance to help you stay consistent. Try different types until you find one that works best for you.
   2. Quality: Review ingredient lists and select options with minimal additives, fillers, artificial flavors, or sweeteners. Ingredients to stay away from are dextrins/maltodextrin, aspartame, Splenda, saccharin, and xanthan gum.
   3. Consider food allergies/ intolerances: Many people choose powders based on how well they tolerate them. For example, a plant-based protein powder might be a better choice if your digestion is sensitive to whey.

   Regardless of the protein source, Rios recommends powders that are third-party tested and certified by the National Science Foundation (NSF), which indicates the product has met specific standards. As a general rule, Rios believes that servings of an effective protein powder should have less than 5 grams of added sugars, between 20-50 grams of protein, and fewer than 25 grams of carbohydrates.

   To learn more or to make an appointment with Tiffany Rios, call 609.365.5300. Tiffany treats patients at the Shore Physicians Group Endocrinology office at 18 West New York Avenue in Somers Point, NJ.

6. Run Your First 5K this October by Following Dr. Cetel’s Advice

   9:05 pm Comments Off on Run Your First 5K this October by Following Dr. Cetel’s Advice

   Shore Medical Center’s Special Care Nursery has been the beneficiary of Leif’s Legacy 5K Fun Run for the past three years, a fundraiser established by Brian and Jen Larsen of Sea Isle City, NJ, to commemorate the life of their infant son Leif Aleutian. Leif was born prematurely at 26.3 weeks and only lived earthside for 52 hours. Since then, Shore has received more than $12,000 for the nursery. If you’ve always wanted to become a runner, Leif’s Legacy on October 15, 2023, is the perfect run to set as your first 5k. But, we recommend you follow this important advice from Dr. Steven Cetel, sports medicine physician with Shore Physicians Group’s Orthopaedic Surgery & Sports Medicine Division in Somers Point. Follow the Leif Aleutian Foundation on Facebook to stay informed about the 2023 Leif’s Legacy 5k!

   Warming up to Running

   There’s a saying, “The best time to start was yesterday. The next best time is now.” That is especially true for being physically active. Physical activity is essential for cardiovascular health. The heart is a muscle that needs to be trained to work as efficiently as possible. Over time, inactivity decreases the efficiency of the heart muscle and can make even basic acts like walking long distances or jogging very difficult. However, proper training can improve elasticity and endurance to make physical activity more manageable and enjoyable. Physical activity also helps improve strength and flexibility, which is critically important for our joints and bone health.

   Running has become increasingly popular over the last 10-15 years, which is great because it provides significant health benefits. When you think of running, perhaps you envision someone competing in a marathon. But you do not have to complete a 26-mile marathon to reap the benefits of running. If you are someone who has never laced up your sneakers and gone out for a run before, don’t be discouraged. Try setting a goal to complete a 5K run. A 5K is 3.1 miles and is well within your reach.

   It’s All in the Intervals

   You’ll want to start low and slow and increase over time; this approach is called interval training. It is important to incorporate rest days throughout interval training to allow muscle recovery time. The more time you have for training, the slower the interval training can be accomplished. A person’s activity level prior to starting will help gauge the type of interval training recommended. Ideally, you should train 4-6 months before your 5K date. But you can get 5K ready in just six weeks if needed. You can download plenty of apps on your phone to help you go from the “Couch to 5K”.

   Interval training can be accomplished either by increasing your distance or duration. Start small, like walking a quarter mile on day one and increasing that to half a mile the next day and a mile on the third day of walking at a slow pace. Then slowly transition to jogging and increase speed. Interval training can also be accomplished by walking for one minute, running for one minute, walking for one minute, and then running for one minute and increasing that duration every other day.

   During any physical activity training, it is always important to listen to your body. You should expect some soreness at first. The soreness is actually a good sign, as it means you’re engaging muscles that have not been engaged in a while. Soreness usually last for about 1-2 days. Significant pain is different; you should address that with your medical provider.

   Don’t Forget to Stretch and Hydrate

   Stretching before and after physical activity is crucial to help with muscle fatigue and soreness. It would help if you also prioritized hydration, which is always essential, but even more so with increased physical activity. The body requires hydration to run all bodily processes, including proper kidney function and metabolism. Water helps to produce energy and eliminate waste in your body. There is no magic number for how much water you should drink throughout the day, but usually, the recommendation is about half an ounce to one ounce per pound of body weight throughout a regular day. When exercising, it is recommended to hydrate before exercising, as well as maintain hydration throughout.

   A good rule of thumb is to assess hydration status based on urine color. If it is anything but clear, this suggests signs of dehydration. Last but certainly not least, you’ll want to consider weather and terrain to ensure you remain safe while running. We advise against running during extreme heat or cold periods for fear of heatstroke or hypothermia. We also recommend checking the fit of your running shoes and switching footwear at least every 300-500 miles to prevent injury.

   Going from the couch to running a 5K is manageable. It might be challenging, but it is well within your reach and worth it. There is no better time to start training than today. Good luck with your journey!

7. Help, My BMI Says I’m Overweight!

   April 11, 2023 12:22 pm Comments Off on Help, My BMI Says I’m Overweight!

   If you’ve ever measured your BMI and were startled to discover you fall into the ‘overweight’ or ‘obese’ category, you’re not alone. 73.6% of adults aged 20 and over are either overweight or obese based on BMI, according to the Centers for Disease Control and Prevention.

   Being overweight or obese can increase the risk of many chronic conditions, including type 2 diabetes, high blood pressure, high cholesterol, obstructive sleep apnea, heart disease, stroke, and even cirrhosis from fatty liver disease.

   Achieving or maintaining a healthy weight can be a challenge for many people. If you are struggling, your primary care physician can help you create a personalized plan to reach your weight goals.

   Why BMI Matters

   Body mass index (BMI) measures body fat based on height and weight, providing a better picture than just weight alone. BMI is calculated by dividing a person’s weight in kilograms by the square of their height in meters. For an easier way to determine your BMI, you can use an online BMI calculator like this one. An ideal BMI is 18.5-24.9. A BMI of 25.0 to 29.9 is considered overweight, and a BMI of 30.0 or higher is considered obese.

   Shore Physicians Group Primary Care Physician Dr. Maria Jose Jimenez Cerna believes all adult patients should have their BMI screened. BMI provides a baseline for those at a healthy weight and helps identify when patients may need help.

   “We have screenings for cancer and many other chronic conditions, so we must screen patients for overweight and obesity as well. If our population experiences a drastic decline in obesity, we’d also see healthier people and a drastic decline in related chronic conditions,” says Dr. Cerna.

   Dr. Cerna says that even people who are at a healthy weight benefit from regular BMI checks. “Generally, women between 40 and 60 experience a 1.5-lb weight gain yearly. Over ten years, that’s an extra 15 lbs, which can begin to affect your health adversely. When we screen for BMI, we can help our patients avoid entering those riskier weight categories. Talking about it early helps normalize conversations about BMI and weight.”

   But BMI Isn’t Everything

   According to Dr. Cerna, for some people, BMI can be skewed.

   “If you have a lot of muscle mass, such as in athletes and bodybuilders, your BMI will be overestimated. In seniors and people with less muscle mass, BMI may be underestimated,” said Dr. Cerna.

   Dr. Cerna also adds that BMI categories may vary for different ethnicities. “People who are Asian have a lower threshold for overweight and obesity. For them, the ideal BMI is 18.5–23.”

   To gather further information about a patient’s weight, Dr. Cerna will also measure waist circumference because abdominal fat has a more severe effect on health than evenly distributed fat. For men, waist circumference should be less than 40″, and for women, less than 35″.

   “If your BMI is high, but all your other numbers are fine, such as blood pressure, glucose, and cholesterol, I would measure your waist circumference. If that’s normal, sometimes you have a high BMI simply because of your genetics, and that’s okay. Medicine is about prevention, so if I start to see that you are becoming prediabetic or your cholesterol is going up, we need to start talking about your risk factors and what we can do to improve things,” says Dr. Cerna.

   How Your Doctor Can Help You

   One of the first things Dr. Cerna will do is a physical exam and a review of medications to see if anything contributes to weight struggles.

   “If I know my patient is really trying, it could be a medication or thyroid problem. Antihistamines like loratadine or SSRIs for depression or anxiety could be making it tough to lose weight,” says Dr. Cerna. “Some women may be hitting menopause, making it hard to lose weight.”

   Dr. Cerna likes to ask her patients what changes they can make first. “Most people know if they are snacking too much or not exercising enough. But sometimes, just having a physician working with you to set goals and follow through helps.”

   Below are just some of the strategies Dr. Cerna will discuss with her patients:

   • Diet: “Studies show that there is no better diet than another,” says Dr. Cerna. “It’s all about what works for you. For some people, intermittent fasting works; for others, the ketogenic diet may work. But I like to talk about it as a diet modification, not going on a diet, because with strict diets, you’ll get sick of it and may slip back into your old habits. I also recommend the support of a dietitian. Sometimes, the more reinforcement we get, the easier it gets.”
   • Apps: “I recommend that my patients keep track of their calories using an app, such as MyFitnessPal. If you want to lose weight, eating less than 1,500 calories daily is a general rule. However, each person is different. Exercise also plays a role.”
   • Exercise: Dr. Cerna suggests patients follow the American Heart Association’s recommendations of getting at least 30 minutes of moderate to high-intensity exercise 5 times a week. “Exercise burns calories, makes you feel good, and improves cardiovascular health, strength, and metabolism.”
   • Weight loss medication: While Dr. Cerna always starts by helping her patients make lifestyle modifications, she says medication may eventually be the answer for some. “If you have BMI more than 28 and you have a comorbidity, such as hypertension, diabetes or heart disease, or your BMI is greater than 30, you’re already a candidate for weight loss medications. If my patient wants to try it, we can definitely discuss it. There are many options now, both oral and injections, such as Wegovy, which helps signal your brain that you are full. These medications can result in a 15-20% weight loss. It depends on what your insurance may cover.”

   Dr. Cerna strives to create an open and honest relationship with her patients where they can feel comfortable talking about weight, no matter their BMI. Ultimately, her goal is to help her patients prevent chronic diseases and live a long and healthy life.

   Dr. Cerna sees patients at Shore Physicians Group’s Northfield office, located at 2605 Shore Road. To schedule an appointment with her, please call 609-365-5300. To learn more about Dr. Cerna, visit her physician profile.

8. Suffering from Seasonal Allergies? Your Doctor Can Help!

   April 4, 2023 1:36 pm Comments Off on Suffering from Seasonal Allergies? Your Doctor Can Help!

   Spring is here, and so are the dreaded seasonal allergies for many people. If you struggle to find relief, it might be time to visit your primary care doctor or allergist.

   Shore Physicians Group Primary Care Physician Dr. Alex Buford of the Mays Landing office is passionate about helping her patients find relief from allergies. Not only has she suffered from allergies herself, she also received additional training in allergy and immunology to work as an Allergy Extender in Air Force Base medical clinics during her service.

   “Many patients self-diagnose and self-treat their seasonal allergies, which can lead to inadequate treatment. If what you’ve tried is not working, your doctor can help you,” says Dr. Buford.

   Your Doctor Can Confirm your Diagnosis

   Depending on what you’re allergic to, allergy season can run from mid-February, when tree pollen allergies can start, all the way through the first frost. If you find yourself playing the “Is it allergies or an illness?” game each year, you don’t have to figure it out alone.

   Dr. Buford says seasonal allergies can come with some or all of the following symptoms:

   • Clear mucus draining from the nose
   • Itchy ears, eyes, mouth and throat
   • Congestion
   • Sneezing
   • Headache or sinus pressure
   • Fatigue

   While some symptoms can mimic those of other conditions, there are a few symptoms that can rule out allergies. “A temperature of 100.4 or greater typically does not accompany allergies. Typically mucus is thin, watery, and clear. It can be thick, green/yellow with viral or bacterial infections,” says Dr. Buford. “But if you’re uncertain, talk to your doctor.”

   Your Doctor Can Recommend the Right Allergy Treatment

   “For me, helping my patients find the right combination of medications is the fun and challenging part,” says Dr. Buford. There are many different over-the-counter treatments for allergies, and everyone will respond to them differently, so choosing the right ones is essential:

   • Second Generation Antihistamines: “Typically, I recommend my patients start with second-generation antihistamines,” says Dr. Buford. “These are oral medications that usually do not cause sleepiness, affect your heart rate or blood pressure. They are typically safe for everyone unless you are allergic to something that is in them, of course. I encourage my patients to shop the medication, not the brand, so you’re looking for fexofenadine, loratadine, cetirizine, or levocetirizine.”
   • Nasal Sprays: In many cases, Dr. Buford recommends combining the oral medication with a nasal steroid (i.e., fluticasone) or a nasal antihistamine (i.e., azelastine). “Nasal sprays can be really helpful with congestion, and they can even help with the itchiness in the ears and eyes, but you have to use them correctly. You can’t just insert the nozzle and tilt your head back because the medication will drip down your throat. You will want to tilt your head forward and tilt the spray nozzle toward the ear on the same side.”
   • Pseudoephedrine: Sometimes, patients will not experience congestion relief from the above options and may need to try something stronger. Dr. Buford may then recommend a pseudoephedrine product; however, she urges patients to use these medications cautiously. “Pseudoephedrine products can cause dizziness and heart rate problems. If you take it too long, it can cause blood pressure issues,” said Dr. Buford.
   • Allergy Shots: For patients who can’t avoid exposure to their allergen and are not responding to over-the-counter medications, allergy shots may be an option, but the allergies must meet specific criteria. “Allergy shots are a form of immunotherapy that can take 3 to 5 years to complete, with monthly shots. It’s a commitment. The end goal is to decrease your allergy response around your allergen. Some people have great success with it.”

   Your Doctor Can Recommend Lifestyle Changes

   In addition to diagnosis and treatment, your doctor can help you modify your home and activities to help reduce your exposure to your allergen. You may want to try these suggestions to start:

   • Shut the windows: While opening windows during nice weather is tempting, you’re inviting pollen into your home, which should be your safe place. “Try to monitor pollen counts, and keep the windows shut on really high pollen days. If you must have the windows open, ensure you’re vacuuming, washing linens and curtains, and wiping surfaces frequently. You may even want to use an air purifier, which can help.”
   • Skip the contact lenses: If you wear contacts, switch to glasses during allergy season. Glasses can reduce the amount of pollen that enters your eyes. If you wear contacts, the pollen can easily get into your eyes and get trapped underneath the contact lens, causing you to rub them all day.
   • Wear a mask: Now that we all probably have masks readily available, consider wearing one if you’re going to be outside for a long time. “We have recommended masks if you have particularly bad allergies, at least until we get your allergies under control,” says Dr. Buford. “It’s an option to consider.”
   • Get clean: After you’ve spent time outdoors, consider using a simple nasal saline spray to cleanse the pollen from your nasal passages. Dr. Buford also recommends washing your face and changing your clothes immediately; otherwise, you could continue inhaling allergens from your clothing.

   Dr. Buford says managing allergies can be tricky, but you don’t merely have to suffer through it. Seasonal allergies that aren’t treated correctly can interfere with all the fun that warmer seasons bring. “Spring is a time to be active and have fun outside, but if your allergies are making that difficult, make an appointment with your doctor so you can get it under control.”

   Dr. Alex Buford sees patients ages eight and up at Shore Physicians Group’s Mays Landing office in the Festival at Hamilton, 4450 East Black Horse Pike. To schedule an appointment or learn more, call 609-365-6217.

9. The Battle of the Brands in the Medication Aisle

   March 22, 2023 4:24 pm Comments Off on The Battle of the Brands in the Medication Aisle

   Manufacturers know they have reached the pinnacle of marketing when their brand name becomes so ingrained in our lexicon that it becomes synonymous with the item it represents. Whether it’s asking for a Kleenex instead of a tissue, a bowl of Jell-O instead of gelatin, or a Xerox instead of a copy, we’ve all been influenced by branding at some level.

   The power of branding influences so many aspects of our lives, including when we are looking for medication to help with illness and pain relief.

   “When a company first comes out with a medication, that medication is known by its active ingredient. The term we use for that active ingredient is what is known as the ‘generic’ name,” explains Scott Warren, PharmD, who treats patients as an Ambulatory Care Pharmacist with Shore Physicians Group. “The pharmaceutical company patents the medication and it is sold under the Brand name. Once the patent expires, other companies can produce the generic drug, and they do so under their own name and so the battle of the brands begins.”

   An example of what Scott Warren is describing is diclofenac sodium topical gel. Originally only available with a prescription, this medication was one of the first topical prescription treatment that patients can apply directly to sites of pain associated with osteoarthritis, such as the knees and hands.

   In 2020, the FDA declassified it as prescription only, the patent expired and it became available over-the-counter and was branded as Voltaren(R) Gel 1%. Very quickly, other brands such as Aspercreme, Aleve, Bengay all had their own version of diclofenac on the market. And of course, pharmacies sell their own private label of diclofenac as well.

   With so many brands, pricing, and packaging, how is a consumer supposed to make the right choice? Warren offers some sound advice.

   “Sometimes a brand name represents multiple products that serve different purposes, so people can end up buying the wrong thing. A great example is Sudafed. Sudafed is a brand that represents many types of medications,” said Warren. “My best advice is to ask for help. Pharmacists are great resources, and they are eager to help. I also recommend looking at the active ingredients. Finally, just because a medication is higher priced does not mean it will work better. It often means the company had to increase the price to offset the branding costs.”

   Scott Warren, PharmD, has prepared a list of some “active ingredient” (generic) medication terms related to common ailments that are treated with over-the-counter medication. If you have questions on these items and would like to make an appointment with Warren, call 609.365.6200. Warren is treating patients in Shore Physicians Group’s offices in Ocean City, Northfield and Somers Point, NJ.

   Itch:
   Hydrocortisone (small areas)
   Pramoxine
   Diphenhydramine (oral or gel)
   Calamine
   Benzocaine/lidocaine

   Allergy:
   Fluticasone (nasal spray)
   Cetirizine
   Loratadine
   Diphenhydramine (allergic reaction)
   Fexofenadine

   Cough/Cold:
   Dextromethorphan
   Guaifenesin
   Pseudoephedrine
   Propylhexedrine
   Eucalyptus

   Joint Pain:
   Diclofenac (gel)
   Ibuprofen (oral)
   Naproxen (oral)
   Trolamine salicylate (cream)
   Acetaminophen (oral)

   Muscle Relief:
   Arnica
   Methyl salicylate
   Menthol
   Lidocaine
   Camphor
   Ibuprofen (oral)

10. Importance of exercise in young adults and teens

    February 21, 2023 5:39 pm Comments Off on Importance of exercise in young adults and teens

    Dr. Dante Marconi, Orthopaedic Surgeon, Shore Physicians Group

    Exercise and fitness are essential for overall health and well-being, and this is particularly true for teens and young adults. During these formative years, the body is developing and growing rapidly, and regular exercise can help to promote physical, emotional, and mental health.

    Regular exercise is essential for maintaining physical health in teens and young adults. Exercise can help to strengthen bones and muscles, improve cardiovascular health, and reduce the risk of chronic diseases such as obesity, type 2 diabetes, and heart disease. Children and adolescents who engage in regular exercise are more likely to maintain a healthy weight, which can reduce the risk of developing health problems later in life. In addition, regular exercise can help to improve body composition by increasing muscle mass and reducing body fat. Exercise can also help to improve immune function, which can reduce the risk of illness and infection. This is particularly important for those who may be exposed to a variety of germs and viruses in school or other social settings.

    Exercise can also have a positive impact on emotional health. Regular exercise can help to reduce stress, anxiety, and depression, and improve mood and self-esteem. This can be particularly important for those who may be dealing with academic or social pressures. Exercise releases endorphins, which are natural chemicals in the body that can help to improve mood and reduce feelings of stress and anxiety. Exercise can also help to provide a sense of accomplishment and boost self-esteem, particularly when goals are achieved or new physical challenges are overcome. Regular exercise can also have a positive impact on mental health in teens and young adults. Exercise has been shown to improve cognitive function, memory, and attention, and reduce the risk of cognitive decline later in life. In addition, exercise can help to reduce the risk of developing mental health problems such as dementia and Alzheimer’s disease. This is particularly important for anyone who may be at risk for these conditions later in life.

    Regular exercise can also help to improve social health. Exercise provides an opportunity to connect with others and build social connections, which can improve overall well-being. Exercise can be a fun and social activity, whether it’s playing team sports, joining a gym, or taking a dance class. These activities can provide a sense of belonging and social support, which can be particularly important for teens and young adults who may be navigating new social environments or dealing with peer pressure.

    It is important for teens and young adults to engage in exercise safely to prevent injury. It’s recommended that teens get at least one hour of moderate to vigorous physical activity each day. Young adults should aim for 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity each week. It’s important to start slowly and gradually increase intensity and duration of exercise over time. It’s also important to use proper equipment and safety gear, such as helmets for biking or skating, and to warm up and cool down before and after exercise. It’s also important to choose activities that are appropriate for age and fitness level. Young athletes should be encouraged to participate in a variety of sports and activities to prevent overuse injuries and burnout. Resistance training has been proven to be safe in children and adolescents if done correctly. Prior concern existed for possible injury with resistance training, but these injuries typically occurred due to improper technique, excessive loading, poor equipment, and lack of adult supervision. Resistance training can improve cardiovascular health, manage weight control, strengthen bone, improve motor coordination, and help prevent sports-related injuries.

    In conclusion, exercise and fitness are essential for overall health and well-being in teens and young adults. Regular exercise can help to promote physical, emotional, and mental health, and improve social connections and well-being. By engaging in regular exercise, teens and young adults can build a foundation for a healthy lifestyle that can benefit them throughout their lives.

    Dante Marconi, MD treats patients at the Shore Physicians Group Division of Orthopaedic Surgery and Sports Medicine, located at 710 Centre Street in Somers Point, NJ. To make an appointment with Dr. Marconi, call 609-365-6280.